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

PubMed

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

2015-01-01

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

Community Multiscale Air Quality Modeling System (CMAQ)

EPA Pesticide Factsheets

CMAQ is a computational tool used for air quality management. It models air pollutants including ozone, particulate matter and other air toxics to help determine optimum air quality management scenarios.

NATIONAL CONFERENCE ON TOOLS FOR URBAN WATER RESOURCE MANAGEMENT AND PROTECTION: PROCEEDINGS, CHICAGO, IL, FEBRUARY 7-10, 2000

EPA Science Inventory

A wide array of effective water quality management and protection tools have been developed for urban environments, but implementation is hindered by a shortage of technology transfer opportunities. This National Conference on Tools for Urban Water Resource Management and Protec...

Innovative Stormwater Quality Tools by SARA for Holistic Watershed Master Planning

NASA Astrophysics Data System (ADS)

Thomas, S. M.; Su, Y. C.; Hummel, P. R.

2016-12-01

Stormwater management strategies such as Best Management Practices (BMP) and Low-Impact Development (LID) have increasingly gained attention in urban runoff control, becoming vital to holistic watershed master plans. These strategies can help address existing water quality impairments and support regulatory compliance, as well as guide planning and management of future development when substantial population growth and urbanization is projected to occur. However, past efforts have been limited to qualitative planning due to the lack of suitable tools to conduct quantitative assessment. The San Antonio River Authority (SARA), with the assistance of Lockwood, Andrews & Newnam, Inc. (LAN) and AQUA TERRA Consultants (a division of RESPEC), developed comprehensive hydrodynamic and water quality models using the Hydrological Simulation Program-FORTRAN (HSPF) for several urban watersheds in the San Antonio River Basin. These models enabled watershed management to look at water quality issues on a more refined temporal and spatial scale than the limited monitoring data. They also provided a means to locate and quantify potential water quality impairments and evaluate the effects of mitigation measures. To support the models, a suite of software tools were developed. including: 1) SARA Timeseries Utility Tool for managing and processing of large model timeseries files, 2) SARA Load Reduction Tool to determine load reductions needed to achieve screening levels for each modeled constituent on a sub-basin basis, and 3) SARA Enhanced BMP Tool to determine the optimal combination of BMP types and units needed to achieve the required load reductions. Using these SARA models and tools, water quality agencies and stormwater professionals can determine the optimal combinations of BMP/LID to accomplish their goals and save substantial stormwater infrastructure and management costs. The tools can also help regulators and permittees evaluate the feasibility of achieving compliance using BMP/LID. The project has gained national attention, being showcased in multiple newsletters, professional magazines, and conference presentations. The project also won the Texas American Council of Engineering Companies (ACEC) Gold Medal Award and the ACEC National Recognition Award in 2016.

Integrating Six Sigma Concepts in an MBA Quality Management Class

ERIC Educational Resources Information Center

Weinstein, Larry B.; Petrick, Joseph; Castellano, Joseph; Vokurka, Robert J.

2008-01-01

Instructors face enormous challenges in presenting effective instruction on concepts and tools of quality management. Most textbooks focus on presenting individual concepts or tools and fail to address complex issues confronted in real-world problem-solving situations. The supplementary use of cases does not help students to understand the dynamic…

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

ERIC Educational Resources Information Center

Owen, Jane

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

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.

Visual quality assessment of alternative silvicultural practices in upland hardwood management

Treesearch

Tim McDonald; Bryce Stokes

1997-01-01

Visual impacts of forest operations are of increasing concern to forest managers. Tools are available for evaluating, and potentially avoiding, problems in visual quality resulting from poorly designed harvest unit boundaries. One of these visualization tools is applied in comparing various harvest unit shape alternatives in an upland hardwood stand on steeply sloping...

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)

MO-E-9A-01: Risk Based Quality Management: TG100 In Action

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

Huq, M; Palta, J; Dunscombe, P

2014-06-15

One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device-specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapymore » process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk-based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program. Learning Objectives: Learn how to design a process map for a radiotherapy process. Learn how to perform a FMEA analysis for a given process. Learn what Fault tree analysis is all about. Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.« less

A tool to measure whether business management capacity in general practice impacts on the quality of chronic illness care.

PubMed

Holton, Christine H; Proudfoot, Judith G; Jayasinghe, Upali W; Grimm, Jane; Bubner, Tanya K; Winstanley, Julie; Harris, Mark F; Beilby, Justin J

2010-11-01

Our aim was to develop a tool to identify specific features of the business and financial management of practices that facilitate better quality care for chronic illness in primary care. Domains of management were identified, resulting in the development of a structured interview tool that was administered in 97 primary care practices in Australia. Interview items were screened and subjected to factor analysis, subscales identified and the overall model fit determined. The instrument's validity was assessed against another measure of quality of care. Analysis provided a four-factor solution containing 21 items, which explained 42.5% of the variance in the total scores. The factors related to administrative processes, human resources, marketing analysis and business development. All scores increased significantly with practice size. The business development subscale and total score were higher for rural practices. There was a significant correlation between the business development subscale and quality of care. The indicators of business and financial management in the final tool appear to be useful predictors of the quality of care. The instrument may help inform policy regarding the structure of general practice and implementation of a systems approach to chronic illness care. It can provide information to practices about areas for further development.

Optimal implementation of best management practices to improve agricultural hydrology and water quality

NASA Astrophysics Data System (ADS)

Liu, Y.; Engel, B.; Collingsworth, P.; Pijanowski, B. C.

2017-12-01

Nutrient loading from the Maumee River watershed is a significant reason for the harmful algal blooms (HABs) problem in Lake Erie. Strategies to reduce nutrient loading from agricultural areas in the Maumee River watershed need to be explored. Best management practices (BMPs) are popular approaches for improving hydrology and water quality. Various scenarios of BMP implementation were simulated in the AXL watershed (an agricultural watershed in Maumee River watershed) using Soil and Water Assessment Tool (SWAT) and a new BMP cost tool to explore the cost-effectiveness of the practices. BMPs of interest included vegetative filter strips, grassed waterways, blind inlets, grade stabilization structures, wetlands, no-till, nutrient management, residue management, and cover crops. The following environmental concerns were considered: streamflow, Total Phosphorous (TP), Dissolved Reactive Phosphorus (DRP), Total Kjeldahl Nitrogen (TKN), and Nitrate+Nitrite (NOx). To obtain maximum hydrological and water quality benefits with minimum cost, an optimization tool was developed to optimally select and place BMPs by connecting SWAT, the BMP cost tool, and optimization algorithms. The optimization tool was then applied in AXL watershed to explore optimization focusing on critical areas (top 25% of areas with highest runoff volume/pollutant loads per area) vs. all areas of the watershed, optimization using weather data for spring (March to July, due to the goal of reducing spring phosphorus in watershed management plan) vs. full year, and optimization results of implementing BMPs to achieve the watershed management plan goal (reducing 2008 TP levels by 40%). The optimization tool and BMP optimization results can be used by watershed groups and communities to solve hydrology and water quality problems.

Recent advances in omic technologies for meat quality management.

PubMed

Picard, B; Lebret, B; Cassar-Malek, I; Liaubet, L; Berri, C; Le Bihan-Duval, E; Hocquette, J F; Renand, G

2015-11-01

The knowledge of the molecular organization of living organisms evolved considerably during the last years. The methodologies associated also progressed with the development of the high-throughput sequencing (SNP array, RNAseq, etc.) and of genomic tools allowing the simultaneous analysis of hundreds or thousands of genes, proteins or metabolites. In farm animals, some proteins, mRNAs or metabolites whose abundance has been associated with meat quality traits have been detected in pig, cattle, chicken. They constitute biomarkers for the assessment and prediction of qualities of interest in each species, with potential biomarkers across species. The ongoing development of rapid methods will allow their use for decision-making and management tools in slaughterhouses, to better allocate carcasses or cuts to the appropriate markets. Besides, their application on living animals will help to improve genetic selection and to adapt a breeding system to fulfill expected quality level. The ultimate goal is to propose effective molecular tools for the management of product quality in meat production chains. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ninth Annual NASA/Contractors Conference on Quality and Productivity. World Class Excellence: The Journey Continues. Conference presentations

NASA Technical Reports Server (NTRS)

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

1992-01-01

The topics covered include the following: The George M. Low Trophy; total quality assessment and measurement; using award criteria to improve organizational effectiveness; results--keeping an eye on the bottom line; capturing customer satisfaction; moving from management to leadership; leadership versus management; transforming the management team; leadership success stories; success stories in the quest for excellence; small business successes; education success stories; government success stories; tools and techniques for total quality management (TQM) integration; planning and organizing for TQM integration; successful stories for implementing system level TQM/CI tools; assessing TQM results; establishing an environment for continuous improvement at NASA; empowerment; synergism of partnering; and partnerships in education.

Integrated Watershed Management using the Watershed Management Optimization Support Tool (WMOST)

EPA Science Inventory

Integrated watershed management is an effective planning strategy to balance tradeoffs between competing water uses within a watershed. WMOST is an Excel-based decision tool to aid planners in making cost effective decisions that meet water quantity and quality regulations. WMOST...

Short-term forecasting tools for agricultural nutrient management

USDA-ARS?s Scientific Manuscript database

The advent of real time/short term farm management tools is motivated by the need to protect water quality above and beyond the general guidance offered by existing nutrient management plans. Advances in high performance computing and hydrologic/climate modeling have enabled rapid dissemination of ...

Information systems as a quality management tool in clinical laboratories

NASA Astrophysics Data System (ADS)

Schmitz, Vanessa; Rosecler Bez el Boukhari, Marta

2007-11-01

This article describes information systems as a quality management tool in clinical laboratories. The quality of laboratory analyses is of fundamental importance for health professionals in aiding appropriate diagnosis and treatment. Information systems allow the automation of internal quality management processes, using standard sample tests, Levey-Jennings charts and Westgard multirule analysis. This simplifies evaluation and interpretation of quality tests and reduces the possibility of human error. This study proposes the development of an information system with appropriate functions and costs for the automation of internal quality control in small and medium-sized clinical laboratories. To this end, it evaluates the functions and usability of two commercial software products designed for this purpose, identifying the positive features of each, so that these can be taken into account during the development of the proposed system.

[A quality evaluation tableau for health institutions: an educational tool].

PubMed

Moll, Marie Christine; Decavel, Frédérique; Merlet, Christine

2009-09-01

For a few years, health institutions have had to comply with the certification and the need to establish the new governance. Thanks to the accreditation version 2 (obtained in 2005), the elaboration of the hospital project (adopted in October, 2006) and the organization in poles since 2006, the quality oriented management became a priority axis at the University Hospital of Angers. The strategic adaptation to quality requirements leads to develop the hospital management, more especially at the level of the clinical, medico technical and administrative poles. The elements of the hospital project including the part about the quality, risk and evaluation aim at being adapted by every pole according to the level of its project. This adaptation which is imposed to each pole manager requires a practical and educational accompaniment allowing at the same time to realize a diagnosis of the progress of the quality approach, a measure of the impact of the global impregnation within the institution and a comparison between pole. A eight axis dashboard with criteria and a user guide were developed from certification ISO 9001, the EFQM manual and the certification manual version 2 of the Healthcare High Authorities. The criteria are transcribed in an EXCEL grid ready to use. Succeeding in estimating your own quality system means that you demonstrate the maturity of the quality approach. The results of this evaluation confirmed those of the certification. The dashboard is a management structuring tool at the service of the multidisciplinary team. Two considerations emerge from these results: First of all, for the hospital top management, the axes to be improved emerge as a priority to determine and target the next annual action plans. The results also allow to support the auto evaluation for the certification version 2010 planned in January of the same year. It is a pragmatic tool which allows auto evaluation and comparison to estimate the pole performances. It is a strategic driving tool for the hospital, for the quality department and for the pole. The pole quality system evaluation dashboard for Healthcare institutions is a simple tool which allies strategy and performance for a better efficiency of the actions to be taken to improve the quality, the risk management and the evaluation of the poles for a better service to the hospital users.

New Tools for Estimating and Managing Local/Regional Air Quality Impacts of Prescribed Burns

DTIC Science & Technology

2013-02-01

189 8.1.2 Conference Papers ...the dryer fuels and horizontal burn configuration would result in a more intense fire and provide emission factors closer to those from the flaming...the EPA web site, the CMAQ Model is a powerful computational tool used by EPA and states for air quality management in that it can be used to design

Ecological Indication, Bioaccumulation, and Phytoremediation as Tools for Environmental Quality Management

DTIC Science & Technology

2004-12-01

ECOLOGICAL INDICATION, BIOACCUMULATION, AND PHYTOREMEDIATION AS TOOLS FOR ENVIRONMENTAL QUALITY MANAGEMENT ELLY P. H. BEST1, HENRY E. TATEM1...subsequent transport to shoots, and degradation, or prevent contaminants from leaving the site in whatever form, such as leachate , runoff, trophic...transfer ( phytoremediation ). We use risk assessment to evaluate the toxicity and need for cleanup. Cleanup costs are expected to greatly exceed the cost

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.

The Definition and Measurement of Evaluation Quality as a Management Tool.

ERIC Educational Resources Information Center

Chelimsky, Eleanor

1983-01-01

Evaluation management requires a system for measuring, improving, and accounting for quality. The Institute for Program Evaluation in the United States General Accounting Office is developing such a system. (Author)

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

DOT National Transportation Integrated Search

2006-01-01

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

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.

An Investigation of Techniques for Detecting Data Anomalies in Earned Value Management Data

DTIC Science & Technology

2011-12-01

Management Studio Harte Hanks Trillium Software Trillium Software System IBM Info Sphere Foundation Tools Informatica Data Explorer Informatica ...Analyst Informatica Developer Informatica Administrator Pitney Bowes Business Insight Spectrum SAP BusinessObjects Data Quality Management DataFlux...menting quality monitoring efforts and tracking data quality improvements Informatica http://www.informatica.com/products_services/Pages/index.aspx

Data Envelopment Analysis (DEA) Model in Operation Management

NASA Astrophysics Data System (ADS)

Malik, Meilisa; Efendi, Syahril; Zarlis, Muhammad

2018-01-01

Quality management is an effective system in operation management to develops, maintains, and improves quality from groups of companies that allow marketing, production, and service at the most economycal level as well as ensuring customer satisfication. Many companies are practicing quality management to improve their bussiness performance. One of performance measurement is through measurement of efficiency. One of the tools can be used to assess efficiency of companies performance is Data Envelopment Analysis (DEA). The aim of this paper is using Data Envelopment Analysis (DEA) model to assess efficiency of quality management. In this paper will be explained CCR, BCC, and SBM models to assess efficiency of quality management.

U.S. EPA's Watershed Management Research Activities

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate alternative plans for environmental quality restoration and protection needs in urban and developing areas. A watershed-scale decision-support system, based on cost optimization, provides an essential tool to suppo...

A web tool for STORET/WQX water quality data retrieval and Best Management Practice scenario suggestion.

PubMed

Park, Youn Shik; Engel, Bernie A; Kim, Jonggun; Theller, Larry; Chaubey, Indrajeet; Merwade, Venkatesh; Lim, Kyoung Jae

2015-03-01

Total Maximum Daily Load is a water quality standard to regulate water quality of streams, rivers and lakes. A wide range of approaches are used currently to develop TMDLs for impaired streams and rivers. Flow and load duration curves (FDC and LDC) have been used in many states to evaluate the relationship between flow and pollutant loading along with other models and approaches. A web-based LDC Tool was developed to facilitate development of FDC and LDC as well as to support other hydrologic analyses. In this study, the FDC and LDC tool was enhanced to allow collection of water quality data via the web and to assist in establishing cost-effective Best Management Practice (BMP) implementations. The enhanced web-based tool provides use of water quality data not only from the US Geological Survey but also from the Water Quality Portal for the U.S. via web access. Moreover, the web-based tool identifies required pollutant reductions to meet standard loads and suggests a BMP scenario based on ability of BMPs to reduce pollutant loads, BMP establishment and maintenance costs. In the study, flow and water quality data were collected via web access to develop LDC and to identify the required reduction. The suggested BMP scenario from the web-based tool was evaluated using the EPA Spreadsheet Tool for the Estimation of Pollutant Load model to attain the required pollutant reduction at least cost. Copyright © 2014 Elsevier Ltd. All rights reserved.

SUSTAIN - A BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads (...

SUSTAIN - A BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads ...

What is Total Quality Management?

ERIC Educational Resources Information Center

Bryan, William A.

1996-01-01

Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

SUSTAIN – A Framework for Placement of Best Management Practices in Urban Watersheds to Protect Water Quality

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate alternative plans for water quality management and flow abatement techniques in urban and developing areas. A watershed-scale, decision-support framework that is based on cost optimization is needed to support gov...

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

PubMed

Clark, G B

1990-01-01

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

TU-AB-BRD-04: Development of Quality Management Program

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

Thomadsen, B.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

NASA Astrophysics Data System (ADS)

Koblen, Ivan; Lestyánszka Škůrková, Katarína

2015-06-01

The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

Design and Testing of an Air Force Services Mystery Shopping Program.

DTIC Science & Technology

1998-11-01

Base level Air Force Services’ lodging and foodservice activities use limited service quality measurement tools to determine customer perceptions of... service quality . These tools, specifically management observation and customer comment cards, do not provide a complete picture of service quality . Other... service quality measurement methods such as mystery shopping are rarely used. Bases do not consider using mystery shopping programs because of the

SUSTAIN - A USEPA BMP PROCESS AND PLACEMENT TOOL FOR URBAN WATERSHEDS

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads (...

C++ software quality in the ATLAS experiment: tools and experience

NASA Astrophysics Data System (ADS)

Martin-Haugh, S.; Kluth, S.; Seuster, R.; Snyder, S.; Obreshkov, E.; Roe, S.; Sherwood, P.; Stewart, G. A.

2017-10-01

In this paper we explain how the C++ code quality is managed in ATLAS using a range of tools from compile-time through to run time testing and reflect on the substantial progress made in the last two years largely through the use of static analysis tools such as Coverity®, an industry-standard tool which enables quality comparison with general open source C++ code. Other available code analysis tools are also discussed, as is the role of unit testing with an example of how the GoogleTest framework can be applied to our codebase.

Improving the accuracy of total quality management instruments.

PubMed

Bechtel, G A; Wood, D

1996-03-01

Total quality management (TQM) instruments are essential tools in defining concepts identified in an Ishikawa or ¿cause-and-effect¿ diagram. Collecting meaningful and accurate data using TQM instruments is imperative if productivity and quality of care are to be enhanced. This article provides managers with techniques and guidelines that will enhance the reliability and validity of TQM instruments, thereby promoting organization efficiency and customer satisfaction.

[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.

A proposed adaptation of the European Foundation for Quality Management Excellence Model to physical activity programmes for the elderly - development of a quality self-assessment tool using a modified Delphi process

PubMed Central

2011-01-01

Background There has been a growing concern in designing physical activity (PA) programmes for elderly people, since evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Complete programme evaluations are a necessary prerequisite to continuous quality improvements. Being able to refine, adapt and create tools that are suited to the realities and contexts of PA programmes for the elderly in order to support its continuous improvement is, therefore, crucial. Thus, the aim of this study was to develop a self-assessment tool for PA programmes for the elderly. Methods A 3-round Delphi process was conducted via the Internet with 43 national experts in PA for the elderly, management and delivery of PA programmes for the elderly, sports management, quality management and gerontology, asking experts to identify the propositions that they considered relevant for inclusion in the self-assessment tool. Experts reviewed a list of proposed statements, based on the criteria and sub-criteria from the European Foundation for Quality Management Excellence Model (EFQM) and PA guidelines for older adults and rated each proposition from 1 to 8 (disagree to agree) and modified and/or added propositions. Propositions receiving either bottom or top scores of greater than 70% were considered to have achieved consensus to drop or retain, respectively. Results In round 1, of the 196 originally-proposed statements (best practice principles), the experts modified 41, added 1 and achieved consensus on 93. In round 2, a total of 104 propositions were presented, of which experts modified 39 and achieved consensus on 53. In the last round, of 51 proposed statements, the experts achieved consensus on 19. After 3 rounds of rating, experts had not achieved consensus on 32 propositions. The resulting tool consisted of 165 statements that assess nine management areas involved in the development of PA programmes for the elderly. Conclusion Based on experts' opinions, a self-assessment tool was found in order to access quality of PA programmes for the elderly. Information obtained with evaluations would be useful to organizations seeking to improve their services, customer satisfaction and, consequently, adherence to PA programmes, targeting the ageing population. PMID:21958203

Improving Indoor Air Quality in St. Cloud Schools.

ERIC Educational Resources Information Center

Forer, Mike; Haus, El

2000-01-01

Describes how the St. Cloud Area School District (Minnesota), using Tools for Schools provided by the U.S. Environmental Protection Agency, managed the improvement of their school building indoor air quality (IAQ). The district goals of the IAQ Management Committee and the policy elements used to maintain high classroom air quality are…

Managing Change to a Quality Philosophy: A Partnership Perspective.

ERIC Educational Resources Information Center

Snyder, Karolyn J.; Acker-Hocevar, Michele

Within the past 5 years there has been an international movement to adapt the principles and practices of Total Quality Management work environments to school-restructuring agendas. This paper reports on the development of a model called the Educational Quality System, a benchmark assessment tool for identifying the essential elements of quality…

[Compatibility of different quality control systems].

PubMed

Invernizzi, Enrico

2002-01-01

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

Recommendations for the Use of E-Tools for Improvements around Assignment Marking Quality

ERIC Educational Resources Information Center

Heinrich, Eva; Milne, John; Ramsay, Annabel; Morrison, David

2009-01-01

This article reports on selected aspects of a larger study on the use of electronic tools in the context of the management and marking of assignments. The study comprised a literature review, interviews and a review of e-tools. The article briefly summarises the findings from the literature on what comprises quality in assignment marking. The…

Tools for developing a quality management program: proactive tools (process mapping, value stream mapping, fault tree analysis, and failure mode and effects analysis).

PubMed

Rath, Frank

2008-01-01

This article examines the concepts of quality management (QM) and quality assurance (QA), as well as the current state of QM and QA practices in radiotherapy. A systematic approach incorporating a series of industrial engineering-based tools is proposed, which can be applied in health care organizations proactively to improve process outcomes, reduce risk and/or improve patient safety, improve through-put, and reduce cost. This tool set includes process mapping and process flowcharting, failure modes and effects analysis (FMEA), value stream mapping, and fault tree analysis (FTA). Many health care organizations do not have experience in applying these tools and therefore do not understand how and when to use them. As a result there are many misconceptions about how to use these tools, and they are often incorrectly applied. This article describes these industrial engineering-based tools and also how to use them, when they should be used (and not used), and the intended purposes for their use. In addition the strengths and weaknesses of each of these tools are described, and examples are given to demonstrate the application of these tools in health care settings.

Implementing Total Quality Management in Vocational Education.

ERIC Educational Resources Information Center

Navaratnam, K. K.; Mountney, Peter

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

Development and Validity Testing of an Arthritis Self-Management Assessment Tool.

PubMed

Oh, HyunSoo; Han, SunYoung; Kim, SooHyun; Seo, WhaSook

Because of the chronic, progressive nature of arthritis and the substantial effects it has on quality of life, patients may benefit from self-management. However, no valid, reliable self-management assessment tool has been devised for patients with arthritis. This study was conducted to develop a comprehensive self-management assessment tool for patients with arthritis, that is, the Arthritis Self-Management Assessment Tool (ASMAT). To develop a list of qualified items corresponding to the conceptual definitions and attributes of arthritis self-management, a measurement model was established on the basis of theoretical and empirical foundations. Content validity testing was conducted to evaluate whether listed items were suitable for assessing arthritis self-management. Construct validity and reliability of the ASMAT were tested. Construct validity was examined using confirmatory factor analysis and nomological validity. The 32-item ASMAT was developed with a sample composed of patients in a clinic in South Korea. Content validity testing validated the 32 items, which comprised medical (10 items), behavioral (13 items), and psychoemotional (9 items) management subscales. Construct validity testing of the ASMAT showed that the 32 items properly corresponded with conceptual constructs of arthritis self-management, and were suitable for assessing self-management ability in patients with arthritis. Reliability was also well supported. The ASMAT devised in the present study may aid the evaluation of patient self-management ability and the effectiveness of self-management interventions. The authors believe the developed tool may also aid the identification of problems associated with the adoption of self-management practice, and thus improve symptom management, independence, and quality of life of patients with arthritis.

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

PubMed

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

2009-01-01

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

Using Quality Management Tools to Enhance Feedback from Student Evaluations

ERIC Educational Resources Information Center

Jensen, John B.; Artz, Nancy

2005-01-01

Statistical tools found in the service quality assessment literature--the "T"[superscript 2] statistic combined with factor analysis--can enhance the feedback instructors receive from student ratings. "T"[superscript 2] examines variability across multiple sets of ratings to isolate individual respondents with aberrant response…

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.

Modeling Cover Crop Effectiveness on Maryland's Eastern Shore

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, hydrologic/water quality models to ecosystem management is increasingly evident as more programs adopt these tools to evaluate the effectiveness of different management scenarios and their impact on the environment. Quality of precipitation data is critical for appropri...

Remote Sensing for Inland Water Quality Monitoring: A U.S. Army Corps of Engineers Perspective

DTIC Science & Technology

2011-10-01

outlined in Water Quality Management Plans , including traditional field sampling (water, sediment, and biological) and measure- ment of physical...at one time, a more comprehen- sive historical record or trend analysis, a planning tool for prioritizing field surveying and sampling, and accurate...estimations of optically active constituents used to characterize water quality. Furthermore, when utilized in water quality management planning

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

PubMed Central

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

2016-01-01

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

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

PubMed

Maurellet-Evrard, S; Daunizeau, A

2013-06-01

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

Guidelines for overcoming hospital managerial challenges: a systematic literature review

PubMed Central

Crema, Maria; Verbano, Chiara

2013-01-01

Purpose The need to respond to accreditation institutes’ and patients’ requirements and to align health care results with increased medical knowledge is focusing greater attention on quality in health care. Different tools and techniques have been adopted to measure and manage quality, but clinical errors are still too numerous, suggesting that traditional quality improvement systems are unable to deal appropriately with hospital challenges. The purpose of this paper is to grasp the current tools, practices, and guidelines adopted in health care to improve quality and patient safety and create a base for future research on this young subject. Methods A systematic literature review was carried out. A search of academic databases, including papers that focus not only on lean management, but also on clinical errors and risk reduction, yielded 47 papers. The general characteristics of the selected papers were analyzed, and a content analysis was conducted. Results A variety of managerial techniques, tools, and practices are being adopted in health care, and traditional methodologies have to be integrated with the latest ones in order to reduce errors and ensure high quality and patient safety. As it has been demonstrated, these tools are useful not only for achieving efficiency objectives, but also for providing higher quality and patient safety. Critical indications and guidelines for successful implementation of new health managerial methodologies are provided and synthesized in an operative scheme useful for extending and deepening knowledge of these issues with further studies. Conclusion This research contributes to introducing a new theme in health care literature regarding the development of successful projects with both clinical risk management and health lean management objectives, and should address solutions for improving health care even in the current context of decreasing resources. PMID:24307833

Managing Epilepsy Well: Emerging e-Tools for epilepsy self-management.

PubMed

Shegog, Ross; Bamps, Yvan A; Patel, Archna; Kakacek, Jody; Escoffery, Cam; Johnson, Erica K; Ilozumba, Ukwuoma O

2013-10-01

The Managing Epilepsy Well (MEW) Network was established in 2007 by the Centers for Disease Control and Prevention Epilepsy Program to expand epilepsy self-management research. The network has employed collaborative research strategies to develop, test, and disseminate evidence-based, community-based, and e-Health interventions (e-Tools) for epilepsy self-management for people with epilepsy, caregivers, and health-care providers. Since its inception, MEW Network collaborators have conducted formative studies (n=7) investigating the potential of e-Health to support epilepsy self-management and intervention studies evaluating e-Tools (n=5). The MEW e-Tools (the MEW website, WebEase, UPLIFT, MINDSET, and PEARLS online training) and affiliated e-Tools (Texting 4 Control) are designed to complement self-management practices in each phase of the epilepsy care continuum. These tools exemplify a concerted research agenda, shared methodological principles and models for epilepsy self-management, and a communal knowledge base for implementing e-Health to improve quality of life for people with epilepsy. © 2013.

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.

Using Quality Management as a Bridge in Educating for Sustainability in a Business School

ERIC Educational Resources Information Center

Rusinko, Cathy A.

2005-01-01

Purpose: To demonstrate how quality management (QM), a widely accepted management paradigm, can be used to advance education for sustainability in the business curriculum. Design/methodology/approach: The assumptions of QM and environmental sustainability are explored. A class exercise is developed that uses QM tools--and in particular, Deming's…

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.…

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

PubMed

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

2001-03-01

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

Management of fish populations in large rivers: a review of tools and approaches

USGS Publications Warehouse

Petts, Geoffrey E.; Imhoff, Jack G.; Manny, Bruce A.; Maher, John F. B.; Weisberg, Stephen B.

1989-01-01

In common with most branches of science, the management of riverine fish populations is characterised by reductionist and isolationist philosophies. Traditional fish management focuses on stocking and controls on fishing. This paper presents a concensus of scientists involved in the LARS workshop on the management of fish populations in large rivers. A move towards a more holistic philosophy is advocated, with fish management forming an integral part of sustainable river development. Based upon a questionnaire survey of LARS members, with wide-ranging expertise and experience from all parts of the world, lists of management tools currently in use are presented. Four categories of tools are described: flow, water-quality, habitat, and biological. The potential applications of tools for fish management in large rivers is discussed and research needs are identified. The lack of scientific evaluations of the different tools remains the major constraint to their wider application.

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to ``give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by ``total quality management` have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by total quality management' have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

Innovative Use of Quality Management Methods for Product Improvement

NASA Astrophysics Data System (ADS)

Midor, Katarzyna; Žarnovský, Jozef

2016-12-01

Organisations constantly look for new, innovative solutions and methods which could be used to improve their efficiency and increase the quality of their products. Identifying the causes for returns is an important issue for modern companies, as returns are the cause for the increase in production costs and, most importantly, the loss of credibility in the eyes of the client. Therefore, for the company to be able to sustain or strengthen its position on the market, it has to follow the rules of quality management. Especially important is the rule of constant improvement. This rule is primarily connected with preventing errors and defects from occurring at all the stages of the production process. To achieve that, one must, among other things, use quality management tools. The article presents an analysis of causes for returns of a vibrating screen produced by a company which manufactures machinery and equipment for the extractive industry, using quality management tools such as the Ishikawa diagram and Pareto analysis. The analysis allowed for the identification of the causes of client returns which could not be previously identified, and proposing solutions for them.

Total Management for Organisations: Concepts and Tools. A Handbook for Tertiary Education.

ERIC Educational Resources Information Center

Cope, Robert; Sherr, Lawrence

This publication offers suggestions for improving management so that organizations, especially further education institutions, will be more effective. The conceptual bases for the book are three "tool chests": strategic thinking, speedy decision, and total quality improvement. Chapter 1 clarifies strategic planning and provides case…

Spatial Data Uncertainty in a Webgis Tool Supporting Sediments Management in Wallonia

NASA Astrophysics Data System (ADS)

Stéphenne, N. R.; Beaumont, B.; Veschkens, M.; Palm, S.; Charlemagne, C.

2015-08-01

This paper describes a WebGIS prototype developed for the Walloon administration to improve the communication and the management of sediments dredging actions carried out in rivers and lakes. In Wallonia, levelling dredged sediments on banks requires an official authorization from the administration. This request refers to geospatial datasets such as the official land use map, the cadastral map or the distance to potential pollution sources. Centralising geodatabases within a web interface facilitate the management of these authorizations for the managers and the central administration. The proposed system integrates various data from disparate sources. Some issues in map scale, spatial search quality and cartographic visualisation are discussed in this paper with the solutions provided. The prototype web application is currently discussed with some potential users in order to understand in which way this tool facilitate the communication, the management and the quality of the authorisation process. The structure of the paper states the why, what, who and how of this communication tool with a special focus on errors and uncertainties.

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.

STORM WATER MANAGEMENT MODEL QUALITY ASSURANCE REPORT: DYNAMIC WAVE FLOW ROUTING

EPA Science Inventory

The Storm Water Management Model (SWMM) is a computer-based tool for simulating storm water runoff quantity and quality from primarily urban areas. In 2002 the U.S. Environmental Protection Agency’s Water Supply and Water Resources Division partnered with the consulting firm CDM ...

Improving Water Management Decision Support Tools Using NASA Satellite and Modeling Data

NASA Astrophysics Data System (ADS)

Toll, D. L.; Arsenault, K.; Nigro, J.; Pinheiro, A.; Engman, E. T.; Triggs, J.; Cosgrove, B.; Alonge, C.; Boyle, D.; Allen, R.; Townsend, P.; Ni-Meister, W.

2006-05-01

One of twelve Applications of National priority within NASA's Applied Science Program, the Water Management Program Element addresses concerns and decision making related to water availability, water forecast and water quality. The goal of the Water Management Program Element is to encourage water management organizations to use NASA Earth science data, models products, technology and other capabilities in their decision support tools for problem solving. The Water Management Program Element partners with Federal agencies, academia, private firms, and may include international organizations. This paper further describes the Water Management Program with the objective of informing the applications community of the potential opportunities for using NASA science products for problem solving. We will illustrate some ongoing and application Water Management projects evaluating and benchmarking NASA data with partnering federal agencies and their decision support tools: 1) Environmental Protection Agency for water quality; 2) Bureau of Reclamation for water supply, demand and forecast; and 3) NOAA National Weather Service for improved weather prediction. Examples of the types of NASA contributions to the these agency decision support tools include: 1) satellite observations within models assist to estimate water storage, i.e., snow water equivalent, soil moisture, aquifer volumes, or reservoir storages; 2) model derived products, i.e., evapotranspiration, precipitation, runoff, ground water recharge, and other 4-dimensional data assimilation products; 3) improve water quality, assessments by using improved inputs from NASA models (precipitation, evaporation) and satellite observations (e.g., temperature, turbidity, land cover) to nonpoint source models; and 4) water (i.e., precipitation) and temperature predictions from days to decades over local, regional and global scales.

Reinvention/reengineering of business and technical processes

NASA Technical Reports Server (NTRS)

Olsen, Eugene A.

1996-01-01

The changing marketplace as evidenced by global competition is requiring American organizations to rethink, regroup, and redesign their processes. The umbrella of total quality management (TQM) includes many quality methods, techniques, tools, and approaches. There is no right way for every situation or circumstance. Adaptability and experimentation of several tools is necessary. Process management when properly applied can lead to continuous quality improvements. But some processes simply need to be discarded and new ones developed. This reengineering often results in vertical compression and job redesign and restructuring. Work activities must be designed around processes, not processes around work activities. Reengineering and process management do not stand alone--they support each other. Senior executive leadership and empowerment of workers at all organizational levels is vital for both short-term and long-term success.

Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools.

PubMed

Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin

2015-05-01

To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.

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

PubMed

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

2018-05-16

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

Quality, risk management and patient safety: the challenge of effective integration.

PubMed

França, Margarida

2008-01-01

Nowadays we observe the development of three waves of intervention and change within healthcare services: quality management, risk management and patient safety. The Patient Safety movement has been launched at international level as a consequence of the Institute of Medicine's report--To Err is Human, and today patient safety constitutes one basic dimension of health quality subjected to the direct intervention of supranational entities (WHO, EU) and Member States' Governments. The objective of this paper is to raise awareness about the value of quality improvement (QI) methodologies and tools to sustainable healthcare quality outcomes.

Satisfaction monitoring for quality control in campground management

Treesearch

Wilbur F. LaPage; Malcolm I. Bevins

1981-01-01

A 4-year study of camper satisfaction indicates that satisfaction monitoring is a useful tool for campground managers to assess their performance and achieve a high level of quality control in their service to the public. An indication of camper satisfaction with campground management is gained from a report card on which a small sample of visitors rates 14 elements of...

A case management tool for occupational health nurses: development, testing, and application.

PubMed

Mannon, J A; Conrad, K M; Blue, C L; Muran, S

1994-08-01

1. Case management is a process of coordinating an individual client's health care services to achieve optimal, quality care delivered in a cost effective manner. The case manager establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains a strong communication link among all the parties. 2. Through development of audit tools such as the one presented in this article, occupational health nurses can document case management activities and provide employers with measurable outcomes. 3. The Case Management Activity Checklist was tested using data from 61 firefighters' musculoskeletal injury cases. 4. The activities on the checklist are a step by step process: case identification/case disposition; assessment; return to work plan; resource identification; collaborative communication; and evaluation.

EPA Guidance for Geospatially Related Quality Assurance Project Plans

EPA Pesticide Factsheets

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

Development of a web-based toolkit to support improvement of care coordination in primary care.

PubMed

Ganz, David A; Barnard, Jenny M; Smith, Nina Z Y; Miake-Lye, Isomi M; Delevan, Deborah M; Simon, Alissa; Rose, Danielle E; Stockdale, Susan E; Chang, Evelyn T; Noël, Polly H; Finley, Erin P; Lee, Martin L; Zulman, Donna M; Cordasco, Kristina M; Rubenstein, Lisa V

2018-05-23

Promising practices for the coordination of chronic care exist, but how to select and share these practices to support quality improvement within a healthcare system is uncertain. This study describes an approach for selecting high-quality tools for an online care coordination toolkit to be used in Veterans Health Administration (VA) primary care practices. We evaluated tools in three steps: (1) an initial screening to identify tools relevant to care coordination in VA primary care, (2) a two-clinician expert review process assessing tool characteristics (e.g. frequency of problem addressed, linkage to patients' experience of care, effect on practice workflow, and sustainability with existing resources) and assigning each tool a summary rating, and (3) semi-structured interviews with VA patients and frontline clinicians and staff. Of 300 potentially relevant tools identified by searching online resources, 65, 38, and 18 remained after steps one, two and three, respectively. The 18 tools cover five topics: managing referrals to specialty care, medication management, patient after-visit summary, patient activation materials, agenda setting, patient pre-visit packet, and provider contact information for patients. The final toolkit provides access to the 18 tools, as well as detailed information about tools' expected benefits, and resources required for tool implementation. Future care coordination efforts can benefit from systematically reviewing available tools to identify those that are high quality and relevant.

Using NEXRAD and Rain Gauge Precipitation Data for Hydrologic Calibration of SWAT in a Northeastern Watershed

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, hydrologic/water quality models to ecosystem management is increasingly evident as more programs adopt these tools to evaluate the effectiveness of different management scenarios and their impact on the environment. Quality of precipitation data is critical for appropri...

The Application and Usefulness of Economic Analyses for Water Quality Management in Coastal Areas

EPA Science Inventory

Economic studies are increasingly sought as tools to contribute to water quality management in estuaries and coastal communities, yet little is known about how the results from existing studies have been received and utilized by the organizations who solicited them. We interviewe...

A Menu of Options for Developing Tribal Air Grant Work Plans and Managing Grants for Environmental Results

EPA Pesticide Factsheets

Tool to assist tribes that apply for Clean Air Act (CAA) funding to draft more effective work plans for projects that will develop tribal knowledge of air quality issues and build tribal expertise to manage air quality on tribal lands.

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...

A Model of Risk Analysis in Analytical Methodology for Biopharmaceutical Quality Control.

PubMed

Andrade, Cleyton Lage; Herrera, Miguel Angel De La O; Lemes, Elezer Monte Blanco

2018-01-01

One key quality control parameter for biopharmaceutical products is the analysis of residual cellular DNA. To determine small amounts of DNA (around 100 pg) that may be in a biologically derived drug substance, an analytical method should be sensitive, robust, reliable, and accurate. In principle, three techniques have the ability to measure residual cellular DNA: radioactive dot-blot, a type of hybridization; threshold analysis; and quantitative polymerase chain reaction. Quality risk management is a systematic process for evaluating, controlling, and reporting of risks that may affects method capabilities and supports a scientific and practical approach to decision making. This paper evaluates, by quality risk management, an alternative approach to assessing the performance risks associated with quality control methods used with biopharmaceuticals, using the tool hazard analysis and critical control points. This tool provides the possibility to find the steps in an analytical procedure with higher impact on method performance. By applying these principles to DNA analysis methods, we conclude that the radioactive dot-blot assay has the largest number of critical control points, followed by quantitative polymerase chain reaction, and threshold analysis. From the analysis of hazards (i.e., points of method failure) and the associated method procedure critical control points, we conclude that the analytical methodology with the lowest risk for performance failure for residual cellular DNA testing is quantitative polymerase chain reaction. LAY ABSTRACT: In order to mitigate the risk of adverse events by residual cellular DNA that is not completely cleared from downstream production processes, regulatory agencies have required the industry to guarantee a very low level of DNA in biologically derived pharmaceutical products. The technique historically used was radioactive blot hybridization. However, the technique is a challenging method to implement in a quality control laboratory: It is laborious, time consuming, semi-quantitative, and requires a radioisotope. Along with dot-blot hybridization, two alternatives techniques were evaluated: threshold analysis and quantitative polymerase chain reaction. Quality risk management tools were applied to compare the techniques, taking into account the uncertainties, the possibility of circumstances or future events, and their effects upon method performance. By illustrating the application of these tools with DNA methods, we provide an example of how they can be used to support a scientific and practical approach to decision making and can assess and manage method performance risk using such tools. This paper discusses, considering the principles of quality risk management, an additional approach to the development and selection of analytical quality control methods using the risk analysis tool hazard analysis and critical control points. This tool provides the possibility to find the method procedural steps with higher impact on method reliability (called critical control points). Our model concluded that the radioactive dot-blot assay has the larger number of critical control points, followed by quantitative polymerase chain reaction and threshold analysis. Quantitative polymerase chain reaction is shown to be the better alternative analytical methodology in residual cellular DNA analysis. © PDA, Inc. 2018.

TU-AB-BRD-00: Task Group 100

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

NONE

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-03: Fault Tree Analysis

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

Dunscombe, P.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-01: Process Mapping

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

Palta, J.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-02: Failure Modes and Effects Analysis

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

Huq, M.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

Development and Implementation of Team-Based Panel Management Tools: Filling the Gap between Patient and Population Information Systems.

PubMed

Watts, Brook; Lawrence, Renée H; Drawz, Paul; Carter, Cameron; Shumaker, Amy Hirsch; Kern, Elizabeth F

2016-08-01

Effective team-based models of care, such as the Patient-Centered Medical Home, require electronic tools to support proactive population management strategies that emphasize care coordination and quality improvement. Despite the spread of electronic health records (EHRs) and vendors marketing population health tools, clinical practices still may lack the ability to have: (1) local control over types of data collected/reports generated, (2) timely data (eg, up-to-date data, not several months old), and accordingly (3) the ability to efficiently monitor and improve patient outcomes. This article describes a quality improvement project at the hospital system level to develop and implement a flexible panel management (PM) tool to improve care of subpopulations of patients (eg, panels of patients with diabetes) by clinical teams. An in-depth case analysis approach is used to explore barriers and facilitators in building a PM registry tool for team-based management needs using standard data elements (eg, laboratory values, pharmacy records) found in EHRs. Also described are factors that may contribute to sustainability; to date the tool has been adapted to 6 disease-focused subpopulations encompassing more than 200,000 patients. Two key lessons emerged from this initiative: (1) though challenging, team-based clinical end users and information technology needed to work together consistently to refine the product, and (2) locally developed population management tools can provide efficient data tracking for frontline clinical teams and leadership. The preliminary work identified critical gaps that were successfully addressed by building local PM registry tools from EHR-derived data and offers lessons learned for others engaged in similar work. (Population Health Management 2016;19:232-239).

CUSTOMER/SUPPLIER ACCOUNTABILITY AND PROGRAM IMPLEMENTATION

EPA Science Inventory

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

Advances in management of low-risk febrile neutropenia.

PubMed

Teuffel, Oliver; Sung, Lillian

2012-02-01

To describe and discuss the most recent advances in the management of low-risk febrile neutropenia in children with cancer. Several risk stratification tools for children with febrile neutropenia have been developed, although none of these tools have been directly compared and few have been validated in independent populations. However, there is good evidence that, for pediatric patients with febrile neutropenia at low risk for severe infection, outpatient management is a well tolerated and efficacious alternative to inpatient care. Moreover, major progress has been made in obtaining and understanding perceived quality of life and preferences for outpatient management in pediatric cancer patients. Many parents prefer inpatient management although child quality of life is, in general, anticipated to be higher with outpatient intravenous therapy. Finally, outpatient strategies are more cost-effective as compared with traditional management in hospital. Outpatient management is a well tolerated and cost-effective strategy for low-risk febrile neutropenia in children with cancer, although parental preferences are highly variable for outpatient versus inpatient management. Future research should examine the effectiveness of outpatient strategies through conduct of large cohort studies. Other future work could focus on development of decision aids and other tools to facilitate ambulatory approaches.

Hoshin Kanri: a technique for strategic quality management.

PubMed

Tennant, C; Roberts, P A

2000-01-01

This paper describes a technique for Strategic Quality Management (SQM), known as Hoshin Kanri, which has been operated as a management system in many Japanese companies since the 1960s. It represents a core aspect of Japanese companies' management systems, and is stated as: the means by which the overall control system and Total Quality Management (TQM) are deployed. Hoshin Kanri is not particularly unique in its concept of establishing and tracking individual goals and objectives, but the manner in which the objectives and the means to achieve them are developed and deployed is. The problem with applying the concept of Strategic Quality Management (SQM) using Hoshin Kanri, is that it can tend to challenge the traditional authoritarian strategic planning models, which have become the paradigms of modern business. Yet Hoshin Kanri provides an appropriate tool for declaration of the strategic vision for the business while integrating goals and targets in a single holistic model. There have been various adaptations of Hoshin Kanri to align the technique to Western thinking and management approaches, yet outside Japan its significance has gone largely unreported. It is proposed that Hoshin Kanri is an effective methodology for SQM, which has a number of benefits over the more conventional planning techniques. The benefits of Hoshin Kanri as a tool for Strategic Quality Management (SQM) compared to conventional planning systems include: integration of strategic objectives with tactical daily management, the application of the plan-do-check-act cycle to business process management, parallel planning and execution methodology, company wide approach, improvements in communication, increased consensus and buy-in to goal setting, and cross-functional-management integration.

Tracking and sustaining improvement initiatives: leveraging quality dashboards to lead change in a neurosurgical department.

PubMed

McLaughlin, Nancy; Afsar-Manesh, Nasim; Ragland, Victoria; Buxey, Farzad; Martin, Neil A

2014-03-01

Increasingly, hospitals and physicians are becoming acquainted with business intelligence strategies and tools to improve quality of care. In 2007, the University of California Los Angeles (UCLA) Department of Neurosurgery created a quality dashboard to help manage process measures and outcomes and ultimately to enhance clinical performance and patient care. At that time, the dashboard was in a platform that required data to be entered manually. It was then reviewed monthly to allow the department to make informed decisions. In 2009, the department leadership worked with the UCLA Medical Center to align mutual quality-improvement priorities. The content of the dashboard was redesigned to include 3 areas of priorities: quality and safety, patient satisfaction, and efficiency and use. Throughout time, the neurosurgery quality dashboard has been recognized for its clarity and its success in helping management direct improvement strategies and monitor impact. We describe the creation and design of the neurosurgery quality dashboard at UCLA, summarize the evolution of its assembly process, and illustrate how it can be used as a powerful tool of improvement and change. The potential challenges and future directions of this business intelligence tool are also discussed.

[Informatics data quality and management].

PubMed

Feng, Rung-Chuang

2009-06-01

While the quality of data affects every aspect of business, it is frequently overlooked in terms of customer data integration, data warehousing, business intelligence and enterprise applications. Regardless of which data terms are used, a high level of data quality is a critical base condition essential to satisfy user needs and facilitate the development of effective applications. In this paper, the author introduces methods, a management framework and the major factors involved in data quality assessment. Author also integrates expert opinions to develop data quality assessment tools.

Six Sigma Quality Management System and Design of Risk-based Statistical Quality Control.

PubMed

Westgard, James O; Westgard, Sten A

2017-03-01

Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors. Simple point estimates of sigma at medical decision concentrations are sufficient for laboratory applications. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings

PubMed Central

Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

2014-01-01

Rationale, aims and objectives Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Methods Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. Results A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. Conclusions There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. PMID:24840066

A case study comparison of landfire fuel loading and emissions generation on a mixed conifer forest in northern Idaho, USA

Treesearch

Josh Hyde; Eva K. Strand; Andrew T. Hudak; Dale Hamilton

2015-01-01

The use of fire as a land management tool is well recognized for its ecological benefits in many natural systems. To continue to use fire while complying with air quality regulations, land managers are often tasked with modeling emissions from fire during the planning process. To populate such models, the Landscape Fire and Resource Management Planning Tools (...

Implementation of an Evidence-Based and Content Validated Standardized Ostomy Algorithm Tool in Home Care: A Quality Improvement Project.

PubMed

Bare, Kimberly; Drain, Jerri; Timko-Progar, Monica; Stallings, Bobbie; Smith, Kimberly; Ward, Naomi; Wright, Sandra

Many nurses have limited experience with ostomy management. We sought to provide a standardized approach to ostomy education and management to support nurses in early identification of stomal and peristomal complications, pouching problems, and provide standardized solutions for managing ostomy care in general while improving utilization of formulary products. This article describes development and testing of an ostomy algorithm tool.

Assessing Lymphatic Filariasis Data Quality in Endemic Communities in Ghana, Using the Neglected Tropical Diseases Data Quality Assessment Tool for Preventive Chemotherapy.

PubMed

de Souza, Dziedzom K; Yirenkyi, Eric; Otchere, Joseph; Biritwum, Nana-Kwadwo; Ameme, Donne K; Sackey, Samuel; Ahorlu, Collins; Wilson, Michael D

2016-03-01

The activities of the Global Programme for the Elimination of Lymphatic Filariasis have been in operation since the year 2000, with Mass Drug Administration (MDA) undertaken yearly in disease endemic communities. Information collected during MDA-such as population demographics, age, sex, drugs used and remaining, and therapeutic and geographic coverage-can be used to assess the quality of the data reported. To assist country programmes in evaluating the information reported, the WHO, in collaboration with NTD partners, including ENVISION/RTI, developed an NTD Data Quality Assessment (DQA) tool, for use by programmes. This study was undertaken to evaluate the tool and assess the quality of data reported in some endemic communities in Ghana. A cross sectional study, involving review of data registers and interview of drug distributors, disease control officers, and health information officers using the NTD DQA tool, was carried out in selected communities in three LF endemic Districts in Ghana. Data registers for service delivery points were obtained from District health office for assessment. The assessment verified reported results in comparison with recounted values for five indicators: number of tablets received, number of tablets used, number of tablets remaining, MDA coverage, and population treated. Furthermore, drug distributors, disease control officers, and health information officers (at the first data aggregation level), were interviewed, using the DQA tool, to determine the performance of the functional areas of the data management system. The results showed that over 60% of the data reported were inaccurate, and exposed the challenges and limitations of the data management system. The DQA tool is a very useful monitoring and evaluation (M&E) tool that can be used to elucidate and address data quality issues in various NTD control programmes.

RESTORED RIPARIAN BUFFERS AS TOOLS FOR ECOSYSTEM RESTORATION IN THE MAIA PROCESSES, ENDPOINTS, AND MEASURES OF SUCCESS FOR WATER, SOIL, FLORA AND FAUNA

EPA Science Inventory

Riparian buffer restorations are used as management tools to produce favorable water quality impacts, moreover the basis for riparian buffers as an instrument of water quality restoration rests on a relatively firm foundation. However, the extent to which buffers can restore rip...

Total Quality Applied in the Classroom: Students in Virginia Beach Find Early Gains from New Instructional Practices.

ERIC Educational Resources Information Center

Konopnicki, Patrick

1996-01-01

After hours of introducing team training, facilitation skills, and Total Quality Management tools, the old classroom practices of "chalk and talk" faded in Virginia Beach schools' technical and career education classes. Academic teachers also improved instruction, using innovative TQM tools such as nominal group voting, course mission…

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.

[How to evaluate the application of Clinical Governance tools in the management of hospitalized hyperglycemic patients: results of a multicentric study].

PubMed

De Belvis, Antonio Giulio; Specchia, Maria Lucia; Ferriero, Anna Maria; Capizzi, Silvio

2017-01-01

Risk management is a key tool in Clinical Governance. Our project aimed to define, share, apply and measure the impact of tools and methodologies for the continuous improvement of quality of care, especially in relation to the multi-disciplinary and integrated management of the hyperglycemic patient in hospital settings. A training project, coordinated by a scientific board of experts in diabetes and health management and an Expert Meeting with representatives of all the participating centers was launched in 2014. The project involved eight hospitals through the organization of meetings with five managers and 25 speakers, including diabetologists, internists, pharmacists and nurses. The analysis showed a wide variability in the adoption of tools and processes towards a comprehensive and coordinated management of hyperglycemic patients.

Nurse Managers' Decisions: Fast and Favoring Remediation

PubMed Central

Effken, Judith A.; Verran, Joyce A.; Logue, Melanie D.; Hsu, Ya-Chuan

2010-01-01

How do nurse managers make decisions about quality issues on their units? We asked 10 nurse managers in 3 Arizona hospitals to describe how they resolved a recent quality issue. The managers tended to use a linear, but cognitively expensive strategy, often jumping from problem to solution without a clear goal and selecting solutions biased toward remedial education. Decision support tools should help managers think more systemically, systematically and efficiently, while encouraging consideration of more alternatives to reach targeted goals. PMID:20305465

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Designing a Supply Chain Management Academic Curriculum Using QFD and Benchmarking

ERIC Educational Resources Information Center

Gonzalez, Marvin E.; Quesada, Gioconda; Gourdin, Kent; Hartley, Mark

2008-01-01

Purpose: The purpose of this paper is to utilize quality function deployment (QFD), Benchmarking analyses and other innovative quality tools to develop a new customer-centered undergraduate curriculum in supply chain management (SCM). Design/methodology/approach: The researchers used potential employers as the source for data collection. Then,…

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

ERIC Educational Resources Information Center

Waks, Shlomo; Frank, Moti

1999-01-01

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

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

ERIC Educational Resources Information Center

Weinstein, Larry

2009-01-01

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

IAQ Tools for Schools: Managing Asthma in the School Environment.

ERIC Educational Resources Information Center

Environmental Protection Agency, Washington, DC. Office of Radiation and Indoor Air.

This manual provides tips on improving indoor air quality within the school environment by removing the elements that trigger asthma attacks in children, and presents a list of organizations where asthma resource information can be obtained. Air quality management tips cover removing of animal and cockroach allergens, cleaning up mold and…

The business process management software for successful quality management and organization: A case study from the University of Split School of Medicine.

PubMed

Sapunar, Damir; Grković, Ivica; Lukšić, Davor; Marušić, Matko

2016-05-01

Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution's work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Software for improving the quality of project management, a case study: international manufacture of electrical equipment

NASA Astrophysics Data System (ADS)

Preradović, D. M.; Mićić, Lj S.; Barz, C.

2017-05-01

Production conditions in today’s world require software support at every stage of production and development of new products, for quality assurance and compliance with ISO standards. In addition to ISO standards such as usual metrics of quality, companies today are focused on other optional standards, such as CMMI (Capability Maturity Model Integrated) or prescribing they own standards. However, while there is intensive progress being made in the PM (project management), there is still a significant number of projects, at the global level, that are failures. These have failed to achieve their goals, within budget or timeframe. This paper focuses on checking the role of software tools through the rate of success in projects implemented in the case of internationally manufactured electrical equipment. The results of this research show the level of contribution of the project management software used to manage and develop new products to improve PM processes and PM functions, and how selection of the software tools affects the quality of PM processes and successfully completed projects.

International Conference on Harmonisation; guidance on Q9 Quality Risk Management; availability. Notice.

PubMed

2006-06-02

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q9 Quality Risk Management."' The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides principles and examples of tools for quality risk management that can be applied to all aspects of pharmaceutical quality throughout the lifecycle of drug substances, drug products, and biological and biotechnological products. The guidance is intended to enable regulators and industry to make more effective and consistent risk-based decisions.

On the Way into the Bologna Reform--A Consideration of the Quality and the Role of Human Resource Management in Higher Education System

ERIC Educational Resources Information Center

Kohont, Andrej; Nadoh Bergoc, Jana

2010-01-01

In the article the concept of higher education quality is discussed, putting an emphasis on the concept of quality as a transformation. In this context the teachers are stimulated to use contemporary teaching/learning tools and to take active role in the development and empowerment of learners. The role of human resource management (HRM) is also…

An Acuity Tool for Heart Failure Case Management: Quantifying Workload, Service Utilization, and Disease Severity.

PubMed

Kilgore, Matthew D

The cardiology service line director at a health maintenance organization (HMO) in Washington State required a valid, reliable, and practical means for measuring workloads and other productivity factors for six heart failure (HF) registered nurse case managers located across three geographical regions. The Kilgore Heart Failure Case Management (KHFCM) Acuity Tool was systematically designed, developed, and validated to measure workload as a dependent function of the number of heart failure case management (HFCM) services rendered and the duration of times spent on various care duties. Research and development occurred at various HMO-affiliated internal medicine and cardiology offices throughout Western Washington. The concepts, methods, and principles used to develop the KHFCM Acuity Tool are applicable for any type of health care professional aiming to quantify workload using a high-quality objective tool. The content matter, scaling, and language on the KHFCM Acuity Tool are specific to HFCM settings. The content matter and numeric scales for the KHFCM Acuity Tool were developed and validated using a mixed-method participant action research method applied to a group of six outpatient HF case managers and their respective caseloads. The participant action research method was selected, because the application of this method requires research participants to become directly involved in the diagnosis of research problems, the planning and execution of actions taken to address those problems, and the implementation of progressive strategies throughout the course of the study, as necessary, to produce the most credible and practical practice improvements (; ; ; ). Heart failure case managers served clients with New York Heart Association Functional Class III-IV HF (), and encounters were conducted primarily by telephone or in-office consultation. A mix of qualitative and quantitative results demonstrated a variety of quality improvement outcomes achieved by the design and practice application of the KHFCM Acuity Tool. Quality improvement outcomes included a more valid reflection of encounter times and demonstration of the KHFCM Acuity Tool as a reliable, practical, credible, and satisfying tool for reflecting HF case manager workloads and HF disease severity. The KHFCM Acuity Tool defines workload simply as a function of the number of HFCM services performed and the duration of time spent on a client encounter. The design of the tool facilitates the measure of workload, service utilization, and HF disease characteristics, independently from the overall measure of acuity, so that differences in individual case manager practice, as well as client characteristics within sites, across sites, and potentially throughout annual seasons, can be demonstrated. Data produced from long-term applications of the KHFCM Acuity Tool, across all regions, could serve as a driver for establishing systemwide HFCM productivity benchmarks or standards of practice for HF case managers. Data produced from localized applications could serve as a reference for coordinating staffing resources or developing HFCM productivity benchmarks within individual regions or sites.

75 FR 8917 - Notice of a Meeting of the Agricultural Air Quality Task Force

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... Feeding Operation Index Tool. Fire As An Ecosystem Management Tool. Thursday, March 11, 2010 Discussion of..., color, national origin, gender, religion, age, sexual orientation, or disability. Additionally...

Automated support for experience-based software management

NASA Technical Reports Server (NTRS)

Valett, Jon D.

1992-01-01

To effectively manage a software development project, the software manager must have access to key information concerning a project's status. This information includes not only data relating to the project of interest, but also, the experience of past development efforts within the environment. This paper describes the concepts and functionality of a software management tool designed to provide this information. This tool, called the Software Management Environment (SME), enables the software manager to compare an ongoing development effort with previous efforts and with models of the 'typical' project within the environment, to predict future project status, to analyze a project's strengths and weaknesses, and to assess the project's quality. In order to provide these functions the tool utilizes a vast corporate memory that includes a data base of software metrics, a set of models and relationships that describe the software development environment, and a set of rules that capture other knowledge and experience of software managers within the environment. Integrating these major concepts into one software management tool, the SME is a model of the type of management tool needed for all software development organizations.

WE-H-BRC-01: Failure Mode and Effects Analysis of Skin Electronic Brachytherapy Using Esteya Unit

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

Ibanez-Rosello, B; Bautista-Ballesteros, J; Bonaque, J

Purpose: A failure mode and effect analysis (FMEA) of skin lesions treatment process using Esteya™ device (Elekta Brachyterapy, Veenendaal, The Netherlands) was performed, with the aim of increasing the quality of the treatment and reducing the likelihood of unwanted events. Methods: A multidisciplinary team with experience in the treatment process met to establish the process map, which outlines the flow of various stages for such patients undergoing skin treatment. Potential failure modes (FM) were identified and the value of severity (S), frequency of occurrence (O), and lack of detectability (D) of the proposed FM were scored individually, each on amore » scale of 1 to 10 following TG-100 guidelines of the AAPM. These failure modes were ranked according to our risk priority number (RPN) and S scores. The efficiency of existing quality management tools was analyzed through a reassessment of the O and D made by consensus. Results: 149 FM were identified, 43 of which had RPN ≥ 100 and 30 had S ≥ 7. After introduction of the tools of quality management, only 3 FM had RPN ≥ 100 and 22 FM had RPN ≥ 50. These 22 FM were thoroughly analyzed and new tools for quality management were proposed. The most common cause of highest RPN FM was associated with the heavy patient workload and the continuous and accurate applicator-patient skin contact during the treatment. To overcome this second item, a regular quality control and setup review by a second individual before each treatment session was proposed. Conclusion: FMEA revealed some of the FM potentials that were not predicted during the initial implementation of the quality management tools. This exercise was useful in identifying the need of periodic update of the FMEA process as new potential failures can be identified.« less

Failure mode and effects analysis of skin electronic brachytherapy using Esteya® unit

PubMed Central

Bautista-Ballesteros, Juan Antonio; Bonaque, Jorge; Celada, Francisco; Lliso, Françoise; Carmona, Vicente; Gimeno-Olmos, Jose; Ouhib, Zoubir; Rosello, Joan; Perez-Calatayud, Jose

2016-01-01

Purpose Esteya® (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) is an electronic brachytherapy device used for skin cancer lesion treatment. In order to establish an adequate level of quality of treatment, a risk analysis of the Esteya treatment process has been done, following the methodology proposed by the TG-100 guidelines of the American Association of Physicists in Medicine (AAPM). Material and methods A multidisciplinary team familiar with the treatment process was formed. This team developed a process map (PM) outlining the stages, through which a patient passed when subjected to the Esteya treatment. They identified potential failure modes (FM) and each individual FM was assessed for the severity (S), frequency of occurrence (O), and lack of detection (D). A list of existing quality management tools was developed and the FMs were consensually reevaluated. Finally, the FMs were ranked according to their risk priority number (RPN) and their S. Results 146 FMs were identified, 106 of which had RPN ≥ 50 and 30 had S ≥ 7. After introducing the quality management tools, only 21 FMs had RPN ≥ 50. The importance of ensuring contact between the applicator and the surface of the patient’s skin was emphasized, so the setup was reviewed by a second individual before each treatment session with periodic quality control to ensure stability of the applicator pressure. Some of the essential quality management tools are already being implemented in the installation are the simple templates for reproducible positioning of skin applicators, that help marking the treatment area and positioning of X-ray tube. Conclusions New quality management tools have been established as a result of the application of the failure modes and effects analysis (FMEA) treatment. However, periodic update of the FMEA process is necessary, since clinical experience has suggested occurring of further new possible potential failure modes. PMID:28115958

[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.

Using Quality Schemes in Adult and Community Learning: A Guide for Managers.

ERIC Educational Resources Information Center

Ewens, David; Watters, Kate

This document examines adult and community learning (ACL) and quality programs across England. The difficulties faced by local education agencies' ACL services in delivering quality are noted, along with ways quality improvement has been supported. Quality programs--whether internal or external, based on awards, or used as diagnostic tools--are…

Development of a new Clinical Engineering Management Tool & Information System (CLE-MANTIS).

PubMed

Panousis, S G; Malataras, P; Patelodimou, C; Kolitsi, Z; Pallikarakis, N

1997-01-01

The evolution of the field of biomedical technology has led to the diffusion of an impressive number of medical devices into healthcare institutions. In this environment, Clinical Engineering Departments (CEDs) are expanding their role in healthcare technology management, by changing their structure and introducing quality systems in order to improve their services and monitor the outcomes. In the framework of the national project BIOTECHNET II, a software tool for the management of biomedical technology, named CLE-MANTIS, has been developed, with the aim to assist CEDs in their tasks. CLE-MANTIS functions include the upkeep of an inventory, the support and monitoring of scheduled maintenance, corrective maintenance, vigilance, equipment acquisition and replacement, service contract management and user training. The system offers clinical engineers the possibility to monitor and evaluate the quality and cost-effectiveness of their departments through the monitoring of quality and cost indicators. This paper presents the main features and functions of the system.

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

Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID)

PubMed Central

Pourasghar, Faramarz; Tabrizi, Jafar Sadegh; Yarifard, Khadijeh

2016-01-01

Background: Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. Objective: This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. Methods: The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients’ medication orders. Results: The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. Conclusion: A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare. PMID:27147802

Design and Development of a Clinical Risk Management Tool Using Radio Frequency Identification (RFID).

PubMed

Pourasghar, Faramarz; Tabrizi, Jafar Sadegh; Yarifard, Khadijeh

2016-04-01

Patient safety is one of the most important elements of quality of healthcare. It means preventing any harm to the patients during medical care process. This paper introduces a cost-effective tool in which the Radio Frequency Identification (RFID) technology is used to identify medical errors in hospital. The proposed clinical error management system (CEMS) is consisted of a reader device, a transfer/receiver device, a database and managing software. The reader device works using radio waves and is wireless. The reader sends and receives data to/from the database via the transfer/receiver device which is connected to the computer via USB port. The database contains data about patients' medication orders. The CEMS has the ability to identify the clinical errors before they occur and then warns the care-giver with voice and visual messages to prevent the error. This device reduces the errors and thus improves the patient safety. A new tool including software and hardware was developed in this study. Application of this tool in clinical settings can help the nurses prevent medical errors. It can also be a useful tool for clinical risk management. Using this device can improve the patient safety to a considerable extent and thus improve the quality of healthcare.

[Medical audit: a modern undervalued management tool].

PubMed

Osorio, Guido; Sayes, Nilda; Fernández, Lautaro; Araya, Ester; Poblete, Dennis

2002-02-01

Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee.

Quality and Safety as a Core Leadership Competency.

PubMed

Bleich, Michael R

2018-05-01

A leader's toolbox of competencies comprises knowledge, skills, and abilities in clinical care, finance, human resource management, and more. As essential as these are, a strong command of quality and safety competencies is sovereign in leading and managing, ensuring an optimal patient experience. Four core areas of quality and safety competencies are presented: systems science, knowledge workers, implementation science and big data, and quality safety tools and techniques. J Contin Educ Nurs. 2018;49(5):200-202. Copyright 2018, SLACK Incorporated.

Information Architecture for Quality Management Support in Hospitals.

PubMed

Rocha, Álvaro; Freixo, Jorge

2015-10-01

Quality Management occupies a strategic role in organizations, and the adoption of computer tools within an aligned information architecture facilitates the challenge of making more with less, promoting the development of a competitive edge and sustainability. A formal Information Architecture (IA) lends organizations an enhanced knowledge but, above all, favours management. This simplifies the reinvention of processes, the reformulation of procedures, bridging and the cooperation amongst the multiple actors of an organization. In the present investigation work we planned the IA for the Quality Management System (QMS) of a Hospital, which allowed us to develop and implement the QUALITUS (QUALITUS, name of the computer application developed to support Quality Management in a Hospital Unit) computer application. This solution translated itself in significant gains for the Hospital Unit under study, accelerating the quality management process and reducing the tasks, the number of documents, the information to be filled in and information errors, amongst others.

Identification, summary and comparison of tools used to measure organizational attributes associated with chronic disease management within primary care settings.

PubMed

Lukewich, Julia; Corbin, Renée; VanDenKerkhof, Elizabeth G; Edge, Dana S; Williamson, Tyler; Tranmer, Joan E

2014-12-01

Given the increasing emphasis being placed on managing patients with chronic diseases within primary care, there is a need to better understand which primary care organizational attributes affect the quality of care that patients with chronic diseases receive. This study aimed to identify, summarize and compare data collection tools that describe and measure organizational attributes used within the primary care setting worldwide. Systematic search and review methodology consisting of a comprehensive and exhaustive search that is based on a broad question to identify the best available evidence was employed. A total of 30 organizational attribute data collection tools that have been used within the primary care setting were identified. The tools varied with respect to overall focus and level of organizational detail captured, theoretical foundations, administration and completion methods, types of questions asked, and the extent to which psychometric property testing had been performed. The tools utilized within the Quality and Costs of Primary Care in Europe study and the Canadian Primary Health Care Practice-Based Surveys were the most recently developed tools. Furthermore, of the 30 tools reviewed, the Canadian Primary Health Care Practice-Based Surveys collected the most information on organizational attributes. There is a need to collect primary care organizational attribute information at a national level to better understand factors affecting the quality of chronic disease prevention and management across a given country. The data collection tools identified in this review can be used to establish data collection strategies to collect this important information. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Lean-Six Sigma: tools for rapid cycle cost reduction.

PubMed

Caldwell, Chip

2006-10-01

Organizational costs can be grouped as process cost, cost of quality, and cost of poor quality. Providers should train managers in the theory and application of Lean-Six Sigma, including the seven categories of waste and how to remove them. Healthcare financial executives should work with managers in eliminating waste to improve service and reduce costs.

Castration-resistant Prostate Cancer: Preservation of Quality of Life and Well-being.

PubMed

Rosario, Derek J; Greasley, Rosa; Bourke, Liam

2016-12-01

Managing optimal health in castrate-resistant prostate cancer is a complex clinical challenge. Quality of life should be assessed with disease-specific validated tools and can be used in clinical practice to assist in considering management options. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Control by quality: proposition of a typology.

PubMed

Pujo, P; Pillet, M

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

Health System Decision Makers' Feedback on Summaries and Tools Supporting the Use of Systematic Reviews: A Qualitative Study

ERIC Educational Resources Information Center

Ellen, Moriah E.; Lavis, John N.; Wilson, Michael G.; Grimshaw, Jeremy; Haynes, R. Brian; Ouimet, Mathieu; Raina, Parminder; Gruen, Russell

2014-01-01

Health system managers and policy makers need timely access to high quality, policy-relevant systematic reviews. Our objectives were to obtain managers' and policy makers' feedback about user-friendly summaries of systematic reviews and about tools related to supporting or assessing their use. Our interviews identified that participants prefer key…

A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of Insurance, and The National Committee on Quality Assurance: The Cost of Multi-Agency Oversight on Medicare+Choice Plans in Texas

DTIC Science & Technology

2001-04-12

Comparison of Oversight Models in Managed Care 1 Running Head: Comparison of Oversight Models in Managed Care A Comparison of the Audit and...TITLE AND SUBTITLE A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing Administration, The Texas Department of...Comparison of Oversight Models in Managed Care 5 A Comparison of the Audit and Accreditation Tools Used By The Health Care Financing

Evaluating the effectiveness of implementing quality management practices in the medical industry.

PubMed

Yeh, T-M; Lai, H-P

2015-01-01

To discuss the effectiveness of 30 quality management practices (QMP) including Strategic Management, Balanced ScoreCard, Knowledge Management, and Total Quality Management in the medical industry. A V-shaped performance evaluation matrix is applied to identify the top ten practices that are important but not easy to use or implement. Quality Function Deployment (QFD) is then utilized to find key factors to improve the implementation of the top ten tools. The questionnaires were sent to the nursing staff and administrators in a hospital through e-mail and posts. A total of 250 copies were distributed and 217 copies were valid. The importance, easiness, and achievement (i.e., implementation level) of 30 quality management practices were used. Key factors for QMP implementation were sequenced in order of importance as top management involvement, inter-department communication and coordination, teamwork, hospital-wide participation, education and training, consultant professionalism, continuous internal auditing, computerized process, and incentive compensation. Top management can implement the V-shaped performance matrix to determine whether quality management practices need improvement and if so, utilize QFD to find the key factors for improvement.

Adaptive Management Using Remote Sensing and Ecosystem Modeling in Response to Climate Variability and Invasive Aquatic Plants for the California Sacramento-San Joaquin Delta Water Resource

NASA Technical Reports Server (NTRS)

Bubenheim, David; Potter, Christopher; Zhang, Minghua; Madsen, John

2017-01-01

The California Sacramento-San Joaquin River Delta is the hub for California's water supply and supports important ecosystem services, agriculture, and communities in Northern to Southern California. Expansion of invasive aquatic plants in the Delta coupled with impacts of changing climate and long-term drought is detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California to develop science-based, adaptive-management strategies for invasive aquatic plant in the Sacramento-San Joaquin Delta. Specific mapping tools developed utilizing satellite and airborne platforms provide regular assessments of population dynamics on a landscape scale and support both strategic planning and operational decision making for resource managers. San Joaquin and Sacramento River watersheds water quality input to the Delta is modeled using the Soil-Water Assessment Tool (SWAT) and a modified SWAT tool has been customized to account for unique landscape and management of agricultural water supply and drainage within the Delta. Environmental response models for growth of invasive aquatic weeds are being parameterized and coupled with spatial distribution/biomass density mapping and water quality to study ecosystem response to climate and aquatic plant management practices. On the water validation and operational utilization of these tools by management agencies and how they are improving decision making, management effectiveness and efficiency will be discussed. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and water resource managers make science-informed decisions regarding management and outcomes.

Software development environments: Status and trends

NASA Technical Reports Server (NTRS)

Duffel, Larry E.

1988-01-01

Currently software engineers are the essential integrating factors tying several components together. The components consist of process, methods, computers, tools, support environments, and software engineers. The engineers today empower the tools versus the tools empowering the engineers. Some of the issues in software engineering are quality, managing the software engineering process, and productivity. A strategy to accomplish this is to promote the evolution of software engineering from an ad hoc, labor intensive activity to a managed, technology supported discipline. This strategy may be implemented by putting the process under management control, adopting appropriate methods, inserting the technology that provides automated support for the process and methods, collecting automated tools into an integrated environment and educating the personnel.

Conceptual basis for an integrated system for the management of a protected area. Examples from its application in a mediterranean area.

PubMed

Cornejo, E; Fungairiño, S G; Barandica, J M; Serrano, J M; Zorrilla, J M; Gómez, T; Zapata, F J; Acosta, F J

2016-01-15

Improving the efficiency of management in protected areas is imperative in a generalized context of limited conservation budgets. However, this is overlooked due to flaws in problem definition, general disregard for cost information, and a lack of suitable tools for measuring costs and management quality. This study describes an innovative methodological framework, implemented in the web application SIGEIN, focused on maximizing the quality of management against its costs, establishing an explicit justification for any decision. The tool integrates, with this aim, a procedure for prioritizing management objects according to a conservation value, modified by a functional criterion; a project management module; and a module for management of continuous assessment. This appraisal associates the relevance of the conservation targets, the efficacy of the methods employed, both resource and personnel investments, and the resulting costs. Preliminary results of a prototypical SIGEIN application on the Site of Community Importance Chafarinas Islands are included. Copyright © 2015 Elsevier Ltd. All rights reserved.

Groundwater sampling: Chapter 5

USGS Publications Warehouse

Wang, Qingren; Munoz-Carpena, Rafael; Foster, Adam; Migliaccio, Kati W.; Li, Yuncong; Migliaccio, Kati

2011-01-01

Discussing an array of water quality topics, from water quality regulations and criteria, to project planning and sampling activities, this book outlines a framework for improving water quality programs. Using this framework, you can easily put the proper training and tools in place for better management of water resources.

AIR QUALITY SIMULATION MODEL PERFORMANCE FOR ONE-HOUR AVERAGES

EPA Science Inventory

If a one-hour standard for sulfur dioxide were promulgated, air quality dispersion modeling in the vicinity of major point sources would be an important air quality management tool. Would currently available dispersion models be suitable for use in demonstrating attainment of suc...

The role of biogeochemical hotspots, landscape heterogeneity, and hydrological connectivity for minimizing forestry effects on water quality.

PubMed

Laudon, Hjalmar; Kuglerová, Lenka; Sponseller, Ryan A; Futter, Martyn; Nordin, Annika; Bishop, Kevin; Lundmark, Tomas; Egnell, Gustaf; Ågren, Anneli M

2016-02-01

Protecting water quality in forested regions is increasingly important as pressures from land-use, long-range transport of air pollutants, and climate change intensify. Maintaining forest industry without jeopardizing sustainability of surface water quality therefore requires new tools and approaches. Here, we show how forest management can be optimized by incorporating landscape sensitivity and hydrological connectivity into a framework that promotes the protection of water quality. We discuss how this approach can be operationalized into a hydromapping tool to support forestry operations that minimize water quality impacts. We specifically focus on how hydromapping can be used to support three fundamental aspects of land management planning including how to (i) locate areas where different forestry practices can be conducted with minimal water quality impact; (ii) guide the off-road driving of forestry machines to minimize soil damage; and (iii) optimize the design of riparian buffer zones. While this work has a boreal perspective, these concepts and approaches have broad-scale applicability.

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

PubMed

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

2015-02-01

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

A data management and publication workflow for a large-scale, heterogeneous sensor network.

PubMed

Jones, Amber Spackman; Horsburgh, Jeffery S; Reeder, Stephanie L; Ramírez, Maurier; Caraballo, Juan

2015-06-01

It is common for hydrology researchers to collect data using in situ sensors at high frequencies, for extended durations, and with spatial distributions that produce data volumes requiring infrastructure for data storage, management, and sharing. The availability and utility of these data in addressing scientific questions related to water availability, water quality, and natural disasters relies on effective cyberinfrastructure that facilitates transformation of raw sensor data into usable data products. It also depends on the ability of researchers to share and access the data in useable formats. In this paper, we describe a data management and publication workflow and software tools for research groups and sites conducting long-term monitoring using in situ sensors. Functionality includes the ability to track monitoring equipment inventory and events related to field maintenance. Linking this information to the observational data is imperative in ensuring the quality of sensor-based data products. We present these tools in the context of a case study for the innovative Urban Transitions and Aridregion Hydrosustainability (iUTAH) sensor network. The iUTAH monitoring network includes sensors at aquatic and terrestrial sites for continuous monitoring of common meteorological variables, snow accumulation and melt, soil moisture, surface water flow, and surface water quality. We present the overall workflow we have developed for effectively transferring data from field monitoring sites to ultimate end-users and describe the software tools we have deployed for storing, managing, and sharing the sensor data. These tools are all open source and available for others to use.

A Quality Model to Select Patients in Cupping Therapy Clinics: A New Tool for Ensuring Safety in Clinical Practice.

PubMed

Aboushanab, Tamer; AlSanad, Saud

2018-06-08

Cupping therapy is a popular treatment in various countries and regions, including Saudi Arabia. Cupping therapy is regulated in Saudi Arabia by the National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health. The authors recommend that this quality model for selecting patients in cupping clinics - first version (QMSPCC-1) - be used routinely as part of clinical practice and quality management in cupping clinics. The aim of the quality model is to ensure the safety of patients and to introduce and facilitate quality and auditing processes in cupping therapy clinics. Clinical evaluation of this tool is recommended. Continued development, re-evaluation and reassessment of this tool are important. Copyright © 2018. Published by Elsevier B.V.

An Approach to Industrial Stormwater Benchmarks: Establishing and Using Site-Specific Threshold Criteria at Lawrence Livermore National Laboratory

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

Campbell, C G; Mathews, S

2006-09-07

Current regulatory schemes use generic or industrial sector specific benchmarks to evaluate the quality of industrial stormwater discharges. While benchmarks can be a useful tool for facility stormwater managers in evaluating the quality stormwater runoff, benchmarks typically do not take into account site-specific conditions, such as: soil chemistry, atmospheric deposition, seasonal changes in water source, and upstream land use. Failing to account for these factors may lead to unnecessary costs to trace a source of natural variation, or potentially missing a significant local water quality problem. Site-specific water quality thresholds, established upon the statistical evaluation of historic data take intomore » account these factors, are a better tool for the direct evaluation of runoff quality, and a more cost-effective trigger to investigate anomalous results. Lawrence Livermore National Laboratory (LLNL), a federal facility, established stormwater monitoring programs to comply with the requirements of the industrial stormwater permit and Department of Energy orders, which require the evaluation of the impact of effluent discharges on the environment. LLNL recognized the need to create a tool to evaluate and manage stormwater quality that would allow analysts to identify trends in stormwater quality and recognize anomalous results so that trace-back and corrective actions could be initiated. LLNL created the site-specific water quality threshold tool to better understand the nature of the stormwater influent and effluent, to establish a technical basis for determining when facility operations might be impacting the quality of stormwater discharges, and to provide ''action levels'' to initiate follow-up to analytical results. The threshold criteria were based on a statistical analysis of the historic stormwater monitoring data and a review of relevant water quality objectives.« less

Master Pump Shutdown MPS Software Quality Assurance Plan (SQAP)

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

BEVINS, R.R.

2000-09-20

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

Publications about Indoor Air Quality in Schools

EPA Pesticide Factsheets

Publications and resources that relate to indoor air quality in schools, and design tools for schools. These publications cover a wide range of issues, including IAQ management, student performance, asthma, mold and moisture, and radon.

The evolution of diagnosis-related groups (DRGs): from its beginnings in case-mix and resource use theory, to its implementation for payment and now for its current utilization for quality within and outside the hospital.

PubMed

Goldfield, Norbert

2010-01-01

Policymakers are searching for ways to control health care costs and improve quality. Diagnosis-related groups (DRGs) are by far the most important cost control and quality improvement tool that governments and private payers have implemented. This article reviews why DRGs have had this singular success both in the hospital sector and, over the past 10 years, in ambulatory and managed care settings. Last, the author reviews current trends in the development and implementation of tools that have the key ingredients of DRG success: categorical clinical model, separation of the clinical model from payment weights, separate payment adjustments for nonclinical factors, and outlier payments. Virtually all current tools used to manage health care costs and improve quality do not have these characteristics. This failure explains a key reason for the failure, for example, of the Medicare Advantage program to control health care costs. This article concludes with a discussion of future developments for DRG-type models outside the hospital sector.

The use of six sigma in health care management: are we using it to its full potential?

PubMed

DelliFraine, Jami L; Wang, Zheng; McCaughey, Deirdre; Langabeer, James R; Erwin, Cathleen O

2014-01-01

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.

The use of six sigma in health care management: are we using it to its full potential?

PubMed

DelliFraine, Jami L; Wang, Zheng; McCaughey, Deirdre; Langabeer, James R; Erwin, Cathleen O

2013-01-01

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.

Prevention and management of "do not return" notices: a quality improvement process for supplemental staffing nursing agencies.

PubMed

Ade-Oshifogun, Jochebed Bosede; Dufelmeier, Thaddeus

2012-01-01

This article describes a quality improvement process for "do not return" (DNR) notices for healthcare supplemental staffing agencies and healthcare facilities that use them. It is imperative that supplemental staffing agencies partner with healthcare facilities in assuring the quality of supplemental staff. Although supplemental staffing agencies attempt to ensure quality staffing, supplemental staff are sometimes subjectively evaluated by healthcare facilities as "DNR." The objective of this article is to describe a quality improvement process to prevent and manage "DNR" within healthcare organizations. We developed a curriculum and accompanying evaluation tool by adapting Rampersad's problem-solving discipline approach: (a) definition of area(s) for improvement; (b) identification of all possible causes; (c) development of an action plan; (d) implementation of the action plan; (e) evaluation for program improvement; and (f) standardization of the process. Face and content validity of the evaluation tool was ascertained by input from a panel of experienced supplemental staff and nursing faculty. This curriculum and its evaluation tool will have practical implications for supplemental staffing agencies and healthcare facilities in reducing "DNR" rates and in meeting certification/accreditation requirements. Further work is needed to translate this process into future research. © 2012 Wiley Periodicals, Inc.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods.

PubMed

Odaga, John; Henriksson, Dorcus K; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K; Valadez, Joseph J

2016-01-01

Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival.

Empowering districts to target priorities for improving child health service in Uganda using change management and rapid assessment methods

PubMed Central

Odaga, John; Henriksson, Dorcus K.; Nkolo, Charles; Tibeihaho, Hector; Musabe, Richard; Katusiime, Margaret; Sinabulya, Zaccheus; Mucunguzi, Stephen; Mbonye, Anthony K.; Valadez, Joseph J.

2016-01-01

Background Local health system managers in low- and middle-income countries have the responsibility to set health priorities and allocate resources accordingly. Although tools exist to aid this process, they are not widely applied for various reasons including non-availability, poor knowledge of the tools, and poor adaptability into the local context. In Uganda, delivery of basic services is devolved to the District Local Governments through the District Health Teams (DHTs). The Community and District Empowerment for Scale-up (CODES) project aims to provide a set of management tools that aid contextualised priority setting, fund allocation, and problem-solving in a systematic way to improve effective coverage and quality of child survival interventions. Design Although the various tools have previously been used at the national level, the project aims to combine them in an integral way for implementation at the district level. These tools include Lot Quality Assurance Sampling (LQAS) surveys to generate local evidence, Bottleneck analysis and Causal analysis as analytical tools, Continuous Quality Improvement, and Community Dialogues based on Citizen Report Cards and U reports. The tools enable identification of gaps, prioritisation of possible solutions, and allocation of resources accordingly. This paper presents some of the tools used by the project in five districts in Uganda during the proof-of-concept phase of the project. Results All five districts were trained and participated in LQAS surveys and readily adopted the tools for priority setting and resource allocation. All districts developed health operational work plans, which were based on the evidence and each of the districts implemented more than three of the priority activities which were included in their work plans. Conclusions In the five districts, the CODES project demonstrated that DHTs can adopt and integrate these tools in the planning process by systematically identifying gaps and setting priority interventions for child survival. PMID:27225791

Application of two quality indices as monitoring and management tools of rivers. Case study: the Imera Meridionale River, Italy.

PubMed

Bonanno, Giuseppe; Lo Giudice, Rosa

2010-04-01

On the basis of the European Water Framework Directive (2000/60), the water resources of the member states of the European Community should reach good quality standards by 2015. Although such regulations illustrate the basic points for a comprehensive and effective policy of water monitoring and management, no practical tools are provided to face and solve the issues concerning freshwater ecosystems such as rivers. The Italian government has developed a set of regulations as adoption of the European Directive but failed to indicate feasible procedures for river monitoring and management. On a local scale, Sicilian authorities have implemented monitoring networks of watersheds, aiming at describing the general conditions of rivers. However, such monitoring programs have provided a relatively fragmentary picture of the ecological conditions of the rivers. In this study, the integrated use of environmental quality indices is proposed as a methodology able to provide a practical approach to river monitoring and management. As a case study, the Imera Meridionale River, Sicily's largest river, was chosen. The water quality index developed by the U.S. National Sanitation Foundation and the floristic quality index based on the Wilhelm method were applied. The former enabled us to describe the water quality according to a spatial-temporal gradient, whereas the latter focused on the ecological quality of riparian vegetation. This study proposes a holistic view of river ecosystems by considering biotic and abiotic factors in agreement with the current European regulations. How the combined use of such indices can guide sustainable management efforts is also discussed.

Adaptive Management Using Remote Sensing and Ecosystem Modeling in Response to Climate Variability and Invasive Aquatic Plants for the California Sacramento-San Joaquin Delta Water Resource

NASA Astrophysics Data System (ADS)

Bubenheim, D.; Potter, C. S.; Zhang, M.; Madsen, J.

2017-12-01

The California Sacramento-San Joaquin River Delta is the hub for California's water supply and supports important ecosystem services, agriculture, and communities in Northern and Southern California. Expansion of invasive aquatic plants in the Delta coupled with impacts of changing climate and long-term drought is detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California to develop science-based, adaptive-management strategies for invasive aquatic plant management in the California Sacramento-San Joaquin Delta. Specific mapping tools developed utilizing satellite and airborne platforms provide regular assessments of population dynamics on a landscape scale and support both strategic planning and operational decision making for resource managers. San Joaquin and Sacramento River watersheds water quality input to the Delta is modeled using the Soil-Water Assessment Tool (SWAT) and a modified SWAT tool has been customized to account for unique landscape and management of agricultural water supply and drainage within the Delta. Environmental response models for growth of invasive aquatic weeds are being parameterized and coupled with spatial distribution/biomass density mapping and water quality to study ecosystem response to climate and aquatic plant management practices. On the water validation and operational utilization of these tools by management agencies and how they improve decision making, management effectiveness and efficiency will be discussed. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and water resource managers make science-informed decisions regarding management and outcomes.

Integrating Hydrologic and Water Quality Models as a Decision Support Tool for Implementation of Low Impact Development in a Coastal Urban Watershed under Climate Variability and Sea Level Rise

NASA Astrophysics Data System (ADS)

Chang, N. B.

2016-12-01

Many countries concern about development and redevelopment efforts in urban regions to reduce the flood risk by considering hazards such as high-tide events, storm surge, flash floods, stormwater runoff, and impacts of sea level rise. Combining these present and future hazards with vulnerable characteristics found throughout coastal communities such as majority low-lying areas and increasing urban development, create scenarios for increasing exposure of flood hazard. As such, the most vulnerable areas require adaptation strategies and mitigation actions for flood hazard management. In addition, in the U.S., Numeric Nutrient Criteria (NNC) are a critical tool for protecting and restoring the designated uses of a waterbody with regard to nitrogen and phosphorus pollution. Strategies such as low impact development (LID) have been promoted in recent years as an alternative to traditional stormwater management and drainage to control both flooding and water quality impact. LID utilizes decentralized multifunctional site designs and incorporates on-site storm water management practices rather than conventional storm water management approaches that divert flow toward centralized facilities. How to integrate hydrologic and water quality models to achieve the decision support becomes a challenge. The Cross Bayou Watershed of Pinellas County in Tampa Bay, a highly urbanized coastal watershed, is utilized as a case study due to its sensitivity to flood hazards and water quality management within the watershed. This study will aid the County, as a decision maker, to implement its stormwater management policy and honor recent NNC state policy via demonstration of an integrated hydrologic and water quality model, including the Interconnected Channel and Pond Routing Model v.4 (ICPR4) and the BMPTRAIN model as a decision support tool. The ICPR4 can be further coupled with the ADCIRC/SWAN model to reflect the storm surge and seal level rise in coastal regions.

PET-Tool: a software suite for comprehensive processing and managing of Paired-End diTag (PET) sequence data.

PubMed

Chiu, Kuo Ping; Wong, Chee-Hong; Chen, Qiongyu; Ariyaratne, Pramila; Ooi, Hong Sain; Wei, Chia-Lin; Sung, Wing-Kin Ken; Ruan, Yijun

2006-08-25

We recently developed the Paired End diTag (PET) strategy for efficient characterization of mammalian transcriptomes and genomes. The paired end nature of short PET sequences derived from long DNA fragments raised a new set of bioinformatics challenges, including how to extract PETs from raw sequence reads, and correctly yet efficiently map PETs to reference genome sequences. To accommodate and streamline data analysis of the large volume PET sequences generated from each PET experiment, an automated PET data process pipeline is desirable. We designed an integrated computation program package, PET-Tool, to automatically process PET sequences and map them to the genome sequences. The Tool was implemented as a web-based application composed of four modules: the Extractor module for PET extraction; the Examiner module for analytic evaluation of PET sequence quality; the Mapper module for locating PET sequences in the genome sequences; and the Project Manager module for data organization. The performance of PET-Tool was evaluated through the analyses of 2.7 million PET sequences. It was demonstrated that PET-Tool is accurate and efficient in extracting PET sequences and removing artifacts from large volume dataset. Using optimized mapping criteria, over 70% of quality PET sequences were mapped specifically to the genome sequences. With a 2.4 GHz LINUX machine, it takes approximately six hours to process one million PETs from extraction to mapping. The speed, accuracy, and comprehensiveness have proved that PET-Tool is an important and useful component in PET experiments, and can be extended to accommodate other related analyses of paired-end sequences. The Tool also provides user-friendly functions for data quality check and system for multi-layer data management.

Quality Management and Building Government Information Services.

ERIC Educational Resources Information Center

Farrell, Maggie

1998-01-01

Discusses serving library-patron needs in terms of customer service and quality control. Highlights include tools for measuring the quality of service (e.g., the SERVQUAL survey), advisory boards or focus groups, library "service statements," changing patron needs, new information formats, and justifying depository library services. (JAK)

Terms of Productivity, Including the Relationship Between Productivity, Effectiveness and Efficiency.

DTIC Science & Technology

1989-04-01

for Awareness Juran on Planning for Quality, 1988, J.M. Juran What is Total Quality Control? The Japanese Way, 1985, Kaoru Ishikawa Guide to Quality...Control, 1982, Kaoru Ishikawa Andrews, M. (1985). Statistical Process Control: Mandatory Management Tool. Production April 1985. Bushe, G. (1988

OPTIMIZING BMP PLACEMENT AT WATERSHED-SCALE USING SUSTAIN

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate alternative plans for environmental quality restoration and protection needs in urban and developing areas. A watershed-scale decision-support system, based on cost optimization, provides an essential tool to suppo...

Open source GIS based tools to improve hydrochemical water resources management in EU H2020 FREEWAT platform

NASA Astrophysics Data System (ADS)

Criollo, Rotman; Velasco, Violeta; Vázquez-Suñé, Enric; Nardi, Albert; Marazuela, Miguel A.; Rossetto, Rudy; Borsi, Iacopo; Foglia, Laura; Cannata, Massimiliano; De Filippis, Giovanna

2017-04-01

Due to the general increase of water scarcity (Steduto et al., 2012), water quantity and quality must be well known to ensure a proper access to water resources in compliance with local and regional directives. This circumstance can be supported by tools which facilitate process of data management and its analysis. Such analyses have to provide research/professionals, policy makers and users with the ability to improve the management of the water resources with standard regulatory guidelines. Compliance with the established standard regulatory guidelines (with a special focus on requirement deriving from the GWD) should have an effective monitoring, evaluation, and interpretation of a large number of physical and chemical parameters. These amounts of datasets have to be assessed and interpreted: (i) integrating data from different sources and gathered with different data access techniques and formats; (ii) managing data with varying temporal and spatial extent; (iii) integrating groundwater quality information with other relevant information such as further hydrogeological data (Velasco et al., 2014) and pre-processing these data generally for the realization of groundwater models. In this context, the Hydrochemical Analysis Tools, akvaGIS Tools, has been implemented within the H2020 FREEWAT project; which aims to manage water resources by modelling water resource management in an open source GIS platform (QGIS desktop). The main goal of AkvaGIS Tools is to improve water quality analysis through different capabilities to improve the case study conceptual model managing all data related into its geospatial database (implemented in Spatialite) and a set of tools for improving the harmonization, integration, standardization, visualization and interpretation of the hydrochemical data. To achieve that, different commands cover a wide range of methodologies for querying, interpreting, and comparing groundwater quality data and facilitate the pre-processing analysis for being used in the realization of groundwater modelling. They include, ionic balance calculations, chemical time-series analysis, correlation of chemical parameters, and calculation of various common hydrochemical diagrams (Salinity, Schöeller-Berkaloff, Piper, and Stiff), among others. Furthermore, it allows the generation of maps of the spatial distributions of parameters and diagrams and thematic maps for the parameters measured and classified in the queried area. References: Rossetto R., Borsi I., Schifani C., Bonari E., Mogorovich P., Primicerio M. (2013). SID&GRID: Integrating hydrological modeling in GIS environment. Rendiconti Online Societa Geologica Italiana, Vol. 24, 282-283 Steduto, P., Faurès, J.M., Hoogeveen, J., Winpenny, J.T., Burke, J.J. (2012). Coping with water scarcity: an action framework for agriculture and food security. ISSN 1020-1203 ; 38 Velasco, V., Tubau, I., Vázquez-Suñé, E., Gogu, R., Gaitanaru, D., Alcaraz, M., Sanchez-Vila, X. (2014). GIS-based hydrogeochemical analysis tools (QUIMET). Computers & Geosciences, 70, 164-180.

Total Quality Management in Space Shuttle Main Engine manufacturing

NASA Technical Reports Server (NTRS)

Ding, J.

1992-01-01

The Total Quality Management (TQM) philosophy developed in the Marshall Space Flight Center (MSFC) is briefly reviewed and the ongoing TQM implementation effort which is being pursued through the continuous improvement (CI) process is discussed. TQM is based on organizational excellence which integrates the new supportive culture with the technical tools necessary to identify, assess, and correct manufacturing processes. Particular attention is given to the prime contractor's change to the organizational excellence management philosophy in SSME manufacturing facilities.

CÆLIS: software for assimilation, management and processing data of an atmospheric measurement network

NASA Astrophysics Data System (ADS)

Fuertes, David; Toledano, Carlos; González, Ramiro; Berjón, Alberto; Torres, Benjamín; Cachorro, Victoria E.; de Frutos, Ángel M.

2018-02-01

Given the importance of the atmospheric aerosol, the number of instruments and measurement networks which focus on its characterization are growing. Many challenges are derived from standardization of protocols, monitoring of the instrument status to evaluate the network data quality and manipulation and distribution of large volume of data (raw and processed). CÆLIS is a software system which aims at simplifying the management of a network, providing tools by monitoring the instruments, processing the data in real time and offering the scientific community a new tool to work with the data. Since 2008 CÆLIS has been successfully applied to the photometer calibration facility managed by the University of Valladolid, Spain, in the framework of Aerosol Robotic Network (AERONET). Thanks to the use of advanced tools, this facility has been able to analyze a growing number of stations and data in real time, which greatly benefits the network management and data quality control. The present work describes the system architecture of CÆLIS and some examples of applications and data processing.

Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting.

PubMed

Gosselin, Emilie; Bourgault, Patricia; Lavoie, Stephan; Coleman, Robin-Marie; Méziat-Burdin, Anne

2014-12-01

Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p < .001) for the whole tool, with variations from 0.619 to 0.920 (p < .01) between dimensions. The expert panel was satisfied with the content and face validity of the tool. The psychometric qualities of the NOTPaM developed in this study are satisfactory. However, the tool could be improved with slight modifications. Nevertheless, it was useful in assessing intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Quality audit--a review of the literature concerning delivery of continence care.

PubMed

Swaffield, J

1995-09-01

This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

Tribal Air Grants Framework - Menu of Options

EPA Pesticide Factsheets

Tool to assist tribes that apply for CAA funding to draft moreeffective work plans for projects that will develop tribal knowledge of air quality issues andbuild tribal expertise to manage air quality on reservations and tribal trust land

GREENROOF RUNOFF WATER QUALITY

EPA Science Inventory

This project evaluated green roofs as a stormwater management tool. Specifically, runoff quantity and quality from green and flat asphalt roofs was compared. Evapotranspiration from planted green roofs and evaporation unplanted media roofs was also compared, and the influence of ...

Guidance on Systematic Planning Using the Data Quality Objectives Process, EPA QA/G-4

EPA Pesticide Factsheets

Provides a standard working tool for project managers and planners to develop DQO for determining the type, quantity, and quality of data needed to reach defensible decisions or make credible estimates.

User’s manual for the Automated Data Assurance and Management application developed for quality control of Everglades Depth Estimation Network water-level data

USGS Publications Warehouse

Petkewich, Matthew D.; Daamen, Ruby C.; Roehl, Edwin A.; Conrads, Paul

2016-09-29

The generation of Everglades Depth Estimation Network (EDEN) daily water-level and water-depth maps is dependent on high quality real-time data from over 240 water-level stations. To increase the accuracy of the daily water-surface maps, the Automated Data Assurance and Management (ADAM) tool was created by the U.S. Geological Survey as part of Greater Everglades Priority Ecosystems Science. The ADAM tool is used to provide accurate quality-assurance review of the real-time data from the EDEN network and allows estimation or replacement of missing or erroneous data. This user’s manual describes how to install and operate the ADAM software. File structure and operation of the ADAM software is explained using examples.

Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

PubMed

Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

2015-11-01

Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Food management behaviours in food-insecure, lone mother-led families.

PubMed

Sim, S Meaghan; Glanville, N Theresa; McIntyre, Lynn

2011-01-01

Little is known about how food is managed in households where food resources are scarce. In this study, the household food management behaviours utilized by food-insecure, lone mother-led families from Atlantic Canada were characterized, and relationships among these behaviours and diet quality were examined. Thematic analysis of 24 in-depth interviews from a larger study of mother-led, low-income families was integrated with sociodemographic characteristics, food-insecurity status, and four weekly 24-hour dietary recalls for all household members to yield a family behaviour score (FBS) as a summative measure of food management behaviours, and a healthy plate score (HPS) as a measure of diet quality. Five distinct food management behaviours were identified: authoritative, healthism, sharing, structured, and planning behaviours. An increase in the FBS was associated with a proportional increase in the HPS. Authoritative, healthism, and planning food management behaviours were the strongest predictors of the HPS for all household members (p<0.05). The structured management behaviour was related to the degree of food insecurity. The FBS and HPS tools hold promise as a way to identify food-insecure families at risk of low diet quality. The next phase of this research will validate the use of these tools in the practice setting.

Development of Quality Management Systems for Clinical Practice Guidelines in Korea.

PubMed

Jo, Heui-Sug; Kim, Dong Ik; Chang, Sung-Goo; Shin, Ein-Soon; Oh, Moo-Kyung

2015-11-01

This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers.

USA Nutrient managment forecasting via the "Fertilizer Forecaster": linking surface runnof, nutrient application and ecohydrology.

NASA Astrophysics Data System (ADS)

Drohan, Patrick; Buda, Anthony; Kleinman, Peter; Miller, Douglas; Lin, Henry; Beegle, Douglas; Knight, Paul

2017-04-01

USA and state nutrient management planning offers strategic guidance that strives to educate farmers and those involved in nutrient management to make wise management decisions. A goal of such programs is to manage hotspots of water quality degradation that threaten human and ecosystem health, water and food security. The guidance provided by nutrient management plans does not provide the day-to-day support necessary to make operational decisions, particularly when and where to apply nutrients over the short term. These short-term decisions on when and where to apply nutrients often make the difference between whether the nutrients impact water quality or are efficiently utilized by crops. Infiltrating rainfall events occurring shortly after broadcast nutrient applications are beneficial, given they will wash soluble nutrients into the soil where they are used by crops. Rainfall events that generate runoff shortly after nutrients are broadcast may wash off applied nutrients, and produce substantial nutrient losses from that site. We are developing a model and data based support tool for nutrient management, the Fertilizer Forecaster, which identifies the relative probability of runoff or infiltrating events in Pennsylvania (PA) landscapes in order to improve water quality. This tool will support field specific decisions by farmers and land managers on when and where to apply fertilizers and manures over 24, 48 and 72 hour periods. Our objectives are to: (1) monitor agricultural hillslopes in watersheds representing four of the five Physiographic Provinces of the Chesapeake Bay basin; (2) validate a high resolution mapping model that identifies soils prone to runoff; (3) develop an empirically based approach to relate state-of-the-art weather forecast variables to site-specific rainfall infiltration or runoff occurrence; (4) test the empirical forecasting model against alternative approaches to forecasting runoff occurrence; and (5) recruit farmers from the four watersheds to use web-based forecast maps in daily manure and fertilizer application decisions. Data from on-farm trials is being used to assess farmer fertilizer, manure, and tillage management decisions before and after use of the Fertilizer Forecaster. This data will help us understand not only the effectiveness of the tool, but also characteristics of farmers with the greatest potential to benefit from such a tool. Feedback from on-farm trials will be used to refine a final tool for field deployment. We hope that the Fertilizer Forecaster will serve as the basis for state (USA-PA), regional (Chesapeake Bay), and national changes in nutrient management planning. This Fertilizer Forecaster is an innovative management practice that is designed to enhance the services of aquatic ecosystems by improving water quality and enhance the services of terrestrial ecosystems by increasing the efficiency of nutrient use by targeted crops.

Integrated Hydrographical Basin Management. Study Case - Crasna River Basin

NASA Astrophysics Data System (ADS)

Visescu, Mircea; Beilicci, Erika; Beilicci, Robert

2017-10-01

Hydrographical basins are important from hydrological, economic and ecological points of view. They receive and channel the runoff from rainfall and snowmelt which, when adequate managed, can provide fresh water necessary for water supply, irrigation, food industry, animal husbandry, hydrotechnical arrangements and recreation. Hydrographical basin planning and management follows the efficient use of available water resources in order to satisfy environmental, economic and social necessities and constraints. This can be facilitated by a decision support system that links hydrological, meteorological, engineering, water quality, agriculture, environmental, and other information in an integrated framework. In the last few decades different modelling tools for resolving problems regarding water quantity and quality were developed, respectively water resources management. Watershed models have been developed to the understanding of water cycle and pollution dynamics, and used to evaluate the impacts of hydrotechnical arrangements and land use management options on water quantity, quality, mitigation measures and possible global changes. Models have been used for planning monitoring network and to develop plans for intervention in case of hydrological disasters: floods, flash floods, drought and pollution. MIKE HYDRO Basin is a multi-purpose, map-centric decision support tool for integrated hydrographical basin analysis, planning and management. MIKE HYDRO Basin is designed for analyzing water sharing issues at international, national and local hydrographical basin level. MIKE HYDRO Basin uses a simplified mathematical representation of the hydrographical basin including the configuration of river and reservoir systems, catchment hydrology and existing and potential water user schemes with their various demands including a rigorous irrigation scheme module. This paper analyzes the importance and principles of integrated hydrographical basin management and develop a case study for Crasna river basin, with the use of MIKE HYDRO Basin advanced hydroinformatic tool for integrated hydrographical basin analysis, planning and management.

Merging Quality Processes & Tools with DACUM.

ERIC Educational Resources Information Center

McLennan, Krystyna S.

This paper explains how merging DACUM (Developing a Curriculum) analysis with quality initiatives can reduce waste, increase job efficiency, assist in development of standard operating procedures, and involve employees in positive job improvement methods. In the first half of the paper, the following principles of total quality management (TQM)…

Modeling the Effects of Conservation Tillage on Water Quality at the Field Scale

USDA-ARS?s Scientific Manuscript database

The development and application of predictive tools to quantitatively assess the effects of tillage and related management activities should be carefully tested against high quality field data. This study reports on: 1) the calibration and validation of the Root Zone Water Quality Model (RZWQM) to a...

Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

PubMed

Granata, Randy L; Hamilton, Karen

2015-01-01

Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

TQM: A bibliography with abstracts. [total quality management

NASA Technical Reports Server (NTRS)

Gottlich, Gretchen L. (Editor)

1992-01-01

This document is designed to function as a special resource for NASA Langley scientists, engineers, and managers during the introduction and development of total quality management (TQM) practices at the Center. It lists approximately 300 bibliographic citations for articles and reports dealing with various aspects of TQM. Abstracts are also available for the majority of the citations. Citations are organized by broad subject areas, including case studies, customer service, senior management, leadership, communication tools, TQM basics, applications, and implementation. An introduction and indexes provide additional information on arrangement and availability of these materials.

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

PubMed

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

2015-07-01

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

Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

PubMed

Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

2017-09-01

Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

Development of a decision support tool to better manage Alabama's rural public transit vehicles

DOT National Transportation Integrated Search

2000-01-01

In an ongoing effort to improve mobility and quality of life for Alabama's citizens, researchers at the University of Alabama in Huntsville are working to improve the state's ability to manage its rural transit fleet. This fleet management consists o...

Tools to Help the NPDES Program Adapt to Fluctuating Environmental Conditions

EPA Pesticide Factsheets

Climate-related circumstances pose challenges for permittees and permit writers. Managing discharges to protect water quality can be aided by the refinement of the methods, tools and information used to develop and implement NPDES permits and programs.

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

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies.

PubMed

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

2014-03-01

The success of quality-improvement projects relies heavily on both project design and the metrics chosen to assess change. In Part II of this three-part American Thoracic Society Seminars series, we begin by describing methods for determining which data to collect, tools for data presentation, and strategies for data dissemination. As Avedis Donabedian detailed a half century ago, defining metrics in healthcare can be challenging; algorithmic determination of the best type of metric (outcome, process, or structure) can help intensive care unit (ICU) managers begin this process. Choosing appropriate graphical data displays (e.g., run charts) can prompt discussions about and promote quality improvement. Similarly, dashboards/scorecards are useful in presenting performance improvement data either publicly or privately in a visually appealing manner. To have compelling data to show, ICU managers must plan quality-improvement projects well. The second portion of this review details four quality-improvement tools-checklists, Six Sigma methodology, lean thinking, and Kaizen. Checklists have become commonplace in many ICUs to improve care quality; thinking about how to maximize their effectiveness is now of prime importance. Six Sigma methodology, lean thinking, and Kaizen are techniques that use multidisciplinary teams to organize thinking about process improvement, formalize change strategies, actualize initiatives, and measure progress. None originated within healthcare, but each has been used in the hospital environment with success. To conclude this part of the series, we demonstrate how to use these tools through an example of improving the timely administration of antibiotics to patients with sepsis.

A Methodology for Writing High Quality Requirement Specifications and for Evaluating Existing Ones

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore

1999-01-01

Requirements development and management have always been critical in the implementation of software systems-engineers are unable to build what analysts can not define. It is generally accepted that the earlier in the life cycle potential risks are identified the easier it is to eliminate or manage the conditions that introduce that risk. Problems that are not found until testing are approximately 14 times more costly to fix than if the problem was found in the requirement phase. The requirements specification, as the first tangible representation of the capability to be produced, establishes the basis for all of the project's engineering management and assurance functions. If the quality of the requirements specification is poor it can give rise to risks in all areas of the project. Recently, automated tools have become available to support requirements management. The use of these tools not only provides support in the definition and tracing of requirements, but it also opens the door to effective use of metrics in characterizing and assessing the quality of the requirement specifications.

A Methodology for Writing High Quality Requirements Specification and Evaluating Existing Ones

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore

1999-01-01

Requirements development and management have always been critical in the implementation of software systems; engineers are unable to build what analysts can't define. It is generally accepted that the earlier in the life cycle potential risks are identified the easier it is to eliminate or manage the conditions that introduce that risk. Problems that are not found until testing are approximately 14 times more costly to fix than if the problem was found in the requirement phase. The requirements specification, as the first tangible representation of the capability to be produced, establishes the basis for all of the project's engineering management and assurance functions. If the quality of the requirements specification is poor it can give rise to risks in all areas of the project. Recently, automated tools have become available to support requirements management. The use of these tools not only provides support in the definition and tracing of requirements, but it also opens the door to effective use of metrics in characterizing and assessing the quality of the requirement specifications.

Negotiating the COAPRT Learning Outcomes Transition Using Quality Management Tools: A Case Study of the COAPRT Beta Test Site

ERIC Educational Resources Information Center

Ellis, Gary D.

2014-01-01

This paper is a case study. It tells the story of the process that the Council on Accreditation for Parks, Recreation, Tourism and Related Professions beta test site created its learning outcomes assessment program. A planning process was used that has evolved from quality management philosophy and practice: DMADV. Use of DMADV required precise…

EQUAL Candida Score: An ECMM score derived from current guidelines to measure QUAlity of Clinical Candidaemia Management.

PubMed

Mellinghoff, Sibylle C; Hoenigl, Martin; Koehler, Philipp; Kumar, Anil; Lagrou, Katrien; Lass-Flörl, Cornelia; Meis, Jacques F; Menon, Vidya; Rautemaa-Richardson, Riina; Cornely, Oliver A

2018-05-01

Candida species frequently cause blood stream infections and are reported to be the third to tenth most commonly isolated pathogens. Guidelines and standardised treatment algorithms provided by professional organisations aim to facilitate decision-making regarding diagnosis, management and treatment of candidaemia. In routine clinical practise, however, it may be challenging to comply with these guidelines. The reasons include lack of familiarity or feasibility to adherence, but also their length and complexity. There is no tool to measure guideline adherence currently. To provide such a tool, we reviewed the current guidelines provided by the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and by the Infectious Diseases Society of America (IDSA), and selected the strongest recommendations for management quality as the bases for our scoring tool. Factors incorporated were diagnostic (blood cultures, echocardiography, ophthalmoscopy, species identification) and follow-up procedures (repeat blood cultures until negative result) as well as key treatment parameters (echinocandin treatment, step down to fluconazole depending on susceptibility result, CVC removal). The EQUAL Candida Score weighs and aggregates factors recommended for the ideal management of candidaemia and provides a tool for antifungal stewardship as well as for measuring guideline adherence. © 2018 Blackwell Verlag GmbH.

Lay and health care professional understandings of self-management: A systematic review and narrative synthesis

PubMed Central

Wolfe, Charles DA; McKevitt, Christopher

2014-01-01

Objectives: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions. Methods: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts. Results: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional–patient relationship (self-management as a tool to promote compliance; different expectations of responsibility); quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support) and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice). Conclusion: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions. PMID:26770733

Application of a New Integrated Decision Support Tool (i-DST) for Urban Water Infrastructure: Analyzing Water Quality Compliance Pathways for Three Los Angeles Watersheds

NASA Astrophysics Data System (ADS)

Gallo, E. M.; Hogue, T. S.; Bell, C. D.; Spahr, K.; McCray, J. E.

2017-12-01

The water quality of receiving streams and waterbodies in urban watersheds are increasingly polluted from stormwater runoff. The implementation of Green Infrastructure (GI), which includes Low Impact Developments (LIDs) and Best Management Practices (BMPs), within a watershed aim to mitigate the effects of urbanization by reducing pollutant loads, runoff volume, and storm peak flow. Stormwater modeling is generally used to assess the impact of GIs implemented within a watershed. These modeling tools are useful for determining the optimal suite of GIs to maximize pollutant load reduction and minimize cost. However, stormwater management for most resource managers and communities also includes the implementation of grey and hybrid stormwater infrastructure. An integrated decision support tool, called i-DST, that allows for the optimization and comprehensive life-cycle cost assessment of grey, green, and hybrid stormwater infrastructure, is currently being developed. The i-DST tool will evaluate optimal stormwater runoff management by taking into account the diverse economic, environmental, and societal needs associated with watersheds across the United States. Three watersheds from southern California will act as a test site and assist in the development and initial application of the i-DST tool. The Ballona Creek, Dominguez Channel, and Los Angeles River Watersheds are located in highly urbanized Los Angeles County. The water quality of the river channels flowing through each are impaired by heavy metals, including copper, lead, and zinc. However, despite being adjacent to one another within the same county, modeling results, using EPA System for Urban Stormwater Treatment and Analysis INtegration (SUSTAIN), found that the optimal path to compliance in each watershed differs significantly. The differences include varied costs, suites of BMPs, and ancillary benefits. This research analyzes how the economic, physical, and hydrological differences between the three watersheds shape the optimal plan for stormwater management.

Analysis of ETMS Data Quality for Traffic Flow Management Decisions

NASA Technical Reports Server (NTRS)

Chatterji, Gano B.; Sridhar, Banavar; Kim, Douglas

2003-01-01

The data needed for air traffic flow management decision support tools is provided by the Enhanced Traffic Management System (ETMS). This includes both the tools that are in current use and the ones being developed for future deployment. Since the quality of decision support provided by all these tools will be influenced by the quality of the input ETMS data, an assessment of ETMS data quality is needed. Motivated by this desire, ETMS data quality is examined in this paper in terms of the unavailability of flight plans, deviation from the filed flight plans, departure delays, altitude errors and track data drops. Although many of these data quality issues are not new, little is known about their extent. A goal of this paper is to document the magnitude of data quality issues supported by numerical analysis of ETMS data. Guided by this goal, ETMS data for a 24-hour period were processed to determine the number of aircraft with missing flight plan messages at any given instant of time. Results are presented for aircraft above 18,000 feet altitude and also at all altitudes. Since deviation from filed flight plan is also a major cause of trajectory-modeling errors, statistics of deviations are presented. Errors in proposed departure times and ETMS-generated vertical profiles are also shown. A method for conditioning the vertical profiles for improving demand prediction accuracy is described. Graphs of actual sector counts obtained using these vertical profiles are compared with those obtained using the Host data for sectors in the Fort Worth Center to demonstrate the benefit of preprocessing. Finally, results are presented to quantify the extent of data drops. A method for propagating track positions during ETMS data drops is also described.

Database and Analytical Tool Development for the Management of Data Derived from US DOE (NETL) Funded Fine Particulate (PM2.5) Research

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

Robinson Khosah

2007-07-31

Advanced Technology Systems, Inc. (ATS) was contracted by the U. S. Department of Energy's National Energy Technology Laboratory (DOE-NETL) to develop a state-of-the-art, scalable and robust web-accessible database application to manage the extensive data sets resulting from the DOE-NETL-sponsored ambient air monitoring programs in the upper Ohio River valley region. The data management system was designed to include a web-based user interface that will allow easy access to the data by the scientific community, policy- and decision-makers, and other interested stakeholders, while providing detailed information on sampling, analytical and quality control parameters. In addition, the system will provide graphical analyticalmore » tools for displaying, analyzing and interpreting the air quality data. The system will also provide multiple report generation capabilities and easy-to-understand visualization formats that can be utilized by the media and public outreach/educational institutions. The project was conducted in two phases. Phase One included the following tasks: (1) data inventory/benchmarking, including the establishment of an external stakeholder group; (2) development of a data management system; (3) population of the database; (4) development of a web-based data retrieval system, and (5) establishment of an internal quality assurance/quality control system on data management. Phase Two involved the development of a platform for on-line data analysis. Phase Two included the following tasks: (1) development of a sponsor and stakeholder/user website with extensive online analytical tools; (2) development of a public website; (3) incorporation of an extensive online help system into each website; and (4) incorporation of a graphical representation (mapping) system into each website. The project is now technically completed.« less

Internal marketing: creating quality employee experiences in health care organizations.

PubMed

Masri, Maysoun Dimachkie; Oetjen, Dawn; Rotarius, Timothy

2011-01-01

To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

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

PubMed

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

2017-06-01

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

Requirement Metrics for Risk Identification

NASA Technical Reports Server (NTRS)

Hammer, Theodore; Huffman, Lenore; Wilson, William; Rosenberg, Linda; Hyatt, Lawrence

1996-01-01

The Software Assurance Technology Center (SATC) is part of the Office of Mission Assurance of the Goddard Space Flight Center (GSFC). The SATC's mission is to assist National Aeronautics and Space Administration (NASA) projects to improve the quality of software which they acquire or develop. The SATC's efforts are currently focused on the development and use of metric methodologies and tools that identify and assess risks associated with software performance and scheduled delivery. This starts at the requirements phase, where the SATC, in conjunction with software projects at GSFC and other NASA centers is working to identify tools and metric methodologies to assist project managers in identifying and mitigating risks. This paper discusses requirement metrics currently being used at NASA in a collaborative effort between the SATC and the Quality Assurance Office at GSFC to utilize the information available through the application of requirements management tools.

Ace Project as a Project Management Tool

ERIC Educational Resources Information Center

Cline, Melinda; Guynes, Carl S.; Simard, Karine

2010-01-01

The primary challenge of project management is to achieve the project goals and objectives while adhering to project constraints--usually scope, quality, time and budget. The secondary challenge is to optimize the allocation and integration of resources necessary to meet pre-defined objectives. Project management software provides an active…

Clackamas County Public Health: Employee Engagement in Quality Improvement and Performance Management Activities.

PubMed

Mason, Philip

This case report provides an example of a local health department's use of performance management tools across its agency. An emphasis is on engaging staff across all levels of the organization so that employees can understand how their work affects overall performance management.

Use Cases for Combining Web Services with ArcPython Tools for Enabling Quality Control of Land Remote Sensing Data Products.

NASA Astrophysics Data System (ADS)

Krehbiel, C.; Maiersperger, T.; Friesz, A.; Harriman, L.; Quenzer, R.; Impecoven, K.

2016-12-01

Three major obstacles facing big Earth data users include data storage, management, and analysis. As the amount of satellite remote sensing data increases, so does the need for better data storage and management strategies to exploit the plethora of data now available. Standard GIS tools can help big Earth data users whom interact with and analyze increasingly large and diverse datasets. In this presentation we highlight how NASA's Land Processes Distributed Active Archive Center (LP DAAC) is tackling these big Earth data challenges. We provide a real life use case example to describe three tools and services provided by the LP DAAC to more efficiently exploit big Earth data in a GIS environment. First, we describe the Open-source Project for a Network Data Access Protocol (OPeNDAP), which calls to specific data, minimizing the amount of data that a user downloads and improves the efficiency of data downloading and processing. Next, we cover the LP DAAC's Application for Extracting and Exploring Analysis Ready Samples (AppEEARS), a web application interface for extracting and analyzing land remote sensing data. From there, we review an ArcPython toolbox that was developed to provide quality control services to land remote sensing data products. Locating and extracting specific subsets of larger big Earth datasets improves data storage and management efficiency for the end user, and quality control services provides a straightforward interpretation of big Earth data. These tools and services are beneficial to the GIS user community in terms of standardizing workflows and improving data storage, management, and analysis tactics.

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.

SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia.

PubMed

Nguyen, Thuong T; McKinney, Barbara; Pierson, Antoine; Luong, Khue N; Hoang, Quynh T; Meharwal, Sandeep; Carvalho, Humberto M; Nguyen, Cuong Q; Nguyen, Kim T; Bond, Kyle B

2014-01-01

The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors' feedback about usability. The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

Assessment of nutritional status and quality of life in patients treated for head and neck cancer.

PubMed

Prevost, V; Joubert, C; Heutte, N; Babin, E

2014-04-01

The purpose of this study was to identify tools for the assessment of nutritional status in head and neck cancer patients, to evaluate the impact of malnutrition on therapeutic management and quality of life and to propose a simple screening approach adapted to routine clinical practice. The authors conducted a review of the literature to identify tools for the assessment of nutritional status in head and neck cancer patients published in French and English. Articles were obtained from the PubMed database and from the references of these articles and selected journals, using the keywords: "nutritional assessment", and "head and neck" and "cancer". Anthropometric indices, laboratory parameters, dietary intake assessment, clinical scores and nutritional risk scores used in patients with head and neck cancers are presented. The relevance of these tools in clinical practice and in research is discussed, together with the links between nutritional status and quality of life. This article is designed to help teams involved in the management of patients with head and neck cancer to choose the most appropriate tools for assessment of nutritional status according to their resources and their objectives. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Multiple Watershed Scales Approach for Placement of BMPs in SUSTAIN

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads ...

RESEARCH NEEDS IN RIPARIAN BUFFER RESTORATION

EPA Science Inventory

Riparian buffer restorations are used as management tools to produce favorable water quality impacts; moreover, the basis for riparian buffers as an instrument of water quality restoration rests on a relatively firm foundation. However, the extent to which buffers can restore rip...

An analysis of total quality management in Aeronautical Systems Division

NASA Astrophysics Data System (ADS)

Caudle, Mark D.

1991-09-01

This study investigated the major schools of thought on various aspects of quality management and quality improvement. Areas covered included definitions of waste and quality, views on the cost of quality, tools and techniques used for quality improvement, and management philosophies and frameworks for continuous improvement. In addition, this study analyzed the structure and training content of the current Total Quality Management program at Aeronautical Systems Division (ASD). Pre- and post-test surveys on employee attitudes toward organizational effectiveness were analyzed from the Advanced Cruise Missile System Program Office (SPO), the F-15 SPO, and the ASD Deputy Chief of Staff for Human Resources (ASD/DP). Data was supplemented with semi-structured, personal interviews with ASD personnel involved in TQM. Survey analysis showed that the ACM SPO significantly improved, ASD/DP significantly digressed, and the F-15 SPO remained basically consistent. This led to the conclusion that ASD allows too much flexibility in the implementation of TQM in the three-letter organizations.

Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition.

PubMed

Kergoat, Marie-Jeanne; Leclerc, Bernard-Simon; Leduc, Nicole; Latour, Judith; Berg, Katherine; Bolduc, Aline

2009-07-29

The number of elderly people requiring hospital care is growing, so, quality and assessment of care for elders are emerging and complex areas of research. Very few validated and reliable instruments exist for the assessment of quality of acute care in this field. This study's objective was to create such a tool for Geriatric Evaluation and Management Units (GEMUs). The methodology involved a reliability and feasibility study of a retrospective chart review on 934 older inpatients admitted in 49 GEMUs during the year 2002-2003 for fall-related trauma as a tracer condition. Pertinent indicators for a chart abstraction tool, the Geriatric Care Tool (GCT), were developed and validated according to five dimensions: access to care, comprehensiveness, continuity of care, patient-centred care and appropriateness. Consensus methods were used to develop the content. Participants were experts representing eight main health care professions involved in GEMUs from 19 different sites. Items associated with high quality of care at each step of the multidisciplinary management of patients admitted due to falls were identified. The GCT was tested for intra- and inter-rater reliability using 30 medical charts reviewed by each of three independent and blinded trained nurses. Kappa and agreement measures between pairs of chart reviewers were computed on an item-by-item basis. Three quarters of 169 items identifying the process of care, from the case history to discharge planning, demonstrated good agreement (kappa greater than 0.40 and agreement over 70%). Indicators for the appropriateness of care showed less reliability. Content validity and reliability results, as well as the feasibility of the process, suggest that the chart abstraction tool can gather standardized and pertinent clinical information for further evaluating quality of care in GEMU using admission due to falls as a tracer condition. However, the GCT should be evaluated in other models of acute geriatric units and new strategies should be developed to improve reliability of peer assessments in characterizing the quality of care for elderly patients with complex conditions.

Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score.

PubMed

Ramnarayan, Padmanabhan; Kapoor, Ritika R; Coren, Michael; Nanduri, Vasantha; Tomlinson, Amanda L; Taylor, Paul M; Wyatt, Jeremy C; Britto, Joseph F

2003-01-01

Few previous studies evaluating the benefits of diagnostic decision support systems have simultaneously measured changes in diagnostic quality and clinical management prompted by use of the system. This report describes a reliable and valid scoring technique to measure the quality of clinical decision plans in an acute medical setting, where diagnostic decision support tools might prove most useful. Sets of differential diagnoses and clinical management plans generated by 71 clinicians for six simulated cases, before and after decision support from a Web-based pediatric differential diagnostic tool (ISABEL), were used. A composite quality score was calculated separately for each diagnostic and management plan by considering the appropriateness value of each component diagnostic or management suggestion, a weighted sum of individual suggestion ratings, relevance of the entire plan, and its comprehensiveness. The reliability and validity (face, concurrent, construct, and content) of these two final scores were examined. Two hundred fifty-two diagnostic and 350 management suggestions were included in the interrater reliability analysis. There was good agreement between raters (intraclass correlation coefficient, 0.79 for diagnoses, and 0.72 for management). No counterintuitive scores were demonstrated on visual inspection of the sets. Content validity was verified by a consultation process with pediatricians. Both scores discriminated adequately between the plans of consultants and medical students and correlated well with clinicians' subjective opinions of overall plan quality (Spearman rho 0.65, p < 0.01). The diagnostic and management scores for each episode showed moderate correlation (r = 0.51). The scores described can be used as key outcome measures in a larger study to fully assess the value of diagnostic decision aids, such as the ISABEL system.

After-School Toolkit: Tips, Techniques and Templates for Improving Program Quality

ERIC Educational Resources Information Center

Gutierrez, Nora; Bradshaw, Molly; Furano, Kathryn

2008-01-01

This toolkit offers program managers a hands-on guide for implementing quality programming in the after-school hours. The kit includes tools and techniques that increased the quality of literacy programming and helped improve student reading gains in the Communities Organizing Resources to Advance Learning (CORAL) initiative of The James Irvine…

A survey-based benchmarking approach for health care using the Baldrige quality criteria.

PubMed

Jennings, K; Westfall, F

1994-09-01

Since 1988, manufacturing and service industries have been using the Malcolm Baldrige National Quality Award to assess their management processes (for example, leadership, information, and analysis) against critical performance criteria. Recognizing that the typical Baldrige assessment is time intensive and dependent on intensive training, The Pacer Group, a consulting firm in Dayton, Ohio, developed a self-assessment tool based on the Baldrige criteria which provides a snapshot assessment of an organization's management practices. The survey was administered at 25 hospitals within a health care system. Hospitals were able to compare their scores with other hospitals in the system, as well as the scores of a Baldrige award winner. Results were also analyzed on a systemwide basis to identify strengths and weaknesses across the system. For all 25 hospitals, the following areas were identified as strengths: management of process quality, leadership, and customer focus and satisfaction. Weaknesses included lack of employee involvement in the quality planning process, poor design of quality systems, and lack of cross-departmental cooperation. One of the surveyed hospitals launched improvement initiatives in knowledge of improvement tools and methods and in a patient satisfaction focus. A team was formed to improve the human resource management system. Also, a new unit was designed using patient-centered care principles. A team re-evaluated every operation that affected patients on the unit. A survey modeled after the Baldrige Award criteria can be useful in benchmarking an organization's quality improvement practices.

Enhancing wind erosion monitoring and assessment for U.S. rangelands

USGS Publications Warehouse

Webb, Nicholas P.; Van Zee, Justin W.; Karl, Jason W.; Herrick, Jeffrey E.; Courtright, Ericha M.; Billings, Benjamin J.; Boyd, Robert C.; Chappell, Adrian; Duniway, Michael C.; Derner, Justin D.; Hand, Jenny L.; Kachergis, Emily; McCord, Sarah E.; Newingham, Beth A.; Pierson, Frederick B.; Steiner, Jean L.; Tatarko, John; Tedela, Negussie H.; Toledo, David; Van Pelt, R. Scott

2017-01-01

On the GroundWind erosion is a major resource concern for rangeland managers because it can impact soil health, ecosystem structure and function, hydrologic processes, agricultural production, and air quality.Despite its significance, little is known about which landscapes are eroding, by how much, and when.The National Wind Erosion Research Network was established in 2014 to develop tools for monitoring and assessing wind erosion and dust emissions across the United States.The Network, currently consisting of 13 sites, creates opportunities to enhance existing rangeland soil, vegetation, and air quality monitoring programs.Decision-support tools developed by the Network will improve the prediction and management of wind erosion across rangeland ecosystems.

[The conceptual bases for an entrepreneurial management of local health systems].

PubMed

Yepes, F J; Durán-Arenas, L

1994-01-01

Health management has become a fashion and it is now common to talk about strategic or service management, or of total quality management applied to health systems. However, all these elements of business management are being translated to health systems without a previous analysis on the implicit health model and the rationality of the prevalent production functions, which can lead to a higher level of efficiency but with an inadequate use of resources. This paper suggests the importance of integrating the advances in management and health sciences and proposes what are considered to be the conceptual basis for the design of a management tool geared to conduct local health systems with effectiveness, efficiency, quality and equity.

Developments to the Sylvan stand structure model to describe wood quality changes in southern bottomland hardwood forests because of forest management

Treesearch

Ian R. Scott

2009-01-01

Growth models can produce a wealth of detailed information that is often very difficult to perceive because it is frequently presented either as summary tables, stand view or landscape view visualizations. We have developed new tools for use with the Sylvan model (Larsen 1994) that allow the analysis of wood-quality changes as a consequence of forest management....

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

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

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

Data management in clinical research: An overview

PubMed Central

Krishnankutty, Binny; Bellary, Shantala; Kumar, Naveen B.R.; Moodahadu, Latha S.

2012-01-01

Clinical Data Management (CDM) is a critical phase in clinical research, which leads to generation of high-quality, reliable, and statistically sound data from clinical trials. This helps to produce a drastic reduction in time from drug development to marketing. Team members of CDM are actively involved in all stages of clinical trial right from inception to completion. They should have adequate process knowledge that helps maintain the quality standards of CDM processes. Various procedures in CDM including Case Report Form (CRF) designing, CRF annotation, database designing, data-entry, data validation, discrepancy management, medical coding, data extraction, and database locking are assessed for quality at regular intervals during a trial. In the present scenario, there is an increased demand to improve the CDM standards to meet the regulatory requirements and stay ahead of the competition by means of faster commercialization of product. With the implementation of regulatory compliant data management tools, CDM team can meet these demands. Additionally, it is becoming mandatory for companies to submit the data electronically. CDM professionals should meet appropriate expectations and set standards for data quality and also have a drive to adapt to the rapidly changing technology. This article highlights the processes involved and provides the reader an overview of the tools and standards adopted as well as the roles and responsibilities in CDM. PMID:22529469

Simplified Metadata Curation via the Metadata Management Tool

NASA Astrophysics Data System (ADS)

Shum, D.; Pilone, D.

2015-12-01

The Metadata Management Tool (MMT) is the newest capability developed as part of NASA Earth Observing System Data and Information System's (EOSDIS) efforts to simplify metadata creation and improve metadata quality. The MMT was developed via an agile methodology, taking into account inputs from GCMD's science coordinators and other end-users. In its initial release, the MMT uses the Unified Metadata Model for Collections (UMM-C) to allow metadata providers to easily create and update collection records in the ISO-19115 format. Through a simplified UI experience, metadata curators can create and edit collections without full knowledge of the NASA Best Practices implementation of ISO-19115 format, while still generating compliant metadata. More experienced users are also able to access raw metadata to build more complex records as needed. In future releases, the MMT will build upon recent work done in the community to assess metadata quality and compliance with a variety of standards through application of metadata rubrics. The tool will provide users with clear guidance as to how to easily change their metadata in order to improve their quality and compliance. Through these features, the MMT allows data providers to create and maintain compliant and high quality metadata in a short amount of time.

Knowledge management in a waste based biorefinery in the QbD paradigm.

PubMed

Rathore, Anurag S; Chopda, Viki R; Gomes, James

2016-09-01

Shifting resource base from fossil feedstock to renewable raw materials for production of chemical products has opened up an area of novel applications of industrial biotechnology-based process tools. This review aims to provide a concise and focused discussion on recent advances in knowledge management to facilitate efficient and optimal operation of a biorefinery. Application of quality by design (QbD) and process analytical technology (PAT) as tools for knowledge creation and management at different levels has been highlighted. Role of process integration, government policies, knowledge exchange through collaboration, and use of databases and computational tools have also been touched upon. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reflective action assessment with a prospective clinical problem solving tool in the context of rehabilitation medicine: an illustrative case study.

PubMed

Kellett, David; Mpofu, Elias; Madden, Richard

2013-06-01

This study describes a case formulation approach applying a prospective ICF derived clinical tool to assess rehabilitation needs for a community dwelling stroke survivor with care from an outpatient rehabilitation medicine clinic. Case history data on the person were assessed for rehabilitation management planning using a prospective tool to interlink current with projected future functional status in everyday settings. Implicit assessment with reflective action informed decision points at each stage of the rehabilitation process. As a result of reflective action using the prospective tool, rehabilitation management led to significant changes in client participation after limitations to mobility and self care were mapped to the living conditions of the stroke survivor. The context sensitive rehabilitative plan resulted in higher subjective health-related quality of life in the stroke survivor and significant other and enhanced their capacity for participation. Reflective action informed assessment applying ICF concepts to clinical problem solving resulted in positive gains in health-related quality of life in a stroke survivor.

Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives.

PubMed

Mehta, N; Williams, R J; Smith, M E; Hall, A; Hardman, J C; Cheung, L; Ellis, M P; Fussey, J M; Lakhani, R; McLaren, O; Nankivell, P C; Sharma, N; Yeung, W; Carrie, S; Hopkins, C

2017-06-01

To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data. Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires. Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5). This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.

Quality improvement in neonatal digital radiography: implementing the basic quality improvement tools.

PubMed

Eslamy, Hedieh K; Newman, Beverley; Weinberger, Ed

2014-12-01

A quality improvement (QI) program may be implemented using the plan-do-study-act cycle (as a model for making improvements) and the basic QI tools (used to visually display and analyze variation in data). Managing radiation dose has come to the forefront as a safety goal for radiology departments. This is especially true in the pediatric population, which is more radiosensitive than the adult population. In this article, we use neonatal digital radiography to discuss developing a QI program with the principle goals of decreasing the radiation dose, decreasing variation in radiation dose, and optimizing image quality. Copyright © 2014 Elsevier Inc. All rights reserved.

[The basis of modern technologies in management of health care system].

PubMed

Nemytin, Iu V

2014-12-01

For the development of national heaIth care it is required to implement modern and effective methods and forms of governance. It is necessary to clearly identify transition to process management followed by an introduction of quality management care. It is necessary to create a complete version of the three-level health care system based on the integration into the system "Clinic - Hospital - Rehabilitation", which will ensure resource conservation in general throughout the industry. The most important task is purposeful comprehensive management training for health care--statesmen who have the potential ability to manage. The leader must possess all forms of management and apply them on a scientific basis. Standards and other tools of health management should constantly improve. Standards should be a teaching tool and help to improve the quality and effectiveness of treatment processes, the transition to the single-channel financing--the most advanced form of payment for the medical assistance. This type of financing requires managers to new management approaches, knowledge of business economics. One of the breakthrough objectives is the creation of a new type of health care organizations, which as lead locomotives for a rest.

Developing Cyberinfrastructure Tools and Services for Metadata Quality Evaluation

NASA Astrophysics Data System (ADS)

Mecum, B.; Gordon, S.; Habermann, T.; Jones, M. B.; Leinfelder, B.; Powers, L. A.; Slaughter, P.

2016-12-01

Metadata and data quality are at the core of reusable and reproducible science. While great progress has been made over the years, much of the metadata collected only addresses data discovery, covering concepts such as titles and keywords. Improving metadata beyond the discoverability plateau means documenting detailed concepts within the data such as sampling protocols, instrumentation used, and variables measured. Given that metadata commonly do not describe their data at this level, how might we improve the state of things? Giving scientists and data managers easy to use tools to evaluate metadata quality that utilize community-driven recommendations is the key to producing high-quality metadata. To achieve this goal, we created a set of cyberinfrastructure tools and services that integrate with existing metadata and data curation workflows which can be used to improve metadata and data quality across the sciences. These tools work across metadata dialects (e.g., ISO19115, FGDC, EML, etc.) and can be used to assess aspects of quality beyond what is internal to the metadata such as the congruence between the metadata and the data it describes. The system makes use of a user-friendly mechanism for expressing a suite of checks as code in popular data science programming languages such as Python and R. This reduces the burden on scientists and data managers to learn yet another language. We demonstrated these services and tools in three ways. First, we evaluated a large corpus of datasets in the DataONE federation of data repositories against a metadata recommendation modeled after existing recommendations such as the LTER best practices and the Attribute Convention for Dataset Discovery (ACDD). Second, we showed how this service can be used to display metadata and data quality information to data producers during the data submission and metadata creation process, and to data consumers through data catalog search and access tools. Third, we showed how the centrally deployed DataONE quality service can achieve major efficiency gains by allowing member repositories to customize and use recommendations that fit their specific needs without having to create de novo infrastructure at their site.

Measuring quality in services for children with an intellectual disability.

PubMed

Koornneef, Erik

2006-01-01

To evaluate the application of one particular quality measurement tool, the SERVQUAL instrument, as a potential mechanism to measure quality in services for children with disabilities Staff and family of children with an intellectual disability in two organisations providing specialist therapy and day completed an adapted SERVQUAL questionnaire. A total of 81 SERVQUAL questionnaires were distributed and 59 questionnaires were returned (response rate of 73 per cent). The SERVQUAL instrument can be considered as a useful diagnostic tool to identify particular strengths and areas for improvement in services for people with disabilities as the instrument lends itself for the monitoring of the effectiveness of quality improvement initiatives over time. The findings also showed relatively high customer expectations and the organisations involved in this research are currently not meeting all of these high expectations as significant quality gaps were found in the areas of reliability and responsiveness. The sample size was relatively small and the measurement of quality using the SERVQUAL instrument remains a challenge, due to the conceptual and empirical difficulties. The SERVQUAL instrument is probably most be attractive to service managers and funding organisations because of its ability to identify gaps in the quality of the service. The tool had been used to measure quality in services for people with disabilities and the research has shown that this tool might be an important additional quality measurement tool for services.

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

PubMed

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

Adaptive Management Methods to Protect the California Sacramento-San Joaquin Delta Water Resource

NASA Technical Reports Server (NTRS)

Bubenheim, David

2016-01-01

The California Sacramento-San Joaquin River Delta is the hub for California's water supply, conveying water from Northern to Southern California agriculture and communities while supporting important ecosystem services, agriculture, and communities in the Delta. Changes in climate, long-term drought, water quality changes, and expansion of invasive aquatic plants threatens ecosystems, impedes ecosystem restoration, and is economically, environmentally, and sociologically detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California and local governments to develop science-based, adaptive-management strategies for the Sacramento-San Joaquin Delta. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and waterway managers make science-informed decisions regarding management and outcomes. The team provides a comprehensive understanding of agricultural and urban land use in the Delta and the major water sheds (San Joaquin/Sacramento) supplying the Delta and interaction with drought and climate impacts on the environment, water quality, and weed growth. The team recommends conservation and modified land-use practices and aids local Delta stakeholders in developing management strategies. New remote sensing tools have been developed to enhance ability to assess conditions, inform decision support tools, and monitor management practices. Science gaps in understanding how native and invasive plants respond to altered environmental conditions are being filled and provide critical biological response parameters for Delta-SWAT simulation modeling. Operational agencies such as the California Department of Boating and Waterways provide testing and act as initial adopter of decision support tools. Methods developed by the project can become routine land and water management tools in complex river delta systems.

Remote Sensing and Modeling for Improving Operational Aquatic Plant Management

NASA Technical Reports Server (NTRS)

Bubenheim, Dave

2016-01-01

The California Sacramento-San Joaquin River Delta is the hub for California’s water supply, conveying water from Northern to Southern California agriculture and communities while supporting important ecosystem services, agriculture, and communities in the Delta. Changes in climate, long-term drought, water quality changes, and expansion of invasive aquatic plants threatens ecosystems, impedes ecosystem restoration, and is economically, environmentally, and sociologically detrimental to the San Francisco Bay/California Delta complex. NASA Ames Research Center and the USDA-ARS partnered with the State of California and local governments to develop science-based, adaptive-management strategies for the Sacramento-San Joaquin Delta. The project combines science, operations, and economics related to integrated management scenarios for aquatic weeds to help land and waterway managers make science-informed decisions regarding management and outcomes. The team provides a comprehensive understanding of agricultural and urban land use in the Delta and the major water sheds (San Joaquin/Sacramento) supplying the Delta and interaction with drought and climate impacts on the environment, water quality, and weed growth. The team recommends conservation and modified land-use practices and aids local Delta stakeholders in developing management strategies. New remote sensing tools have been developed to enhance ability to assess conditions, inform decision support tools, and monitor management practices. Science gaps in understanding how native and invasive plants respond to altered environmental conditions are being filled and provide critical biological response parameters for Delta-SWAT simulation modeling. Operational agencies such as the California Department of Boating and Waterways provide testing and act as initial adopter of decision support tools. Methods developed by the project can become routine land and water management tools in complex river delta systems.

Multiple Watershed Scales Approach for Placement of Best Managemnet Practices in SUSTAIN

EPA Science Inventory

Watershed and stormwater managers need modeling tools to evaluate how best to address environmental quality restoration and protection needs in urban and developing areas. Significant investments are needed to protect and restore water quality, address total maximum daily loads ...

Comparison of Measured to Predicted Estimations of Nonpoint Source Contaminants Using Conservation Practices in an Agriculturally-Dominated Watershed in Northeast Arkansas, USA.

PubMed

Frasher, Sarah K; Woodruff, Tracy M; Bouldin, Jennifer L

2016-06-01

In efforts to reduce nonpoint source runoff and improve water quality, Best Management Practices (BMPs) were implemented in the Outlet Larkin Creek Watershed. Farmers need to make scientifically informed decisions concerning BMPs addressing contaminants from agricultural fields. The BMP Tool was developed from previous studies to estimate BMP effectiveness at reducing nonpoint source contaminants. The purpose of this study was to compare the measured percent reduction of dissolved phosphorus (DP) and total suspended solids to the reported percent reductions from the BMP Tool for validation. Similarities were measured between the BMP Tool and the measured water quality parameters. Construction of a sedimentation pond resulted in 74 %-76 % reduction in DP as compared to 80 % as predicted with the BMP Tool. However, further research is needed to validate the tool for additional water quality parameters. The BMP Tool is recommended for future BMP implementation as a useful predictor for farmers.

SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia

PubMed Central

Nguyen, Thuong T.; McKinney, Barbara; Pierson, Antoine; Luong, Khue N.; Hoang, Quynh T.; Meharwal, Sandeep; Carvalho, Humberto M.; Nguyen, Cuong Q.; Nguyen, Kim T.

2014-01-01

Background The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. Development of e-Tool In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors’ feedback about usability. Outcomes The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries. PMID:29043190

Quality Improvement Project: Replacing the Numeric Rating Scale with a Clinically Aligned Pain Assessment (CAPA) Tool.

PubMed

Topham, Debra; Drew, Debra

2017-12-01

CAPA is a multifaceted pain assessment tool that was adopted at a large tertiary Midwest hospital to replace the numeric scale for adult patients who could self-report their pain experience. This article describes the process of implementation and the effect on patient satisfaction scores. Use of the tool is supported by the premise that pain assessment entails more than just pain intensity and that assessment is an exchange of meaning between patients and clinicians dependent on internal and external factors. Implementation of the tool was a transformative process resulting in modest increases in patient satisfaction scores with pain management. Patient reports that "staff did everything to manage pain" had the biggest gains and were sustained for more than 2 years. The CAPA tool meets regulatory requirements for pain assessment. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

[Evaluation of the "initiative pain-free clinic" for quality improvement in postoperative pain management. A prospective controlled study].

PubMed

Lehmkuhl, D; Meissner, W; Neugebauer, E A M

2011-09-01

Demonstration of improved postoperative pain management by implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, by the integrated quality management concept "quality management acute pain" of the TÜV Rheinland or by participation in the benchmark project "Quality improvement in postoperative pain management" (QUIPS). A prospective controlled study (pre-post design) was carried out in hospitals with various levels of care comparing three hospital groups (n = 17/7/3, respectively). Group 1: participation in the QUIPS project (intraclinic and interclinic comparison of outcome data of postoperative pain treatment), group 2: participation in the quality management acute pain program (certified by TÜV Rheinland), group 3: control group with no involvement in either of the two concepts. In all three groups, an anonymous data collection was performed consisting of patient-reported pain intensity, side effects, pain disability and patient satisfaction. Pain therapy intervention was carried out only in group 2 by an integrated quality management concept (certification project: Quality management acute pain) with a package of measures to improve structure, process and outcome quality. The TÜV Rheinland certified clinics (group 2) showed a significant improvement in the pre-post comparison (before versus after certification) in the areas maximum pain (from visual analogue scale VAS 4.6 to 3.7), stress pain (5.3 to 3.9), pain-related impairment (proportion of patients with pain-linked decreased mobility and movement 26% to 16.1%, coughing and breathing 23.1% to 14.3%) and patient satisfaction (from 13.2 to 13.7; scale 0 completely unsatisfied, 15 very satisfied). The clinics with participation in QUIPS for 2 years also showed a significant improvement in stress pain (numeric rating scale NRS for pain 4.5 to 4.2), pain-linked-limitation of coughing and breathing (28% to 23.6%), and patient satisfaction (from 11.9 to 12.4). There were no differences in postoperative nausea and vomiting between any of the groups. The main objective of the certification concept quality management acute pain as a tool for the successful implementation of the S3 guidelines on treatment of acute perioperative and posttraumatic pain, led to a significant improvement in patient outcome. Participation in QUIPS is an ideal supplement to TÜV Rheinland certification and can be recommended as a benchmarking tool to evaluate outcome.

The quest for quality and productivity in health services.

PubMed

Sahney, V K; Warden, G L

1991-01-01

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

Balanced scorecards for performance management.

PubMed

Park, Eun-Jun; Huber, Diane L

2007-01-01

Nurse administrators who manage nursing case management programs are challenged to demonstrate the improved quality of patient care and financial outcomes to their organization that result from such programs. This article introduces the balanced scorecard and discusses its benefits and practical concerns for adopting the scorecard. The balanced scorecard is a useful performance management tool used to both evaluate and direct case management performance in meeting organizational missions and strategies.

Self-Management Plan, Perceived Quality of Life and Medical Resource Utilization of Asthmatic Children.

DTIC Science & Technology

1997-05-07

quality of life , however, has not been addressed. This descriptive, correlational study compared the perceived quality of life and number of...not adhere to a plan. Quality of life was measured using the Childhood Asthma Questionnaire, a valid and reliable quality of life measurement tool for...children of different ages. There were no significant differences between the Adherence and Non-adherence groups relative to quality of life

Streamlining the Online Course Development Process by Using Project Management Tools

ERIC Educational Resources Information Center

Abdous, M'hammed; He, Wu

2008-01-01

Managing the design and production of online courses is challenging. Insufficient instructional design and inefficient management often lead to issues such as poor course quality and course delivery delays. In an effort to facilitate, streamline, and improve the overall design and production of online courses, this article discusses how we…

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 systems and quality risk management.

Optimising the use of observational electronic health record data: Current issues, evolving opportunities, strategies and scope for collaboration.

PubMed

Liaw, Siaw-Teng; Powell-Davies, Gawaine; Pearce, Christopher; Britt, Helena; McGlynn, Lisa; Harris, Mark F

2016-03-01

With increasing computerisation in general practice, national primary care networks are mooted as sources of data for health services and population health research and planning. Existing data collection programs - MedicinesInsight, Improvement Foundation, Bettering the Evaluation and Care of Health (BEACH) - vary in purpose, governance, methodologies and tools. General practitioners (GPs) have significant roles as collectors, managers and users of electronic health record (EHR) data. They need to understand the challenges to their clinical and managerial roles and responsibilities. The aim of this article is to examine the primary and secondary use of EHR data, identify challenges, discuss solutions and explore directions. Representatives from existing programs, Medicare Locals, Local Health Districts and research networks held workshops on the scope, challenges and approaches to the quality and use of EHR data. Challenges included data quality, interoperability, fragmented governance, proprietary software, transparency, sustainability, competing ethical and privacy perspectives, and cognitive load on patients and clinicians. Proposed solutions included effective change management; transparent governance and management of intellectual property, data quality, security, ethical access, and privacy; common data models, metadata and tools; and patient/community engagement. Collaboration and common approaches to tools, platforms and governance are needed. Processes and structures must be transparent and acceptable to GPs.

Free web-based modelling platform for managed aquifer recharge (MAR) applications

NASA Astrophysics Data System (ADS)

Stefan, Catalin; Junghanns, Ralf; Glaß, Jana; Sallwey, Jana; Fatkhutdinov, Aybulat; Fichtner, Thomas; Barquero, Felix; Moreno, Miguel; Bonilla, José; Kwoyiga, Lydia

2017-04-01

Managed aquifer recharge represents a valuable instrument for sustainable water resources management. The concept implies purposeful infiltration of surface water into underground for later recovery or environmental benefits. Over decades, MAR schemes were successfully installed worldwide for a variety of reasons: to maximize the natural storage capacity of aquifers, physical aquifer management, water quality management, and ecological benefits. The INOWAS-DSS platform provides a collection of free web-based tools for planning, management and optimization of main components of MAR schemes. The tools are grouped into 13 specific applications that cover most relevant challenges encountered at MAR sites, both from quantitative and qualitative perspectives. The applications include among others the optimization of MAR site location, the assessment of saltwater intrusion, the restoration of groundwater levels in overexploited aquifers, the maximization of natural storage capacity of aquifers, the improvement of water quality, the design and operational optimization of MAR schemes, clogging development and risk assessment. The platform contains a collection of about 35 web-based tools of various degrees of complexity, which are either included in application specific workflows or used as standalone modelling instruments. Among them are simple tools derived from data mining and empirical equations, analytical groundwater related equations, as well as complex numerical flow and transport models (MODFLOW, MT3DMS and SEAWAT). Up to now, the simulation core of the INOWAS-DSS, which is based on the finite differences groundwater flow model MODFLOW, is implemented and runs on the web. A scenario analyser helps to easily set up and evaluate new management options as well as future development such as land use and climate change and compare them to previous scenarios. Additionally simple tools such as analytical equations to assess saltwater intrusion are already running online. Besides the simulation tools, a web-based data base is under development where geospatial and time series data can be stored, managed, and processed. Furthermore, a web-based information system containing user guides for the various developed tools and applications as well as basic information on MAR and related topics is published and will be regularly expanded as new tools are getting implemented. The INOWAS-DSS including its simulation tools, data base and information system provides an extensive framework to manage, plan and optimize MAR facilities. As the INOWAS-DSS is an open-source software accessible via the internet using standard web browsers, it offers new ways for data sharing and collaboration among various partners and decision makers.

Evaluating Digital Authoring Tools

ERIC Educational Resources Information Center

Wilde, Russ

2004-01-01

As the quality of authoring software increases, online course developers become less reliant on proprietary learning management systems, and develop skills in the design of original, in-house materials and the delivery platforms for them. This report examines the capabilities of digital authoring software tools for the development of learning…

PICASSO: an end-to-end image simulation tool for space and airborne imaging systems

NASA Astrophysics Data System (ADS)

Cota, Steve A.; Bell, Jabin T.; Boucher, Richard H.; Dutton, Tracy E.; Florio, Chris J.; Franz, Geoffrey A.; Grycewicz, Thomas J.; Kalman, Linda S.; Keller, Robert A.; Lomheim, Terrence S.; Paulson, Diane B.; Willkinson, Timothy S.

2008-08-01

The design of any modern imaging system is the end result of many trade studies, each seeking to optimize image quality within real world constraints such as cost, schedule and overall risk. Image chain analysis - the prediction of image quality from fundamental design parameters - is an important part of this design process. At The Aerospace Corporation we have been using a variety of image chain analysis tools for many years, the Parameterized Image Chain Analysis & Simulation SOftware (PICASSO) among them. In this paper we describe our PICASSO tool, showing how, starting with a high quality input image and hypothetical design descriptions representative of the current state of the art in commercial imaging satellites, PICASSO can generate standard metrics of image quality in support of the decision processes of designers and program managers alike.

PICASSO: an end-to-end image simulation tool for space and airborne imaging systems

NASA Astrophysics Data System (ADS)

Cota, Stephen A.; Bell, Jabin T.; Boucher, Richard H.; Dutton, Tracy E.; Florio, Christopher J.; Franz, Geoffrey A.; Grycewicz, Thomas J.; Kalman, Linda S.; Keller, Robert A.; Lomheim, Terrence S.; Paulson, Diane B.; Wilkinson, Timothy S.

2010-06-01

The design of any modern imaging system is the end result of many trade studies, each seeking to optimize image quality within real world constraints such as cost, schedule and overall risk. Image chain analysis - the prediction of image quality from fundamental design parameters - is an important part of this design process. At The Aerospace Corporation we have been using a variety of image chain analysis tools for many years, the Parameterized Image Chain Analysis & Simulation SOftware (PICASSO) among them. In this paper we describe our PICASSO tool, showing how, starting with a high quality input image and hypothetical design descriptions representative of the current state of the art in commercial imaging satellites, PICASSO can generate standard metrics of image quality in support of the decision processes of designers and program managers alike.

Effects and Implications of Self-Management for Students with Autism: A Meta-Analysis

ERIC Educational Resources Information Center

Lee, Suk-Hyang; Simpson, Richard L.; Shogren, Karrie A.

2007-01-01

Self-management for students with autism is important both as a management tool and as a means to enhance students' quality of life by empowering them to control their own behavior. This article reports the results of an examination of the efficacy of self-management for increasing appropriate behavior of children and youth with autism.…

An Expert System for Environmental Data Management.

ERIC Educational Resources Information Center

Berka, Petr; Jirku, Petr

1995-01-01

Examines the possibility of using expert system tools for environmental data management. Describes the domain-independent expert system shell SAK and Knowledge EXplorer, a system that learns rules from data. Demonstrates the functionality of Knowledge EXplorer on an example of water quality evaluation. (LZ)

Total Quality Improvement Guide for Institutions of Higher Education.

ERIC Educational Resources Information Center

Cornesky, Robert A.; McCool, Samuel A.

This book describes the steps and tools of Total Quality Management (TQM) and their use in the academic units of colleges and universities for Total Quality Improvement (TQI), illustrated by a case study from the School of Arts & Sciences at a state university. Section 1 explains how to: (1) identify problems contributing to non-value-added…

Assessing and Managing Quality of Information Assurance

DTIC Science & Technology

2010-11-01

such as firewalls, antivirus scanning tools and mechanisms for user authentication and authorization. Advanced mission-critical systems often...imply increased risk to DoD information systems. The Process and Organizational Maturity (POM) class focuses on the maturity of the software and...include architectural quality. Common Weakness Enumeration (CWE) is a recent example that highlights the connection between software quality and

TH-C-18A-08: A Management Tool for CT Dose Monitoring, Analysis, and Protocol Review

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

Wang, J; Chan, F; Newman, B

2014-06-15

Purpose: To develop a customizable tool for enterprise-wide managing of CT protocols and analyzing radiation dose information of CT exams for a variety of quality control applications Methods: All clinical CT protocols implemented on the 11 CT scanners at our institution were extracted in digital format. The original protocols had been preset by our CT management team. A commercial CT dose tracking software (DoseWatch,GE healthcare,WI) was used to collect exam information (exam date, patient age etc.), scanning parameters, and radiation doses for all CT exams. We developed a Matlab-based program (MathWorks,MA) with graphic user interface which allows to analyze themore » scanning protocols with the actual dose estimates, and compare the data to national (ACR,AAPM) and internal reference values for CT quality control. Results: The CT protocol review portion of our tool allows the user to look up the scanning and image reconstruction parameters of any protocol on any of the installed CT systems among about 120 protocols per scanner. In the dose analysis tool, dose information of all CT exams (from 05/2013 to 02/2014) was stratified on a protocol level, and within a protocol down to series level, i.e. each individual exposure event. This allows numerical and graphical review of dose information of any combination of scanner models, protocols and series. The key functions of the tool include: statistics of CTDI, DLP and SSDE, dose monitoring using user-set CTDI/DLP/SSDE thresholds, look-up of any CT exam dose data, and CT protocol review. Conclusion: our inhouse CT management tool provides radiologists, technologists and administration a first-hand near real-time enterprise-wide knowledge on CT dose levels of different exam types. Medical physicists use this tool to manage CT protocols, compare and optimize dose levels across different scanner models. It provides technologists feedback on CT scanning operation, and knowledge on important dose baselines and thresholds.« less

Risk-based Process Development of Biosimilars as Part of the Quality by Design Paradigm.

PubMed

Zalai, Dénes; Dietzsch, Christian; Herwig, Christoph

2013-01-01

In the last few years, several quality by design (QbD) studies demonstrated the benefit of systematic approaches for biopharmaceutical development. However, only very few studies identified biosimilars as a special case of product development. The targeted quality profile of biosimilars is strictly defined by the originator's product characteristic. Moreover, the major source of prior knowledge is the experience with the originator product itself. Processing this information in biosimilar development has a major effect on risk management and process development strategies. The main objective of this contribution is to demonstrate how risk management can facilitate the implementation of QbD in early-stage product development with special emphasis on fitting the reported approaches to biosimilars. Risk assessments were highlighted as important tools to integrate prior knowledge in biosimilar development. The risk assessment process as suggested by the International Conference on Harmonization (ICH Q9) was reviewed and three elements were identified to play a key role in targeted risk assessment approaches: proper understanding of target linkage, risk assessment tool compliance, and criticality threshold value. Adjusting these steps to biosimilar applications helped to address some unique challenges of these products such as a strictly defined quality profile or a lack of process knowledge. This contribution demonstrates the need for tailored risk management approaches for the risk-based development of biosimilars and provides novel tools for the integration of additional knowledge available for these products. The pharmaceutical industry is facing challenges such as profit loss and price competition. Companies are forced to rationalize business models and to cut costs in development as well as manufacturing. These trends recently hinder the implementation of any concepts that do not offer certain financial benefit or promise a long return of investment. Quality by design (QbD) is a concept that is currently struggling for more acceptance from the side of the pharmaceutical industry. To achieve this, the major goals of QbD have to be revisited and QbD tools have to be subsequently developed. This contribution offers an example as to how implement risk management in early-stage biosimilar development as part of the QbD concept. The main goal was to go beyond the conventional QbD workflow and to adjust risk management to the challenges of biosimilar products. Accordingly, instead of using methods like failure mode and effects analysis, recommendations of the ICH Q9 guideline were reviewed and put into practice by creating tailored risk assessment tools. The novelty of this contribution is to report those tailored tools ready-to-use for early bioprocess development of biosimilars along QbD principles.

Projecting manpower to attain quality

NASA Technical Reports Server (NTRS)

Rone, K. Y.

1983-01-01

The resulting model is useful as a projection tool but must be validated in order to be used as an on-going software cost engineering tool. A procedure is developed to facilitate the tracking of model projections and actual data to allow the model to be tuned. Finally, since the model must be used in an environment of overlapping development activities on a progression of software elements in development and maintenance, a manpower allocation model is developed for use in a steady state development/maintenance environment. In these days of soaring software costs it becomes increasingly important to properly manage a software development project. One element of the management task is the projection and tracking of manpower required to perform the task. In addition, since the total cost of the task is directly related to the initial quality built into the software, it becomes a necessity to project the development manpower in a way to attain that quality. An approach to projecting and tracking manpower with quality in mind is described.

[Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

PubMed

Birkner, B

2000-09-01

The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

TH-E-19A-01: Quality and Safety in Radiation Therapy

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

Ford, E; Ezzell, G; Miller, B

2014-06-15

Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

Towards knowledge-based systems in clinical practice: development of an integrated clinical information and knowledge management support system.

PubMed

Kalogeropoulos, Dimitris A; Carson, Ewart R; Collinson, Paul O

2003-09-01

Given that clinicians presented with identical clinical information will act in different ways, there is a need to introduce into routine clinical practice methods and tools to support the scientific homogeneity and accountability of healthcare decisions and actions. The benefits expected from such action include an overall reduction in cost, improved quality of care, patient and public opinion satisfaction. Computer-based medical data processing has yielded methods and tools for managing the task away from the hospital management level and closer to the desired disease and patient management level. To this end, advanced applications of information and disease process modelling technologies have already demonstrated an ability to significantly augment clinical decision making as a by-product. The wide-spread acceptance of evidence-based medicine as the basis of cost-conscious and concurrently quality-wise accountable clinical practice suffices as evidence supporting this claim. Electronic libraries are one-step towards an online status of this key health-care delivery quality control environment. Nonetheless, to date, the underlying information and knowledge management technologies have failed to be integrated into any form of pragmatic or marketable online and real-time clinical decision making tool. One of the main obstacles that needs to be overcome is the development of systems that treat both information and knowledge as clinical objects with same modelling requirements. This paper describes the development of such a system in the form of an intelligent clinical information management system: a system which at the most fundamental level of clinical decision support facilitates both the organised acquisition of clinical information and knowledge and provides a test-bed for the development and evaluation of knowledge-based decision support functions.

Emerging tools for continuous nutrient monitoring networks: Sensors advancing science and water resources protection

USGS Publications Warehouse

Pellerin, Brian; Stauffer, Beth A; Young, Dwane A; Sullivan, Daniel J.; Bricker, Suzanne B.; Walbridge, Mark R; Clyde, Gerard A; Shaw, Denice M

2016-01-01

Sensors and enabling technologies are becoming increasingly important tools for water quality monitoring and associated water resource management decisions. In particular, nutrient sensors are of interest because of the well-known adverse effects of nutrient enrichment on coastal hypoxia, harmful algal blooms, and impacts to human health. Accurate and timely information on nutrient concentrations and loads is integral to strategies designed to minimize risk to humans and manage the underlying drivers of water quality impairment. Using nitrate sensors as an example, we highlight the types of applications in freshwater and coastal environments that are likely to benefit from continuous, real-time nutrient data. The concurrent emergence of new tools to integrate, manage and share large data sets is critical to the successful use of nutrient sensors and has made it possible for the field of continuous nutrient monitoring to rapidly move forward. We highlight several near-term opportunities for Federal agencies, as well as the broader scientific and management community, that will help accelerate sensor development, build and leverage sites within a national network, and develop open data standards and data management protocols that are key to realizing the benefits of a large-scale, integrated monitoring network. Investing in these opportunities will provide new information to guide management and policies designed to protect and restore our nation’s water resources.

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."

The Grand Challenge of Basin-Scale Groundwater Quality Management Modelling

NASA Astrophysics Data System (ADS)

Fogg, G. E.

2017-12-01

The last 50+ years of agricultural, urban and industrial land and water use practices have accelerated the degradation of groundwater quality in the upper portions of many major aquifer systems upon which much of the world relies for water supply. In the deepest and most extensive systems (e.g., sedimentary basins) that typically have the largest groundwater production rates and hold fresh groundwaters on decadal to millennial time scales, most of the groundwater is not yet contaminated. Predicting the long-term future groundwater quality in such basins is a grand scientific challenge. Moreover, determining what changes in land and water use practices would avert future, irreversible degradation of these massive freshwater stores is a grand challenge both scientifically and societally. It is naïve to think that the problem can be solved by eliminating or reducing enough of the contaminant sources, for human exploitation of land and water resources will likely always result in some contamination. The key lies in both reducing the contaminant sources and more proactively managing recharge in terms of both quantity and quality, such that the net influx of contaminants is sufficiently moderate and appropriately distributed in space and time to reverse ongoing groundwater quality degradation. Just as sustainable groundwater quantity management is greatly facilitated with groundwater flow management models, sustainable groundwater quality management will require the use of groundwater quality management models. This is a new genre of hydrologic models do not yet exist, partly because of the lack of modeling tools and the supporting research to model non-reactive as well as reactive transport on large space and time scales. It is essential that the contaminant hydrogeology community, which has heretofore focused almost entirely on point-source plume-scale problems, direct it's efforts toward the development of process-based transport modeling tools and analyses capable of appropriately upscaling advection-dispersion and reactions at the basin scale (10^2 km). A road map for research and development in groundwater quality management modeling and its application toward securing future groundwater resources will be discussed.

Facilitating adaptive management in the Chesapeake Bay Watershed through the use of online decision support tools

USGS Publications Warehouse

Mullinx, Cassandra; Phillips, Scott; Shenk, Kelly; Hearn, Paul; Devereux, Olivia

2009-01-01

The Chesapeake Bay Program (CBP) is attempting to more strategically implement management actions to improve the health of the Nation’s largest estuary. In 2007 the U.S. Geological Survey (USGS) and U.S. Environmental Protection Agency (USEPA) CBP office began a joint effort to develop a suite of Internetaccessible decision-support tools and to help meet the needs of CBP partners to improve water quality and habitat conditions in the Chesapeake Bay and its watersheds. An adaptive management framework is being used to provide a structured decision process for information and individual tools needed to implement and assess practices to improve the condition of the Chesapeake Bay ecosystem. The Chesapeake Online Adaptive Support Toolkit (COAST) is a collection of web-based analytical tools and information, organized in an adaptive management framework, intended to aid decisionmakers in protecting and restoring the integrity of the Bay ecosystem. The initial version of COAST is focused on water quality issues. During early and mid- 2008, initial ideas for COAST were shared and discussed with various CBP partners and other potential user groups. At these meetings, test cases were selected to help improve understanding of the types of information and analytical functionality that would be most useful for specific partners’ needs. These discussions added considerable knowledge about the nature of decisionmaking for Federal, State, local and nongovernmental partners. Version 1.0 of COAST, released in early winter of 2008, will be further reviewed to determine improvements needed to address implementation and assessment of water quality practices. Future versions of COAST may address other aspects of ecosystem restoration, including restoration of habitat and living resources and maintaining watershed health.

Evapotranspiration Calculator Desktop Tool

EPA Pesticide Factsheets

The Evapotranspiration Calculator estimates evapotranspiration time series data for hydrological and water quality models for the Hydrologic Simulation Program - Fortran (HSPF) and the Stormwater Management Model (SWMM).

A Statistical Project Control Tool for Engineering Managers

NASA Technical Reports Server (NTRS)

Bauch, Garland T.

2001-01-01

This slide presentation reviews the use of a Statistical Project Control Tool (SPCT) for managing engineering projects. A literature review pointed to a definition of project success, (i.e., A project is successful when the cost, schedule, technical performance, and quality satisfy the customer.) The literature review also pointed to project success factors, and traditional project control tools, and performance measures that are detailed in the report. The essential problem is that with resources becoming more limited, and an increasing number or projects, project failure is increasing, there is a limitation of existing methods and systematic methods are required. The objective of the work is to provide a new statistical project control tool for project managers. Graphs using the SPCT method plotting results of 3 successful projects and 3 failed projects are reviewed, with success and failure being defined by the owner.

FEST-C 1.3 & 2.0 for CMAQ Bi-directional NH3, Crop Production, and SWAT Modeling

EPA Science Inventory

The Fertilizer Emission Scenario Tool for CMAQ (FEST-C) is developed in a Linux environment, a festc JAVA interface that integrates 14 tools and scenario management options facilitating land use/crop data processing for the Community Multiscale Air Quality (CMAQ) modeling system ...

Tools for Measuring and Improving Performance.

ERIC Educational Resources Information Center

Jurow, Susan

1993-01-01

Explains the need for meaningful performance measures in libraries and the Total Quality Management (TQM) approach to data collection. Five tools representing different stages of a TQM inquiry are covered (i.e., the Shewhart Cycle, flowcharts, cause-and-effect diagrams, Pareto charts, and control charts), and benchmarking is addressed. (Contains…

Design of an instrument to measure the quality of care in Physical Therapy.

PubMed

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; Prado, Cristiane do; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

Coproducing Aboriginal patient journey mapping tools for improved quality and coordination of care.

PubMed

Kelly, Janet; Dwyer, Judith; Mackean, Tamara; O'Donnell, Kim; Willis, Eileen

2016-12-08

This paper describes the rationale and process for developing a set of Aboriginal patient journey mapping tools with Aboriginal patients, health professionals, support workers, educators and researchers in the Managing Two Worlds Together project between 2008 and 2015. Aboriginal patients and their families from rural and remote areas, and healthcare providers in urban, rural and remote settings, shared their perceptions of the barriers and enablers to quality care in interviews and focus groups, and individual patient journey case studies were documented. Data were thematically analysed. In the absence of suitable existing tools, a new analytical framework and mapping approach was developed. The utility of the tools in other settings was then tested with health professionals, and the tools were further modified for use in quality improvement in health and education settings in South Australia and the Northern Territory. A central set of patient journey mapping tools with flexible adaptations, a workbook, and five sets of case studies describing how staff adapted and used the tools at different sites are available for wider use.

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal

PubMed Central

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M. Juliana; Hural, John

2014-01-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×106 ±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8–3.2×106 cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%–130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. PMID:24709391

Application of Quality Management Tools for Evaluating the Failure Frequency of Cutter-Loader and Plough Mining Systems

NASA Astrophysics Data System (ADS)

Biały, Witold

2017-06-01

Failure frequency in the mining process, with a focus on the mining machine, has been presented and illustrated by the example of two coal-mines. Two mining systems have been subjected to analysis: a cutter-loader and a plough system. In order to reduce costs generated by failures, maintenance teams should regularly make sure that the machines are used and operated in a rational and effective way. Such activities will allow downtimes to be reduced, and, in consequence, will increase the effectiveness of a mining plant. The evaluation of mining machines' failure frequency contained in this study has been based on one of the traditional quality management tools - the Pareto chart.

PROJECT SUMMARY: DEVELOPMENT OF THE VIRTUAL BEACH MODEL, PHASE I: AN EMPIRICAL MODEL

EPA Science Inventory

Mathematical models based on water-quality and other environmental surrogates may help to provide water quality assessment within a few hours and potentially provide one to three day forecasts, providing beach managers and public-health officials a tool for developing beach-speci...

Development, application, and sensitivity analysis of a water quality index for drinking water management in small systems.

PubMed

Scheili, A; Rodriguez, Manuel J; Sadiq, R

2015-11-01

The aim of this study was to produce a drinking water assessment tool for operators of small distribution systems. A drinking water quality index (DWQI) was developed and applied to small systems based on the water quality index of the Canadian Council of Ministers of Environment. The drinking water quality index was adapted to specific needs by creating four drinking water quality scenarios. First, the temporal and spatial dimensions of drinking water quality variability were taken into account. The DWQI was designed to express global drinking water quality according to different monitoring frequencies. Daily, monthly, and seasonal assessment was also considered. With the data made available, it was possible to use the index as a spatial monitoring tool and express water quality in different points in the distribution system. Moreover, adjustments were made to prioritize the type of contaminant to monitor. For instance, monitoring contaminants with acute health effects led to a scenario based on daily measures, including easily accessible and affordable water quality parameters. On the other hand, contaminants with chronic effects, especially disinfection by-products, were considered in a seasonal monitoring scenario where disinfection by-product reference values were redefined according to their seasonal variability. A sensitivity analysis was also carried out to validate the index. Globally, the DWQI developed is adapted to the needs of small systems. In fact, expressing drinking water quality using the DWQI contributes to the identification of problematic periods and segments in the distribution system. Further work may include this index in the development of a customized decision-making tool for small-system operators and managers.

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.

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

PubMed Central

Trollip, Andre; Erni, Donatelle; Kao, Kekeletso

2017-01-01

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

LC Data QUEST: A Technical Architecture for Community Federated Clinical Data Sharing.

PubMed

Stephens, Kari A; Lin, Ching-Ping; Baldwin, Laura-Mae; Echo-Hawk, Abigail; Keppel, Gina A; Buchwald, Dedra; Whitener, Ron J; Korngiebel, Diane M; Berg, Alfred O; Black, Robert A; Tarczy-Hornoch, Peter

2012-01-01

The University of Washington Institute of Translational Health Sciences is engaged in a project, LC Data QUEST, building data sharing capacity in primary care practices serving rural and tribal populations in the Washington, Wyoming, Alaska, Montana, Idaho region to build research infrastructure. We report on the iterative process of developing the technical architecture for semantically aligning electronic health data in primary care settings across our pilot sites and tools that will facilitate linkages between the research and practice communities. Our architecture emphasizes sustainable technical solutions for addressing data extraction, alignment, quality, and metadata management. The architecture provides immediate benefits to participating partners via a clinical decision support tool and data querying functionality to support local quality improvement efforts. The FInDiT tool catalogues type, quantity, and quality of the data that are available across the LC Data QUEST data sharing architecture. These tools facilitate the bi-directional process of translational research.

LC Data QUEST: A Technical Architecture for Community Federated Clinical Data Sharing

PubMed Central

Stephens, Kari A.; Lin, Ching-Ping; Baldwin, Laura-Mae; Echo-Hawk, Abigail; Keppel, Gina A.; Buchwald, Dedra; Whitener, Ron J.; Korngiebel, Diane M.; Berg, Alfred O.; Black, Robert A.; Tarczy-Hornoch, Peter

2012-01-01

The University of Washington Institute of Translational Health Sciences is engaged in a project, LC Data QUEST, building data sharing capacity in primary care practices serving rural and tribal populations in the Washington, Wyoming, Alaska, Montana, Idaho region to build research infrastructure. We report on the iterative process of developing the technical architecture for semantically aligning electronic health data in primary care settings across our pilot sites and tools that will facilitate linkages between the research and practice communities. Our architecture emphasizes sustainable technical solutions for addressing data extraction, alignment, quality, and metadata management. The architecture provides immediate benefits to participating partners via a clinical decision support tool and data querying functionality to support local quality improvement efforts. The FInDiT tool catalogues type, quantity, and quality of the data that are available across the LC Data QUEST data sharing architecture. These tools facilitate the bi-directional process of translational research. PMID:22779052

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

PubMed Central

2013-01-01

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

The application of total quality management principles to spacecraft mission operations

NASA Astrophysics Data System (ADS)

Sweetin, Maury

1993-03-01

By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

The application of total quality management principles to spacecraft mission operations

NASA Technical Reports Server (NTRS)

Sweetin, Maury

1993-01-01

By now, the philosophies of Total Quality Management have had an impact on every aspect of American industrial life. The trail-blazing work of Deming, Juran, and Crosby, first implemented in Japan, has 're-migrated' across the Pacific and now plays a growing role in America's management culture. While initially considered suited only for a manufacturing environment, TQM has moved rapidly into the 'service' areas of offices, sales forces, and even fast-food restaurants. The next logical step has also been taken - TQM has found its way into virtually all departments of the Federal Government, including NASA. Because of this widespread success, it seems fair to ask whether this new discipline is directly applicable to the profession of spacecraft operations. The results of quality emphasis on OAO Corporation's contract at JPL provide strong support for Total Quality Management as a useful tool in spacecraft operations.

[Customer satisfaction with a quality management system according to DIN EN ISO 9001:2000: Increase in the satisfaction of cooperating clinics].

PubMed

Beholz, Sven; Konertz, Wolfgang

2006-01-01

The evaluation of customers' satisfaction is elementary for any quality management system. In our university cardiac surgery unit that has been certified according to DIN EN ISO 9001:2000 the influence of repeated evaluation of the referring physicians' satisfaction conducted in the course of three consecutive years on structures and processes in the scope of the quality management system was examined. Customers' satisfaction with the possibility of access to the department could be increased by targeted interventions. Further interventions in the field of documentation led to a measurable increase in satisfaction with postoperative communication. Repeated annual evaluation of the satisfaction of referring physicians has proved to be a valuable tool in the process of continuous quality improvement.

Taguchi Approach to Design Optimization for Quality and Cost: An Overview

NASA Technical Reports Server (NTRS)

Unal, Resit; Dean, Edwin B.

1990-01-01

Calibrations to existing cost of doing business in space indicate that to establish human presence on the Moon and Mars with the Space Exploration Initiative (SEI) will require resources, felt by many, to be more than the national budget can afford. In order for SEI to succeed, we must actually design and build space systems at lower cost this time, even with tremendous increases in quality and performance requirements, such as extremely high reliability. This implies that both government and industry must change the way they do business. Therefore, new philosophy and technology must be employed to design and produce reliable, high quality space systems at low cost. In recognizing the need to reduce cost and improve quality and productivity, Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) have initiated Total Quality Management (TQM). TQM is a revolutionary management strategy in quality assurance and cost reduction. TQM requires complete management commitment, employee involvement, and use of statistical tools. The quality engineering methods of Dr. Taguchi, employing design of experiments (DOE), is one of the most important statistical tools of TQM for designing high quality systems at reduced cost. Taguchi methods provide an efficient and systematic way to optimize designs for performance, quality, and cost. Taguchi methods have been used successfully in Japan and the United States in designing reliable, high quality products at low cost in such areas as automobiles and consumer electronics. However, these methods are just beginning to see application in the aerospace industry. The purpose of this paper is to present an overview of the Taguchi methods for improving quality and reducing cost, describe the current state of applications and its role in identifying cost sensitive design parameters.

Radiation safety requirements for radioactive waste management in the framework of a quality management system

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

Salgado, M.M.; Benitez, J.C.; Pernas, R.

2007-07-01

The Center for Radiation Protection and Hygiene (CPHR) is the institution responsible for the management of radioactive wastes generated from nuclear applications in medicine, industry and research in Cuba. Radioactive Waste Management Service is provided at a national level and it includes the collection and transportation of radioactive wastes to the Centralized Waste Management Facilities, where they are characterized, segregated, treated, conditioned and stored. A Quality Management System, according to the ISO 9001 Standard has been implemented for the RWM Service at CPHR. The Management System includes the radiation safety requirements established for RWM in national regulations and in themore » Licence's conditions. The role of the Regulatory Body and the Radiation Protection Officer in the Quality Management System, the authorization of practices, training and personal qualification, record keeping, inspections of the Regulatory Body and internal inspection of the Radiation Protection Officer, among other aspects, are described in this paper. The Quality Management System has shown to be an efficient tool to demonstrate that adequate measures are in place to ensure the safety in radioactive waste management activities and their continual improvement. (authors)« less

Sensitivity, Calibration, and Validation of SWAT in the Choptank River Basin

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

Benchmark for Strategic Performance Improvement.

ERIC Educational Resources Information Center

Gohlke, Annette

1997-01-01

Explains benchmarking, a total quality management tool used to measure and compare the work processes in a library with those in other libraries to increase library performance. Topics include the main groups of upper management, clients, and staff; critical success factors for each group; and benefits of benchmarking. (Author/LRW)

Why Model Recreation Use?

Treesearch

David N. Cole; Kerri Cahill; Marilyn Hof

2005-01-01

As the demographics of public land recreational visitors change, planners and managers of public lands face the challenge of protecting resources while providing high quality visitor experiences. Because our political environment demands ever more reliance on scientific data and transparent decisionmaking, planners and managers need better tools to help them understand...

THE STORM WATER MANAGEMENT MODEL (SWMM) AND RELATED WATERSHED TOOLS DEVELOPMENT

EPA Science Inventory

The Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. It is the only publicly available model capable of performing a comprehensiv...

Alternative Land-Use Method for Spatially Informed Watershed Management Decision Making Using SWAT

EPA Science Inventory

In this study, a modification is proposed to the Soil and Water Assessment Tool (SWAT) to enable identification of areas where the implementation of best management practices would likely result in the most significant improvement in downstream water quality. To geospatially link...

Cardiovascular point of care initiative: enhancements in clinical data management.

PubMed

Robertson, Jane

2003-01-01

The Department of Cardiovascular Surgery at East Alabama Medical Center (EAMC) initiated a program in 1996 to improve the quality and usefulness of clinical outcomes data. After years of using a commercial vendor product and enduring a tedious collection process, the department decided to develop its own tools to support quality improvement efforts. Using a hand-held personal data assistant (PDA), the team developed tools that allowed ongoing data collection at the point of care delivery. The tools and methods facilitated the collection of real time, accurate information that allowed EAMC to participate in multiple clinical quality initiatives. The ability to conduct rapid-cycle performance improvement studies propelled EAMC's Cardiovascular Surgery Program into the Top 100 as recognized by HCIA, now Solucient, for 3 consecutive years (1999-2001). This report will describe the evolution of the data collection process as well as the quality improvements that resulted.

Cause-and-effect mapping of critical events.

PubMed

Graves, Krisanne; Simmons, Debora; Galley, Mark D

2010-06-01

Health care errors are routinely reported in the scientific and public press and have become a major concern for most Americans. In learning to identify and analyze errors health care can develop some of the skills of a learning organization, including the concept of systems thinking. Modern experts in improving quality have been working in other high-risk industries since the 1920s making structured organizational changes through various frameworks for quality methods including continuous quality improvement and total quality management. When using these tools, it is important to understand systems thinking and the concept of processes within organization. Within these frameworks of improvement, several tools can be used in the analysis of errors. This article introduces a robust tool with a broad analytical view consistent with systems thinking, called CauseMapping (ThinkReliability, Houston, TX, USA), which can be used to systematically analyze the process and the problem at the same time. Copyright 2010 Elsevier Inc. All rights reserved.

A combined geostatistical-optimization model for the optimal design of a groundwater quality monitoring network

NASA Astrophysics Data System (ADS)

Kolosionis, Konstantinos; Papadopoulou, Maria P.

2017-04-01

Monitoring networks provide essential information for water resources management especially in areas with significant groundwater exploitation due to extensive agricultural activities. In this work, a simulation-optimization framework is developed based on heuristic optimization methodologies and geostatistical modeling approaches to obtain an optimal design for a groundwater quality monitoring network. Groundwater quantity and quality data obtained from 43 existing observation locations at 3 different hydrological periods in Mires basin in Crete, Greece will be used in the proposed framework in terms of Regression Kriging to develop the spatial distribution of nitrates concentration in the aquifer of interest. Based on the existing groundwater quality mapping, the proposed optimization tool will determine a cost-effective observation wells network that contributes significant information to water managers and authorities. The elimination of observation wells that add little or no beneficial information to groundwater level and quality mapping of the area can be obtain using estimations uncertainty and statistical error metrics without effecting the assessment of the groundwater quality. Given the high maintenance cost of groundwater monitoring networks, the proposed tool could used by water regulators in the decision-making process to obtain a efficient network design that is essential.

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.

Relationship between structural features and water chemistry in boreal headwater streams--evaluation based on results from two water management survey tools suggested for Swedish forestry.

PubMed

Lestander, Ragna; Löfgren, Stefan; Henrikson, Lennart; Ågren, Anneli M

2015-04-01

Forestry may cause adverse impacts on water quality, and the forestry planning process is a key factor for the outcome of forest operation effects on stream water. To optimise environmental considerations and to identify actions needed to improve or maintain the stream biodiversity, two silvicultural water management tools, BIS+ (biodiversity, impact, sensitivity and added values) and Blue targeting, have been developed. In this study, we evaluate the links between survey variables, based on BIS+ and Blue targeting data, and water chemistry in 173 randomly selected headwater streams in the hemiboreal zone. While BIS+ and Blue targeting cannot replace more sophisticated monitoring methods necessary for classifying water quality in streams according to the EU Water Framework Directive (WFD, 2000/60/EC), our results lend support to the idea that the BIS+ protocol can be used to prioritise the protection of riparian forests. The relationship between BIS+ and water quality indicators (concentrations of nutrients and organic matter) together with data from fish studies suggests that this field protocol can be used to give reaches with higher biodiversity and conservation values a better protection. The tools indicate an ability to mitigate forestry impacts on water quality if the operations are adjusted to this knowledge in located areas.

Accreditations as Local Management Tools

ERIC Educational Resources Information Center

Cret, Benoit

2011-01-01

The development of accreditation agencies within the Higher Education sector in order to assess and guarantee the quality of services or product is still a growing phenomenon in Europe. Accreditations are conceived by institutional authors and by authors who directly deal with quality assurance processes as a means of legitimization or a means of…

INTERNATIONAL PERSPECTIVE: U.S. EPA'S APPROACH TO SURVEILLANCE AND MANAGEMENT OF WATER QUALITY

EPA Science Inventory

For the past 35 years, the Environmental Protection Agency (EPA) has been establishing health-based standards for more than 80 contaminants and developing water quality methods and tools to monitor, assess, and report on the health of America's water resources. The Safe Drinking ...

Spatial and temporal variation of fecal indicator organisms in two creeks in Beltsville, Maryland

USDA-ARS?s Scientific Manuscript database

Evaluation of microbial water quality is commonly achieved by monitoring populations of indicator bacteria such as E. coli and enterococci. Monitoring data are utilized by water managers to predict potential fecal contaminations as well as a decision tool to improve microbial water quality. Both te...

The Human Side of Quality: Employee Care and Empowerment.

ERIC Educational Resources Information Center

Thor, Linda M.

Frequently, educational institutions seeking to implement Total Quality Management (TQM) as a means to improve institutional effectiveness, overemphasize training in the application of TQM tools and fail to fully address human needs and concerns, such as the critical issue of employee empowerment. Four principal barriers exist to adequately…

NEIGHBORHOOD SCALE MODELING OF PM 2.5 AND AIR TOXICS CONCENTRATION DISTRIBUTIONS TO DRIVE HUMAN EXPOSURE MODELS

EPA Science Inventory

Air quality (AQ) simulation models provide a basis for implementing the National Ambient Air Quality Standards (NAAQS) and are a tool for performing risk-based assessments and for developing environmental management strategies. Fine particulate matter (PM 2.5), its constituent...

Quality use of antipsychotic medicines inresidential aged care facilities in New Zealand.

PubMed

Ndukwe, Henry C; Nishtala, Prasad S; Wang, Ting; Tordoff, June M

2016-12-01

INTRODUCTION Antipsychotic medicines are used regularly or when required in residential aged care facilities to treat symptoms of dementia, but have been associated with several adverse effects. AIM The aim of this study was to examine 'quality use' of antipsychotic medicines in residential aged care facilities in New Zealand, by surveying nurse managers. METHODS A cross-sectional survey was mailed to 318 nurse managers working in a nationally representative sample of aged care facilities. A purpose-developed, pre-tested, 22-item structured questionnaire was used to explore practice related to the quality use of antipsychotic medicines. RESULTS Overall, 31.4% of nurse managers responded to the survey. They mostly (88%) had ≥ 1 year's relevant work experience and 83% of facilities provided care for those within the range of 21 to 100 residents. Respondents reported that staff education on dementia management occurred early in employment. Two-thirds of participants reported non-pharmacological interventions were commonly used for managing challenging behaviours, while less than half (45%) cited administering antipsychotic medicine. Respondents reported 'managing behavioural symptoms' (81%) as one of the main indications for antipsychotic use. Frequently identified adverse effects of antipsychotic medicines were drowsiness or sedation (64%) and falls (61%). Over 90% reported general practitioners reviewed antipsychotic use with respect to residents' target behaviour 3-monthly, and two-thirds used an assessment tool to appraise residents' behaviour. DISCUSSION Staff education on dementia management soon after employment and resident 3-monthly antipsychotic medicine reviews were positive findings. However, a wider use of behavioural assessment tools might improve the care of residents with dementia and the quality use of antipsychotic medicines.

Measuring, managing and maximizing performance of mineral processing plants

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

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

1995-12-31

The implementation of continuous quality improvement is the confluence of Total Quality Management, People Empowerment, Performance Indicators and Information Engineering. The supporting information technologies allow a mineral processor to narrow the gap between management business objectives and the process control level. One of the most important contributors is the user friendliness and flexibility of the personal computer in a client/server environment. This synergistic combination when used for real time performance monitoring translates into production cost savings, improved communications and enhanced decision support. Other savings come from reduced time to collect data and perform tedious calculations, act quickly with fresh newmore » data, generate and validate data to be used by others. This paper presents an integrated view of plant management. The selection of the proper tools for continuous quality improvement are described. The process of selecting critical performance monitoring indices for improved plant performance are discussed. The importance of a well balanced technological improvement, personnel empowerment, total quality management and organizational assets are stressed.« less

Database and Analytical Tool Development for the Management of Data Derived from US DOE (NETL) Funded Fine Particulate (PM2.5) Research

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

Robinson P. Khosah; Frank T. Alex

2007-02-11

Advanced Technology Systems, Inc. (ATS) was contracted by the U. S. Department of Energy's National Energy Technology Laboratory (DOE-NETL) to develop a state-of-the-art, scalable and robust web-accessible database application to manage the extensive data sets resulting from the DOE-NETL-sponsored ambient air monitoring programs in the upper Ohio River valley region. The data management system was designed to include a web-based user interface that will allow easy access to the data by the scientific community, policy- and decision-makers, and other interested stakeholders, while providing detailed information on sampling, analytical and quality control parameters. In addition, the system will provide graphical analyticalmore » tools for displaying, analyzing and interpreting the air quality data. The system will also provide multiple report generation capabilities and easy-to-understand visualization formats that can be utilized by the media and public outreach/educational institutions. The project is being conducted in two phases. Phase One includes the following tasks: (1) data inventory/benchmarking, including the establishment of an external stakeholder group; (2) development of a data management system; (3) population of the database; (4) development of a web-based data retrieval system, and (5) establishment of an internal quality assurance/quality control system on data management. Phase Two, which is currently underway, involves the development of a platform for on-line data analysis. Phase Two includes the following tasks: (1) development of a sponsor and stakeholder/user website with extensive online analytical tools; (2) development of a public website; (3) incorporation of an extensive online help system into each website; and (4) incorporation of a graphical representation (mapping) system into each website. The project is now into its forty-eighth month of development activities.« less

DATABASE AND ANALYTICAL TOOL DEVELOPMENT FOR THE MANAGEMENT OF DATA DERIVED FROM US DOE (NETL) FUNDED FINE PARTICULATE (PM 2.5) RESEARCH

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

Robinson P. Khosah; Charles G. Crawford

2006-02-11

Advanced Technology Systems, Inc. (ATS) was contracted by the U. S. Department of Energy's National Energy Technology Laboratory (DOE-NETL) to develop a state-of-the-art, scalable and robust web-accessible database application to manage the extensive data sets resulting from the DOE-NETL-sponsored ambient air monitoring programs in the upper Ohio River valley region. The data management system was designed to include a web-based user interface that will allow easy access to the data by the scientific community, policy- and decision-makers, and other interested stakeholders, while providing detailed information on sampling, analytical and quality control parameters. In addition, the system will provide graphical analyticalmore » tools for displaying, analyzing and interpreting the air quality data. The system will also provide multiple report generation capabilities and easy-to-understand visualization formats that can be utilized by the media and public outreach/educational institutions. The project is being conducted in two phases. Phase One includes the following tasks: (1) data inventory/benchmarking, including the establishment of an external stakeholder group; (2) development of a data management system; (3) population of the database; (4) development of a web-based data retrieval system, and (5) establishment of an internal quality assurance/quality control system on data management. Phase Two, which is currently underway, involves the development of a platform for on-line data analysis. Phase Two includes the following tasks: (1) development of a sponsor and stakeholder/user website with extensive online analytical tools; (2) development of a public website; (3) incorporation of an extensive online help system into each website; and (4) incorporation of a graphical representation (mapping) system into each website. The project is now into its forty-second month of development activities.« less

DATABASE AND ANALYTICAL TOOL DEVELOPMENT FOR THE MANAGEMENT OF DATA DERIVED FROM US DOE (NETL) FUNDED FINE PARTICULATE (PM2.5) RESEARCH

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

Robinson P. Khosah; Charles G. Crawford

Advanced Technology Systems, Inc. (ATS) was contracted by the U. S. Department of Energy's National Energy Technology Laboratory (DOE-NETL) to develop a state-of-the-art, scalable and robust web-accessible database application to manage the extensive data sets resulting from the DOE-NETL-sponsored ambient air monitoring programs in the upper Ohio River valley region. The data management system was designed to include a web-based user interface that will allow easy access to the data by the scientific community, policy- and decision-makers, and other interested stakeholders, while providing detailed information on sampling, analytical and quality control parameters. In addition, the system will provide graphical analyticalmore » tools for displaying, analyzing and interpreting the air quality data. The system will also provide multiple report generation capabilities and easy-to-understand visualization formats that can be utilized by the media and public outreach/educational institutions. The project is being conducted in two phases. Phase 1, which is currently in progress and will take twelve months to complete, will include the following tasks: (1) data inventory/benchmarking, including the establishment of an external stakeholder group; (2) development of a data management system; (3) population of the database; (4) development of a web-based data retrieval system, and (5) establishment of an internal quality assurance/quality control system on data management. In Phase 2, which will be completed in the second year of the project, a platform for on-line data analysis will be developed. Phase 2 will include the following tasks: (1) development of a sponsor and stakeholder/user website with extensive online analytical tools; (2) development of a public website; (3) incorporation of an extensive online help system into each website; and (4) incorporation of a graphical representation (mapping) system into each website. The project is now into its eleventh month of Phase 1 development activities.« less

Clinical decision support tools for osteoporosis disease management: a systematic review of randomized controlled trials.

PubMed

Kastner, Monika; Straus, Sharon E

2008-12-01

Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management.

Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

FluxCTTX: A LIMS-based tool for management and analysis of cytotoxicity assays data

PubMed Central

2015-01-01

Background Cytotoxicity assays have been used by researchers to screen for cytotoxicity in compound libraries. Researchers can either look for cytotoxic compounds or screen "hits" from initial high-throughput drug screens for unwanted cytotoxic effects before investing in their development as a pharmaceutical. These assays may be used as an alternative to animal experimentation and are becoming increasingly important in modern laboratories. However, the execution of these assays in large scale and different laboratories requires, among other things, the management of protocols, reagents, cell lines used as well as the data produced, which can be a challenge. The management of all this information is greatly improved by the utilization of computational tools to save time and guarantee quality. However, a tool that performs this task designed specifically for cytotoxicity assays is not yet available. Results In this work, we have used a workflow based LIMS -- the Flux system -- and the Together Workflow Editor as a framework to develop FluxCTTX, a tool for management of data from cytotoxicity assays performed at different laboratories. The main work is the development of a workflow, which represents all stages of the assay and has been developed and uploaded in Flux. This workflow models the activities of cytotoxicity assays performed as described in the OECD 129 Guidance Document. Conclusions FluxCTTX presents a solution for the management of the data produced by cytotoxicity assays performed at Interlaboratory comparisons. Its adoption will contribute to guarantee the quality of activities in the process of cytotoxicity tests and enforce the use of Good Laboratory Practices (GLP). Furthermore, the workflow developed is complete and can be adapted to other contexts and different tests for management of other types of data. PMID:26696462

Management. A continuing bibliography with indexes. [March 1980

NASA Technical Reports Server (NTRS)

1980-01-01

This bibliography cites 604 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1979 covering the management of research and development, contracts, production, logistics, personnel, safety, reliability and quality control. Program, project, and systems management; management policy, philosophy, tools, and techniques; decision making processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting are also covered. Abstracts are provided as well as subject, personal author, and corporate source indexes.

Why Lean doesn't work for everyone.

PubMed

Kaplan, Gary S; Patterson, Sarah H; Ching, Joan M; Blackmore, C Craig

2014-12-01

Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. We argue that delivery of safer, more efficient, and higher quality-patient focused care requires organisational transformation of which the Lean toolkit is only one component. To successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

On the question of economic efficiency and how to assess it

NASA Astrophysics Data System (ADS)

Petrosyan, M. O.; Kovalev, I. V.; Zelenkov, P. V.; Chuvashova, M. N.; Grishina, I. A.; Pershakova, K. K.

2016-04-01

Over the years, since the world moved to a system of market-based economic relations scientists and businessmen worldwide wonder how to ease and modernize the process of analyzing business performance. During this time, a variety of methods and tools have been developed to deal with this problem. After all, the productivity of the company is directly related to it’s competitive qualities, so the managers are interested in the quality of evaluation of their companies. The article deals with the traditional methods of evaluating the performance of enterprises and some of the tools used in order to improve its quality.

The Empower project - a new way of assessing and monitoring test comparability and stability.

PubMed

De Grande, Linde A C; Goossens, Kenneth; Van Uytfanghe, Katleen; Stöckl, Dietmar; Thienpont, Linda M

2015-07-01

Manufacturers and laboratories might benefit from using a modern integrated tool for quality management/assurance. The tool should not be confounded by commutability issues and focus on the intrinsic analytical quality and comparability of assays as performed in routine laboratories. In addition, it should enable monitoring of long-term stability of performance, with the possibility to quasi "real-time" remedial action. Therefore, we developed the "Empower" project. The project comprises four pillars: (i) master comparisons with panels of frozen single-donation samples, (ii) monitoring of patient percentiles and (iii) internal quality control data, and (iv) conceptual and statistical education about analytical quality. In the pillars described here (i and ii), state-of-the-art as well as biologically derived specifications are used. In the 2014 master comparisons survey, 125 laboratories forming 8 peer groups participated. It showed not only good intrinsic analytical quality of assays but also assay biases/non-comparability. Although laboratory performance was mostly satisfactory, sometimes huge between-laboratory differences were observed. In patient percentile monitoring, currently, 100 laboratories participate with 182 devices. Particularly, laboratories with a high daily throughput and low patient population variation show a stable moving median in time with good between-instrument concordance. Shifts/drifts due to lot changes are sometimes revealed. There is evidence that outpatient medians mirror the calibration set-points shown in the master comparisons. The Empower project gives manufacturers and laboratories a realistic view on assay quality/comparability as well as stability of performance and/or the reasons for increased variation. Therefore, it is a modern tool for quality management/assurance toward improved patient care.

Quality control management and communication between radiologists and technologists.

PubMed

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

2008-06-01

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

Visual Decision Support Tool for Supporting Asset Management Performance, Risk, and Cost Analysis (WERF Report INFR5R12)

EPA Science Inventory

Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and m...

Comparison of SWAT Model Water Balance Calibration Using NEXRAD and Surface Rain Gauge Data

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

Comparison of Flow Calibration Using NEXRAD and Surface Rain Gauge Data in ArcSWAT

USDA-ARS?s Scientific Manuscript database

The value of watershed-scale, water quality models to ecosystem management is increasingly evident as more programs adopt these tools to help assess the effectiveness of different management scenarios on the environment. The USDA-Conservation Effects Assessment Project (CEAP) is one such program whi...

Development of cropland management dataset to support U.S. SWAT assessments

USDA-ARS?s Scientific Manuscript database

The Soil and Water Assessment Tool (SWAT) is a widely used hydrologic/water quality simulation model in the U.S. Process-based models like SWAT require a great deal of data to accurately represent the natural world, including topography, landuse, soils, weather, and management. With the exception ...

Tools for beach health data management, data processing, and predictive model implementation

USGS Publications Warehouse

,

2013-01-01

This fact sheet describes utilities created for management of recreational waters to provide efficient data management, data aggregation, and predictive modeling as well as a prototype geographic information system (GIS)-based tool for data visualization and summary. All of these utilities were developed to assist beach managers in making decisions to protect public health. The Environmental Data Discovery and Transformation (EnDDaT) Web service identifies, compiles, and sorts environmental data from a variety of sources that help to define climatic, hydrologic, and hydrodynamic characteristics including multiple data sources within the U.S. Geological Survey and the National Oceanic and Atmospheric Administration. The Great Lakes Beach Health Database (GLBH-DB) and Web application was designed to provide a flexible input, export, and storage platform for beach water quality and sanitary survey monitoring data to compliment beach monitoring programs within the Great Lakes. A real-time predictive modeling strategy was implemented by combining the capabilities of EnDDaT and the GLBH-DB for timely, automated prediction of beach water quality. The GIS-based tool was developed to map beaches based on their physical and biological characteristics, which was shared with multiple partners to provide concepts and information for future Web-accessible beach data outlets.

American Pharmacists Association

MedlinePlus

... Tools Quality Measures Transitions of Care Chronic Care Management Appointment Based Model OTC Supplement OPIOID Center Nuclear Pharmacy Clinical Guidelines Conducting Research Projects GET INVOLVED Participate House of Delegates APhA-APPM ...

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

Floristic Quality Index of Restored Wetlands in Coastal Louisiana

DTIC Science & Technology

2017-08-01

been used to monitor and assess project performance, resilience, and adaptive management needs. An emerging tool for performing bioassessments in...condition have been used to monitor and assess project performance, resilience, and adaptive management needs. There are three basic levels of wetland...result of saltwater intrusion and rapid subsidence; nevertheless, multiple hydrologic restoration projects (Naomi Outfall Management BA-03c and

Diagnosis and management of bronchiectasis.

PubMed

Smith, Maeve P

2017-06-19

KEY POINTS Following a diagnosis of bronchiectasis, it is important to investigate for an underlying cause. Goals of management are to suppress airway infection and inflammation, to improve symptoms and health-related quality of life. There are now validated scoring tools to help assess disease severity, which can help to stratify management. Good evidence supports the use of both exercise training and long-term macrolide therapy in long-term disease management.

SIMBA: a web tool for managing bacterial genome assembly generated by Ion PGM sequencing technology.

PubMed

Mariano, Diego C B; Pereira, Felipe L; Aguiar, Edgar L; Oliveira, Letícia C; Benevides, Leandro; Guimarães, Luís C; Folador, Edson L; Sousa, Thiago J; Ghosh, Preetam; Barh, Debmalya; Figueiredo, Henrique C P; Silva, Artur; Ramos, Rommel T J; Azevedo, Vasco A C

2016-12-15

The evolution of Next-Generation Sequencing (NGS) has considerably reduced the cost per sequenced-base, allowing a significant rise of sequencing projects, mainly in prokaryotes. However, the range of available NGS platforms requires different strategies and software to correctly assemble genomes. Different strategies are necessary to properly complete an assembly project, in addition to the installation or modification of various software. This requires users to have significant expertise in these software and command line scripting experience on Unix platforms, besides possessing the basic expertise on methodologies and techniques for genome assembly. These difficulties often delay the complete genome assembly projects. In order to overcome this, we developed SIMBA (SImple Manager for Bacterial Assemblies), a freely available web tool that integrates several component tools for assembling and finishing bacterial genomes. SIMBA provides a friendly and intuitive user interface so bioinformaticians, even with low computational expertise, can work under a centralized administrative control system of assemblies managed by the assembly center head. SIMBA guides the users to execute assembly process through simple and interactive pages. SIMBA workflow was divided in three modules: (i) projects: allows a general vision of genome sequencing projects, in addition to data quality analysis and data format conversions; (ii) assemblies: allows de novo assemblies with the software Mira, Minia, Newbler and SPAdes, also assembly quality validations using QUAST software; and (iii) curation: presents methods to finishing assemblies through tools for scaffolding contigs and close gaps. We also presented a case study that validated the efficacy of SIMBA to manage bacterial assemblies projects sequenced using Ion Torrent PGM. Besides to be a web tool for genome assembly, SIMBA is a complete genome assemblies project management system, which can be useful for managing of several projects in laboratories. SIMBA source code is available to download and install in local webservers at http://ufmg-simba.sourceforge.net .

Short-term Forecasting Tools for Agricultural Nutrient Management.

PubMed

Easton, Zachary M; Kleinman, Peter J A; Buda, Anthony R; Goering, Dustin; Emberston, Nichole; Reed, Seann; Drohan, Patrick J; Walter, M Todd; Guinan, Pat; Lory, John A; Sommerlot, Andrew R; Sharpley, Andrew

2017-11-01

The advent of real-time, short-term farm management tools is motivated by the need to protect water quality above and beyond the general guidance offered by existing nutrient management plans. Advances in high-performance computing and hydrologic or climate modeling have enabled rapid dissemination of real-time information that can assist landowners and conservation personnel with short-term management planning. This paper reviews short-term decision support tools for agriculture that are under various stages of development and implementation in the United States: (i) Wisconsin's Runoff Risk Advisory Forecast (RRAF) System, (ii) New York's Hydrologically Sensitive Area Prediction Tool, (iii) Virginia's Saturated Area Forecast Model, (iv) Pennsylvania's Fertilizer Forecaster, (v) Washington's Application Risk Management (ARM) System, and (vi) Missouri's Design Storm Notification System. Although these decision support tools differ in their underlying model structure, the resolution at which they are applied, and the hydroclimates to which they are relevant, all provide forecasts (range 24-120 h) of runoff risk or soil moisture saturation derived from National Weather Service Forecast models. Although this review highlights the need for further development of robust and well-supported short-term nutrient management tools, their potential for adoption and ultimate utility requires an understanding of the appropriate context of application, the strategic and operational needs of managers, access to weather forecasts, scales of application (e.g., regional vs. field level), data requirements, and outreach communication structure. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

PubMed

Arunasalam, Mark; Paulson, Albert; Wallace, William

2003-01-01

Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

LANDSAT supports data needs for EPA 208 planning. [water quality control and waste treatment management

NASA Technical Reports Server (NTRS)

1979-01-01

Excerpts from federal legislation and regulations mandating areawide waster treatment management as a means of restoring and maintaining the integrity of the nation's water are presented along with requirements for grants to the states for water quality planning, management, and implementation. Experiences using LANDSAT to identify nonpoint sources of water pollution as well as land/use/land cover features in South Dakota, Kentucky, Georgia, New Jersey, and Texas are described. Present activities suggest that this type of remote sensing is an efficient, effective tool for areawide water quality planning. Interaction with cognizant federal, state, and local government personnel involved in EPA section 208 planning activities can guide the development of new capabilities and enhance their utility and prospect for use.

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme.

PubMed

de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D

2005-01-01

Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.

Innovative Digital Tools and Surveillance Systems for the Timely Detection of Adverse Events at the Point of Care: A Proof-of-Concept Study.

PubMed

Hoppe, Christian; Obermeier, Patrick; Muehlhans, Susann; Alchikh, Maren; Seeber, Lea; Tief, Franziska; Karsch, Katharina; Chen, Xi; Boettcher, Sindy; Diedrich, Sabine; Conrad, Tim; Kisler, Bron; Rath, Barbara

2016-10-01

Regulatory authorities often receive poorly structured safety reports requiring considerable effort to investigate potential adverse events post hoc. Automated question-and-answer systems may help to improve the overall quality of safety information transmitted to pharmacovigilance agencies. This paper explores the use of the VACC-Tool (ViVI Automated Case Classification Tool) 2.0, a mobile application enabling physicians to classify clinical cases according to 14 pre-defined case definitions for neuroinflammatory adverse events (NIAE) and in full compliance with data standards issued by the Clinical Data Interchange Standards Consortium. The validation of the VACC-Tool 2.0 (beta-version) was conducted in the context of a unique quality management program for children with suspected NIAE in collaboration with the Robert Koch Institute in Berlin, Germany. The VACC-Tool was used for instant case classification and for longitudinal follow-up throughout the course of hospitalization. Results were compared to International Classification of Diseases , Tenth Revision (ICD-10) codes assigned in the emergency department (ED). From 07/2013 to 10/2014, a total of 34,368 patients were seen in the ED, and 5243 patients were hospitalized; 243 of these were admitted for suspected NIAE (mean age: 8.5 years), thus participating in the quality management program. Using the VACC-Tool in the ED, 209 cases were classified successfully, 69 % of which had been missed or miscoded in the ED reports. Longitudinal follow-up with the VACC-Tool identified additional NIAE. Mobile applications are taking data standards to the point of care, enabling clinicians to ascertain potential adverse events in the ED setting and during inpatient follow-up. Compliance with Clinical Data Interchange Standards Consortium (CDISC) data standards facilitates data interoperability according to regulatory requirements.

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.

Development of a self-assessment tool for measuring competences of obstetric nurses in rooming-in wards in China

PubMed Central

Zhang, Ju; Ye, Wenqin; Fan, Fan

2015-01-01

Introduction: To provide high-quality nursing care, a reliable and feasible competency assessment tool is critical. Although several questionnaire-based competency assessment tools have been reported, a tool specific for obstetric nurses in rooming-in wards is lacking. Therefore, the purpose of this research is to develop a competency assessment tool for obstetric rooming-in ward nurses. Methods: A literature review was conducted to create an individual intensive interview with 14 nurse managers, educators, and primary nurses in rooming-in wards. Expert reviews (n = 15) were conducted to identify emergent themes in a Delphi fashion. A competency assessment questionnaire was then developed and tested with 246 rooming-in ward nurses in local hospitals. Results: We constructed a three-factor linear model for obstetric rooming-in nurse competency assessment. Further refinement resulted in a self-assessment questionnaire containing three first-tier, 12 second-tier, and 43 third-tier items for easy implementation. The questionnaire was reliable, contained satisfactory content, and had construct validity. Discussion: Our competency assessment tool provides a systematic, easy, and operational subjective evaluation model for nursing managers and administrators to evaluate obstetric rooming-in ward primary nurses. The application of this tool will facilitate various human resources functions, such as nurse training/education effect evaluation, and will eventually promote high-quality nursing care delivery. PMID:26770468

A new tool to adapt the treatment of Parkinson's disease patients in nursing homes.

PubMed

Geny, Christian; Verna, Claudia; Arifi, Alexia; Ferreira, Ernestine; Boubakri, Choukri; Blain, Hubert

2018-03-01

Parkinson's disease (PD) is a common condition in nursing home (NH) residents. The primary treatment for Parkinson's disease is levodopa therapy to relieve motor symptoms and maximize physical function. Non-motor symptoms are highly prevalent in NH residents with Parkinson's disease and dramatically decrease quality of life. Choices in drug treatment need to take into account the complex interactions between aging, comorbidity and non-motor symptoms. Optimal management requires expertise and cooperative effort from prescribing neurologists and nursing home health professionals. The objective is to evaluate the pertinence of the CHEF, a new tool to screen daily life clinical data helpful for the management of neurologist consultants. NH nurses were asked to briefly report falls and gait problems, hallucinations, sleep disorders and motor fluctuations. Analysis of the results obtained in 26 patients showed that CHEF was perceived as a helpful complement to existing ressources. The use of this tool has the potential to enhance the quality of NH care of Parkinsonian patients.

Lean management: innovative tools for engaging teams in continuous quality improvement.

PubMed

Perreault, Lucille; Vaillancourt, Lise; Filion, Catherine; Hadj, Camélia

2014-01-01

Lean management has proven to be a sustainable method to ensure a high level of patient care through innovation and teamwork. It involves a set of six tools that allow for visual management shared among team members. The team focuses their efforts on the improvement of organizational indicators in a standardized and engaging way, resulting in the sustainability of improvements. This article outlines the program's rollout at Montfort Hospital (l'Hôpital Montfort). In only a few months, two pilot units accomplished close to 50 improvements each. In addition, the organizational employee satisfaction questionnaire showed very positive results. Copyright © 2014 Longwoods Publishing.

Institutional Advancement: Using the Malcolm Baldrige National Quality Award Criteria for Self-Study and Accreditation.

ERIC Educational Resources Information Center

Cooke, Brian

The criteria used for the Malcolm Baldrige National Quality Award can provide community colleges with a strategic tool for college planning, management, assessment, and accreditation. The Criteria focus on two measurable objectives for institutional effectiveness: the delivery of educational value to current and future students through instruction…

Quality Management and Self Assessment Tools for Public Libraries.

ERIC Educational Resources Information Center

Evans, Margaret Kinnell

This paper describes a two-year study by the British Library Research and Innovation Centre that examined the potential of self-assessment for public library services. The approaches that formed the basis for the investigation were the Business Excellence Model, the Quality Framework, and the Democratic Approach. Core values were identified by…

QUALITY ASSURANCE AND QUALITY CONTROL IN THE DEVELOPMENT AND APPLICATION OF THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Planning and assessment in land and water resource management are evolving from simple, local-scale problems toward complex, spatially explicit regional ones. Such problems have to be addressed with distributed models that can compute runoff and erosion at different spatial and t...

Defining Strategic and Excellence Bases for the Development of Portuguese Higher Education

ERIC Educational Resources Information Center

Rosa, Maria Joao; Saraiva, Pedro M.; Diz, Henrique

2005-01-01

A self-assessment model was developed for the Portuguese higher education institutions (HEIs) which was based on an empirical study aiming at better understanding their strategic and quality management and innovation practices and tools and on the study of several quality assessment models developed both for HEIs and business organisations. From…

Monitoring Urban Quality of Life: The Porto Experience

ERIC Educational Resources Information Center

Santos, Luis Delfim; Martins, Isabel

2007-01-01

This paper describes the monitoring system of the urban quality of life developed by the Porto City Council, a new tool being used to support urban planning and management. The two components of this system--a quantitative approach based on statistical indicators and a qualitative analysis based on the citizens' perceptions of the conditions of…

Analytical steady-state solutions for water-limited cropping systems using saline irrigation water

USDA-ARS?s Scientific Manuscript database

Due to the diminishing availability of good quality water for irrigation, it is increasingly important that irrigation and salinity management tools be able to target submaximal crop yields and support the use of marginal quality waters. In this work, we present a steady-state irrigated systems mod...

GLIMPSE: A decision support tool for simultaneously achieving our air quality management and climate change mitigation goals

NASA Astrophysics Data System (ADS)

Pinder, R. W.; Akhtar, F.; Loughlin, D. H.; Henze, D. K.; Bowman, K. W.

2012-12-01

Poor air quality, ecosystem damages, and climate change all are caused by the combustion of fossil fuels, yet environmental management often addresses each of these challenges separately. This can lead to sub-optimal strategies and unintended consequences. Here we present GLIMPSE -- a decision support tool for simultaneously achieving our air quality and climate change mitigation goals. GLIMPSE comprises of two types of models, (i) the adjoint of the GEOS-Chem chemical transport model, to calculate the relationship between emissions and impacts at high spatial resolution, and (ii) the MARKAL energy system model, to calculate the relationship between energy technologies and emissions. This presentation will demonstrate how GLIMPSE can be used to explore energy scenarios to better achieve both improved air quality and mitigate climate change. Second, this presentation will discuss how space-based observations can be incorporated into GLIMPSE to improve decision-making. NASA satellite products, namely ozone radiative forcing from the Tropospheric Emission Spectrometer (TES), are used to extend GLIMPSE to include the impact of emissions on ozone radiative forcing. This provides a much needed observational constraint on ozone radiative forcing.

[Process orientation as a tool of strategic approaches to corporate governance and integrated management systems].

PubMed

Sens, Brigitte

2010-01-01

The concept of general process orientation as an instrument of organisation development is the core principle of quality management philosophy, i.e. the learning organisation. Accordingly, prestigious quality awards and certification systems focus on process configuration and continual improvement. In German health care organisations, particularly in hospitals, this general process orientation has not been widely implemented yet - despite enormous change dynamics and the requirements of both quality and economic efficiency of health care processes. But based on a consistent process architecture that considers key processes as well as management and support processes, the strategy of excellent health service provision including quality, safety and transparency can be realised in daily operative work. The core elements of quality (e.g., evidence-based medicine), patient safety and risk management, environmental management, health and safety at work can be embedded in daily health care processes as an integrated management system (the "all in one system" principle). Sustainable advantages and benefits for patients, staff, and the organisation will result: stable, high-quality, efficient, and indicator-based health care processes. Hospitals with their broad variety of complex health care procedures should now exploit the full potential of total process orientation. Copyright © 2010. Published by Elsevier GmbH.

Role of Knowledge Management in Development and Lifecycle Management of Biopharmaceuticals.

PubMed

Rathore, Anurag S; Garcia-Aponte, Oscar Fabián; Golabgir, Aydin; Vallejo-Diaz, Bibiana Margarita; Herwig, Christoph

2017-02-01

Knowledge Management (KM) is a key enabler for achieving quality in a lifecycle approach for production of biopharmaceuticals. Due to the important role that it plays towards successful implementation of Quality by Design (QbD), an analysis of KM solutions is needed. This work provides a comprehensive review of the interface between KM and QbD-driven biopharmaceutical production systems as perceived by academic as well as industrial viewpoints. A comprehensive set of 356 publications addressing the applications of KM tools to QbD-related tasks were screened and a query to gather industrial inputs from 17 major biopharmaceutical organizations was performed. Three KM tool classes were identified as having high relevance for biopharmaceutical production systems and have been further explored: knowledge indicators, ontologies, and process modeling. A proposed categorization of 16 distinct KM tool classes allowed for the identification of holistic technologies supporting QbD. In addition, the classification allowed for addressing the disparity between industrial and academic expectations regarding the application of KM methodologies. This is a first of a kind attempt and thus we think that this paper would be of considerable interest to those in academia and industry that are engaged in accelerating development and commercialization of biopharmaceuticals.

MedAd-AppQ: A quality assessment tool for medication adherence apps on iOS and android platforms.

PubMed

Ali, Eskinder Eshetu; Teo, Amanda Kai Sin; Goh, Sherlyn Xue Lin; Chew, Lita; Yap, Kevin Yi-Lwern

2018-02-02

With the recent proliferation of smartphone medication adherence applications (apps), it is increasingly more difficult for patients and clinicians to identify the most useful app. To develop a quality assessment tool for medication adherence apps, and evaluate the quality of such apps from the major app stores. In this study, a Medication Adherence App Quality assessment tool (MedAd-AppQ) was developed and two evaluators independently assessed apps that fulfilled the following criteria: availability in English, had at least a medication reminder feature, non-specific to certain disease conditions (generic apps), free of technical malfunctions and availability on both the iPhone Operating System (iOS) and Android platforms. Descriptive statistics, Mann-Whitney U test, Pearson product moment correlation and Spearman rank-order correlation were used for statistical analysis. MedAd-AppQ was designed to have 24 items (total 43 points) categorized under three sections: content reliability (11 points), feature usefulness (29 points) and feature convenience (3 points). The three sections of MedAd-AppQ were found to have inter-rater correlation coefficients of 0.801 (p-value < .001) or higher. Based on analysis of 52 apps (27 iOS and 25 Android), quality scores ranged between 7/43 (16.3%) and 28/43 (65.1%). There was no significant difference between the quality scores of the Android and iOS versions. None of the apps had features for self-management of side effects. Only two apps in each platform provided disease-related and/or medication information. MedAd-AppQ can be used to reliably assess the quality of adherence apps. Clinicians can use the tool in selecting apps for use by patients. Developers of adherence apps should consider features that provide therapy-related information and help patients in medications and side-effects management. Copyright © 2018 Elsevier Inc. All rights reserved.

Using ESRI Online Mapping Tools to Support STEM Learning through Analysis of the Impact of Land Use/Land Cover Change on Water Quality

NASA Astrophysics Data System (ADS)

Powley, C.; Alian, S.; Mayer, A.

2017-12-01

In the 2004 National Water Quality Report to the Congress, the US EPA states that about 44% of the streams, 64% of lakes and 30% of estuaries that were assessed were not suitable for basic use like fishing and swimming. Pollutants from nonpoint sources are most likely the cause. The needs of landowners to use their land for other uses is enormous and most are likely willing to forgo the potential damage to achieve monetary gains. These are difficult decisions as there are many positive gains in commercialized development, although this comes with a cost. So it is imperative for all entities to work together in developing an awareness that benefits all stakeholders. We used this water quality management context to prepare lessons for high school students to map water quality problem areas in Rifle River and the West Branch in Ogemaw County, Michigan based on field samples and by using ESRI online data entry and mapping tools. The students also used Long Term Hydrologic Impact Analysis (L-THIA) to evaluate the impacts of different land use/cover types, developing an understanding of the implication of land management on surface water quality.

Chesapeake Bay Program Water Quality Database

EPA Pesticide Factsheets

The Chesapeake Information Management System (CIMS), designed in 1996, is an integrated, accessible information management system for the Chesapeake Bay Region. CIMS is an organized, distributed library of information and software tools designed to increase basin-wide public access to Chesapeake Bay information. The information delivered by CIMS includes technical and public information, educational material, environmental indicators, policy documents, and scientific data. Through the use of relational databases, web-based programming, and web-based GIS a large number of Internet resources have been established. These resources include multiple distributed on-line databases, on-demand graphing and mapping of environmental data, and geographic searching tools for environmental information. Baseline monitoring data, summarized data and environmental indicators that document ecosystem status and trends, confirm linkages between water quality, habitat quality and abundance, and the distribution and integrity of biological populations are also available. One of the major features of the CIMS network is the Chesapeake Bay Program's Data Hub, providing users access to a suite of long- term water quality and living resources databases. Chesapeake Bay mainstem and tidal tributary water quality, benthic macroinvertebrates, toxics, plankton, and fluorescence data can be obtained for a network of over 800 monitoring stations.

Faculty Recommendations for Web Tools: Implications for Course Management Systems

ERIC Educational Resources Information Center

Oliver, Kevin; Moore, John

2008-01-01

A gap analysis of web tools in Engineering was undertaken as one part of the Digital Library Network for Engineering and Technology (DLNET) grant funded by NSF (DUE-0085849). DLNET represents a Web portal and an online review process to archive quality knowledge objects in Engineering and Technology disciplines. The gap analysis coincided with the…

Spawning Ideas--Moving from Ideas to Action: Quality Tools for Collective Problem-Solving and Continuous Learning.

ERIC Educational Resources Information Center

Flor, Richard F.; Troskey, Matthew D.

This paper explores the dynamics of managing collective problem solving and decision making, and the application of tools and strategies to deal with the emergent complexity of systems in which educators work. Schools and educational programs are complex adaptive systems that respond to changes in internal and external environments. Functioning…

A Quantitative Analysis of Open Source Software's Acceptability as Production-Quality Code

ERIC Educational Resources Information Center

Fischer, Michael

2011-01-01

The difficulty in writing defect-free software has been long acknowledged both by academia and industry. A constant battle occurs as developers seek to craft software that works within aggressive business schedules and deadlines. Many tools and techniques are used in attempt to manage these software projects. Software metrics are a tool that has…

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal.

PubMed

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M Juliana; Hural, John

2014-07-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure that viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×10(6)±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8-3.2×10(6) cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and a recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%-130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. Copyright © 2014 Elsevier B.V. All rights reserved.

Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

PubMed

Reed, Shelby D; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L; Bowers, Margaret T; Samsa, Gregory P; Paul, Sara; Schulman, Kevin A; Whellan, David J; Riegel, Barbara J

2012-01-01

Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

Supporting Goal-Oriented Primary Health Care for Seniors with Complex Care Needs Using Mobile Technology: Evaluation and Implementation of the Health System Performance Research Network, Bridgepoint Electronic Patient Reported Outcome Tool.

PubMed

Steele Gray, Carolyn; Wodchis, Walter P; Upshur, Ross; Cott, Cheryl; McKinstry, Brian; Mercer, Stewart; Palen, Ted E; Ramsay, Tim; Thavorn, Kednapa

2016-06-24

Older adults experiencing multiple chronic illnesses are at high risk of hospitalization and health decline if they are unable to manage the significant challenges posed by their health conditions. Goal-oriented care approaches can provide better care for these complex patients, but clinicians find the process of ascertaining goals "too complex and too-time consuming," and goals are often not agreed upon between complex patients and their providers. The electronic patient reported outcomes (ePRO) mobile app and portal offers an innovative approach to creating and monitoring goal-oriented patient-care plans to improve patient self-management and shared decision-making between patients and health care providers. The ePRO tool also supports proactive patient monitoring by the patient, caregiver(s), and health care provider. It was developed with and for older adults with complex care needs as a means to improve their quality of life. Our proposed project will evaluate the use, effectiveness, and value for money of the ePRO tool in a 12-month multicenter, randomized controlled trial in Ontario; targeting individuals 65 or over with two or more chronic conditions that require frequent health care visits to manage their health conditions. Intervention groups using the ePRO tool will be compared with control groups on measures of quality of life, patient experience, and cost-effectiveness. We will also evaluate the implementation of the tool. The proposed project presented in this paper will be funded through the Canadian Institute for Health Research (CIHR) eHealth Innovation Partnerships Program (eHIPP) program (CIHR-348362). The expected completion date of the study is November, 2019. We anticipate our program of work will support improved quality of life and patient self-management, improved patient-centered primary care delivery, and will encourage the adoption of goal-oriented care approaches across primary health care systems. We have partnered with family health teams and quality improvement organizations in Ontario to ensure that our research is practical and that findings are shared widely. We will work with our established international network to develop an implementation framework to support continued adaptation and adoption across Canada and internationally.

Supporting Goal-Oriented Primary Health Care for Seniors with Complex Care Needs Using Mobile Technology: Evaluation and Implementation of the Health System Performance Research Network, Bridgepoint Electronic Patient Reported Outcome Tool

PubMed Central

Wodchis, Walter P; Upshur, Ross; Cott, Cheryl; McKinstry, Brian; Mercer, Stewart; Palen, Ted E; Ramsay, Tim; Thavorn, Kednapa

2016-01-01

Background Older adults experiencing multiple chronic illnesses are at high risk of hospitalization and health decline if they are unable to manage the significant challenges posed by their health conditions. Goal-oriented care approaches can provide better care for these complex patients, but clinicians find the process of ascertaining goals “too complex and too-time consuming,” and goals are often not agreed upon between complex patients and their providers. The electronic patient reported outcomes (ePRO) mobile app and portal offers an innovative approach to creating and monitoring goal-oriented patient-care plans to improve patient self-management and shared decision-making between patients and health care providers. The ePRO tool also supports proactive patient monitoring by the patient, caregiver(s), and health care provider. It was developed with and for older adults with complex care needs as a means to improve their quality of life. Objective Our proposed project will evaluate the use, effectiveness, and value for money of the ePRO tool in a 12-month multicenter, randomized controlled trial in Ontario; targeting individuals 65 or over with two or more chronic conditions that require frequent health care visits to manage their health conditions. Methods Intervention groups using the ePRO tool will be compared with control groups on measures of quality of life, patient experience, and cost-effectiveness. We will also evaluate the implementation of the tool. Results The proposed project presented in this paper will be funded through the Canadian Institute for Health Research (CIHR) eHealth Innovation Partnerships Program (eHIPP) program (CIHR–143559). The expected completion date of the study is November, 2019. Conclusions We anticipate our program of work will support improved quality of life and patient self-management, improved patient-centered primary care delivery, and will encourage the adoption of goal-oriented care approaches across primary health care systems. We have partnered with family health teams and quality improvement organizations in Ontario to ensure that our research is practical and that findings are shared widely. We will work with our established international network to develop an implementation framework to support continued adaptation and adoption across Canada and internationally. PMID:27341765

Communicative Management in Ambulatory Services: Prehospital Management Communication--Limits and Possibilities.

PubMed

Nordby, Halvor

2015-01-01

Poor management communication in healthcare services affects employees' motivation, commitment, and, in the final instance, organizational performance and the quality of patient care. In any area of health management, good communication is, therefore, key to successful management. This article discusses how managers of ambulance stations should secure communication with their paramedic crews. The first part uses ethical concepts to analyze communicative disagreement in interactive dialogue between managers and paramedics. The second part outlines basic communication principles that can serve as conceptual tools for avoiding misinterpretation in prehospital manager-employee interaction.

AQUATIC ECOSYSTEM PROTECTION AND FISHERIES MANAGEMENT IN THE MID-ATLANTIC HIGHLANDS (USA) USING WHAT IF: A COLLABORATION OF THE CANAAN VALLEY INSTITUTE, THE OFFICE OF RESEARCH AND DEVELOPMENT AND REGION III

EPA Science Inventory

As described in its Highlands Action Program, the Canaan Valley Institute (CVI) partnered with the US EPA to develop a watershed assessment and management tool that allows managers to evaluate riparian restoration actions to improve instream habitat quality and aquatic community ...

Forecasting landscape-scale, cumulative effects of forest management on vegetation and wildlife habitat: a case study of issues, limitations, and opportunities

Treesearch

Stephen R. Shifley; Frank R. Thompson; William D. Dijak; Zhaofei F. Fan

2008-01-01

Forest landscape disturbance and succession models have become practical tools for large-scale, long-term analyses of the cumulative effects of forest management on real landscapes. They can provide essential information in a spatial context to address management and policy issues related to forest planning, wildlife habitat quality, timber harvesting, fire effects,...

Course Management Systems in Higher Education: Understanding Student Experiences

ERIC Educational Resources Information Center

Yuen, Allan; Fox, Robert; Sun, Angie; Deng, Liping

2009-01-01

Purpose: The course management system (CMS), as an evolving tool and innovation, is increasingly used to promote the quality, efficiency and flexibility of teaching and learning in higher education. This paper aims to examine students' experiences of CMSs across faculties at a comprehensive university in Hong Kong. Design/methodology/approach:…

The 4Rs for cover crops and other advances in cover crop management for environmental quality

USDA-ARS?s Scientific Manuscript database

Cover crops (CC) are universal tools that can be used to improve management practices to draw multiple benefits with increased sustainability across different continents (Dabney et al. 2001; Reeves 1994; Woodruff and Siddoway 1965; Frye et al. 1985; Holderbaum et al. 1990; Bilbro 1991; Langdale et a...

A review of distributed parameter groundwater management modeling methods

USGS Publications Warehouse

Gorelick, Steven M.

1983-01-01

Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.

A Review of Distributed Parameter Groundwater Management Modeling Methods

NASA Astrophysics Data System (ADS)

Gorelick, Steven M.

1983-04-01

Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.

Facilitating quality control for spectra assignments of small organic molecules: nmrshiftdb2--a free in-house NMR database with integrated LIMS for academic service laboratories.

PubMed

Kuhn, Stefan; Schlörer, Nils E

2015-08-01

nmrshiftdb2 supports with its laboratory information management system the integration of an electronic lab administration and management into academic NMR facilities. Also, it offers the setup of a local database, while full access to nmrshiftdb2's World Wide Web database is granted. This freely available system allows on the one hand the submission of orders for measurement, transfers recorded data automatically or manually, and enables download of spectra via web interface, as well as the integrated access to prediction, search, and assignment tools of the NMR database for lab users. On the other hand, for the staff and lab administration, flow of all orders can be supervised; administrative tools also include user and hardware management, a statistic functionality for accounting purposes, and a 'QuickCheck' function for assignment control, to facilitate quality control of assignments submitted to the (local) database. Laboratory information management system and database are based on a web interface as front end and are therefore independent of the operating system in use. Copyright © 2015 John Wiley & Sons, Ltd.

Design of an instrument to measure the quality of care in Physical Therapy

PubMed Central

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; do Prado, Cristiane; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care. PMID:26154548

Real-time video quality monitoring

NASA Astrophysics Data System (ADS)

Liu, Tao; Narvekar, Niranjan; Wang, Beibei; Ding, Ran; Zou, Dekun; Cash, Glenn; Bhagavathy, Sitaram; Bloom, Jeffrey

2011-12-01

The ITU-T Recommendation G.1070 is a standardized opinion model for video telephony applications that uses video bitrate, frame rate, and packet-loss rate to measure the video quality. However, this model was original designed as an offline quality planning tool. It cannot be directly used for quality monitoring since the above three input parameters are not readily available within a network or at the decoder. And there is a great room for the performance improvement of this quality metric. In this article, we present a real-time video quality monitoring solution based on this Recommendation. We first propose a scheme to efficiently estimate the three parameters from video bitstreams, so that it can be used as a real-time video quality monitoring tool. Furthermore, an enhanced algorithm based on the G.1070 model that provides more accurate quality prediction is proposed. Finally, to use this metric in real-world applications, we present an example emerging application of real-time quality measurement to the management of transmitted videos, especially those delivered to mobile devices.

The relationship between advertising, price, and nursing home quality.

PubMed

Kash, Bita A; Miller, Thomas R

2009-01-01

Theoretically, nursing homes should engage in advertising for the following two reasons: (a) to improve awareness of the services offered in a particular market and (b) to signal high-quality services. In this study, we build upon results from prior studies of nursing home advertising activity, market competition, and quality. The purpose of this study was to examine the association between advertising expenses, price, and quality. We focused on answering the question: Do nursing homes use advertising and price to signal superior quality? The Texas Nursing Facilities Medicaid Cost Report, the Texas Quality Reporting System, and the Area Resource File were merged for the year 2003. We used three alternative measures of quality to improve the robustness of this exploratory analysis. Quality measures were examined using Bonferroni correlation coefficient analysis. Associations between advertising expenses and quality were evaluated using three regression models predicting quality. We also examined the association of the price of a private bed per day with quality. Advertising expenses were not associated with better nursing home quality as measured by three quality scales. The average price customers pay for one private bed per day was associated with better quality only in one of the three quality regression models. The price of nursing home care might be a better indicator of quality and necessary to increase as quality of care is improved in the nursing homes sector. Because more advertising expenditures are not necessarily associated with better quality, consumers could be mislead by advertisements and choose poor quality nursing homes. Nursing home administrators should focus on customer relationship management tools instead of expensive advertising. Relationship management tools are proven marketing techniques for the health services sector, usually less expensive than advertising, and help with staff retention and quality outcomes.

Assessing the evidence of Six Sigma and Lean in the health care industry.

PubMed

DelliFraine, Jami L; Langabeer, James R; Nembhard, Ingrid M

2010-01-01

Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality. The authors conducted a comprehensive literature review to assess the empirical evidence relating SS/L to improved clinical outcomes, processes of care, and financial performance of health care organizations. The authors identified 177 articles on SS/L published in the last 10 years. However, only 34 of them reported any outcomes of the SS/L projects studied, and less than one-third of these articles included statistical analyses to test for significant changes in outcomes. This review demonstrates that there are significant gaps in the SS/L health care quality improvement literature and very weak evidence that SS/L improve health care quality.

An object-oriented watershed management tool (QnD-VFS) to engage stakeholders in targeted implementation of filter strips in an arid surface irrigation area

NASA Astrophysics Data System (ADS)

Campo, M. A.; Perez-Ovilla, O.; Munoz-Carpena, R.; Kiker, G.; Ullman, J. L.

2012-12-01

Agricultural nonpoint source pollution cause the majority of the 1,224 different waterbodies failing to meet designated water use criteria in Washington. Although various best management practices (BMPs) are effective in mitigating agricultural pollutants, BMP placement is often haphazard and fails to address specific high-risk locations. Limited financial resources necessitate optimization of conservation efforts to meet water quality goals. Thus, there is a critical need to develop decision-making tools that target BMP implementation in order to maximize water quality protection. In addition to field parameters, it is essential to incorporate economic and social determinants in the decision-making process to encourage producer involvement. Decision-making tools that identify strategic pollution sources and integrate socio-economic factors will lead to more cost-effective water quality improvement, as well as encourage producer participation by incorporating real-world limitations. Therefore, this study examines vegetative filter strip use under different scenarios as a BMP to mitigate sediment and nutrients in the highly irrigated Yakima River Basin of central Washington. We developed QnD-VFS to integrate and visualize alternative, spatially-explicit, water management strategies and its economic impact. The QnDTM system was created as a decision education tool that incorporates management, economic, and socio- political issues in a user-friendly scenario framework. QnDTM, which incorporates elements of Multi-Criteria Decision Analysis (MCDA) and risk assessment, is written in object-oriented Java and can be deployed as a stand-alone program or a web-accessed tool. The model performs Euler numerical integration of various rate transformation and mass-balance transfer equations. The novelty of this object-oriented approach is that these differential equations are detailed in modular XML format for instantiation within the Java code. This design allows many levels of complexity to be quickly designed and rendered in QnDTM without time-consuming additions of new Java code. Thus, temporal and spatial scales used in the equations become part of model development and iteration. A salient aspect is that QnDTM links spatial components within GIS (ArcInfo Shape) files to the abiotic (e.g., climate), biotic and chemical/contaminant interactions. QnD-VFS integrates environmental, management and socio-economic/cultural factors identified through stakeholder input. Several scenarios have been studied. Thus one of the main results show that changing water management, improved irrigation, is equivalent to changing length of vegetative filter strips, with a low economic impacts for farmers. Concurrently, these interactive tools allow resource managers to identify economic and social determinants that may impede conservation efforts.

Increasing the Use of Earth Science Data and Models in Air Quality Management.

PubMed

Milford, Jana B; Knight, Daniel

2017-04-01

In 2010, the U.S. National Aeronautics and Space Administration (NASA) initiated the Air Quality Applied Science Team (AQAST) as a 5-year, $17.5-million award with 19 principal investigators. AQAST aims to increase the use of Earth science products in air quality-related research and to help meet air quality managers' information needs. We conducted a Web-based survey and a limited number of follow-up interviews to investigate federal, state, tribal, and local air quality managers' perspectives on usefulness of Earth science data and models, and on the impact AQAST has had. The air quality managers we surveyed identified meeting the National Ambient Air Quality Standards for ozone and particulate matter, emissions from mobile sources, and interstate air pollution transport as top challenges in need of improved information. Most survey respondents viewed inadequate coverage or frequency of satellite observations, data uncertainty, and lack of staff time or resources as barriers to increased use of satellite data by their organizations. Managers who have been involved with AQAST indicated that the program has helped build awareness of NASA Earth science products, and assisted their organizations with retrieval and interpretation of satellite data and with application of global chemistry and climate models. AQAST has also helped build a network between researchers and air quality managers with potential for further collaborations. NASA's Air Quality Applied Science Team (AQAST) aims to increase the use of satellite data and global chemistry and climate models for air quality management purposes, by supporting research and tool development projects of interest to both groups. Our survey and interviews of air quality managers indicate they found value in many AQAST projects and particularly appreciated the connections to the research community that the program facilitated. Managers expressed interest in receiving continued support for their organizations' use of satellite data, including assistance in retrieving and interpreting data from future geostationary platforms meant to provide more frequent coverage for air quality and other applications.

Total Quality Management in Construction

DTIC Science & Technology

1993-08-01

1989. I Ishikawa , Kaoru . Guide to Quality Control. White Plains, New York: Asian Productivity Organization, 1982. 5 Kelso, Frank B. II, Admiral...category are explored to determine the most significant causes which produce the effect. Figure 24 shows a typical cause-and effect diagram. Kaoru ... Ishikawa describes cause-and-effect diagrams as I an effective tool "to clearly illustrate the various causes I affecting quality by sorting out and relating

Meeting the challenge of assessing clinical competence of occupational therapists within a program management environment.

PubMed

Salvatori, Penny; Simonavicius, Nijole; Moore, Joan; Rimmer, Georgina; Patterson, Michele

2008-02-01

Program management models have raised concerns among occupational therapists about professional standards related to clinical competence, performance review procedures, and quality improvement initiatives. This paper describes how a chart-stimulated recall (CSR) peer-review process and interview tool was revised, implemented, and evaluated as a pilot project to assess the clinical competence of occupational therapy staff at a large urban health centre in southern Ontario. Fourteen pairs (n=28) of occupational therapists representing various practice areas participated in this project. Half served as peer assessors and half as interviewees. Peer assessors conducted an independent chart review followed by a one-hour personal interview with a peer partner to discuss clinical management issues related to the client cases. Each interviewer rated his or her partner's clinical competence in eight areas of performance using a 7-point Likert scale. Results indicated that the CSR tool could discriminate among occupational therapists in terms of overall levels of clinical competence and also identify specific areas of concern that could be targeted for professional development. Feedback from participants was positive. The CSR tool was found to be useful for assessing clinical competence of occupational therapists in this large health centre as a quality improvement initiative within that discipline group. Further research is needed to establish the reliability and validity of the CSR tool.

Data warehousing as a tool for quality management in oncology.

PubMed

Hölzer, S; Tafazzoli, A G; Altmann, U; Wächter, W; Dudeck, J

1999-01-01

At present, physicians are constrained by their limited skills to integrate and understand the growing amount of electronic medical information. To handle, extract, integrate, analyse and take advantage of the gathered information regarding the quality of patient care, the concept of a data warehouse seems to be especially interesting in medicine. Medical data warehousing allows the physicians to take advantage of all the operational data they have been collecting over the years. Our purpose is to build a data warehouse in order to use all available information about cancer patients. We think that with the sensible use of this tool, there are economic benefits for the Society and an improvement of quality of medical care for patients.

Implementing iRound: A Computer-Based Auditing Tool.

PubMed

Brady, Darcie

Many hospitals use rounding or auditing as a tool to help identify gaps and needs in quality and process performance. Some hospitals are also using rounding to help improve patient experience. It is known that purposeful rounding helps improve Hospital Consumer Assessment of Healthcare Providers and Systems scores by helping manage patient expectations, provide service recovery, and recognize quality caregivers. Rounding works when a standard method is used across the facility, where data are comparable and trustworthy. This facility had a pen-and-paper process in place that made data reporting difficult, created a silo culture between departments, and most audits and rounds were completed differently on each unit. It was recognized that this facility needed to standardize the rounding and auditing process. The tool created by the Advisory Board called iRound was chosen as the tool this facility would use for patient experience rounds as well as process and quality rounding. The success of the iRound tool in this facility depended on several factors that started many months before implementation to current everyday usage.

Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

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

Taggart, J.; Sikora, J.; Wiehagen, J.

2011-12-01

This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling andmore » quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.« less

Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

PubMed Central

Straus, Sharon E.

2008-01-01

BACKGROUND Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. OBJECTIVE To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. DATA SOURCES Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. REVIEW METHODS Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. RESULTS Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). CONCLUSION Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0812-9) contains supplementary material, which is available to authorized users. PMID:18836782

Prostate cancer: how assessment of QoL can improve delivery of care.

PubMed

Brown, Michelle

Prostate cancer treatments often affect quality of life and problems may present at any point during treatment. Measuring and identifying issues of quality of life (QoL) may create an opportunity for the patient to discuss problems and induce information transfer from health professional to patient and vice versa. Many practitioners already assess QoL in patients with prostate cancer because treatment for the disease can have a dramatic impact on lifestyle. QoL may facilitate a more holistic approach to patient care. Using a QoL assessment tool may promote and enhance the current service provision and aid identification of bothersome side-effects, for example loss of libido, gynaecomastia (i.e. abnormal over-development of the breasts in a man), and hot flushes. The Functional Assessment of Cancer Therapy-Prostate scale (FACT-P) (Cella et al, 1993) is a prostate-specific QoL assessment tool, which can be self-administered and takes little time to complete. This may be a useful tool in the ongoing management of patients with advanced prostate cancer. With the emphasis on quality of service for cancer patients (Department of Health (DH), 2000; DH, 2007a; National Health Service Improvement, 2009), it is paramount that health professionals continually examine practice and the quality of the service delivered. Addressing QoL issues for the patient with cancer should be a priority. This article will outline the significant side-effects that a patient with advanced prostate cancer may sustain and attempts to indicate how QoL assessment tools may contribute to care management and delivery.

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.

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

PubMed

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

2009-03-01

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

Assessment of coastal management options by means of multilayered ecosystem models

NASA Astrophysics Data System (ADS)

Nobre, Ana M.; Ferreira, João G.; Nunes, João P.; Yan, Xiaojun; Bricker, Suzanne; Corner, Richard; Groom, Steve; Gu, Haifeng; Hawkins, Anthony J. S.; Hutson, Rory; Lan, Dongzhao; Silva, João D. Lencart e.; Pascoe, Philip; Telfer, Trevor; Zhang, Xuelei; Zhu, Mingyuan

2010-03-01

This paper presents a multilayered ecosystem modelling approach that combines the simulation of the biogeochemistry of a coastal ecosystem with the simulation of the main forcing functions, such as catchment loading and aquaculture activities. This approach was developed as a tool for sustainable management of coastal ecosystems. A key feature is to simulate management scenarios that account for changes in multiple uses and enable assessment of cumulative impacts of coastal activities. The model was applied to a coastal zone in China with large aquaculture production and multiple catchment uses, and where management efforts to improve water quality are under way. Development scenarios designed in conjunction with local managers and aquaculture producers include the reduction of fish cages and treatment of wastewater. Despite the reduction in nutrient loading simulated in three different scenarios, inorganic nutrient concentrations in the bay were predicted to exceed the thresholds for poor quality defined by Chinese seawater quality legislation. For all scenarios there is still a Moderate High to High nutrient loading from the catchment, so further reductions might be enacted, together with additional decreases in fish cage culture. The model predicts that overall, shellfish production decreases by 10%-28% using any of these development scenarios, principally because shellfish growth is being sustained by the substances to be reduced for improvement of water quality. The model outcomes indicate that this may be counteracted by zoning of shellfish aquaculture at the ecosystem level in order to optimize trade-offs between productivity and environmental effects. The present case study exemplifies the value of multilayered ecosystem modelling as a tool for Integrated Coastal Zone Management and for the adoption of ecosystem approaches for marine resource management. This modelling approach can be applied worldwide, and may be particularly useful for the application of coastal management regulation, for instance in the implementation of the European Marine Strategy Framework Directive.

Pairing top-down and bottom-up approaches to analyze catchment scale management of water quality and quantity

NASA Astrophysics Data System (ADS)

Lovette, J. P.; Duncan, J. M.; Band, L. E.

2016-12-01

Watershed management requires information on the hydrologic impacts of local to regional land use, land cover and infrastructure conditions. Management of runoff volumes, storm flows, and water quality can benefit from large scale, "top-down" screening tools, using readily available information, as well as more detailed, "bottom-up" process-based models that explicitly track local runoff production and routing from sources to receiving water bodies. Regional scale data, available nationwide through the NHD+, and top-down models based on aggregated catchment information provide useful tools for estimating regional patterns of peak flows, volumes and nutrient loads at the catchment level. Management impacts can be estimated with these models, but have limited ability to resolve impacts beyond simple changes to land cover proportions. Alternatively, distributed process-based models provide more flexibility in modeling management impacts by resolving spatial patterns of nutrient source, runoff generation, and uptake. This bottom-up approach can incorporate explicit patterns of land cover, drainage connectivity, and vegetation extent, but are typically applied over smaller areas. Here, we first model peak flood flows and nitrogen loads across North Carolina's 70,000 NHD+ catchments using USGS regional streamflow regression equations and the SPARROW model. We also estimate management impact by altering aggregated sources in each of these models. To address the missing spatial implications of the top-down approach, we further explore the demand for riparian buffers as a management strategy, simulating the accumulation of nutrient sources along flow paths and the potential mitigation of these sources through forested buffers. We use the Regional Hydro-Ecological Simulation System (RHESSys) to model changes across several basins in North Carolina's Piedmont and Blue Ridge regions, ranging in size from 15 - 1,130 km2. The two approaches provide a complementary set of tools for large area screening, followed by smaller, more process based assessment and design tools.

FREEWAT: an HORIZON 2020 project to build open source tools for water management.

NASA Astrophysics Data System (ADS)

Foglia, L.; Rossetto, R.; Borsi, I.; Mehl, S.; Velasco Mansilla, V.

2015-12-01

FREEWAT is an HORIZON 2020 EU project. FREEWAT main result will be an open source and public domain GIS integrated modelling environment for the simulation of water quantity and quality in surface water and groundwater with an integrated water management and planning module. FREEWAT aims at promoting water resource management by simplifying the application of the Water Framework Directive and related Directives. Specific objectives of the project are: to coordinate previous EU and national funded research to integrate existing software modules for water management in a single environment into the GIS based FREEWAT and to support the FREEWAT application in an innovative participatory approach gathering technical staff and relevant stakeholders (policy and decision makers) in designing scenarios for application of water policies. The open source characteristics of the platform allow to consider this an initiative "ad includendum", as further institutions or developers may contribute to the development. Core of the platform is the SID&GRID framework (GIS integrated physically-based distributed numerical hydrological model based on a modified version of MODFLOW 2005; Rossetto et al. 2013) in its version ported to QGIS desktop. Activities are carried out on two lines: (i) integration of modules to fulfill the end-users requirements, including tools for producing feasibility and management plans; (ii) a set of activities to fix bugs and to provide a well-integrated interface for the different tools implemented. Further capabilities to be integrated are: - module for water management and planning; - calibration, uncertainty and sensitivity analysis; - module for solute transport in unsaturated zone; - module for crop growth and water requirements in agriculture; - tools for groundwater quality issues and for the analysis, interpretation and visualization of hydrogeological data. Through creating a common environment among water research/professionals, policy makers and implementers, FREEWAT main impact will be on enhancing science- and participatory approach and evidence-based decision making in water resource management, hence producing relevant and appropriate outcomes for policy implementation. Large stakeholders involvement is thought to guarantee results dissemination and exploitation.

Environmental Perceptions of Surface Water Quality and Management: a tool to strengthen public participation in the search for solutions to the imbalance of water in nature. A study applied in Chiapas's Río Fogótico Microbasin

NASA Astrophysics Data System (ADS)

Benez, M. C.; Kauffer Michel, E. F.

2013-05-01

The study of environmental perceptions can expose interstings aspects involved in imbalance of water in nature. The main objective of this study was to assess the perceptions of quality and management of surface water in the Fogótico River microbasin in San Cristóbal de Las Casas, Chiapas, from the perspective of differents social groups. Secondary objectives consisted in analyzing the differences of perception according to social groups and considering the potential contribution of perception studies for watershed management.; t;

The intelligent clinical laboratory as a tool to increase cancer care management productivity.

PubMed

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity.

EPA Announces Improvements to Keep Massachusetts Waters Clean

EPA Pesticide Factsheets

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

Measuring Competencies of Higher Education Graduates

ERIC Educational Resources Information Center

Allen, Jim; Ramaekers, Ger; van der Velden, Rolf

2005-01-01

This chapter describes a new conceptual model for measuring competencies of higher education graduates. The proposed instrument can become a valuable tool for higher education quality management, policy evaluation, and scientific research. (Contains 1 figure.)

Impacts of agricultural management practices on soil quality in Europe and China - an assessment within the framework of the EU iSQAPER project

NASA Astrophysics Data System (ADS)

Alaoui, Abdallah; Schwilch, Gudrun; Barão, Lúcia; Basch, Gottlieb; Sukkel, Wijnand; Lemesle, Julie; Ferreira, Carla; Garcia-Orenes, Fuensanta; Morugan, Alicia; Mataix, Jorge; Kosmas, Costas; Glavan, Matjaž; Tóth, Brigitta; Petrutza Gate, Olga; Lipiec, Jerzy; Reintam, Endla; Xu, Minggang; Di, Jiaying; Fan, Hongzhu; Geissen, Violette

2017-04-01

Agricultural soils are under a wide variety of pressures, including from increasing global demand for food associated with population growth, changing diets, land degradation, and associated productivity reductions potentially exacerbated by climate change. To manage the use of agricultural soils well, decision-makers need science-based, easily applicable, and cost-effective tools for assessing soil quality and soil functions. Since a practical assessment of soil quality requires the integrated consideration of key soil properties and their variations in space and time, providing such tools remains a challenging task. This study aims to assess the impact of innovative agricultural management practices on soil quality in 14 study sites across Europe (10) and China (4), covering the major pedo-climatic zones. The study is part of the European H2020 project iSQAPER, which involves 25 partners across Europe and China and is coordinated by Wageningen University, The Netherlands. iSQAPER is aimed at interactive soil quality assessment in Europe and China for agricultural productivity and environmental resilience. The study began with a thorough literature analysis to inform the selection of indicators for the assessment of soil structure and soil functions. A manual was then developed in order to standardize and facilitate the task of inventorying soil quality and management practices at the case study sites. The manual provides clear and precise instructions on how to assess the 11 selected soil quality indicators based on a visual soil assessment methodology. A newly developed infiltrometer was used to easily assess the soil infiltration capacity in the field and investigate hydrodynamic flow processes. Based on consistent calibration, the infiltrometer enables reliable prediction of key soil hydraulic properties. The main aim of this inventory is to link agricultural management practices to the soil quality status at the case study sites, and to identify innovative practices that have improved soil quality. The inventory and the scoring of soil quality are done together with land users at each study site. The idea is to compare the soil quality on a farm where management practices have changed 3 or more years ago with that on a control farm where practices have not changed, with both farms located in the same pedo-climatic zone and having comparable soil conditions. The case study partners were requested to identify at least 3 newly adopted management practices (or combinations thereof) and 3 related control farms. First results show that among 88 sets of paired plots, 60 pairs (68 %) show a positive impact of innovative agricultural management practices on soil quality. 18 pairs (21 %) do not show any difference in soil quality between soils under innovative practices and soils in the control plots, and the remaining 10 plots (11 %) show an inverse effect. The non-detectable effect of the innovative practices on soil quality are due to type of tillage management, soil type and fertility that mask the effect of management practices on soil and also due to time of the assessment. This assessment will be repeated in the coming years, with the aim of providing sound data on soil quality and its improvement through innovative management practices across Europe and China.

Wildland fire decision support system air quality tools

Treesearch

Sim Larkin; Tim Brown; Pete Lahm; Tom Zimmerman

2010-01-01

Smoke and air quality information have an important role in wildland fire decisionmaking that is reinforced in the 2009 "Guidance for Implementation of Federal Wildland Fire Management Policy." A key intent of the guidance is to allow consideration and use of the full range of strategic and tactical options that are available in the response to every wildland...

Estimating fuel consumption for the upper coastal plain of South Carolina

Treesearch

S.L. Goodrick; D. Shea; J. Blake

2010-01-01

Recent changes in air quality regulations present a potential obstacle to continued use of prescribed fire as a land management tool. towering of the acceptable daily concentration of particulate matter from 6510 35 jig/m' will bring much closer scrutiny of prescribed burning practices from the air quality community. To work within this narrow window, land...

Forage resource evaluation system for habitat—deer: an interactive deer habitat model

Treesearch

Thomas A. Hanley; Donald E. Spalinger; Kenrick J. Mock; Oran L. Weaver; Grant M. Harris

2012-01-01

We describe a food-based system for quantitatively evaluating habitat quality for deer called the Forage Resource Evaluation System for Habitat and provide its rationale and suggestions for use. The system was developed as a tool for wildlife biologists and other natural resource managers and planners interested in evaluating habitat quality and, especially, comparing...

New steady-state models for water-limited cropping systems using saline irrigation waters: Analytical solutions and applications

USDA-ARS?s Scientific Manuscript database

Due to the diminishing availability of good quality water for irrigation, it is increasingly important that irrigation and salinity management tools be able to target submaximal crop yields and support the use of marginal quality waters. In this work, we present a steady-state irrigated systems mod...

New steady-state models for water-limited cropping systems using saline irrigation waters: Analytical solutions and applications

USDA-ARS?s Scientific Manuscript database

Due to the diminishing availability of good quality water for irrigation, it is increasingly important that irrigation and salinity management tools be able to target submaximal crop yields and support the use of marginal quality waters. In this work, we present a steady-state irrigated systems mode...

Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

PubMed

Thatte, Nandita; Choi, Yoonjoung

2015-04-01

Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be explored to better understand the relationship between HR management and FP service quality. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

A scope classification of data quality requirements for food composition data.

PubMed

Presser, Karl; Hinterberger, Hans; Weber, David; Norrie, Moira

2016-02-15

Data quality is an important issue when managing food composition data since the usage of the data can have a significant influence on policy making and further research. Although several frameworks for data quality have been proposed, general tools and measures are still lacking. As a first step in this direction, we investigated data quality requirements for an information system to manage food composition data, called FoodCASE. The objective of our investigation was to find out if different requirements have different impacts on the intrinsic data quality that must be regarded during data quality assessment and how these impacts can be described. We refer to the resulting classification with its categories as the scope classification of data quality requirements. As proof of feasibility, the scope classification has been implemented in the FoodCASE system. Copyright © 2015 Elsevier Ltd. All rights reserved.

A quality tool for health insurers. A new scale measures "quality orientation" from the customer's point of view.

PubMed

Westbrook, K W; Pedrick, D; Bush, V

1996-01-01

This study defines a company's quality orientation as "all process-related activities that can be discerned by customers." This even includes certain processes internal to the company that can be seen and evaluated by customers. One significant contribution this study provides is scale development centered on customer rather than employee perceptions. To generate scale items, input was gathered from experts involved in the study, senior managers employed with the target company, focus groups of employees working on the front line with customers, and users of the services. Because the sale measures customer perceptions of quality in comparison with the firm's closest competitor, it provides managers with information for benchmarking performance relative to others in the marketplace.

Concept Mapping as an Innovative Tool for the Assessment of Learning: An Experimental Experience among Business Management Degree Students

ERIC Educational Resources Information Center

Ruiz-Palomino, Pablo; Martinez-Canas, Ricardo

2013-01-01

In the search to improve the quality of education at the university level, the use of concept mapping is becoming an important instructional technique for enhancing the teaching-learning process. This educational tool is based on cognitive theories by making a distinction between learning by rote (memorizing) and learning by meaning, where…

Development of a Self-Assessment Tool to Facilitate Decision-Making in Choosing a Long Term Care Administration Major

ERIC Educational Resources Information Center

Johs-Artisensi, Jennifer L.; Olson, Douglas M.; Nahm, Abraham Y.

2016-01-01

Long term care administrators need a broad base of knowledge, skills, and interests to provide leadership and be successful in managing a fiscally responsible, quality long term care organization. Researchers developed a tool to help students assess whether a long term care administration major is a compatible fit. With input from professionals in…

Using a Client Survey to Support Continuous Improvement: An Australian Case Study in Managing Change

ERIC Educational Resources Information Center

Besch, Janice

2014-01-01

With the arrival of online survey tools that are low-cost, readily available and easy to administer, all organizations have access to one of the most effective mechanisms for determining quality improvement priorities and measuring progress towards achieving those priorities over time. This case study outlines the use made of this simple tool by a…

Optical Method For Monitoring Tool Control For Green Burnishing With Using Of Algorithms With Adaptive Settings

NASA Astrophysics Data System (ADS)

Lukyanov, A. A.; Grigoriev, S. N.; Bobrovskij, I. N.; Melnikov, P. A.; Bobrovskij, N. M.

2017-05-01

With regard to the complexity of the new technology and increase its reliability requirements laboriousness of control operations in industrial quality control systems increases significantly. The importance of quality management control due to the fact that its promotes the correct use of production conditions, the relevant requirements are required. Digital image processing allows to reach a new technological level of production (new technological way). The most complicated automated interpretation of information is the basis for decision-making in the management of production processes. In the case of surface analysis of tools used for processing with the using of metalworking fluids (MWF) it is more complicated. The authors suggest new algorithm for optical inspection of the wear of the cylinder tool for burnishing, which used in surface plastic deformation without using of MWF. The main advantage of proposed algorithm is the possibility of automatic recognition of images of burnisher tool with the subsequent allocation of its boundaries, finding a working surface and automatically allocating the defects and wear area. Software that implements the algorithm was developed by the authors in Matlab programming environment, but can be implemented using other programming languages.

Managing obesity in primary care.

PubMed

Goldie, Christine; Brown, Jenny

Obesity is a complex problem and often difficult to tackle in primary care. A year-long pilot of a practice nurse-led scheme that used a holistic approach towards self-care in obesity management was set up to reduce the cardiovascular risk of patients who were obese and improve their quality of life. This person-centred approach may offer an important tool in the management of these patients in the GP surgery.

Application of Strategic Management Principles as Tool to Improve Quality of Construction Technological Process

NASA Astrophysics Data System (ADS)

Kluchnikova, O.; Pobegaylov, O.

2017-11-01

The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.

Effective workforce management starts with leveraging technology, while staffing optimization requires true collaboration.

PubMed

Crist-Grundman, Deborah; Mulrooney, Gail

2011-01-01

Effective staffing is at the very core of quality patient care. Staffing that achieves a balance between quality, safety, labor costs, and staff satisfaction is incredibly complex. Technology can make the complexity manageable and provide health care leaders with the tools to optimize their most valuable resource--their employees. Through such a partnership, the business intelligence brought forth will not only meet the unique needs and goals of each organization, but will also result in innovations and advancements in best practices around excellence in staffing.

Management: A continuing literature survey with indexes, March 1976

NASA Technical Reports Server (NTRS)

1976-01-01

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

Quality Management Tools: Facilitating Clinical Research Data Integrity by Utilizing Specialized Reports with Electronic Case Report Forms

PubMed Central

Trocky, NM; Fontinha, M

2005-01-01

Data collected throughout the course of a clinical research trial must be reviewed for accuracy and completeness continually. The Oracle Clinical® (OC) data management application utilized to capture clinical data facilitates data integrity through pre-programmed validations, edit and range checks, and discrepancy management modules. These functions were not enough. Coupled with the use of specially created reports in Oracle Discoverer® and Integrated Review TM, both ad-hoc query and reporting tools, research staff have enhanced their ability to clean, analyze and report more accurate data captured within and among Case Report Forms (eCRFs) by individual study or across multiple studies. PMID:16779428

Modeling soil erosion and transport on forest landscape

Treesearch

Ge Sun; Steven G McNulty

1998-01-01

Century-long studies on the impacts of forest management in North America suggest sediment can cause major reduction on stream water quality. Soil erosion patterns in forest watersheds are patchy and heterogeneous. Therefore, patterns of soil erosion are difficult to model and predict. The objective of this study is to develop a user friendly management tool for land...

Outsourcing occupational health services. Critical elements.

PubMed

Dyck, Dianne

2002-02-01

Successful management of an outsourcing relationship produces a highly interactive, flexible relationship between two organizations. The unique skills and resources of the service provider can be leveraged by the purchasing organization to achieve its business goals. Occupational and environmental health nurses can orchestrate this process and implement this important management tool in the provision of quality occupational health services.

Visual simulations of forest wildlife habitat structure, change, and landscape context in New England

Treesearch

Richard M. DeGraaf; Anna M. Lester; Mariko Yamasaki; William B. Leak

2007-01-01

Visualization is a powerful tool for depicting projections of forest structure and landscape conditions, for communicating habitat management practices, and for providing a landscape context to private landowners and to those concerned with public land management. Recent advances in visualization technology, especially in graphics quality, ease of use, and relative...

Using the annual phosphorus loss estimator (APLE) model to evaluate the University of Maryland phosphorus management tool

USDA-ARS?s Scientific Manuscript database

Maryland’s phosphorus site index (PSI) has been used to guide management decisions to minimize the potential for P loss from agricultural fields in Maryland since the adoption of the Water Quality Improvement Act of 1998. The index was recently revised and renamed the University of Maryland Phospho...

[Total quality management in times of crisis. The case of Argentina].

PubMed

Larroca, Norberto

2003-01-01

Healthcare organizations were faced with so great a challenge following the financial slump that they were forced to 'sharpen their wits' in order to survive. Integrated Quality Management (in Spanish GIC), proved the ideal instrument. GIC has four foundational elements, the application of which allow for successful management of crisis situations. They are as follows: TRAINING of human resources EVALUATION of healthcare institutions SELF-EVALUATION by institutions QUALITY ACCREDITATION of institutions All our organizations have the appropriate tools to carry out these activities which form the basis of our project: CAES (Argentinean Chamber of Healthcare Institutions) -training-, CIDCAM (Inter-institutional Committee for Quality Development in Medical Care) -evaluation and self-evaluation-, CENAS (Specialist Centre for the Standardization and Accreditation in Health Care)-accreditation-. In times of crisis, we play an active part, that is, instead of withdrawing our efforts, we do our best to achieve the best and most adequate objective in order to meet the needs of the population through Integrated Quality Management. Eventually, when the results are examined, medical care that meets the best quality standards is found to be, after all, the most economical (that is best results, better satisfaction of healthcare users and providers as well as less mistakes).

Implementation of Cyberinfrastructure and Data Management Workflow for a Large-Scale Sensor Network

NASA Astrophysics Data System (ADS)

Jones, A. S.; Horsburgh, J. S.

2014-12-01

Monitoring with in situ environmental sensors and other forms of field-based observation presents many challenges for data management, particularly for large-scale networks consisting of multiple sites, sensors, and personnel. The availability and utility of these data in addressing scientific questions relies on effective cyberinfrastructure that facilitates transformation of raw sensor data into functional data products. It also depends on the ability of researchers to share and access the data in useable formats. In addition to addressing the challenges presented by the quantity of data, monitoring networks need practices to ensure high data quality, including procedures and tools for post processing. Data quality is further enhanced if practitioners are able to track equipment, deployments, calibrations, and other events related to site maintenance and associate these details with observational data. In this presentation we will describe the overall workflow that we have developed for research groups and sites conducting long term monitoring using in situ sensors. Features of the workflow include: software tools to automate the transfer of data from field sites to databases, a Python-based program for data quality control post-processing, a web-based application for online discovery and visualization of data, and a data model and web interface for managing physical infrastructure. By automating the data management workflow, the time from collection to analysis is reduced and sharing and publication is facilitated. The incorporation of metadata standards and descriptions and the use of open-source tools enhances the sustainability and reusability of the data. We will describe the workflow and tools that we have developed in the context of the iUTAH (innovative Urban Transitions and Aridregion Hydrosustainability) monitoring network. The iUTAH network consists of aquatic and climate sensors deployed in three watersheds to monitor Gradients Along Mountain to Urban Transitions (GAMUT). The variety of environmental sensors and the multi-watershed, multi-institutional nature of the network necessitate a well-planned and efficient workflow for acquiring, managing, and sharing sensor data, which should be useful for similar large-scale and long-term networks.

Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.

PubMed

Effken, Judith A; Brewer, Barbara B; Logue, Melanie D; Gephart, Sheila M; Verran, Joyce A

2011-10-01

To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager's work domain. Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in three Arizona hospitals. The WDA described the nurse manager's environment in terms of the constraints it imposes on the nurse manager's ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. The results highlight the competing priorities, and external and internal constraints that today's nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering "what if" questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogeneous sample and the reliance on interview data targeting safety and quality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Cast Off expansion plan by rapid improvement through Optimization tool design, Tool Parameters and using Six Sigma’s ECRS Technique

NASA Astrophysics Data System (ADS)

Gopalakrishnan, T.; Saravanan, R.

2017-03-01

Powerful management concepts step-up the quality of the product, time saving in producing the product thereby increase the production rate, improves tools and techniques, work culture, work place and employee motivation and morale. In this paper discussed about the case study of optimizing the tool design, tool parameters to cast off expansion plan according ECRS technique. The proposed designs and optimal tool parameters yielded best results and meet the customer demand without expansion plan. Hence the work yielded huge savings of money (direct and indirect cost), time and improved the motivation and more of employees significantly.

The State of Cloud-Based Biospecimen and Biobank Data Management Tools.

PubMed

Paul, Shonali; Gade, Aditi; Mallipeddi, Sumani

2017-04-01

Biobanks are critical for collecting and managing high-quality biospecimens from donors with appropriate clinical annotation. The high-quality human biospecimens and associated data are required to better understand disease processes. Therefore, biobanks have become an important and essential resource for healthcare research and drug discovery. However, collecting and managing huge volumes of data (biospecimens and associated clinical data) necessitate that biobanks use appropriate data management solutions that can keep pace with the ever-changing requirements of research. To automate biobank data management, biobanks have been investing in traditional Laboratory Information Management Systems (LIMS). However, there are a myriad of challenges faced by biobanks in acquiring traditional LIMS. Traditional LIMS are cost-intensive and often lack the flexibility to accommodate changes in data sources and workflows. Cloud technology is emerging as an alternative that provides the opportunity to small and medium-sized biobanks to automate their operations in a cost-effective manner, even without IT personnel. Cloud-based solutions offer the advantage of heightened security, rapid scalability, dynamic allocation of services, and can facilitate collaboration between different research groups by using a shared environment on a "pay-as-you-go" basis. The benefits offered by cloud technology have resulted in the development of cloud-based data management solutions as an alternative to traditional on-premise software. After evaluating the advantages offered by cloud technology, several biobanks have started adopting cloud-based tools. Cloud-based tools provide biobanks with easy access to biospecimen data for real-time sharing with clinicians. Another major benefit realized by biobanks by implementing cloud-based applications is unlimited data storage on the cloud and automatic backups for protecting any data loss in the face of natural calamities.

Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective.

PubMed

Winter, Alfred; Takabayashi, Katsuhiko; Jahn, Franziska; Kimura, Eizen; Engelbrecht, Rolf; Haux, Reinhold; Honda, Masayuki; Hübner, Ursula H; Inoue, Sozo; Kohl, Christian D; Matsumoto, Takehiro; Matsumura, Yasushi; Miyo, Kengo; Nakashima, Naoki; Prokosch, Hans-Ulrich; Staemmler, Martin

2017-08-07

For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.

Health-related quality of life anticipated with different management strategies for paediatric febrile neutropaenia

PubMed Central

Cheng, S; Teuffel, O; Ethier, M C; Diorio, C; Martino, J; Mayo, C; Regier, D; Wing, R; Alibhai, S M H; Sung, L

2011-01-01

Background: To describe (1) anticipated health-related quality of life during different strategies for febrile neutropaenia (FN) management and (2) attributes of those preferring inpatient management. Methods: Respondents were parents of children 0–18 years and children 12–18 years receiving cancer treatment. Anticipated health-related quality of life was elicited for four different FN management strategies: entire inpatient, early discharge, outpatient oral and outpatient intravenous (i.v.) therapy. Tools used to measure health-related quality of life were visual analogue scale (VAS), willingness to pay and time trade off. Results: A total of 155 parents and 43 children participated. For parents, median VAS scores were highest for early discharge (5.9, interquartile range 4.4–7.2) and outpatient i.v. (5.9, interquartile range 4.4–7.3). For children, median scores were highest for early discharge (6.1, interquartile range 4.6–7.2). In contrast, the most commonly preferred strategy for parents and children was inpatient in 55.0% and 37.2%, respectively. Higher current child health-related quality of life was associated with a stronger preference for outpatient management. Conclusion: Early discharge and outpatient i.v. management are associated with higher anticipated health-related quality of life, although the most commonly preferred strategy was inpatient care. This data may help with determining more cost-effective strategies for paediatric FN. PMID:21694729

Health-related quality of life anticipated with different management strategies for paediatric febrile neutropaenia.

PubMed

Cheng, S; Teuffel, O; Ethier, M C; Diorio, C; Martino, J; Mayo, C; Regier, D; Wing, R; Alibhai, S M H; Sung, L

2011-08-23

To describe (1) anticipated health-related quality of life during different strategies for febrile neutropaenia (FN) management and (2) attributes of those preferring inpatient management. Respondents were parents of children 0-18 years and children 12-18 years receiving cancer treatment. Anticipated health-related quality of life was elicited for four different FN management strategies: entire inpatient, early discharge, outpatient oral and outpatient intravenous (i.v.) therapy. Tools used to measure health-related quality of life were visual analogue scale (VAS), willingness to pay and time trade off. A total of 155 parents and 43 children participated. For parents, median VAS scores were highest for early discharge (5.9, interquartile range 4.4-7.2) and outpatient i.v. (5.9, interquartile range 4.4-7.3). For children, median scores were highest for early discharge (6.1, interquartile range 4.6-7.2). In contrast, the most commonly preferred strategy for parents and children was inpatient in 55.0% and 37.2%, respectively. Higher current child health-related quality of life was associated with a stronger preference for outpatient management. Early discharge and outpatient i.v. management are associated with higher anticipated health-related quality of life, although the most commonly preferred strategy was inpatient care. This data may help with determining more cost-effective strategies for paediatric FN.

Managing water quality under drought conditions in the Llobregat River Basin.

PubMed

Momblanch, Andrea; Paredes-Arquiola, Javier; Munné, Antoni; Manzano, Andreu; Arnau, Javier; Andreu, Joaquín

2015-01-15

The primary effects of droughts on river basins include both depleted quantity and quality of the available water resources, which can render water resources useless for human needs and simultaneously damage the environment. Isolated water quality analyses limit the action measures that can be proposed. Thus, an integrated evaluation of water management and quality is warranted. In this study, a methodology consisting of two coordinated models is used to combine aspects of water resource allocation and water quality assessment. Water management addresses water allocation issues by considering the storage, transport and consumption elements. Moreover, the water quality model generates time series of concentrations for several pollutants according to the water quality of the runoff and the demand discharges. These two modules are part of the AQUATOOL decision support system shell for water resource management. This tool facilitates the analysis of the effects of water management and quality alternatives and scenarios on the relevant variables in a river basin. This paper illustrates the development of an integrated model for the Llobregat River Basin. The analysis examines the drought from 2004 to 2008, which is an example of a period when the water system was quantitative and qualitatively stressed. The performed simulations encompass a wide variety of water management and water quality measures; the results provide data for making informed decisions. Moreover, the results demonstrated the importance of combining these measures depending on the evolution of a drought event and the state of the water resources system. Copyright © 2014 Elsevier B.V. All rights reserved.

Air Research

EPA Pesticide Factsheets

EPA's air research provides the critical science to develop and implement outdoor air regulations under the Clean Air Act and puts new tools and information in the hands of air quality managers and regulators to protect the air we breathe.

EPA Announces Improvements to Keep New Hampshire Waters Clean

EPA Pesticide Factsheets

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

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

PubMed Central

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

2017-01-01

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

Adaptation of the Quality Indicator for Rehabilitative Care (QuIRC) for use in mental health supported accommodation services (QuIRC-SA).

PubMed

Killaspy, Helen; White, Sarah; Dowling, Sarah; Krotofil, Joanna; McPherson, Peter; Sandhu, Sima; Arbuthnott, Maurice; Curtis, Sarah; Leavey, Gerard; Priebe, Stefan; Shepherd, Geoff; King, Michael

2016-04-14

No standardised tools for assessing the quality of specialist mental health supported accommodation services exist. To address this, we adapted the Quality Indicator for Rehabilitative care-QuIRC-that was originally developed to assess the quality of longer term inpatient and community based mental health facilities. The QuIRC, which is completed by the service manager and gives ratings of seven domains of care, has good psychometric properties. Focus groups with staff of the three main types of supported accommodation in the UK (residential care, supported housing and floating outreach services) were carried out to identify potential amendments to the QuIRC. Additional advice was gained from consultation with three expert panels, two of which comprised service users with lived experience of mental health and supported accommodation services. The amended QuIRC (QuIRC-SA) was piloted with a manager of each of the three service types. Item response variance, inter-rater reliability and internal consistency were assessed in a random sample of 52 services. Factorial structure and discriminant validity were assessed in a larger random sample of 87 services. The QuIRC-SA comprised 143 items of which only 18 items showed a narrow range of response and five items had poor inter-rater reliability. The tool showed good discriminant validity, with supported housing services generally scoring higher than the other two types of supported accommodation on most domains. Exploratory factor analysis showed that the QuIRC-SA items loaded onto the domains to which they had been allocated. The QuIRC-SA is the first standardised tool for quality assessment of specialist mental health supported accommodation services. Its psychometric properties mean that it has potential for use in research as well as audit and quality improvement programmes. A web based application is being developed to make it more accessible which will produce a printable report for the service manager about the performance of their service, comparison data for similar services and suggestions on how to improve service quality.

mtDNAmanager: a Web-based tool for the management and quality analysis of mitochondrial DNA control-region sequences

PubMed Central

Lee, Hwan Young; Song, Injee; Ha, Eunho; Cho, Sung-Bae; Yang, Woo Ick; Shin, Kyoung-Jin

2008-01-01

Background For the past few years, scientific controversy has surrounded the large number of errors in forensic and literature mitochondrial DNA (mtDNA) data. However, recent research has shown that using mtDNA phylogeny and referring to known mtDNA haplotypes can be useful for checking the quality of sequence data. Results We developed a Web-based bioinformatics resource "mtDNAmanager" that offers a convenient interface supporting the management and quality analysis of mtDNA sequence data. The mtDNAmanager performs computations on mtDNA control-region sequences to estimate the most-probable mtDNA haplogroups and retrieves similar sequences from a selected database. By the phased designation of the most-probable haplogroups (both expected and estimated haplogroups), mtDNAmanager enables users to systematically detect errors whilst allowing for confirmation of the presence of clear key diagnostic mutations and accompanying mutations. The query tools of mtDNAmanager also facilitate database screening with two options of "match" and "include the queried nucleotide polymorphism". In addition, mtDNAmanager provides Web interfaces for users to manage and analyse their own data in batch mode. Conclusion The mtDNAmanager will provide systematic routines for mtDNA sequence data management and analysis via easily accessible Web interfaces, and thus should be very useful for population, medical and forensic studies that employ mtDNA analysis. mtDNAmanager can be accessed at . PMID:19014619

Urban Stormwater Management Model and Tools for Designing Stormwater Management of Green Infrastructure Practices

NASA Astrophysics Data System (ADS)

Haris, H.; Chow, M. F.; Usman, F.; Sidek, L. M.; Roseli, Z. A.; Norlida, M. D.

2016-03-01

Urbanization is growing rapidly in Malaysia. Rapid urbanization has known to have several negative impacts towards hydrological cycle due to decreasing of pervious area and deterioration of water quality in stormwater runoff. One of the negative impacts of urbanization is the congestion of the stormwater drainage system and this situation leading to flash flood problem and water quality degradation. There are many urban stormwater management softwares available in the market such as Storm Water Drainage System design and analysis program (DRAINS), Urban Drainage and Sewer Model (MOUSE), InfoWorks River Simulation (InfoWork RS), Hydrological Simulation Program-Fortran (HSPF), Distributed Routing Rainfall-Runoff Model (DR3M), Storm Water Management Model (SWMM), XP Storm Water Management Model (XPSWMM), MIKE-SWMM, Quality-Quantity Simulators (QQS), Storage, Treatment, Overflow, Runoff Model (STORM), and Hydrologic Engineering Centre-Hydrologic Modelling System (HEC-HMS). In this paper, we are going to discuss briefly about several softwares and their functionality, accessibility, characteristics and components in the quantity analysis of the hydrological design software and compare it with MSMA Design Aid and Database. Green Infrastructure (GI) is one of the main topics that has widely been discussed all over the world. Every development in the urban area is related to GI. GI can be defined as green area build in the develop area such as forest, park, wetland or floodway. The role of GI is to improve life standard such as water filtration or flood control. Among the twenty models that have been compared to MSMA SME, ten models were selected to conduct a comprehensive review for this study. These are known to be widely accepted by water resource researchers. These ten tools are further classified into three major categories as models that address the stormwater management ability of GI in terms of quantity and quality, models that have the capability of conducting the economic analysis of GI and models that can address both stormwater management and economic aspects together.

Applying the metro map to software development management

NASA Astrophysics Data System (ADS)

Aguirregoitia, Amaia; Dolado, J. Javier; Presedo, Concepción

2010-01-01

This paper presents MetroMap, a new graphical representation model for controlling and managing the software development process. Metromap uses metaphors and visual representation techniques to explore several key indicators in order to support problem detection and resolution. The resulting visualization addresses diverse management tasks, such as tracking of deviations from the plan, analysis of patterns of failure detection and correction, overall assessment of change management policies, and estimation of product quality. The proposed visualization uses a metaphor with a metro map along with various interactive techniques to represent information concerning the software development process and to deal efficiently with multivariate visual queries. Finally, the paper shows the implementation of the tool in JavaFX with data of a real project and the results of testing the tool with the aforementioned data and users attempting several information retrieval tasks. The conclusion shows the results of analyzing user response time and efficiency using the MetroMap visualization system. The utility of the tool was positively evaluated.

Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol.

PubMed

Nieuwesteeg, Anke M; Pouwer, Frans; van Bakel, Hedwig Ja; Emons, Wilco Hm; Aanstoot, Henk-Jan; Odink, Roelof; Hartman, Esther E

2011-04-14

In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food) may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life). First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15). Observed behaviors are described into rating scales, with each scale describing characteristics of parent-child interactional behaviors. Next, we apply the observational tool on a larger scale for further evaluation of the instrument (N = 120). The parents are asked twice (with two years in between) to fill out questionnaires about psychosocial functioning of their child with T1DM. Furthermore, glycemic control (HbA1c) will be obtained from their medical records. A disease-specific observational tool will enable the detailed assessment of the quality of diabetes-specific parent-child interactions. The availability of such a tool will facilitate future (intervention) studies that will yield more knowledge about impact of parent-child interactions on psychosocial functioning, and glycemic control of children with T1DM.

Quality of the parent-child interaction in young children with type 1 diabetes mellitus: study protocol

PubMed Central

2011-01-01

Background In young children with type 1 diabetes mellitus (T1DM) parents have full responsibility for the diabetes-management of their child (e.g. blood glucose monitoring, and administering insulin). Behavioral tasks in childhood, such as developing autonomy, and oppositional behavior (e.g. refusing food) may interfere with the diabetes-management to achieve an optimal blood glucose control. Furthermore, higher blood glucose levels are related to more behavioral problems. So parents might need to negotiate with their child on the diabetes-management to avoid this direct negative effect. This interference, the negotiations, and the parent's responsibility for diabetes may negatively affect the quality of parent-child interaction. Nevertheless, there is little knowledge about the quality of interaction between parents and young children with T1DM, and the possible impact this may have on glycemic control and psychosocial functioning of the child. While widely used global parent-child interaction observational methods are available, there is a need for an observational tool specifically tailored to the interaction patterns of parents and children with T1DM. The main aim of this study is to construct a disease-specific observational method to assess diabetes-specific parent-child interaction. Additional aim is to explore whether the quality of parent-child interactions is associated with the glycemic control, and psychosocial functioning (resilience, behavioral problems, and quality of life). Methods/Design First, we will examine which situations are most suitable for observing diabetes-specific interactions. Then, these situations will be video-taped in a pilot study (N = 15). Observed behaviors are described into rating scales, with each scale describing characteristics of parent-child interactional behaviors. Next, we apply the observational tool on a larger scale for further evaluation of the instrument (N = 120). The parents are asked twice (with two years in between) to fill out questionnaires about psychosocial functioning of their child with T1DM. Furthermore, glycemic control (HbA1c) will be obtained from their medical records. Discussion A disease-specific observational tool will enable the detailed assessment of the quality of diabetes-specific parent-child interactions. The availability of such a tool will facilitate future (intervention) studies that will yield more knowledge about impact of parent-child interactions on psychosocial functioning, and glycemic control of children with T1DM. PMID:21492413

Intelligent Chemistry Management System (ICMS)--A new approach to steam generator chemistry control

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

Barto, R.J.; Farrell, D.M.; Noto, F.A.

1986-04-01

The Intelligent Chemistry Management System (ICMS) is a new tool which assists in steam generator chemistry control. Utilizing diagnostic capabilities, the ICMS will provide utility and industrial boiler operators, system chemists, and plant engineers with a tool for monitoring, diagnosing, and controlling steam generator system chemistry. By reducing the number of forced outages through early identification of potentially detrimental conditions, suggestion of possible causes, and execution of corrective actions, improvements in unit availability and reliability will result. The system monitors water and steam quality at a number of critical locations in the plant.

[Management of pre-analytical nonconformities].

PubMed

Berkane, Z; Dhondt, J L; Drouillard, I; Flourié, F; Giannoli, J M; Houlbert, C; Surgat, P; Szymanowicz, A

2010-12-01

The main nonconformities enumerated to facilitate consensual codification. In each case, an action is defined: refusal to realize the examination with request of a new sample, request of information or correction, results cancellation, nurse or physician information. A traceability of the curative, corrective and preventive actions is needed. Then, methodology and indicators are proposed to assess nonconformity and to follow the quality improvements. The laboratory information system can be used instead of dedicated software. Tools for the follow-up of nonconformities scores are proposed. Finally, we propose an organization and some tools allowing the management and control of the nonconformities occurring during the pre-examination phase.

Triple aim program: assessing its effectiveness as a hospital management tool.

PubMed

Coyne, Joseph S; Hilsenrath, Peter E; Arbuckle, Barry S; Kureshy, Fareed; Vaughan, David; Grayson, David; Saygin, Tuba

2014-01-01

According to a recent national survey of Hospital chief executive officers, financial challenges are their top concern, especially government reimbursement. Moreover, the patient faces greater deductibles forcing hospitals to prioritize price transparency. The Triple Aim program is a tool available to hospital management to help address these challenges. This study indicates that the Triple Aim is valuable to healthcare providers and patients by reducing medical errors, improving healthcare quality, and reducing costs on a per capita basis. Managerial implications are discussed for hospitals and health systems considering this approach to addressing financial challenges.

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

Quality Metadata Management for Geospatial Scientific Workflows: from Retrieving to Assessing with Online Tools

NASA Astrophysics Data System (ADS)

Leibovici, D. G.; Pourabdollah, A.; Jackson, M.

2011-12-01

Experts and decision-makers use or develop models to monitor global and local changes of the environment. Their activities require the combination of data and processing services in a flow of operations and spatial data computations: a geospatial scientific workflow. The seamless ability to generate, re-use and modify a geospatial scientific workflow is an important requirement but the quality of outcomes is equally much important [1]. Metadata information attached to the data and processes, and particularly their quality, is essential to assess the reliability of the scientific model that represents a workflow [2]. Managing tools, dealing with qualitative and quantitative metadata measures of the quality associated with a workflow, are, therefore, required for the modellers. To ensure interoperability, ISO and OGC standards [3] are to be adopted, allowing for example one to define metadata profiles and to retrieve them via web service interfaces. However these standards need a few extensions when looking at workflows, particularly in the context of geoprocesses metadata. We propose to fill this gap (i) at first through the provision of a metadata profile for the quality of processes, and (ii) through providing a framework, based on XPDL [4], to manage the quality information. Web Processing Services are used to implement a range of metadata analyses on the workflow in order to evaluate and present quality information at different levels of the workflow. This generates the metadata quality, stored in the XPDL file. The focus is (a) on the visual representations of the quality, summarizing the retrieved quality information either from the standardized metadata profiles of the components or from non-standard quality information e.g., Web 2.0 information, and (b) on the estimated qualities of the outputs derived from meta-propagation of uncertainties (a principle that we have introduced [5]). An a priori validation of the future decision-making supported by the outputs of the workflow once run, is then provided using the meta-propagated qualities, obtained without running the workflow [6], together with the visualization pointing out the need to improve the workflow with better data or better processes on the workflow graph itself. [1] Leibovici, DG, Hobona, G Stock, K Jackson, M (2009) Qualifying geospatial workfow models for adaptive controlled validity and accuracy. In: IEEE 17th GeoInformatics, 1-5 [2] Leibovici, DG, Pourabdollah, A (2010a) Workflow Uncertainty using a Metamodel Framework and Metadata for Data and Processes. OGC TC/PC Meetings, September 2010, Toulouse, France [3] OGC (2011) www.opengeospatial.org [4] XPDL (2008) Workflow Process Definition Interface - XML Process Definition Language.Workflow Management Coalition, Document WfMC-TC-1025, 2008 [5] Leibovici, DG Pourabdollah, A Jackson, M (2011) Meta-propagation of Uncertainties for Scientific Workflow Management in Interoperable Spatial Data Infrastructures. In: Proceedings of the European Geosciences Union (EGU2011), April 2011, Austria [6] Pourabdollah, A Leibovici, DG Jackson, M (2011) MetaPunT: an Open Source tool for Meta-Propagation of uncerTainties in Geospatial Processing. In: Proceedings of OSGIS2011, June 2011, Nottingham, UK

Using Academy Standards of Excellence in Nutrition and Dietetics for organization self-assessment and quality improvement.

PubMed

Price, Joyce A; Kent, Sue; Cox, Sharon A; McCauley, Sharon M; Parekh, Janki; Klein, Catherine J

2014-08-01

Standards of Excellence in Nutrition and Dietetics for an Organization is a self-assessment tool to measure and evaluate an organization's program, services, and initiatives that identify and distinguish the Registered Dietitian Nutritionist (RDN) brand as the professional expert in food and nutrition. The Standards of Excellence will serve as a road map to recognize RDNs as leaders and collaborators. Standards of Excellence criteria apply to all practice segments of nutrition and dietetics: health care, education and research, business and industry, and community nutrition and public health. Given the membership's call to action to be recognized for their professional expertise, the Academy of Nutrition and Dietetics Quality Management Committee developed four Standards of Excellence in Nutrition and Dietetics for Organizations: Quality of Leadership, Quality of Organization, Quality of Practice, and Quality of Outcomes. Within each standard, specific indicators provide strategies for an organization to demonstrate excellence. The Academy will develop a self-evaluation scoring tool to assist the organization in applying and implementing one or more of the strategies in the Standards of Excellence indicators. The organization can use the self-assessment tool to establish itself as a Center of Excellence in Nutrition and Dietetics. The role examples illustrate initiatives RDNs and organizations can take to identify themselves as a Center of Excellence in Nutrition and Dietetics. Achieving the Excellence level is an important collaborative initiative between nutrition and dietetics organizations and the Academy to provide increased autonomy, supportive management, respect within peers and community, opportunities for professional development, support for further education, and compensation for the RDN. For purposes of the Standards, "organization" means workplace or practice setting. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Mediator effect of statistical process control between Total Quality Management (TQM) and business performance in Malaysian Automotive Industry

NASA Astrophysics Data System (ADS)

Ahmad, M. F.; Rasi, R. Z.; Zakuan, N.; Hisyamudin, M. N. N.

2015-12-01

In today's highly competitive market, Total Quality Management (TQM) is vital management tool in ensuring a company can success in their business. In order to survive in the global market with intense competition amongst regions and enterprises, the adoption of tools and techniques are essential in improving business performance. There are consistent results between TQM and business performance. However, only few previous studies have examined the mediator effect namely statistical process control (SPC) between TQM and business performance. A mediator is a third variable that changes the association between an independent variable and an outcome variable. This study present research proposed a TQM performance model with mediator effect of SPC with structural equation modelling, which is a more comprehensive model for developing countries, specifically for Malaysia. A questionnaire was prepared and sent to 1500 companies from automotive industry and the related vendors in Malaysia, giving a 21.8 per cent rate. Attempts were made at findings significant impact of mediator between TQM practices and business performance showed that SPC is important tools and techniques in TQM implementation. The result concludes that SPC is partial correlation between and TQM and BP with indirect effect (IE) is 0.25 which can be categorised as high moderator effect.

Impacts Of Long-Term Prescribed Fire On Decomposition And Litter Quality In Uneven-Aged Loblolly Pine Stands

Treesearch

Michele L. Renschin; Hal O. Liechty; Michael G. Shelton

2002-01-01

Abstract - Although fire has long been an important forest management tool in the southern United States, little is known concerning the effects of long-term fire use on nutrient cycling and decomposition. To better understand the effects of fire on these processes, decomposition rates, and foliage litter quality were quantified in a study...

[Usefulness of the budget and the balanced scorecard in managing Primary Care Centres. Impact on staff motivation].

PubMed

Ramón-Jerónimo, Juan Manuel; Flórez-López, Raquel; Domínguez-Lario, Natalia

2018-03-01

To analyse the utility perceived by managers of centers of primary care about management tools (budget and balanced scorecard), together their impact on human resources motivation. Qualitative study (case study) based on grounded theory performed between January and June 2014. Units of Clinical Management of Primary Health (UGCAP) in Metropolitan Health Area of Seville, Spain. UGCAP managers and Health Area (CEO) managers. Data were collected through 8 semi-structured interviews using non-probabilistic intentional sampling with representation and sufficiency criteria of discourse. Interviews were recorded, literally transcripted and analysis through in-vivo codes. Both tools are fully implemented but differently used in primary care centers. Budget is perceived as a coercive management tool, which has been imposed for cost saving; however, it is scarcely adequate for day-by-day management. While balanced scorecard is a more flexible tool that allows identifying financial and welfare problems, budgeting limits heavily reduce the possibility of implementing adequate solutions. The policy of incentives is not adequate either, leading on de-motivation. This study shows that budgeting restrictions have led to a significant reduction in autonomy of Spanish Primary Care centers. Management decision making is much centralised, also focused on cost saving over quality of healthcare. As a result, two needs emerge for the future: increasing centers' autonomy and improving staff commitment through training and professional development programs. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Formalization of the engineering science discipline - knowledge engineering

NASA Astrophysics Data System (ADS)

Peng, Xiao

Knowledge is the most precious ingredient facilitating aerospace engineering research and product development activities. Currently, the most common knowledge retention methods are paper-based documents, such as reports, books and journals. However, those media have innate weaknesses. For example, four generations of flying wing aircraft (Horten, Northrop XB-35/YB-49, Boeing BWB and many others) were mostly developed in isolation. The subsequent engineers were not aware of the previous developments, because these projects were documented such which prevented the next generation of engineers to benefit from the previous lessons learned. In this manner, inefficient knowledge retention methods have become a primary obstacle for knowledge transfer from the experienced to the next generation of engineers. In addition, the quality of knowledge itself is a vital criterion; thus, an accurate measure of the quality of 'knowledge' is required. Although qualitative knowledge evaluation criteria have been researched in other disciplines, such as the AAA criterion by Ernest Sosa stemming from the field of philosophy, a quantitative knowledge evaluation criterion needs to be developed which is capable to numerically determine the qualities of knowledge for aerospace engineering research and product development activities. To provide engineers with a high-quality knowledge management tool, the engineering science discipline Knowledge Engineering has been formalized to systematically address knowledge retention issues. This research undertaking formalizes Knowledge Engineering as follows: 1. Categorize knowledge according to its formats and representations for the first time, which serves as the foundation for the subsequent knowledge management function development. 2. Develop an efficiency evaluation criterion for knowledge management by analyzing the characteristics of both knowledge and the parties involved in the knowledge management processes. 3. Propose and develop an innovative Knowledge-Based System (KBS), AVD KBS, forming a systematic approach facilitating knowledge management. 4. Demonstrate the efficiency advantages of AVDKBS over traditional knowledge management methods via selected design case studies. This research formalizes, for the first time, Knowledge Engineering as a distinct discipline by delivering a robust and high-quality knowledge management and process tool, AVDKBS. Formalizing knowledge proves to significantly impact the effectiveness of aerospace knowledge retention and utilization.

The impact of a novel resident leadership training curriculum.

PubMed

Awad, Samir S; Hayley, Barbara; Fagan, Shawn P; Berger, David H; Brunicardi, F Charles

2004-11-01

Today's complex health care environment coupled with the 80-hour workweek mandate has required that surgical resident team interactions evolve from a military command-and-control style to a collaborative leadership style. A novel educational curriculum was implemented with objectives of training the residents to have the capacity/ability to create and manage powerful teams through alignment, communication, and integrity integral tools to practicing a collaborative leadership style while working 80 hours per week. Specific strategies were as follows: (1) to focus on quality of patient care and service while receiving a high education-to-service ratio, and (2) to maximize efficiency through time management. This article shows that leadership training as part of a resident curriculum can significantly increase a resident's view of leadership in the areas of alignment, communication, and integrity; tools previously shown in business models to be vital for effective and efficient teams. This curriculum, over the course of the surgical residency, can provide residents with the necessary tools to deliver efficient quality of care while working within the 80-hour workweek mandate in a more collaborative style environment.

Management: A continuing literature survey with indexes

NASA Technical Reports Server (NTRS)

1978-01-01

This bibliography lists 782 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1977. The citations, and abstracts when available, are reproduced exactly as they appeared originally in IAA and STAR, including the original accession numbers from the respective announcement journals. Topics cover the management of research and development contracts, production, logistics, personnel, safety, reliability and quality control citations. Includes references on: program, project and systems management; management policy, philosophy, tools, and techniques; decisionmaking processes for managers; technology assessment; management of urban problems; and information for managers on Federal resources, expenditures, financing, and budgeting.

Quality assurance planning for lunar Mars exploration

NASA Technical Reports Server (NTRS)

Myers, Kay

1991-01-01

A review is presented of the tools and techniques required to meet the challenge of total quality in the goal of traveling to Mars and returning to the moon. One program used by NASA to ensure the integrity of baselined requirements documents is configuration management (CM). CM is defined as an integrated management process that documents and identifies the functional and physical characteristics of a facility's systems, structures, computer software, and components. It also ensures that changes to these characteristics are properly assessed, developed, approved, implemented, verified, recorded, and incorporated into the facility's documentation. Three principal areas are discussed that will realize significant efficiencies and enhanced effectiveness, change assessment, change avoidance, and requirements management.

Using standard treatment protocols to manage costs and quality of hospital services.

PubMed

Meyer, J W; Feingold, M G

1993-06-01

The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

Emerging Role of Quality Indicators in Physical Therapist Practice and Health Service Delivery

PubMed Central

Klemm, Alexandria; Li, Linda C.; Jones, C. Allyson

2016-01-01

Quality-based care is a hallmark of physical therapy. Treatment effectiveness must be evident to patients, managers, employers, and funders. Quality indicators (QIs) are tools that specify the minimum acceptable standard of practice. They are used to measure health care processes, organizational structures, and outcomes that relate to aspects of high-quality care of patients. Physical therapists can use QIs to guide clinical decision making, implement guideline recommendations, and evaluate and report treatment effectiveness to key stakeholders, including third-party payers and patients. Rehabilitation managers and senior decision makers can use QIs to assess care gaps and achievement of benchmarks as well as to guide quality improvement initiatives and strategic planning. This article introduces the value and use of QIs to guide clinical practice and health service delivery specific to physical therapy. A framework to develop, select, report, and implement QIs is outlined, with total joint arthroplasty rehabilitation as an example. Current initiatives of Canadian and American physical therapy associations to develop tools to help clinicians report and access point-of-care data on patient progress, treatment effectiveness, and practice strengths for the purpose of demonstrating the value of physical therapy to patients, decision makers, and payers are discussed. Suggestions on how physical therapists can participate in QI initiatives and integrate a quality-of-care approach in clinical practice are made. PMID:26089040

NCCDS configuration management process improvement

NASA Technical Reports Server (NTRS)

Shay, Kathy

1993-01-01

By concentrating on defining and improving specific Configuration Management (CM) functions, processes, procedures, personnel selection/development, and tools, internal and external customers received improved CM services. Job performance within the section increased in both satisfaction and output. Participation in achieving major improvements has led to the delivery of consistent quality CM products as well as significant decreases in every measured CM metrics category.

Quality in translation: case management in the international marketplace.

PubMed

Beichl, Lisa; Craig, Kathy

2009-01-01

This article identifies three categories of case management (CM), in-country, international, and micro, that are poised to serve as the quality proxy for the international medical patient in the rapidly emerging globalized healthcare marketplace. The content concentrates on describing in-country CM and international CM (ICM). Because CM professionals are the providers of patient-centered quality and safety improvements, they are capable of filling the chasm between the travel industry and the regulators who specialize in accrediting hospital systems. In-country and ICM case managers are equipped to perform surveillance and intervention at the level of the international patient's bedside, activate network connections, and use culture-sensitive communication skills to safeguard patients in their individual sojourns abroad. The article discusses useful concepts and sources, including an algorithmic tool under development that is geared to identify and quantify risks for lay and business individuals who seek to engage the global medical market. The article's information is provided for front-line and front-office healthcare practitioners to understand or enter the worldwide medical marketplace. Content is targeted to CM generalists, specialists, and business developers interested in learning about safeguarding the patients who travel internationally to receive medical care. It can also be applied by those within and outside the healthcare practice arena, particularly those interested in the development of quality initiatives. All research and syntheses were executed by the authors. Sources included scholarly treatises, business correspondence, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. International health insurance, economics, and financing expertise stems from one author (L.B.). Clinical competencies stem from the international practice experiences of one author (K.C.). This article identifies Web sites and sources that constitute high-quality resources for ongoing reference by ICM practitioners. Two strategic tools are introduced: one for assessing the readiness of the regional marketplace for CM and the Beichl-Craig Medical Travel Risk Evaluator for international medical consumer risk identification. The emerging global healthcare marketplace is certain to change the way case managers anticipate and respond to care delivery concerns in different regional systems. A systematic structure for analyzing specific country and CM "readiness" is introduced. For case managers who assist clients to receive care internationally, the application of these concepts will help them know where a range of potential obstacles lie and how to calibrate risks and set realistic expectations. For healthcare product developers and quality analysts, the information will help stimulate discourse regarding innovative strategies, tools, and metrics geared to identify, measure, and mitigate risks for patients in the global medical marketplace.

Interpreting drinking water quality in the distribution system using Dempster-Shafer theory of evidence.

PubMed

Sadiq, Rehan; Rodriguez, Manuel J

2005-04-01

Interpreting water quality data routinely generated for control and monitoring purposes in water distribution systems is a complicated task for utility managers. In fact, data for diverse water quality indicators (physico-chemical and microbiological) are generated at different times and at different locations in the distribution system. To simplify and improve the understanding and the interpretation of water quality, methodologies for aggregation and fusion of data must be developed. In this paper, the Dempster-Shafer theory also called theory of evidence is introduced as a potential methodology for interpreting water quality data. The conceptual basis of this methodology and the process for its implementation are presented by two applications. The first application deals with the interpretation of spatial water quality data fusion, while the second application deals with the development of water quality index based on key monitored indicators. Based on the obtained results, the authors discuss the potential contribution of theory of evidence as a decision-making tool for water quality management.

International Watershed Technology: Improving Water Quality and Quantity at the Local, Basin, and Regional Scales

USGS Publications Warehouse

Tollner, Ernest W.; Douglas-Mankin, Kyle R.

2017-01-01

This article introduces the five papers in the “International Watershed Technology” collection. These papers were selected from 60 technical presentations at the fifth biennial ASABE 21st Century Watershed Technology Conference and Workshop: Improving the Quality of Water Resources at Local, Basin, and Regional Scales, held in Quito, Ecuador, on 3-9 December 2016. The conference focused on solving spatial and temporal water quality and quantity problems and addressed topics such as watershed management in developing countries, aquatic ecology and ecohydrology, ecosystem services, climate change mitigation strategies, flood forecasting, remote sensing, and water resource policy and management. While diverse, the presentation topics reflected the continuing evolution of the “data mining” and “big data” themes of past conferences related to geospatial data applications, with increasing emphasis on practical solutions. The papers selected for this collection represent applications of spatial data analyses toward practical ends with a theme of “tools and techniques for sustainability.” The papers address a range of topics, including the matching of crops with water availability, and assessing the environmental impacts of agricultural production. The papers identify some of the latest tools and techniques for improving sustainability in watershed resource management that are relevant to both developing and developed countries.

Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

PubMed Central

Reed, Shelby D.; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L.; Bowers, Margaret T.; Samsa, Gregory P.; Paul, Sara; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara J.

2011-01-01

Background Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Methods and Results Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers or health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. Conclusions The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions. PMID:22147884

Innovative Tools for Water Quality/Quantity Management: New York City's Operations Support Tool

NASA Astrophysics Data System (ADS)

Wang, L.; Schaake, J. C.; Day, G. N.; Porter, J.; Sheer, D. P.; Pyke, G.

2011-12-01

The New York City Department of Environmental Protection (DEP) manages New York City's water supply, which is comprised of over 20 reservoirs and supplies more than 1 billion gallons of water per day to over 9 million customers. Recently, DEP has initiated design of an Operations Support Tool (OST), a state-of-the-art decision support system to provide computational and predictive support for water supply operations and planning. This presentation describes the technical structure of OST, including the underlying water supply and water quality models, data sources and database management, reservoir inflow forecasts, and the functionalities required to meet the needs of a diverse group of end users. OST is a major upgrade of DEP's current water supply - water quality model, developed to evaluate alternatives for controlling turbidity in NYC's Catskill reservoirs. While the current model relies on historical hydrologic and meteorological data, OST can be driven by forecasted future conditions. It will receive a variety of near-real-time data from a number of sources. OST will support two major types of simulations: long-term, for evaluating policy or infrastructure changes over an extended period of time; and short-term "position analysis" (PA) simulations, consisting of multiple short simulations, all starting from the same initial conditions. Typically, the starting conditions for a PA run will represent those for the current day and traces of forecasted hydrology will drive the model for the duration of the simulation period. The result of these simulations will be a distribution of future system states based on system operating rules and the range of input ensemble streamflow predictions. DEP managers will analyze the output distributions and make operation decisions using risk-based metrics such as probability of refill. Currently, in the developmental stages of OST, forecasts are based on antecedent hydrologic conditions and are statistical in nature. The statistical algorithm is a relatively simple and versatile, but lacks short-term skill critical for water quality and spill management. To improve short-term skill, OST will ultimately operate with meteorologically driven hydrologic forecasts provided by the National Weather Service (NWS). OST functionalities will support a wide range of DEP uses, including short term operational projections, outage planning and emergency management, operating rule development, and water supply planning. A core use of OST will be to inform reservoir management strategies to control and mitigate turbidity events while ensuring water supply reliability. OST will also allow DEP to manage its complex reservoir system to meet multiple objectives, including ecological flows, tailwater fisheries and recreational releases, and peak flow mitigation for downstream communities.

TESPI (Tool for Environmental Sound Product Innovation): a simplified software tool to support environmentally conscious design in SMEs

NASA Astrophysics Data System (ADS)

Misceo, Monica; Buonamici, Roberto; Buttol, Patrizia; Naldesi, Luciano; Grimaldi, Filomena; Rinaldi, Caterina

2004-12-01

TESPI (Tool for Environmental Sound Product Innovation) is the prototype of a software tool developed within the framework of the "eLCA" project. The project, (www.elca.enea.it)financed by the European Commission, is realising "On line green tools and services for Small and Medium sized Enterprises (SMEs)". The implementation by SMEs of environmental product innovation (as fostered by the European Integrated Product Policy, IPP) needs specific adaptation to their economic model, their knowledge of production and management processes and their relationships with innovation and the environment. In particular, quality and costs are the main driving forces of innovation in European SMEs, and well known barriers exist to the adoption of an environmental approach in the product design. Starting from these considerations, the TESPI tool has been developed to support the first steps of product design taking into account both the quality and the environment. Two main issues have been considered: (i) classic Quality Function Deployment (QFD) can hardly be proposed to SMEs; (ii) the environmental aspects of the product life cycle need to be integrated with the quality approach. TESPI is a user friendly web-based tool, has a training approach and applies to modular products. Users are guided through the investigation of the quality aspects of their product (customer"s needs and requirements fulfilment) and the identification of the key environmental aspects in the product"s life cycle. A simplified check list allows analyzing the environmental performance of the product. Help is available for a better understanding of the analysis criteria. As a result, the significant aspects for the redesign of the product are identified.

Hydromentor: An integrated water resources monitoring and management system at modified semi-arid watersheds

NASA Astrophysics Data System (ADS)

Vasiliades, Lampros; Sidiropoulos, Pantelis; Tzabiras, John; Kokkinos, Konstantinos; Spiliotopoulos, Marios; Papaioannou, George; Fafoutis, Chrysostomos; Michailidou, Kalliopi; Tziatzios, George; Loukas, Athanasios; Mylopoulos, Nikitas

2015-04-01

Natural and engineered water systems interact throughout watersheds and while there is clearly a link between watershed activities and the quantity and quality of water entering the engineered environment, these systems are considered distinct operational systems. As a result, the strategic approach to data management and modeling within the two systems is very different, leading to significant difficulties in integrating the two systems in order to make comprehensive watershed decisions. In this paper, we describe the "HYDROMENTOR" research project, a highly-structured data storage and exchange system that integrates multiple tools and models describing both natural and modified environments, to provide an integrated tool for management of water resources. Our underlying objective in presenting our conceptual design for this water information system is to develop an integrated and automated system that will achieve monitoring and management of the water quantity and quality at watershed level for both surface water (rivers and lakes) and ground water resources (aquifers). The uniqueness of the system is the integrated treatment of the water resources management issue in terms of water quantity and quality in current climate conditions and in future conditions of climatic change. On an operational level, the system provides automated warnings when the availability, use and pollution levels exceed allowable limits pre-set by the management authorities. Decision making with respect to the apportionment of water use by surface and ground water resources are aided through this system, while the relationship between the polluting activity of a source to total incoming pollution by sources are determined; this way, the best management practices for dealing with a crisis are proposed. The computational system allows the development and application of actions, interventions and policies (alternative management scenarios) so that the impacts of climate change in quantity, quality and use of water resources could be evaluated and managed. Acknowledgements: This study has been supported by the research project "Hydromentor" funded by the Greek General Secretariat of Research and Technology in the framework of the E.U. co-funded National Action "Cooperation".

TEAM-HF Cost-Effectiveness Model: A Web-Based Program Designed to Evaluate the Cost-Effectiveness of Disease Management Programs in Heart Failure

PubMed Central

Reed, Shelby D.; Neilson, Matthew P.; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H.; Polsky, Daniel E.; Graham, Felicia L.; Bowers, Margaret T.; Paul, Sara C.; Granger, Bradi B.; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara; Levy, Wayne C.

2015-01-01

Background Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. Methods We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics, use of evidence-based medications, and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model (SHFM). Projections of resource use and quality of life are modeled using relationships with time-varying SHFM scores. The model can be used to evaluate parallel-group and single-cohort designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. Results The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. Conclusion The TEAM-HF Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. PMID:26542504

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

PubMed

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

2015-01-01

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

[Clinical Management: Basics and organization].

PubMed

Torres, Juan; Mingo, Carlos

2015-01-01

Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

Electrical resistivity tomography to delineate greenhouse soil variability

NASA Astrophysics Data System (ADS)

Rossi, R.; Amato, M.; Bitella, G.; Bochicchio, R.

2013-03-01

Appropriate management of soil spatial variability is an important tool for optimizing farming inputs, with the result of yield increase and reduction of the environmental impact in field crops. Under greenhouses, several factors such as non-uniform irrigation and localized soil compaction can severely affect yield and quality. Additionally, if soil spatial variability is not taken into account, yield deficiencies are often compensated by extra-volumes of crop inputs; as a result, over-irrigation and overfertilization in some parts of the field may occur. Technology for spatially sound management of greenhouse crops is therefore needed to increase yield and quality and to address sustainability. In this experiment, 2D-electrical resistivity tomography was used as an exploratory tool to characterize greenhouse soil variability and its relations to wild rocket yield. Soil resistivity well matched biomass variation (R2=0.70), and was linked to differences in soil bulk density (R2=0.90), and clay content (R2=0.77). Electrical resistivity tomography shows a great potential in horticulture where there is a growing demand of sustainability coupled with the necessity of stabilizing yield and product quality.

A geographic information system screening tool to tackle diffuse pollution through the use of sustainable drainage systems.

PubMed

Todorovic, Zorica; Breton, Neil P

2014-01-01

Sustainable drainage systems (SUDS) offer many benefits that traditional solutions do not. Traditional approaches are unable to offer a solution to problems of flood management and water quality. Holistic consideration of the wide range of benefits from SUDS can result in advantages such as improved flood resilience and water quality enhancement through consideration of diffuse pollution sources. Using a geographical information system (GIS) approach, diffuse pollutant sources and opportunities for SUDS are easily identified. Consideration of potential SUDS locations results in source, site and regional controls, leading to improved water quality (to meet Water Framework Directive targets). The paper will discuss two different applications of the tool, the first of which is where the pollutant of interest is known. In this case the outputs of the tool highlight and isolate the areas contributing the pollutants and suggest the adequate SUDS measures to meet the required criteria. The second application is where the tool identifies likely pollutants at a receiving location, and SUDS measures are proposed to reduce pollution with assessed efficiencies.

[Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

PubMed

Bergholz, W

2008-11-01

In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.

The concentration-discharge slope as a tool for water quality management.

PubMed

Bieroza, M Z; Heathwaite, A L; Bechmann, M; Kyllmar, K; Jordan, P

2018-07-15

Recent technological breakthroughs of optical sensors and analysers have enabled matching the water quality measurement interval to the time scales of stream flow changes and led to an improved understanding of spatially and temporally heterogeneous sources and delivery pathways for many solutes and particulates. This new ability to match the chemograph with the hydrograph has promoted renewed interest in the concentration-discharge (c-q) relationship and its value in characterizing catchment storage, time lags and legacy effects for both weathering products and anthropogenic pollutants. In this paper we evaluated the stream c-q relationships for a number of water quality determinands (phosphorus, suspended sediments, nitrogen) in intensively managed agricultural catchments based on both high-frequency (sub-hourly) and long-term low-frequency (fortnightly-monthly) routine monitoring data. We used resampled high-frequency data to test the uncertainty in water quality parameters (e.g. mean, 95th percentile and load) derived from low-frequency sub-datasets. We showed that the uncertainty in water quality parameters increases with reduced sampling frequency as a function of the c-q slope. We also showed that different sources and delivery pathways control c-q relationship for different solutes and particulates. Secondly, we evaluated the variation in c-q slopes derived from the long-term low-frequency data for different determinands and catchments and showed strong chemostatic behaviour for phosphorus and nitrogen due to saturation and agricultural legacy effects. The c-q slope analysis can provide an effective tool to evaluate the current monitoring networks and the effectiveness of water management interventions. This research highlights how improved understanding of solute and particulate dynamics obtained with optical sensors and analysers can be used to understand patterns in long-term water quality time series, reduce the uncertainty in the monitoring data and to manage eutrophication in agricultural catchments. Copyright © 2018 Elsevier B.V. All rights reserved.

Raising the quality of rheumatology management recommendations: lessons from the EULAR process 10 years after provision of standard operating procedures.

PubMed

Colebatch-Bourn, Alexandra N; Conaghan, Philip G; Arden, Nigel K; Cooper, Cyrus; Dougados, Maxime; Edwards, Christopher J

2015-08-01

To increase understanding of how to raise the quality of rheumatology guidelines by reviewing European League Against Rheumatism (EULAR) management recommendations, using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, 10 years after publication of the EULAR standardized operating procedures (SOP) for the production of recommendations. It was hoped that this work could help inform improvements in guideline development by other societies and organizations. The SOP were published in 2004 to ensure the quality of EULAR-endorsed recommendations. We reviewed 27 published EULAR recommendations for management using the AGREE II tool. This provides a framework to assess the quality of guidelines across six broad domains using 23 specific questions. Overall the EULAR recommendations reviewed have been performed to a high standard. There are particular strengths in the methodology and presentation of the guidelines; however, the results indicate areas for development in future recommendations: in particular, stakeholder involvement and applicability of the recommendations. Improvements in quality were evident in recent years, with patient representation in 9 of 15 (60.0%) recommendations published 2010-14 compared with 4 of 12 (33.3%) published 2000-09. In the last 10 years the overall quality of recommendations was good, with standards improving over the decade following publication of the SOP. However, this review process has identified potential areas for improvement, especially in patient representation and provision of implementation tools. The lessons from this work can be applied to the development of rheumatology guidelines by other societies and organizations. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Managing and learning with multiple models: Objectives and optimization algorithms

USGS Publications Warehouse

Probert, William J. M.; Hauser, C.E.; McDonald-Madden, E.; Runge, M.C.; Baxter, P.W.J.; Possingham, H.P.

2011-01-01

The quality of environmental decisions should be gauged according to managers' objectives. Management objectives generally seek to maximize quantifiable measures of system benefit, for instance population growth rate. Reaching these goals often requires a certain degree of learning about the system. Learning can occur by using management action in combination with a monitoring system. Furthermore, actions can be chosen strategically to obtain specific kinds of information. Formal decision making tools can choose actions to favor such learning in two ways: implicitly via the optimization algorithm that is used when there is a management objective (for instance, when using adaptive management), or explicitly by quantifying knowledge and using it as the fundamental project objective, an approach new to conservation.This paper outlines three conservation project objectives - a pure management objective, a pure learning objective, and an objective that is a weighted mixture of these two. We use eight optimization algorithms to choose actions that meet project objectives and illustrate them in a simulated conservation project. The algorithms provide a taxonomy of decision making tools in conservation management when there is uncertainty surrounding competing models of system function. The algorithms build upon each other such that their differences are highlighted and practitioners may see where their decision making tools can be improved. ?? 2010 Elsevier Ltd.

Design of a Decision Support Tool for Nutrient Credit Exchange Feasibility in Stormwater Regulatory Compliance

DOT National Transportation Integrated Search

2015-06-01

Virginia Stormwater Management Program (VSMP) regulations require transportation projects to account for stormwater runoff impacts from increased impervious surfaces in order to prevent water quality reduction, erosion, and flooding.1 Organizations l...

Green Roofs for Stormwater Runoff Control - Abstract

EPA Science Inventory

This project evaluated green roofs as a stormwater management tool. Specifically, runoff quantity and quality from green and flat asphalt roofs were compared. Evapotranspiration from planted green roofs and evaporation from unplanted media roofs were also compared. The influence...

Green Roofs for Stormwater Runoff Control

EPA Science Inventory

This project evaluated green roofs as a stormwater management tool. Specifically, runoff quantity and quality from green and flat asphalt roofs were compared. Evapotranspiration from planted green roofs and evaporation from unplanted media roofs were also compared. The influence...

DATA TOOLS AND INTERPRETATION

EPA Science Inventory

As watershed groups in the state of Georgia form and develop, they have a need for collecting, managing, and analyzing data associated with their watershed. Possible sources of data for flow, water quality, biology, habitat, and watershed characteristics include the U.S. Geologic...

Measuring couple relationship quality in a rural African population: Validation of a Couple Functionality Assessment Tool in Malawi.

PubMed

Ruark, Allison; Chase, Rachel; Hembling, John; Davis, Valerie Rhoe; Perrin, Paul Clayton; Brewster-Lee, Dorothy

2017-01-01

Available data suggest that individual and family well-being are linked to the quality of women's and men's couple relationships, but few tools exist to assess couple relationship functioning in low- and middle-income countries. In response to this gap, Catholic Relief Services has developed a Couple Functionality Assessment Tool (CFAT) to capture valid and reliable data on various domains of relationship quality. This tool is designed to be used by interventions which aim to improve couple and family well-being as a means of measuring the effectiveness of these interventions, particularly related to couple relationship quality. We carried out a validation study of the CFAT among 401 married and cohabiting adults (203 women and 198 men) in rural Chikhwawa District, Malawi. Using psychometric scales, the CFAT addressed six domains of couple relationship quality (intimacy, partner support, sexual satisfaction, gender roles, decision-making, and communication and conflict management), and included questions on intimate partner violence. We used exploratory factor analysis to assess scale performance of each domain and produce a shortened Relationship Quality Index (RQI) composed of items from five relationship quality domains. This article reports the performance of the RQI. Internal reliability and validity of the RQI were found to be good. Regression analyses examined the relationship of the RQI to outcomes important to health and development: intra-household cooperation, positive health behaviors, intimate partner violence, and gender-equitable norms. We found many significant correlations between RQI scores and these couple- and family-level development issues. There is a need to further validate the tool with use in other populations as well as to continue to explore whether the observed linkages between couple functionality and development outcomes are causal relationships.

Measuring couple relationship quality in a rural African population: Validation of a Couple Functionality Assessment Tool in Malawi

PubMed Central

Chase, Rachel; Hembling, John; Davis, Valerie Rhoe; Perrin, Paul Clayton; Brewster-Lee, Dorothy

2017-01-01

Available data suggest that individual and family well-being are linked to the quality of women’s and men’s couple relationships, but few tools exist to assess couple relationship functioning in low- and middle-income countries. In response to this gap, Catholic Relief Services has developed a Couple Functionality Assessment Tool (CFAT) to capture valid and reliable data on various domains of relationship quality. This tool is designed to be used by interventions which aim to improve couple and family well-being as a means of measuring the effectiveness of these interventions, particularly related to couple relationship quality. We carried out a validation study of the CFAT among 401 married and cohabiting adults (203 women and 198 men) in rural Chikhwawa District, Malawi. Using psychometric scales, the CFAT addressed six domains of couple relationship quality (intimacy, partner support, sexual satisfaction, gender roles, decision-making, and communication and conflict management), and included questions on intimate partner violence. We used exploratory factor analysis to assess scale performance of each domain and produce a shortened Relationship Quality Index (RQI) composed of items from five relationship quality domains. This article reports the performance of the RQI. Internal reliability and validity of the RQI were found to be good. Regression analyses examined the relationship of the RQI to outcomes important to health and development: intra-household cooperation, positive health behaviors, intimate partner violence, and gender-equitable norms. We found many significant correlations between RQI scores and these couple- and family-level development issues. There is a need to further validate the tool with use in other populations as well as to continue to explore whether the observed linkages between couple functionality and development outcomes are causal relationships. PMID:29190769

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

The Structured Assessment of Violence Risk in Adults with Intellectual Disability: A Systematic Review.

PubMed

Hounsome, J; Whittington, R; Brown, A; Greenhill, B; McGuire, J

2018-01-01

While structured professional judgement approaches to assessing and managing the risk of violence have been extensively examined in mental health/forensic settings, the application of the findings to people with an intellectual disability is less extensively researched and reviewed. This review aimed to assess whether risk assessment tools have adequate predictive validity for violence in adults with an intellectual disability. Standard systematic review methodology was used to identify and synthesize appropriate studies. A total of 14 studies were identified as meeting the inclusion criteria. These studies assessed the predictive validity of 18 different risk assessment tools, mainly in forensic settings. All studies concluded that the tools assessed were successful in predicting violence. Studies were generally of a high quality. There is good quality evidence that risk assessment tools are valid for people with intellectual disability who offend but further research is required to validate tools for use with people with intellectual disability who offend. © 2016 John Wiley & Sons Ltd.

Environmental Policy Tools: A User’s Guide.

DTIC Science & Technology

1995-09-01

Quality RTUs Remote Terminal Units EG&S Environmental Goods and Services SAB (EPA) Science Advisory Board ( Industry ) SCAQMD South Coast Air Quality...Management EPA Environmental Protection Agency District EPCRA Emergency Planning and Community- SIC Standard Industrial Code Right-To-Know Act SIP State...solution will be significantly different than complicate the decision. Foremost among these today’s? is: Will costs and burdens to industry and gov

The Effect of Training with TQM on the Perceptions of Teachers about the Quality of Schools

ERIC Educational Resources Information Center

Altunay, Esen

2016-01-01

The purpose of this research is to explore the effect of training with total quality management (TQM) on the perceptions of teachers. In this research was used experimental model. The study group of the research consisted of teachers working in the schools of Education Ministry. The questionnaire was used as a data collection tool. Finally, it was…

Evaluating Quality of Life in Urban Areas (Case Study: Noorabad City, Iran)

ERIC Educational Resources Information Center

Rezvani, Mohammad Reza; Mansourian, Hossain; Sattari, Mohammad Hossain

2013-01-01

Quality of urban life (QOUL) has become an important field within urban studies. The increased level of attention to this topic is due to the increasing importance of QoL studies in monitoring public policies and in the role they can play as effective tools in urban management and planning. The main objective of this study is to measure the QOUL…

Analysis and Evaluation of Forecasting Methods and Tools to Predict Future Demand for Secondary Chemical-Biological Configuration Items

DTIC Science & Technology

2013-06-01

quantity, the lead time, the process quality and the number of deliveries (Yang & Pan, 2004). Inventory management systems are classified as either...22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington DC 20503. 1. AGENCY USE ONLY (Leave blank... managed by the Defense Logistics Agency (DLA), Edgewood Chemical Biological Center (ECBC) must be able to complete reviews of all procurement

Software engineering project management - A state-of-the-art report

NASA Technical Reports Server (NTRS)

Thayer, R. H.; Lehman, J. H.

1977-01-01

The management of software engineering projects in the aerospace industry was investigated. The survey assessed such features as contract type, specification preparation techniques, software documentation required by customers, planning and cost-estimating, quality control, the use of advanced program practices, software tools and test procedures, the education levels of project managers, programmers and analysts, work assignment, automatic software monitoring capabilities, design and coding reviews, production times, success rates, and organizational structure of the projects.

Requirements UML Tool (RUT) Expanded for Extreme Programming (CI02)

NASA Technical Reports Server (NTRS)

McCoy, James R.

2003-01-01

A procedure for capturing and managing system requirements that incorporates XP user stories. Because costs associated with identifying problems in requirements increase dramatically over the lifecycle of a project, a method for identifying sources of software risks in user stories is urgently needed. This initiative aims to determine a set of guide-lines for user stories that will result in high-quality requirement. To further this initiative, a tool is needed to analyze user stories that can assess the quality of individual user stories, detect sources cf software risk's, produce software metrics, and identify areas in user stories that can be improved.

Odel of Dynamic Integration of Lean Shop Floor Management Within the Organizational Management System

NASA Astrophysics Data System (ADS)

Iuga, Virginia; Kifor, Claudiu

2014-12-01

The key to achieve a sustainable development lies in the customer satisfaction through improved quality, reduced cost, reduced delivery lead times and proper communication. The objective of the lean manufacturing system (LMS) is to identify and eliminate the processes and resources which do not add value to a product. The following paper aims to present a proposal of further development of integrated management systems in organizations through the implementation of lean shop floor management. In the first part of the paper, a dynamic model of the implementation steps will be presented. Furthermore, the paper underlines the importance of implementing a lean culture parallel with each step of integrating the lean methods and tools. The paper also describes the Toyota philosophy, tools, and the supporting lean culture necessary to implementing an efficient lean system in productive organizations

Integrating Diabetes Guidelines into a Telehealth Screening Tool.

PubMed

Gervera, Kelly; Graves, Barbara Ann

2015-01-01

Diabetes is the seventh leading cause of death in the United States and contributes to long-term complications that are costly to healthcare systems. Twenty-five percent of all veterans in the Veterans Health Administration (VHA) have diabetes. The purpose of this article is to describe the development and implementation of a quality improvement project to embed an evidence-based diabetes screening tool, based on Veterans Affairs/Department of Defense diabetes clinical practice guidelines, into the VHA electronic medical record. The objectives of the screening tool were threefold: to promote evidence-based care, to standardize care coordination, and to promote self-management and proper utilization of resources. Record reviews were conducted to evaluate the effectiveness of the screening tool. Results showed an 88 percent increase in the assessment of annual exams and/or labs, a 16.5 percent increase in disease management assessment and offering of services, and a 50 percent increase in goal-setting activity.

Promoting quality improvement in French healthcare organisations: design and impact of a compendium of models and tools

PubMed Central

Erbault, M; Glikman, J; Ravineau, M; Lajzerowicz, N; Terra, J

2003-01-01



 Relevant and user friendly information should be provided to professionals who wish to promote quality improvement in healthcare organisations (HCOs). In response to requests from French HCOs, we designed a compendium of methods and tools for use in quality improvement. Its contents were based on a critical review of the literature, face-to-face interviews with three industrial/business experts in quality, the views of 13 healthcare professionals knowledgeable in quality issues, and comments from over 40 potential users of the compendium. Overall, 14 methods and 20 tools relevant and applicable to the healthcare sector were identified. They were classified according to their main thrust, explained in detail, illustrated with specific cases from the literature or from personal experience, and published as a loose leaf compendium. The compendium was posted on the worldwide web and presented to healthcare managers in September 2000. It has become one of the most popular ANAES publications (approximately 5400 downloads over the first 6 months), partly because all French HCOs are legally bound to undergo accreditation which has been set up and is being implemented by ANAES. PMID:14532370

Chronic disease management systems registries in rural health care.

PubMed

Skinner, Anne; Fraser-Maginn, Roslyn; Mueller, Keith J

2006-05-01

Health care quality is being addressed from a variety of policy perspectives. The 2001 Institute of Medicine report, Crossing the Quality Chasm, calls for sweeping action involving a five-part strategy for change in the U.S. health care system. This agenda for change includes use of evidence-based approaches to address common conditions, the majority of which are chronic. A Chronic Disease Management System (CDMS), or registry, is a tool that helps providers efficiently collect and analyze patient information to promote quality care for the rural population. CDMSs can provide a technological entry point for the impending use of Electronic Medical Records. A CDMS is a patient-centered electronic database tool that helps providers diagnose, treat, and manage chronic diseases. The purpose of this brief is to discuss the different types of CDMSs used by a sample of 14 state organizations and 19 local rural clinics in Maine, Nebraska, New Mexico, South Carolina, Washington, and Wisconsin. As part of a larger study examining the challenges and innovations in implementing disease management programs in rural areas, we conducted interviews with national, state, and local contacts. During interviews, respondents helped us understand the usefulness and functionalities of commonly used CDMSs in rural facilities. Our focus was on the use of CDMSs in the management of diabetes, a disease prevalent in rural populations. (1) CDMSs are readily available to rural clinics and are being implemented and maintained by clinic staff with minimal expenditures for technology. (2) Use of a standardized system in a collaborative helps provide data comparisons and share costs involved with technical assistance services across the group.

QAIT: a quality assurance issue tracking tool to facilitate the improvement of clinical data quality.

PubMed

Zhang, Yonghong; Sun, Weihong; Gutchell, Emily M; Kvecher, Leonid; Kohr, Joni; Bekhash, Anthony; Shriver, Craig D; Liebman, Michael N; Mural, Richard J; Hu, Hai

2013-01-01

In clinical and translational research as well as clinical trial projects, clinical data collection is prone to errors such as missing data, and misinterpretation or inconsistency of the data. A good quality assurance (QA) program can resolve many such errors though this requires efficient communications between the QA staff and data collectors. Managing such communications is critical to resolving QA problems but imposes a major challenge for a project involving multiple clinical and data processing sites. We have developed a QA issue tracking (QAIT) system to support clinical data QA in the Clinical Breast Care Project (CBCP). This web-based application provides centralized management of QA issues with role-based access privileges. It has greatly facilitated the QA process and enhanced the overall quality of the CBCP clinical data. As a stand-alone system, QAIT can supplement any other clinical data management systems and can be adapted to support other projects. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Using Remote Sensing Mapping and Growth Response to Environmental Variability to Aide Aquatic Invasive Plant Management

NASA Technical Reports Server (NTRS)

Bubenheim, David L.; Schlick, Greg; Genovese, Vanessa; Wilson, Kenneth D.

2018-01-01

Management of aquatic weeds in complex watersheds and river systems present many challenges to assessment, planning and implementation of management practices for floating and submerged aquatic invasive plants. The Delta Region Areawide Aquatic Weed Project (DRAAWP), a USDA sponsored area-wide project, is working to enhance planning, decision-making and operational efficiency in the California Sacramento-San Joaquin Delta. Satellite and airborne remote sensing are used map (area coverage and biomass density), direct operations, and assess management impacts on plant communities. Archived satellite records enable review of results following previous climate and management events and aide in developing long-term strategies. Examples of remote sensing aiding effectiveness of aquatic weed management will be discussed as well as areas for potential technological improvement. Modeling at local and watershed scales using the SWAT modeling tool provides insight into land-use effects on water quality (described by Zhang in same Symposium). Controlled environment growth studies have been conducted to quantify the growth response of invasive aquatic plants to water quality and other environmental factors. Environmental variability occurs across a range of time scales from long-term climate and seasonal trends to short-term water flow mediated variations. Response time for invasive species response are examined at time scales of weeks, day, and hours using a combination of study duration and growth assessment techniques to assess water quality, temperature (air and water), nitrogen, phosphorus, and light effects. These provide response parameters for plant growth models in response to the variation and interact with management and economic models associated with aquatic weed management. Plant growth models are to be informed by remote sensing and applied spatially across the Delta to balance location and type of aquatic plant, growth response to altered environments and phenology. Initial utilization of remote sensing tools developed for mapping of aquatic invasive plants improved operational efficiency in management practices. These assessment methods provide a comprehensive and quantitative view of aquatic invasive plants communities in the California Delta.

Developing "My Asthma Diary": a process exemplar of a patient-driven arts-based knowledge translation tool.

PubMed

Archibald, Mandy M; Hartling, Lisa; Ali, Samina; Caine, Vera; Scott, Shannon D

2018-06-05

Although it is well established that family-centered education is critical to managing childhood asthma, the information needs of parents of children with asthma are not being met through current educational approaches. Patient-driven educational materials that leverage the power of the storytelling and the arts show promise in communicating health information and assisting in illness self-management. However, such arts-based knowledge translation approaches are in their infancy, and little is known about how to develop such tools for parents. This paper reports on the development of "My Asthma Diary" - an innovative knowledge translation tool based on rigorous research evidence and tailored to parents' asthma-related information needs. We used a multi-stage process to develop four eBook prototypes of "My Asthma Diary." We conducted formative research on parents' information needs and identified high quality research evidence on childhood asthma, and used these data to inform the development of the asthma eBooks. We established interdisciplinary consulting teams with health researchers, practitioners, and artists to help iteratively create the knowledge translation tools. We describe the iterative, transdisciplinary process of developing asthma eBooks which incorporates: (I) parents' preferences and information needs on childhood asthma, (II) quality evidence on childhood asthma and its management, and (III) the engaging and informative powers of storytelling and visual art as methods to communicate complex health information to parents. We identified four dominant methodological and procedural challenges encountered during this process: (I) working within an inter-disciplinary team, (II) quantity and ordering of information, (III) creating a composite narrative, and (IV) balancing actual and ideal management scenarios. We describe a replicable and rigorous multi-staged approach to developing a patient-driven, creative knowledge translation tool, which can be adapted for use with different populations and contexts. We identified specific procedural and methodological challenges that others conducting comparable work should consider, particularly as creative, patient-driven knowledge translation strategies continue to emerge across health disciplines.

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The same tool could then be applied to assess any improvement after corrective actions are taken. This is the first comprehensive audit program in nuclear medicine that helps evaluate managerial aspects, safety of patients and workers, clinical practice, and radiopharmacy, and, above all, keeps them under control all together, with the intention of continuous improvement. Copyright © 2017. Published by Elsevier Inc.

Quality management of medical education at the Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany.

PubMed

Dieter, Peter Erich

2008-12-01

The Carl Gustav Carus Faculty of Medicine, University of Technology Dresden, Germany, was founded in 1993 after the reunification of Germany. In 1999, a reform process of medical education was started together with Harvard Medical International. The traditional teacher and discipline-centred curriculum was replaced by a student-centred, interdisciplinary and integrative curriculum which has been named DIPOL (Dresden Integrative Patient/Problem- Oriented Learning). The reform process was accompanied and supported by a parallel-ongoing Faculty Development Program. In 2004, a Quality Management Program in medical education was implemented, and in 2005 medical education received DIN EN ISO 9001:2000 certification. Quality Management Program and DIN EN ISO 9001:2000 certification were/are unique for the 34 medical schools in Germany. The students played a very important strategic role in all processes. They were/are members in all committees like the Faculty Board, the Board of Study Affairs (with equal representation) and the ongoing audits in the Quality Management Program. Students are the only ones who experience all years of the curriculum and are capable of detecting, for example gaps, overlaps, inconsistencies of the curriculum and assessments. Therefore, the in-depth knowledge of students about the medical school's curriculum is a very helpful and essential tool in curriculum reform processes and Quality Management Programs of medical education. The reform in medical education, the establishment of the Quality Management program and the certification resulted in an improvement of quality and output of medical education and medical research.

Evolution of diabetes management in the 21st century: the contribution of quality of life measurement in Asians.

PubMed

Goh, Shereen Giap Kah; Rusli, Bin Nordin; Khalid, Bin Abdul Kadir

2015-01-01

Diabetes mellitus (DM) is a complex and chronic disease with multiple complications leading to increased mortality and poor quality of life. Current studies have shown that lowering glycosylated haemoglobin (HbA1c) confers protection against microvascular complications. However, with more intensive glucose control to achieve HbA1c of less than 6.5%, there seems to be a significant increased risk of mortality and cardiovascular events. The current recommendation worldwide is for "tailoring" of DM management to risk and also quality of Life (QOL) which is a crucial component in determining the success or failure of DM management. In Asia, DM has become a health crisis but there is a lack of QOL assessment tool that is specific for Asians with wide spectrum of ethnicity, languages, religions and socio-economic differences. In this review, we discuss the evolution of DM management over the decade and the issues pertaining to QOL among people living with diabetes in Asia.

IEC 61511 and the capital project process--a protective management system approach.

PubMed

Summers, Angela E

2006-03-17

This year, the process industry has reached an important milestone in process safety-the acceptance of an internationally recognized standard for safety instrumented systems (SIS). This standard, IEC 61511, documents good engineering practice for the assessment, design, operation, maintenance, and management of SISs. The foundation of the standard is established by several requirements in Part 1, Clauses 5-7, which cover the development of a management system aimed at ensuring that functional safety is achieved. The management system includes a quality assurance process for the entire SIS lifecycle, requiring the development of procedures, identification of resources and acquisition of tools. For maximum benefit, the deliverables and quality control checks required by the standard should be integrated into the capital project process, addressing safety, environmental, plant productivity, and asset protection. Industry has become inundated with a multitude of programs focusing on safety, quality, and cost performance. This paper introduces a protective management system, which builds upon the work process identified in IEC 61511. Typical capital project phases are integrated with the management system to yield one comprehensive program to efficiently manage process risk. Finally, the paper highlights areas where internal practices or guidelines should be developed to improve program performance and cost effectiveness.

E-nursing documentation as a tool for quality assurance.

PubMed

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

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

Particulate source strength determination for low-intensity prescribed fires

Treesearch

Darold E. Ward; Ernest R. Elliott; Charles K McMahon; Dale D. Wade

1974-01-01

Prescribed fire is the intentional use of fire to achieve certain land management goals. Over 2 million acres of forest land in the southern United States are treated with this tool each year. The benefits from these burns can be offset by a degradation of air quality due to improper management of combustion products. This paper reports on a portion of the overall...

Travel simulation modeling: an emerging tool for visitor management in wilderness

Treesearch

David N. Cole

2004-01-01

Rhe amount, type, timing, and location of visitor use all have profound effects on the quality of the natural resources and visitor experiences in wilderness. Therefore, it is important to monitor the flow of visitation, in space and over time, and predict how distributions are likely to change in response to both management actions and factors that are not subject to...

Friendship and Thomas More: Using Erasmus's Letter to Ulrich von Hutten as a Tool in Developing a Classroom Management Plan

ERIC Educational Resources Information Center

Brown, Joshua W.; Rud, A. G.

2006-01-01

The development of course management plans and student behavioral guidelines are a necessary component for the foundation of any school or learning community. In this article the authors explore a few of the principal foundations of creating these plans based on the qualities Erasmus described in his great friend Thomas More. Teachers and…

Perceptions of Physical Inspections as a Tool to Protect Housing Quality and Promote Health Equity.

PubMed

Holtzen, Holly; Klein, Elizabeth G; Keller, Brittney; Hood, Nancy

2016-01-01

Physical inspections that assess how well affordable housing properties meet quality and safety standards help to ensure that low-income tenants live in a healthy built environment. This study was part of a larger Health Impact Assessment (HIA) conducted between January 2012 and November 2013 to inform policymakers about the potential health consequences of a proposed policy decision to align the physical inspections required by housing funding agencies, which would result in a reduction of the frequency of physical inspections. Key informant interviews (n=18) of property managers and tenants were used to explore the inspection process, identification of housing quality issues, and potential effects on the health of affordable housing tenants and the impact on property management practices. Results indicate that physical inspection frequency may be an important trigger for property managers and tenants to adhere to proper maintenance schedules.

Contract management using cause-effect clues in service worksheets.

PubMed

Chen, J H

1996-01-01

Sophisticated equipment often needs intensive technical resources to maintain its system availability. Service contracts can be an easy channel to outside technical resources. Usually, a service contract purchaser only sees its cost instead of its maintenance quality. A system's needs, however, depend on the trade-off between the cost paid and the quality received. If a clinical engineer can actively interpret and integrate the cause-effect consequences on the compiled service worksheets, those clues can serve as a criterion to justify the quality and the cost-effectiveness of a service contract. Through the analysis of the service labor consumed, the justification of the parts replaced, and the assessment of the "fit" to system availability, this paper provides a cost-effective tool for equipment management.

Management and modeling: Tools to improve water quality

USDA-ARS?s Scientific Manuscript database

Agricultural, urban and suburban sources contribute to the contamination of surface waters, which has been observed by the detection of pesticides, excess nutrients, industrial pollutants, antibiotics, pharmaceuticals, and personal care products in both natural waters and treated wastewaters. The us...

From field notes to data portal - An operational QA/QC framework for tower networks

NASA Astrophysics Data System (ADS)

Sturtevant, C.; Hackley, S.; Meehan, T.; Roberti, J. A.; Holling, G.; Bonarrigo, S.

2016-12-01

Quality assurance and control (QA/QC) is one of the most important yet challenging aspects of producing research-quality data. This is especially so for environmental sensor networks collecting numerous high-frequency measurement streams at distributed sites. Here, the quality issues are multi-faceted, including sensor malfunctions, unmet theoretical assumptions, and measurement interference from the natural environment. To complicate matters, there are often multiple personnel managing different sites or different steps in the data flow. For large, centrally managed sensor networks such as NEON, the separation of field and processing duties is in the extreme. Tower networks such as Ameriflux, ICOS, and NEON continue to grow in size and sophistication, yet tools for robust, efficient, scalable QA/QC have lagged. Quality control remains a largely manual process relying on visual inspection of the data. In addition, notes of observed measurement interference or visible problems are often recorded on paper without an explicit pathway to data flagging during processing. As such, an increase in network size requires a near-proportional increase in personnel devoted to QA/QC, quickly stressing the human resources available. There is a need for a scalable, operational QA/QC framework that combines the efficiency and standardization of automated tests with the power and flexibility of visual checks, and includes an efficient communication pathway from field personnel to data processors to end users. Here we propose such a framework and an accompanying set of tools in development, including a mobile application template for recording tower maintenance and an R/shiny application for efficiently monitoring and synthesizing data quality issues. This framework seeks to incorporate lessons learned from the Ameriflux community and provide tools to aid continued network advancements.

Optimizing the patient transport function at Mayo Clinic.

PubMed

Kuchera, Dustin; Rohleder, Thomas R

2011-01-01

In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

Sharpening policy instruments with catchment evaluations and the water quality continuum

NASA Astrophysics Data System (ADS)

Jordan, P.; Melland, A. R.; Mellander, P.-E.; Murphy, P.; Shortle, G.; Wall, D.; Mechan, S.; Shine, O.

2012-04-01

There is a scale dichotomy in water quality management in European agricultural catchments due to the fact that impacts identified at river basin scale are mitigated by management that is typically asserted from research at field or plot scale and implemented at farm scale. Evaluations of management impact are then undertaken back at the river basin scale. The policy instruments in place to mitigate water quality impacts are also based on the integration of scientific research and stakeholder negotiations and can sometimes be blunt compromises. Nevertheless, expectations of accruing water quality benefits remain high and sometimes unchallenged. Evaluating all catchment components of a pollution transfer continuum from source to impact enables important elements such as lag time between policy implementation and water quality response, water body sampling frequency and allocation of correct dose-response mechanisms to be assessed. These points are particularly important in complex agricultural catchments where multiple nutrient pollution sources have variable impacts on different water body types - and at different times of year. The tools of catchment water quality policy evaluation are diverse and include metrics of natural resource management, soil and water chemistry, hydrology, ecology and palaeolimnology. Used in combination and with river basin scale and site-specific data inventories, they can provide a powerful suite of evidence for further iterations of water quality policy and projecting realistic expectations of policy success.

Evaluating the implementation of confusion assessment method-intensive care unit using a quality improvement approach.

PubMed

Stewart, C; Bench, S

2018-05-15

Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium. Using the Model for Improvement framework, a multidisciplinary working group was established. A delirium assessment tool was introduced via a series of educational initiatives. New local guidelines regarding the use of delirium assessment and management for the multidisciplinary team were also produced. Audit data were collected at 6 weeks and 5 months post-implementation to evaluate compliance with the use of the tool across three critical care units within a single hospital in London. At 6 weeks, in 134 assessment points out of a possible 202, the tool was deemed to be used appropriately, meaning that 60% of patients received timely assessment; 18% of patients were identified as delirious in audit one. Five months later, only 95 assessment points out of a possible 199 were being appropriately assessed (47%); however, a greater number (32%) were identified as delirious. This project emphasizes the complexity of changing practice in a large busy critical care centre. Despite an initial increase in delirium assessment, this was not sustained over time. The use of a QI model highlights the continuous process of embedding changes into clinical practice and the need to use a QI method that can address the challenging nature of modern health care. QI models guide changes in practice. Consideration should be given to the type of QI model used. © 2018 British Association of Critical Care Nurses.

Using an interview guide to identify effective nurse managers: phase II, outcomes.

PubMed

Fosbinder, D; Everson-Bates, S; Hendrix, L

2000-01-01

The investigators report validation of a survey tool called the Interview Guide to assist in the selection of nurses who will be effective as managers. Nurse administrators rated nurse managers at six months and two years after hire. The Interview Guide rated the management qualities "seeing the big picture" and potential for "rehire" as the best predictors of managerial success. After two years, a good "self-concept" or a "flexible attitude" was the best predictor. The ability to manage conflict was the most significant competency for predicting rehire at both six months and two years.

Enhancing a rainfall-runoff model to assess the impacts of BMPs and LID practices on storm runoff.

PubMed

Liu, Yaoze; Ahiablame, Laurent M; Bralts, Vincent F; Engel, Bernard A

2015-01-01

Best management practices (BMPs) and low impact development (LID) practices are increasingly being used as stormwater management techniques to reduce the impacts of urban development on hydrology and water quality. To assist planners and decision-makers at various stages of development projects (planning, implementation, and evaluation), user-friendly tools are needed to assess the effectiveness of BMPs and LID practices. This study describes a simple tool, the Long-Term Hydrologic Impact Assessment-LID (L-THIA-LID), which is enhanced with additional BMPs and LID practices, improved approaches to estimate hydrology and water quality, and representation of practices in series (meaning combined implementation). The tool was used to evaluate the performance of BMPs and LID practices individually and in series with 30 years of daily rainfall data in four types of idealized land use units and watersheds (low density residential, high density residential, industrial, and commercial). Simulation results were compared with the results of other published studies. The simulated results showed that reductions in runoff volume and pollutant loads after implementing BMPs and LID practices, both individually and in series, were comparable with the observed impacts of these practices. The L-THIA-LID 2.0 model is capable of assisting decision makers in evaluating environmental impacts of BMPs and LID practices, thereby improving the effectiveness of stormwater management decisions. Copyright © 2014 Elsevier Ltd. All rights reserved.