Sample records for quality program implementation
-
Shek, Daniel T L; Law, Moon Y M
2017-02-01
This study examined the perceptions of the Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social programmes) among Chinese secondary school students displaying greater psychosocial needs. Results showed that participants held positive views of program qualities, implementer qualities, as well as the perceived effectiveness of the program. Significant grade differences in terms of various indicators of satisfaction related to program qualities, implementer qualities, and program effectiveness were found. Correlation analyses showed that there were significant inter-relationships amongst program qualities, implementer qualities and program effectiveness. In line with the predictions, both program qualities and implementer qualities were significant predictors of perceived program effectiveness. The present study provides support for the perceived effectiveness of the Tier 2 Program of the Project P.A.T.H.S. in the community-based project context.
-
Shek, Daniel T L; Ng, Catalina S M; Law, Moon Y M
2017-02-01
As program implementers' views are seldom included in program evaluation and there are few related studies in different Chinese communities, this study examined the perceptions of the program implementers who implemented the Tier 2 Program of the P.A.T.H.S. Program in Hong Kong. The Tier 2 Program was designed to promote the development of adolescents with greater psychosocial needs. In the community-based P.A.T.H.S. Project, 400 program implementers completed a subjective outcome evaluation form (Form D) for program implementers. Consistent with the previous findings, program implementers generally held positive views towards the program, implementers, and program effectiveness and their views towards these three domains did not differ across grades. In line with the hypotheses, perceived program quality and perceived implementer quality predicted program effectiveness. The present findings provided an alternative perspective showing that the Tier 2 Program was well received by the program implementers and they regarded the program to be beneficial to the program participants.
-
Benjamin-Chung, Jade; Sultana, Sonia; Halder, Amal K; Ahsan, Mohammed Ali; Arnold, Benjamin F; Hubbard, Alan E; Unicomb, Leanne; Luby, Stephen P; Colford, John M
2017-05-01
To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. SHEWA-B did not meet UNICEF's ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B's design was suboptimal for improving these outcomes.
-
Sultana, Sonia; Halder, Amal K.; Ahsan, Mohammed Ali; Arnold, Benjamin F.; Hubbard, Alan E.; Unicomb, Leanne; Luby, Stephen P.; Colford, John M.
2017-01-01
Objectives. To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. Methods. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Results. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. Conclusions. SHEWA-B did not meet UNICEF’s ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B’s design was suboptimal for improving these outcomes. PMID:28323462
-
2013-01-01
Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was conducted in 2010. The sample consisted of hospital administrators that were selected by provincial review boards. The questionnaire consisted of 3 sections: 20 healthcare technology items, 16 quality improvement program items and 63 culture items. Results Rasch model analysis revealed that a hierarchy existed among the healthcare technologies based upon the difficulty of implementation. The results also showed a significant relationship existed between the ability to implement healthcare technologies and the number of quality improvement programs adopted. In addition, culture within a hospital served a mediating role in quality improvement programs adoption. Conclusions Healthcare technologies each have different levels of difficulty. As a consequence, hospitals need to understand their current level of capability before selecting a particular technology in order to assess the level of resources needed. Further the usage of quality improvement programs is related to the ability to implement technology and the culture within a hospital. PMID:24119419
-
Ingabire, Willy; Reine, Petera M; Hedt-Gauthier, Bethany L; Hirschhorn, Lisa R; Kirk, Catherine M; Nahimana, Evrard; Nepomscene Uwiringiyemungu, Jean; Ndayisaba, Aphrodis; Manzi, Anatole
2015-12-01
Implementation lessons: (1) implementation of an effective quality improvement and patient safety program in a rural hospital setting requires collaboration between hospital leadership, Ministry of Health and other stakeholders. (2) Building Quality Improvement (QI) capacity to develop engaged QI teams supported by mentoring can improve quality and patient safety. Copyright © 2015 Elsevier Inc. All rights reserved.
-
Dusenbury, Linda; Brannigan, Rosalind; Hansen, William B; Walsh, John; Falco, Mathea
2005-06-01
As prevention programs become disseminated, the most serious threat to effectiveness is maintaining the quality of implementation intended by the developers. This paper proposes a methodology for measuring quality of implementation in school settings and presents data from a pilot study designed to test several of the proposed components. These methods included assessments of adherence, quality of process, the positive or negative valence of adaptations, teachers' attitudes and teachers' understanding of program content. This study was conducted with 11 teachers who had varying degrees of experience who taught Life Skills Training. Observation and interview data were collected during visits to schools. Results suggest that quality of implementation can be measured through observation and interview. Teachers varied in adherence and quality of program delivery. All teachers made adaptations to the program. Experienced teachers were more likely to adhere to the curriculum, deliver it in a way that was more interactive and engaging to students, communicate the goals and objectives better, and make positive adaptations. The field can use these findings as the basis for exploring strategies for measuring and improving quality of implementation.
-
Implementation of a hospital-based quality assessment program for rectal cancer.
Hendren, Samantha; McKeown, Ellen; Morris, Arden M; Wong, Sandra L; Oerline, Mary; Poe, Lyndia; Campbell, Darrell A; Birkmeyer, Nancy J
2014-05-01
Quality improvement programs in Europe have had a markedly beneficial effect on the processes and outcomes of rectal cancer care. The quality of rectal cancer care in the United States is not as well understood, and scalable quality improvement programs have not been developed. The purpose of this article is to describe the implementation of a hospital-based quality assessment program for rectal cancer, targeting both community and academic hospitals. We recruited 10 hospitals from a surgical quality improvement organization. Nurse reviewers were trained to abstract rectal cancer data from hospital medical records, and abstracts were assessed for accuracy. We conducted two surveys to assess the training program and limitations of the data abstraction. We validated data completeness and accuracy by comparing hospital medical record and tumor registry data. Nine of 10 hospitals successfully performed abstractions with ≥ 90% accuracy. Experienced nurse reviewers were challenged by the technical details in operative and pathology reports. Although most variables had less than 10% missing data, outpatient testing information was lacking from some hospitals' inpatient records. This implementation project yielded a final quality assessment program consisting of 20 medical records variables and 11 tumor registry variables. An innovative program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This data platform and training program can serve as a template for other organizations that are interested in assessing and improving the quality of rectal cancer care. Copyright © 2014 by American Society of Clinical Oncology.
-
Dy, Sydney M; Al Hamayel, Nebras Abu; Hannum, Susan M; Sharma, Ritu; Isenberg, Sarina R; Kuchinad, Kamini; Zhu, Junya; Smith, Katherine; Lorenz, Karl A; Kamal, Arif H; Walling, Anne M; Weaver, Sallie J
2017-12-01
Although critical for improving patient outcomes, palliative care quality indicators are not yet widely used. Better understanding of facilitators and barriers to palliative care quality measurement and improvement might improve their use and program quality. Development of a survey tool to assess palliative care team perspectives on facilitators and barriers to quality measurement and improvement in palliative care programs. We used the adapted Consolidated Framework for Implementation Research to define domains and constructs to select instruments. We assembled a draft survey and assessed content validity through pilot testing and cognitive interviews with experts and frontline practitioners for key items. We analyzed responses using a constant comparative process to assess survey item issues and potential solutions. We developed a final survey using these results. The survey includes five published instruments and two additional item sets. Domains include organizational characteristics, individual and team characteristics, intervention characteristics, and process of implementation. Survey modules include Quality Improvement in Palliative Care, Implementing Quality Improvement in the Palliative Care Program, Teamwork and Communication, Measuring the Quality of Palliative Care, and Palliative Care Quality in Your Program. Key refinements from cognitive interviews included item wording on palliative care team members, programs, and quality issues. This novel, adaptable instrument assesses palliative care team perspectives on barriers and facilitators for quality measurement and improvement in palliative care programs. Next steps include evaluation of the survey's construct validity and how survey results correlate with findings from program quality initiatives. Copyright © 2017 American Academy of Hospice and Palliative Medicine. All rights reserved.
-
ERIC Educational Resources Information Center
Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.
2014-01-01
Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may…
-
Air quality management in Mexico.
Fernández-Bremauntz, Adrián
2008-01-01
Several significant program and policy measures have been implemented in Mexico over the past 15 yr to improve air quality. This article provides an overview of air quality management strategies in Mexico, including (1) policy initiatives such as vehicle use restrictions, air quality standards, vehicle emissions, and fuel quality standards, and (2) supporting programs including establishment of a national emission inventory, an air pollution episodes program, and the implementation of exposure and health effects studies. Trends in air pollution episodes and ambient air pollutant concentrations are described.
-
42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2011 CFR
2011-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2011-10-01 2011-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality improvement...
-
42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2014 CFR
2014-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
-
42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2012 CFR
2012-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2012-10-01 2012-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
-
42 CFR 422.152 - Quality improvement program.
Code of Federal Regulations, 2013 CFR
2013-10-01
..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...
-
Implications of Modeling Uncertainty for Water Quality Decision Making
NASA Astrophysics Data System (ADS)
Shabman, L.
2002-05-01
The report, National Academy of Sciences report, "Assessing the TMDL Approach to Water Quality Management" endorsed the "watershed" and "ambient water quality focused" approach" to water quality management called for in the TMDL program. The committee felt that available data and models were adequate to move such a program forward, if the EPA and all stakeholders better understood the nature of the scientific enterprise and its application to the TMDL program. Specifically, the report called for a greater acknowledgement of model prediction uncertinaity in making and implementing TMDL plans. To assure that such uncertinaity was addressed in water quality decision making the committee called for a commitment to "adaptive implementation" of water quality management plans. The committee found that the number and complexity of the interactions of multiple stressors, combined with model prediction uncertinaity means that we need to avoid the temptation to make assurances that specific actions will result in attainment of particular water quality standards. Until the work on solving a water quality problem begins, analysts and decision makers cannot be sure what the correct solutions are, or even what water quality goals a community should be seeking. In complex systems we need to act in order to learn; adaptive implementation is a concurrent process of action and learning. Learning requires (1) continued monitoring of the waterbody to determine how it responds to the actions taken and (2) carefully designed experiments in the watershed. If we do not design learning into what we attempt we are not doing adaptive implementation. Therefore, there needs to be an increased commitment to monitoring and experiments in watersheds that will lead to learning. This presentation will 1) explain the logic for adaptive implementation; 2) discuss the ways that water quality modelers could characterize and explain model uncertinaity to decision makers; 3) speculate on the implications of the adaptive implementation for setting of water quality standards, for design of watershed monitoring programs and for the regulatory rules governing the TMDL program implementation.
-
Shek, Daniel T L; Ma, Cecilia M S
2012-01-17
The present study was conducted to explore the implementation quality of the Secondary 3 Program of the Tier 1 Program of Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in the third year of the Full Implementation Phase. Classroom observations of 182 units in 129 schools were conducted. Results showed that the overall level of program adherence was 73.9%. Thirteen aspects concerning program delivery were significantly correlated. Multiple regression analyses revealed that overall implementation quality was significantly predicted by student participation and involvement, strategies to enhance student motivation, use of positive and supportive feedback, degree of achievement of the objectives, and lesson preparation. Success of implementation was significantly predicted by student participation and involvement, classroom control, use of positive and supportive feedback, opportunity for reflection, degree of achievement of the objectives and time management. The present findings generally suggest that the implementation quality of Project P.A.T.H.S. was high.
-
Managing Air Quality - Program Implementation
Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-11-18
... Promulgation of Air Quality Implementation Plans; Texas; System Cap Trading Program AGENCY: Environmental..., 2001, and August 16, 2007, that create and amend the System Cap Trading (SCT) Program at Title 30 of.... What action is EPA proposing? II. What did Texas submit? III. What is the System Cap Trading Program...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-23
... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... the Illinois State Implementation Plan (SIP) to reflect current national ambient air quality standards...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U...
-
Implementation of Programmatic Quality and the Impact on Safety
NASA Technical Reports Server (NTRS)
Huls, Dale Thomas; Meehan, Kevin
2005-01-01
The purpose of this paper is to discuss the implementation of a programmatic quality assurance discipline within the International Space Station Program and the resulting impact on safety. NASA culture has continued to stress safety at the expense of quality when both are extremely important and both can equally influence the success or failure of a Program or Mission. Although safety was heavily criticized in the media after Colimbiaa, strong case can be made that it was the failure of quality processes and quality assurance in all processes that eventually led to the Columbia accident. Consequently, it is possible to have good quality processes without safety, but it is impossible to have good safety processes without quality. The ISS Program quality assurance function was analyzed as representative of the long-term manned missions that are consistent with the President s Vision for Space Exploration. Background topics are as follows: The quality assurance organizational structure within the ISS Program and the interrelationships between various internal and external organizations. ISS Program quality roles and responsibilities with respect to internal Program Offices and other external organizations such as the Shuttle Program, JSC Directorates, NASA Headquarters, NASA Contractors, other NASA Centers, and International Partner/participants will be addressed. A detailed analysis of implemented quality assurance responsibilities and functions with respect to NASA Headquarters, the JSC S&MA Directorate, and the ISS Program will be presented. Discussions topics are as follows: A comparison of quality and safety resources in terms of staffing, training, experience, and certifications. A benchmark assessment of the lessons learned from the Columbia Accident Investigation (CAB) Report (and follow-up reports and assessments), NASA Benchmarking, and traditional quality assurance activities against ISS quality procedures and practices. The lack of a coherent operational and sustaining quality assurance strategy for long-term manned space flight. An analysis of the ISS waiver processes and the Problem Reporting and Corrective Action (PRACA) process implemented as quality functions. Impact of current ISS Program procedures and practices with regards to operational safety and risk A discussion regarding a "defense-in-depth" approach to quality functions will be provided to address the issue of "integration vs independence" with respect to the roles of Programs, NASA Centers, and NASA Headquarters. Generic recommendations are offered to address the inadequacies identified in the implementation of ISS quality assurance. A reassessment by the NASA community regarding the importance of a "quality culture" as a component within a larger "safety culture" will generate a more effective and value-added functionality that will ultimately enhance safety.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-06
... duration of the timing of quality assurance audits performed by the Pennsylvania Department of...) Program--Quality Assurance Protocol for the Safety Inspection Program in Non-I/M Counties AGENCY... quality assurance program for its motor vehicle inspection and maintenance program (I/M program...
-
ERIC Educational Resources Information Center
Darojat, Ojat
2018-01-01
This paper is to examine the implementation of quality assurance (QA) programs in distance higher education. Different challenges related to the development of QA programs at a distance higher institution and how to manage and implement the programs are discussed to show how the programs have been used to ensure the survival of the institution. A…
-
ERIC Educational Resources Information Center
Childcare Resources, Birmingham, AL.
The purpose of this manual is to provide school-age child care center staff in Alabama with information about school-age children that facilitates program planning and provides a basis for implementing and evaluating a high quality school-age child care (SACC) program. Sections of the manual discuss: (1) teacher competencies addressed by the…
-
Understanding Real-World Implementation Quality and “Active Ingredients” of PBIS
Molloy, Lauren E.; Moore, Julia E.; Trail, Jessica; Van Epps, John James; Hopfer, Suellen
2014-01-01
Programs delivered in the “real world” often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the “real-world” implementation quality of PBIS, and to take a first step toward identifying the components of PBIS that “matter most” for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral (ODR) during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three “active ingredients” of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in “real-world” settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy. PMID:23408283
-
Understanding real-world implementation quality and "active ingredients" of PBIS.
Molloy, Lauren E; Moore, Julia E; Trail, Jessica; Van Epps, John James; Hopfer, Suellen
2013-12-01
Programs delivered in the "real world" often look substantially different from what was originally intended by program developers. Depending on which components of a program are being trimmed or altered, such modifications may seriously undermine the effectiveness of a program. In the present study, these issues are explored within a widely used school-based, non-curricular intervention, Positive Behavioral Intervention and Supports. The present study takes advantage of a uniquely large dataset to gain a better understanding of the "real-world" implementation quality of PBIS and to take a first step toward identifying the components of PBIS that "matter most" for student outcomes. Data from 27,689 students and 166 public primary and secondary schools across seven states included school and student demographics, indices of PBIS implementation quality, and reports of problem behaviors for any student who received an office discipline referral during the 2007-2008 school year. Results of the present study identify three key components of PBIS that many schools are failing to implement properly, three program components that were most related to lower rates of problem behavior (i.e., three "active ingredients" of PBIS), and several school characteristics that help to account for differences across schools in the quality of PBIS implementation. Overall, findings highlight the importance of assessing implementation quality in "real-world" settings, and the need to continue improving understanding of how and why programs work. Findings are discussed in terms of their implications for policy.
-
75 FR 41963 - Wheat and Oilseed Programs; Durum Wheat Quality Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-20
... Programs; Durum Wheat Quality Program AGENCY: Farm Service Agency and Commodity Credit Corporation, USDA. ACTION: Final rule. SUMMARY: This rule implements specific requirements for the Durum Wheat Quality... of the Council on Environmental Quality (40 CFR parts 1500-1508), and FSA regulations for compliance...
-
Rafii, Zahra; Ahmadi, Fazlollah; Nourbakhsh, Sayed Mohamad Kazem; Hajizadeh, Ebrahim
2016-09-01
Introduction: Medical advances have improved life expectancy and survival of patients with thalassemia. However, as getting older, patients with thalassemia experience different complications which impair their quality of life. The aim of this study was to examine the effects of a nurse-implemented orientation program on quality of life in patients with thalassemia. Methods: A convenience sample of 55 patients with thalassemia were recruited in this quasi-experimental study. Patients were randomly allocated to control or experimental groups. A demographic questionnaire, Thalassemia quality of life questionnaire, and 36-item short form health survey were used for data collection before and one month after the intervention. In the intervention group, 1.5-month orientation program including of the three steps of inauguration, implementation, and closure was implemented, while the control group received routine care. The Chi-square, independent t-test and paired-samples t-test were used for data analysis by using SPSS ver.13 software. Results: The intervention and control group did not differ significantly from each other regarding demographic characteristics. Moreover, no significant difference was observed between the two groups regarding the quality of life scores after the implementation of orientation program. Conclusion: Implementing a short-term orientation program was not effective in enhancing the quality of life in patients with thalassemia; hence, developing long-term multimodal strategies may result in better improvement.
-
Mihalic, Sharon F; Fagan, Abigail A; Argamaso, Susanne
2008-01-18
Widespread replication of effective prevention programs is unlikely to affect the incidence of adolescent delinquency, violent crime, and substance use until the quality of implementation of these programs by community-based organizations can be assured. This paper presents the results of a process evaluation employing qualitative and quantitative methods to assess the extent to which 432 schools in 105 sites implemented the LifeSkills Training (LST) drug prevention program with fidelity. Regression analysis was used to examine factors influencing four dimensions of fidelity: adherence, dosage, quality of delivery, and student responsiveness. Although most sites faced common barriers, such as finding room in the school schedule for the program, gaining full support from key participants (i.e., site coordinators, principals, and LST teachers), ensuring teacher participation in training workshops, and classroom management difficulties, most schools involved in the project implemented LST with very high levels of fidelity. Across sites, 86% of program objectives and activities required in the three-year curriculum were delivered to students. Moreover, teachers were observed using all four recommended teaching practices, and 71% of instructors taught all the required LST lessons. Multivariate analyses found that highly rated LST program characteristics and better student behavior were significantly related to a greater proportion of material taught by teachers (adherence). Instructors who rated the LST program characteristics as ideal were more likely to teach all lessons (dosage). Student behavior and use of interactive teaching techniques (quality of delivery) were positively related. No variables were related to student participation (student responsiveness). Although difficult, high implementation fidelity by community-based organizations can be achieved. This study suggests some important factors that organizations should consider to ensure fidelity, such as selecting programs with features that minimize complexity while maximizing flexibility. Time constraints in the classroom should be considered when choosing a program. Student behavior also influences program delivery, so schools should train teachers in the use of classroom management skills. This project involved comprehensive program monitoring and technical assistance that likely facilitated the identification and resolution of problems and contributed to the overall high quality of implementation. Schools should recognize the importance of training and technical assistance to ensure quality program delivery.
-
Stanton, Bonita; Wang, Bo; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Mortimer, Arvis; Li, Xiaoming; Marshall, Sharon; Poitier, Maxwell; Adderley, Richard
2015-01-01
More information is needed about factors influencing real-life implementation and program impact of interventions effective in controlled study conditions. Ongoing national implementation of an evidence-based HIV prevention program targeting grade 6 students in The Bahamas offers the opportunity to examine patterns of implementation and relate them to student outcomes. Data were collected from 208 grade 6 teachers, 75 grade 7 teachers and 4,411 grade 6 students followed over two years. Mixed-effects modeling analysis examined the association of teachers’ patterns of implementation with student outcomes. High quality program implementation in grade 6 (high implementation dosage and fidelity) was significantly related to student outcomes six and 18 months post-intervention. Quality of implementation of the booster session in grade 7 was also significantly related to student outcomes in grade 7. Quality of delivery of the brief booster session a year after initial implementation is important in maintaining or resetting the student outcome trajectory. PMID:26093781
-
ERIC Educational Resources Information Center
Bandy, Tawana; Burkhauser, Mary; Metz, Allison J. R.
2009-01-01
Although many program managers look to data to inform decision-making and manage their programs, high-quality program data may not always be available. Yet such data are necessary for effective program implementation. The use of high-quality data facilitates program management, reduces reliance on anecdotal information, and ensures that data are…
-
Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs
Fonjungo, Peter N.; Osmanov, Saladin; Kuritsky, Joel; Ndihokubwayo, Jean Bosco; Bachanas, Pam; Peeling, Rosanna W.; Timperi, Ralph; Fine, Glenn; Stevens, Wendy; Habiyambere, Vincent; Nkengasong, John N.
2016-01-01
Objective: The objective of the WHO/US President's Emergency Plan for AIDS Relief consultation was to discuss innovative strategies, offer guidance, and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). Methods: The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative), United States Agency for International Development, Centers for Disease Control and Prevention/President's Emergency Plan for AIDS Relief Cooperative Agreement Partners, and experts from more than 25 countries, including policy makers, clinicians, laboratory experts, and program implementers. Main outcomes: There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment, and care programs. The following four strategies were recommended: implement a newly proposed concept of a sustainable quality assurance cycle that includes careful planning; definition of goals and targets; timely implementation; continuous monitoring; improvements and adjustments, where necessary; and a detailed evaluation; the importance of supporting a cadre of workers [e.g. volunteer quality corps (Q-Corps)] with the role to ensure that the quality assurance cycle is followed and sustained; implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and joint partnership under the leadership of the ministries of health to ensure sustainability of implementing novel approaches. Conclusion: The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT. PMID:26807969
-
ERIC Educational Resources Information Center
Crosse, Scott; Williams, Barbara; Hagen, Carol A.; Harmon, Michele; Ristow, Liam; DiGaetano, Ralph; Broene, Pamela; Alexander, Debbie; Tseng, Margaret; Derzon, James H.
2011-01-01
This report presents descriptive information about the prevalence and quality of implementation of research-based programs from the Study of the Implementation of Research-Based Programs to Prevent Youth Substance Abuse and School Crime. The study found that, while schools reported implementing a large number of prevention programs during the…
-
Williford, Amanda P; Wolcott, Catherine Sanger; Whittaker, Jessica Vick; Locasale-Crouch, Jennifer
2015-11-01
This study examined the relationship among baseline program and teacher characteristics and subsequent implementation of Banking Time. Banking Time is a dyadic intervention intended to improve a teacher's interaction quality with a specific child. Banking Time implementation was examined in the current study using a sample of 59 teachers and preschool children displaying disruptive behaviors in the classroom (~three children per classroom). Predictors included preschool program type, teacher demographic characteristics (personal and professional), and teacher beliefs (self-efficacy, authoritarian beliefs, and negative attributions about child disruptive behavior). Multiple measures and methods (i.e., teacher report, consultant report, independent observations) were used to assess implementation. We created three implementation composite measures (dosage, quality, and generalized practice) that had high internal consistencies within each composite but were only modestly associated with one another, suggesting unique constructs of implementation. We found that type of preschool program was associated with dosage and quality. Aspects of teacher demographics related to all three implementation composites. Teacher beliefs predicted dosage and generalized practice. Results suggest that the factors that predict the implementation of Banking Time vary as a function of the type of implementation being assessed.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-01
... Promulgation of Air Quality Implementation Plans; Ohio; Oxides of Nitrogen Budget Trading Program; Technical... concerning 240 allowances under the Nitrogen Oxides Budget Trading Program added to the SIP by EPA rulemaking... EPA approve rule revisions [[Page 11083
-
Ammerman, Robert T; Putnam, Frank W; Kopke, Jonathan E; Gannon, Thomas A; Short, Jodie A; Van Ginkel, Judith B; Clark, Margaret J; Carrozza, Mark A; Spector, Alan R
2007-01-01
As home visitation programs go to scale, numerous challenges are faced in implementation and quality assurance. This article describes the origins and implementation of Every Child Succeeds, a multisite home visitation program in southwestern Ohio and Northern Kentucky. In order to optimize quality assurance and generate new learning for the field, a Web-based system (eECS) was designed to systematically collect and use data. Continuous quality assurance procedures derived from business and industry have been established. Findings from data collection have documented outcomes, and have identified clinical needs that potentially undermine the impact of home visitation. An augmented module approach has been used to address these needs, and a program to treat maternal depression is described as an example of this approach. Challenges encountered are also discussed.
-
ERIC Educational Resources Information Center
Iskandar
2017-01-01
Implementation of quality assurance systems in IAIN STS Jambi implemented in early 2012, through the build system of internal quality assurance based on ISO 9001: 2008, in the process of implementation required strong reasons behind not growing atmosphere of academic standards of accreditation of study programs and institutions that are reflected…
-
Giuliani, Jacopo; Marzola, Marina; Indelli, Monica; Frassoldati, Antonio
2012-02-01
The aim of this study is to analyse the oncological quality indicators on our Colorectal Cancer Program, that are reflective of the scope of care, feasible to implement and supported by evidence. We compared two different populations during the same period: patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program. On the basis of our experience, we concluded for high-quality care for both population. Any critical point should be carefully analysed in order to implement quality of care.
-
Montroy, Joshua; Breau, Rodney H; Cnossen, Sonya; Witiuk, Kelsey; Binette, Andrew; Ferrier, Taylor; Lavallée, Luke T; Fergusson, Dean A; Schramm, David
2016-01-01
The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery. A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR) and 95% confidence intervals (CI). Eleven articles reporting on 35 health care institutions were included. Nine (82%) of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91), deep (pRR 0.82; 95% CI0.64-1.05) and organ space (pRR 1.15; 95% CI 0.96-1.37) infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71). Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program. These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.
-
Montroy, Joshua; Breau, Rodney H.; Cnossen, Sonya; Witiuk, Kelsey; Binette, Andrew; Ferrier, Taylor; Lavallée, Luke T.; Fergusson, Dean A.; Schramm, David
2016-01-01
Background The American College of Surgeons’ National Surgical Quality Improvement Program (NSQIP) is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery. Study Design A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR) and 95% confidence intervals (CI). Results Eleven articles reporting on 35 health care institutions were included. Nine (82%) of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72–0.91), deep (pRR 0.82; 95% CI0.64–1.05) and organ space (pRR 1.15; 95% CI 0.96–1.37) infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39–0.77; deep pRR 0.61, 95% CI 0.50–0.75, and organ space pRR 0.60, 95% CI 0.50–0.71). Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program. Conclusions These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities. PMID:26812596
-
Mohammadi, S Mehrdad; Mohammadi, S Farzad; Hedges, Jerris R; Zohrabi, Morteza; Ameli, Omid
2007-08-01
Reports addressing continuous quality improvement (CQI) methods in developing countries are scant and there are questions about the applicability of quality improvement methods in such settings. The structure and output of a formal quality improvement program implemented in a teaching hospital affiliated with the Tehran University of Medical Sciences is presented. OBJECTIVE METHOD: During a nine-month period, a multi-stage quality improvement program was implemented. It comprised: (i) training workshops; (ii) a steering committee; (iii) weekly consultation and facilitation of improvement projects; and (iv) a day-long demonstration and recognition meeting. Four cycles of workshops were held in which 132 employees were trained in the basics of CQI. Thirty improvement projects were initiated. Twenty-five of the projects were completed. In an evaluation survey more than 70% of respondents assessed a 'positive impact' on organizational culture, work efficiency and quality of services. More than 90% believed that the changes were sustained, and more than 60% reported that they have implemented additional improvement projects. Our quality improvement package supported rapid implementation of multiple projects. The underlying 'change structure' comprised the improvement teams, top management and the university's quality improvement office; it integrated project management, support and facilitation functions by the respective participant. Organization-wide change was more limited than anticipated. To institutionalize the program and ensure sustainability, a local structure for change should be organized, management coaching should be sustained, local facilitators should be developed, incentives should be established and physician involvement should be emphasized.
-
Shek, Daniel T L; Tam, Suet-yan
2009-01-01
To understand the implementation quality of the Tier 1 Program (Secondary 2 Curriculum) of the P.A.T.H.S. Project, process evaluation was carried out by co-walkers through classroom observation of 195 units in 131 schools. Results showed that the overall level of program adherence was generally high with an average of 84.55%, and different factors of the implementation process were evaluated as positive. Quality of program implementation and achievement of program objectives were predicted by students' participation and involvement, strategies to enhance students' motivation, opportunity for reflection, time management, and class preparation. Success in program implementation was predicted by students' participation and involvement, classroom control, interactive delivery method, strategies to enhance students' motivation, opportunity for reflection, and lesson preparation.
-
ERIC Educational Resources Information Center
Pierre, Ketly Dieudonne
2014-01-01
There is a need to implement a comprehensive training program to build employees' knowledge, skills, and attitudes in order to improve quality service at ABC Restaurant because of a surge in customer complaints. The purpose of this study was to develop a training program that included an employee handbook as a training tool, a handbook designed…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-27
... Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... the prevention of significant deterioration (PSD) construction permit program under the Federal Clean... potentially subject to the PSD construction permit program. On July 16, 2010, Michigan submitted revisions...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-22
... Promulgation of Air Quality Implementation Plans; Illinois; Greif Packaging, LLC Adjusted Standard AGENCY...) 408-2279. 4. Mail: Doug Aburano, Chief, Attainment Planning and Maintenance Section, Air Programs.... 5. Hand Delivery: Doug Aburano, Chief, Attainment Planning and Maintenance Section, Air Programs...
-
78 FR 70516 - Approval and Promulgation of Air Quality Implementation Plans; Illinois
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-26
...] Approval and Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...
-
78 FR 40013 - Approval and Promulgation of Air Quality Implementation Plans; Illinois
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-03
... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...
-
78 FR 63148 - Approval and Promulgation of Air Quality Implementation Plans; Indiana
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-23
...] Approval and Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...
-
75 FR 78646 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-16
... Promulgation of Air Quality Implementation Plans; Minnesota AGENCY: Environmental Protection Agency (EPA...: Douglas Aburano, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental..., Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency...
-
Quality assurance programs for pressure ulcers.
Xakellis, G C
1997-08-01
Traditional medical quality assurance programs are beginning to incorporate the principles of continuous quality improvement pioneered by Juran and Deming. Strategies for incorporating these principles into a long-term care facility are described, and two examples of successful implementation of continuous quality improvement programs for pressure ulcers are presented.
-
Quality Implementation in Transition: A Framework for Specialists and Administrators.
ERIC Educational Resources Information Center
Wald, Judy L.; Repetto, Jeanne B.
1995-01-01
Quality Implementation in Transition is a framework designed to guide transition specialists and administrators in the implementation of total quality management. The framework uses the tenets set forth by W. Edwards Deming and is intended to help professionals facilitate change within transition programs. (Author/JOW)
-
Duke University's Quality Appearance Program
ERIC Educational Resources Information Center
Jackson, Joe
2008-01-01
The Grounds Services Unit at Duke University has implemented a new program that involves a process of self evaluation, which embraces the concept of perpetual and continuous improvement. The Quality Appearance Program (QAP) embellishes and expands upon the Quality Assurance Program concept, but with a twist to grounds management improvement…
-
Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre
2016-02-01
Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.
-
Minnesota 4-H Youth Program Quality Improvement Model
ERIC Educational Resources Information Center
Herman, Margo; Grant, Samantha
2015-01-01
The University of Minnesota Extension Center for Youth Development made an organizational decision in 2011 to invest in a system-wide approach to implement youth program quality into the 4-H program using the Youth Program Quality Assessment (YPQA) tool. This article describes the four key components to the Minnesota Youth Program Quality…
-
Implementing Quality Service-Learning Programs in Community Colleges
ERIC Educational Resources Information Center
Vaknin, Lauren Weiner; Bresciani, Marilee J.
2013-01-01
This cross-case comparative study at Western Community College and the University of the Coast explored through a constructive lens the characteristics that lead to sustainable, high quality service-learning programs and how they are implemented at institutions of higher education. The researchers determined that both Western Community College and…
-
75 FR 48895 - Approval and Promulgation of Air Quality Implementation Plans; MN
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-12
... Promulgation of Air Quality Implementation Plans; MN AGENCY: Environmental Protection Agency (EPA). ACTION..., Chief, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Jay Bortzer, Chief, Air Programs Branch (AR-18J), U.S...
-
77 FR 41914 - Approval and Promulgation of Air Quality Implementation Plans; Indiana
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-17
... Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION..., Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard...
-
75 FR 14077 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; NOX
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-24
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2009-0964; FRL-9129-9] Approval and Promulgation of Air Quality Implementation Plans; Illinois; NO X Budget Trading Program; Correction AGENCY... Scientist, Criteria Pollutant Section, Air Programs Branch (AR-18J), Environmental Protection Agency, Region...
-
78 FR 40086 - Approval and Promulgation of Air Quality Implementation Plans; Illinois
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-03
... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U... Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S...
-
75 FR 45568 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota
Federal Register 2010, 2011, 2012, 2013, 2014
2010-08-03
... Promulgation of Air Quality Implementation Plans; Minnesota AGENCY: Environmental Protection Agency (EPA.... Fax: (312) 629-2054. 4. Mail: Jay Bortzer, Chief, Air Programs Branch (AR-18J), U.S. Environmental..., Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago...
-
Quality Enhancement: An Overview. Program Services Papers.
ERIC Educational Resources Information Center
North Carolina Partnership for Children, Raleigh.
Leading a series of in-depth technical assistance papers on improving the quality in early care and education programs, this brochure is designed to help local communities consider the most effective strategies in designing and implementing programs that improve child care quality. A quality enhancement approach is taken whereby communities begin…
-
ERIC Educational Resources Information Center
Johnsen, Susan K., Ed.
2012-01-01
The new Pre-K-Grade 12 Gifted Education Programming Standards should be part of every school district's repertoire of standards to ensure that the learning needs of advanced students are being met. "NAGC Pre-K-Grade 12 Gifted Education Programming Standards: A Guide to Planning and Implementing High-Quality Services" details six standards that…
-
10 CFR 63.143 - Implementation.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 2 2010-01-01 2010-01-01 false Implementation. 63.143 Section 63.143 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN A GEOLOGIC REPOSITORY AT YUCCA MOUNTAIN, NEVADA Quality Assurance § 63.143 Implementation. DOE shall implement a quality assurance program...
-
School Indoor Air Quality Assessment and Program Implementation.
ERIC Educational Resources Information Center
Prill, R.; Blake, D.; Hales, D.
This paper describes the effectiveness of a three-step indoor air quality (IAQ) program implemented by 156 schools in the states of Washington and Idaho during the 2000-2001 school year. An experienced IAQ/building science specialist conducted walk-through assessments at each school. These assessments documented deficiencies and served as an…
-
Scaling up Quality in Early Childhood Programs: New Jersey's Story
ERIC Educational Resources Information Center
Lauter, Nancy; Rice, Cynthia
2008-01-01
Preschool systems changed significantly in New Jersey in 1998 when the State's Supreme Court required the poorest school districts to implement high quality, intensive preschool programs for all three- and four-year-olds. Since the first year of implementation in 1999, New Jersey's Abbott districts have been providing preschoolers with access to…
-
77 FR 59879 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; PBR and PTIO
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-01
... its air pollution permit program more efficient. Approving these additions will make the Permits by... revisions will make Ohio's air permit program more efficient while continuing to protect human health and...-9714-6] Approval and Promulgation of Air Quality Implementation Plans; Ohio; PBR and PTIO AGENCY...
-
More than attendance: the importance of after-school program quality.
Hirsch, Barton J; Mekinda, Megan A; Stawicki, Julieann
2010-06-01
A central theme of the articles featured in this issue is the need to improve the quality of after-school programs. In this commentary, we discuss why student engagement, program characteristics and implementation, staff training, and citywide policy are key considerations in the effort to define and achieve high quality programs for youth.
-
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…
-
Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre
2016-01-01
Background and aim: Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. Methods: We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. Results: We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists’ perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Conclusion: Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers. PMID:26878037
-
Air quality evaluation of Rhode Island's incident management program
DOT National Transportation Integrated Search
1997-09-01
The objective of this preliminary air quality analysis was to assess the potential air quality benefits associated with the implementation of Providence's Metropolitan portion of Rhode Island's Incident Management Program. Specifically, the air quali...
-
ERIC Educational Resources Information Center
Metz, Allison J. R.; Burkhauser; Mary; Bowie, Lillian
2009-01-01
A skilled and sustainable workforce is one of the most important markers of high-quality out-of-school time programs. Given the links between skilled staff, high-quality programs, and better youth outcomes, staff training has become an essential part of program implementation. To expand what is known about staff training, Child Trends recently…
-
Pay-for-performance as a method to establish the business case for quality.
Wheeler, John R C; White, Bert; Rauscher, Simone; Nahra, Tammie A; Reiter, Kristin L; Curtin, Kathleen M; Damberg, Cheryl L
2007-01-01
One of the major reasons providers give for not implementing promising quality-enhancing interventions (QEI) is that no "business case" for quality has been made. This article clarifies the concepts of the business case for quality and the related economic case for quality and identifies the perspectives of the various actors in health care financing, production, and consumption decisions. A methodology to evaluate the business case for quality from the perspective of payers and providers is presented. The article then uses implemented QEIs to show how a pay-for-performance (P4P) program can alter the business cases for payers and providers. Specifically, the P4P programs described in this article allow a provider to implement a QEI with the financial alignment of the payer in order to achieve financial and non-financial benefits. In some cases, providers and payers may be able to establish P4P programs providing net benefits for both parties.
-
Pettigrew, Jonathan; Graham, John W.; Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Shin, Young Ju
2014-01-01
Poor implementation quality (IQ) is known to reduce program effects making it important to consider IQ for evaluation and dissemination of prevention programs. However, less is known about the ways specific implementation variables relate to outcomes. In this study, two versions of the keepin’ it REAL, 7th grade drug prevention intervention were implemented in 78 classrooms in 25 schools in rural districts in Pennsylvania and Ohio. IQ was measured through observational coding of 276 videos. IQ variables included adherence to the curriculum, teacher engagement (attentiveness, enthusiasm, seriousness, clarity, positivity), student engagement (attention, participation), and a global rating of teacher delivery quality. Factor analysis showed that teacher engagement, student engagement, and delivery quality formed one factor, which was labeled delivery. A second factor was adherence to the curriculum. Self-report student surveys measured substance use, norms (beliefs about prevalence and acceptability of use), and efficacy (beliefs about one’s ability to refuse substance offers) at two waves (pretest, immediate posttest). Mixed model regression analysis which accounted for missing data and controlled for pretest levels examined implementation quality’s effects on individual level outcomes, statistically controlling for cluster level effects. Results show that when implemented well, students show positive outcomes compared to students receiving a poorly implemented program. Delivery significantly influenced substance use and norms, but not efficacy. Adherence marginally significantly predicted use and significantly predicted norms, but not efficacy. Findings underscore the importance of comprehensively measuring and accounting for IQ, particularly delivery, when evaluating prevention interventions. PMID:24442403
-
Malloy, Margaret; Acock, Alan; DuBois, David L; Vuchinich, Samuel; Silverthorn, Naida; Ji, Peter; Flay, Brian R
2015-11-01
Organizational climate has been proposed as a factor that might influence a school's readiness to successfully implement school-wide prevention programs. The aim of this study was to evaluate the influence of teachers' perceptions of three dimensions of school organizational climate on the dosage and quality of teacher implementation of Positive Action, a social-emotional and character development (SECD) program. The dimensions measured were teachers' perceptions of (a) the school's openness to innovation, (b) the extent to which schools utilize participatory decision-making practices, and (c) the existence of supportive relationships among teachers (teacher-teacher affiliation). Data from 46 teachers in seven schools enrolled in the treatment arm of a longitudinal, cluster-randomized, controlled trial were analyzed. Teacher perceptions of a school's tendency to be innovative was associated with a greater number of lessons taught and self-reported quality of delivery, and teacher-teacher affiliation was associated with a higher use of supplementary activities. The findings suggest that perceptions of a school's organizational climate impact teachers' implementation of SECD programs and have implications for school administrators and technical assistance providers as they work to implement and sustain prevention programs in schools.
-
CUSTOMER/SUPPLIER ACCOUNTABILITY AND PROGRAM IMPLEMENTATION
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...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-16
... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California State.... ``Improving Air Quality with Economic Incentive Programs,'' EPA- 452/R-01-001, January 2001. B. Does the rule...
-
40 CFR 130.0 - Program summary and purpose.
Code of Federal Regulations, 2010 CFR
2010-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...
-
40 CFR 130.0 - Program summary and purpose.
Code of Federal Regulations, 2014 CFR
2014-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...
-
40 CFR 130.0 - Program summary and purpose.
Code of Federal Regulations, 2012 CFR
2012-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...
-
40 CFR 130.0 - Program summary and purpose.
Code of Federal Regulations, 2013 CFR
2013-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.0 Program summary and purpose. (a) This subpart establishes policies and program requirements for water quality planning, management and implementation under sections 106, 205(j), non-construction management 205(g), 208, 303 and 305 of the Clean Water Act. The Water Quality...
-
Latysh, Natalie E.; Wetherbee, Gregory A.
2007-01-01
The U.S. Geological Survey (USGS) Branch of Quality Systems operates external quality assurance programs for the National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Beginning in 2004, three programs have been implemented: the system blank program, the interlaboratory comparison program, and the blind audit program. Each program was designed to measure error contributed by specific components in the data-collection process. The system blank program assesses contamination that may result from sampling equipment, field exposure, and routine handling and processing of the wet-deposition samples. The interlaboratory comparison program evaluates bias and precision of analytical results produced by the Mercury Analytical Laboratory (HAL) for the NADP/MDN, operated by Frontier GeoSciences, Inc. The HAL's performance is compared with the performance of five other laboratories. The blind audit program assesses bias and variability of MDN data produced by the HAL using solutions disguised as environmental samples to ascertain true laboratory performance. This report documents the implementation of quality assurance procedures for the NADP/MDN and the operating procedures for each of the external quality assurance programs conducted by the USGS. The USGS quality assurance information provides a measure of confidence to NADP/MDN data users that measurement variability is distinguished from environmental signals.
-
Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A
2018-05-15
The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
-
Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T
2003-03-01
In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.
-
González, Lorena; Elgart, Jorge F; Calvo, Héctor; Gagliardino, Juan J
2013-01-01
To measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care. Observational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration's database. The implementation of the program in "real world" conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs. The implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.
-
Quality assurance program for isotopic power systems
NASA Astrophysics Data System (ADS)
Hannigan, R. L.; Harnar, R. R.
1982-12-01
The Sandia National Laboratories Quality Assurance Program that applies to non-weapon (reimbursable) Radioisotopic Thermoelectric Generators is summarized. The program was implemented over the past 16 years on power supplies used in various space and terrestrial systems. The quality assurance (QA) activity of the program is in support of the Department of Energy, Office of Space Nuclear Projects. Basic elements of the program are described and examples of program documentation are presented.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-23
... Promulgation of Air Quality Implementation Plans; West Virginia; Regional Haze State Implementation Plan AGENCY... limited disapproval of West Virginia's Regional Haze State Implementation Plan (SIP) revision. EPA is... mandatory Class I areas through a regional haze program. EPA is also approving this revision as meeting the...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-02
... Promulgation of Air Quality Implementation Plans; District of Columbia; Regional Haze State Implementation Plan... of Columbia Regional Haze Plan, a revision to the District of Columbia State Implementation Plan (SIP... existing anthropogenic impairment of visibility in mandatory Class I areas through a regional haze program...
-
Safety, reliability, maintainability and quality provisions for the Space Shuttle program
NASA Technical Reports Server (NTRS)
1990-01-01
This publication establishes common safety, reliability, maintainability and quality provisions for the Space Shuttle Program. NASA Centers shall use this publication both as the basis for negotiating safety, reliability, maintainability and quality requirements with Shuttle Program contractors and as the guideline for conduct of program safety, reliability, maintainability and quality activities at the Centers. Centers shall assure that applicable provisions of the publication are imposed in lower tier contracts. Centers shall give due regard to other Space Shuttle Program planning in order to provide an integrated total Space Shuttle Program activity. In the implementation of safety, reliability, maintainability and quality activities, consideration shall be given to hardware complexity, supplier experience, state of hardware development, unit cost, and hardware use. The approach and methods for contractor implementation shall be described in the contractors safety, reliability, maintainability and quality plans. This publication incorporates provisions of NASA documents: NHB 1700.1 'NASA Safety Manual, Vol. 1'; NHB 5300.4(IA), 'Reliability Program Provisions for Aeronautical and Space System Contractors'; and NHB 5300.4(1B), 'Quality Program Provisions for Aeronautical and Space System Contractors'. It has been tailored from the above documents based on experience in other programs. It is intended that this publication be reviewed and revised, as appropriate, to reflect new experience and to assure continuing viability.
-
ERIC Educational Resources Information Center
Collins, Ashleigh; Burkhauser, Mary
2008-01-01
The implementation of high-quality evidence-based practices cannot occur without facilitative administration, systems-level partnerships, and decision-support data systems. The authors believe that understanding "what works" in program "implementation" is just as important as understanding "what works" in a program "model." Recently, researchers…
-
Determining the Quality and Impact of an E-Mentoring Program on At-Risk Youth
ERIC Educational Resources Information Center
Culpepper, Diane W.; Hernandez-Gantes, Victor M.; Blank, William E.
2015-01-01
The purpose of this study was to determine the quality of an e-mentoring program and the impact of participation on at-risk high school students enrolled in dropout prevention programs. The quality of the program was evaluated based on the ease of implementation, use of technology, and overall satisfaction. Indicators of student's self-esteem,…
-
ERIC Educational Resources Information Center
Weiner, Lauren; Bresciani, Marilee J.
2011-01-01
The researchers explored whether implementation of a systematic outcomes-based assessment process is necessary for demonstrating quality in service learning programs at a two-year and a four-year institution. The findings revealed that Western Community College and the University of the Coast maintained quality service-learning programs, which met…
-
Torres, Daniel; Gugala, Zbigniew; Lindsey, Ronald W
2015-04-01
Programs seek to expose trainees to research during residency. However, little is known in any formal sense regarding how to do this effectively, or whether these efforts result in more or better-quality research output. The objective of our study was to evaluate a dedicated resident research program in terms of the quantity and quality of resident research peer-reviewed publications. Specifically we asked: (1) Did residents mentored through a dedicated resident research program have more peer-reviewed publications in higher-impact journals with higher citation rates compared with residents who pursued research projects under a less structured approach? (2) Did this effect continue after graduation? In 2006, our department of orthopaedic surgery established a dedicated resident research program, which consisted of a new research policy and a research committee to monitor quality and compliance with this policy. Peer-reviewed publications (determined from PubMed) of residents who graduated 6 years before establishing the dedicated resident research program were compared with publications from an equal period of the research-program-directed residents. The data were assessed using descriptive statistics and regression analysis. Twenty-four residents graduated from 2001 to 2006 (before implementation of the dedicated resident research program); 27 graduated from 2007 to 2012 (after implementation of the dedicated resident research program). There were 74 eligible publications as defined by the study inclusion and exclusion criteria. Residents who trained after implementation of the dedicated resident research program published more papers during residency than did residents who trained before the program was implemented (1.15 versus 0.79 publications per resident; 95% CI [0.05,0.93]; p = 0.047) and the journal impact factor was greater in the group that had the research program (1.25 versus 0.55 per resident; 95% CI [0.2,1.18]; p = 0.005). There were no differences between postresidency publications by trainees who graduated with versus without the research program in the number of publications, citations, and average journal impact factor per resident. A regression analysis showed no difference in citation rates of the residents' published papers before and since implementation of the research program. Currently in the United States, there are no standard policies or requirements that dictate how research should be incorporated in orthopaedic surgery residency training programs. The results of our study suggest that implementation of a dedicated resident research program improves the quantity and to some extent quality of orthopaedic resident research publications, but this effect did not persist after graduation.
-
Designing, testing, and implementing a sustainable nurse home visiting program: right@home.
Goldfeld, Sharon; Price, Anna; Kemp, Lynn
2018-05-01
Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.
-
Implementation of a clinical quality control program in a mammography screening service of Brazil.
DE Souza Sabino, Silvia Maria Prioli; Silva, Thiago Buosi; Watanabe, Anapaula Hidemi Uema; Syrjänen, Kari; Carvalho, André Lopes; Mauad, Edmundo Carvalho
2014-09-01
To evaluate the effect of a clinical quality control program on the final quality of a mammography screening service. We conducted retrospective assessment of the clinical quality of 5,000 mammograms taken in a Mammography Screening Program between November 2010 and September 2011, following the implementation of a Clinical Quality Control Program based on the European Guidelines. Among the 105,000 evaluated quality items, there were 8,588 failures (8.2%) - 1.7 failures per examination. Altogether, 89% of the failures were associated with positioning. The recall rate due to a technical error reached a maximum of 0.5% in the early phase of the observation period and subsequently stabilized (0.09%). The ongoing education and monitoring combined with personalized training increased the critical thinking of the involved professionals, reducing the technical failures and unnecessary exposure of patients to radiation, with substantial improvement in the final quality of mammography. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
-
Building an Ecosystem for a New Engineering Program
NASA Astrophysics Data System (ADS)
Grebski, Wieslaw; Grebski, Michalene Eva
2018-06-01
Penn State Hazleton has recently developed and implemented a new Engineering program with a focus on energy efficiency and energy sustainability. To accelerate the implementation cycle of the program, it was necessary to very rapidly create and establish the components of an ecosystem needed for the Engineering program to prosper and grow. This paper describes the individual components of the ecosystem as well as the methods used to establish them. The paper also discusses the different initiatives to increase enrollment as well as placement rates for graduates. Continuous quality improvement procedure applied to maintain the quality of the program is also being discussed.
-
Shin, YoungJu; Miller-Day, Michelle; Pettigrew, Jonathan; Hecht, Michael L.; Krieger, Janice L.
2014-01-01
Enhancing the delivery quality of school-based, evidence-based prevention programs is one key to ensuring uniform program effects on student outcomes. Program evaluations often focus on content dosage when implementing prevention curricula, however, less is known about implementation quality of prevention content, especially among teachers who may or may not have a prevention background. The goal of the current study is to add to the scholarly literature on implementation quality for a school-based substance use prevention intervention. Twenty-five schools in Ohio and Pennsylvania implemented the original keepin’ REAL (kiR) substance use prevention curriculum. Each of the 10, 40–45 min lessons of the kiR curriculum was video recorded. Coders observed and rated a random sample of 276 videos reflecting 78 classes taught by 31 teachers. Codes included teachers’ delivery techniques (e.g. lecture, discussion, demonstration and role play) and engagement with students (e.g. attentiveness, enthusiasm and positivity). Based on the video ratings, a latent profile analysis was run to identify typology of delivery quality. Five profiles were identified: holistic approach, attentive teacher-orientated approach, enthusiastic lecture approach, engaged interactive learning approach and skill practice-only approach. This study provides a descriptive typology of delivery quality while implementing a school-based substance use prevention intervention. PMID:25274721
-
EPA is taking final action to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California State Implementation Plan (SIP). This revision concerns the District's New Source Review (NSR) permitting program.
-
75 FR 11503 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-11
... Promulgation of Air Quality Implementation Plans; Minnesota AGENCY: Environmental Protection Agency (EPA... PM 10 emission limits are being reduced, the air quality of Ramsey County will be protected. DATES...: (312) 385-5501. 4. Mail: Genevieve Damico, Acting Chief, Criteria Pollutant Section, Air Programs...
-
77 FR 30212 - Approval and Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-22
... Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... numerous sources located over a wide geographic area (also referred to as the ``regional haze program...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-19
... Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... Significant Deterioration (PSD) construction permit program of State of Michigan's State Implementation Plan (SIP) to meet the Clean Air Act (CAA) requirements for PSD in Class I Areas attaining the National...
-
Will the circle be unbroken: a history of the U.S. National Ambient Air Quality Standards.
Bachmann, John
2007-06-01
In celebration of the 100th anniversary of the Air & Waste Management Association, this review examines the history of air quality management (AQM) in the United States over the last century, with an emphasis on the ambient standards programs established by the landmark 1970 Clean Air Act (CAA) Amendments. The current CAA system is a hybrid of several distinct air pollution control philosophies, including the recursive or circular system driven by ambient standards. Although this evolving system has resulted in tremendous improvements in air quality, it has been far from perfect in terms of timeliness and effectiveness. The paper looks at several periods in the history of the U.S. program, including: (1) 1900-1970, spanning the early smoke abatement and smog control programs, the first federal involvement, and the development of a hybrid AQM approach in the 1970 CAA; (2) 1971-1976, when the first National Ambient Air Quality Standards (NAAQS) were set and implemented; (3) 1977-1993, a period of the first revisions to the standards, new CAA Amendments, delays in implementation and decision-making, and key science/policy/legislative developments that would alter both the focus and scale of air pollution programs and how they are implemented; and (4) 1993-2006, the second and third wave of NAAQS revisions and their implementation in the context of the 1990 CAA. This discussion examines where NAAQS have helped drive implementation programs and how improvements in both effects and air quality/control sciences influenced policy and legislation to enhance the effectiveness of the system over time. The review concludes with a look toward the future of AQM, emphasizing challenges and ways to meet them. The most significant of these is the need to make more efficient progress toward air quality goals, while adjusting the system to address the growing intersections between air quality management and climate change.
-
ERIC Educational Resources Information Center
Reyes, Maria Regina; Brackett, Marc A.; Rivers, Susan E.; Elbertson, Nicole A.; Salovey, Peter
2012-01-01
This study examined how training, dosage, and implementation quality of a social and emotional learning program, The RULER Approach, were related to students' social and emotional competencies. There were no main effects for any of the variables on student outcomes, but students had more positive outcomes when their teachers (a) attended more…
-
Ravinetto, Raffaella; Roosen, Tim; Dujardin, Catherine
2018-01-01
Today, a combination of globalization of pharmaceutical production, lack of regulatory harmonization, and weakness of Medicines Regulatory Authorities, creates the "perfect conditions" for poor-quality medicine to circulate in the global market and to penetrate the less-regulated countries. Medicines regulation is the responsibility of the national regulatory authorities in the recipient country, but in the poorer countries, in practice, the responsibility of supply of quality-assured medicines is often taken by Non-Governmental Organizations and other implementers. But with some notable exceptions, many donors lack a pharmaceutical procurement policy with adequate quality requirements; and many implementers lack the skills and expertise needed to orient themselves in the complex web of global pharmaceutical supply. Thus, patients served by humanitarian or development programs may remain exposed to the risk of poor-quality medicines. When public money is used to purchase medicines for medical programs to be carried out overseas, adequate policies should be in place to assure that the same quality requirements are set that would be required for medicines marketed in the "donor" country. We will describe here a policy recently adopted in Belgium, i.e. the "Commitment to Quality Assurance for Pharmaceutical Products", signed in October 2017 by the Vice Prime Minister and Minister for Development Cooperation and 19 Belgian implementing agencies. By signing the new policy, the counterparts committed to ensure quality of medicines in the programs funded by Belgium's Official Development Assistance, and to build quality-assurance capacity in the recipient countries. Implementers are requested to integrate in their financing applications a section for pharmaceutical quality assurance, with a justified budget. They are also invited to consider how costs could be rationalized and mutualized by aligning the strengths of the various implementers. This model policy has the potential to be considered for adoption by other donors, to help to reduce the current multiple standards in pharmaceutical quality, and to contribute to protect vulnerable communities from the plague of poor-quality medicines. The online version of this article (10.1186/s40545-018-0136-z) contains an additional file, which is available to authorized users.
-
76 FR 23196 - Approval and Promulgation of Air Quality Implementation Plans; IL
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-26
... Promulgation of Air Quality Implementation Plans; IL AGENCY: Environmental Protection Agency (EPA). ACTION... VOC for purposes of preparing SIPs to attain the national ambient air quality standard for ozone under... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard...
-
Bond, Gary R; Drake, Robert E; Rapp, Charles A; McHugo, Gregory J; Xie, Haiyi
2009-09-01
Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.
-
Dent, Clyde W.; Skara, Silvana; Sun, Ping; Sussman, Steve
2011-01-01
This paper presents the results of an effectiveness trial of Project Towards No Drug Abuse [TND], in which we compared program delivery by regular classroom teachers and program specialists within the same high schools. Within 18 schools that were randomly assigned to the program or control conditions, health classrooms were assigned to program delivery by teachers or (outside) specialists. Classroom sessions were observed by pairs of observers to assess three domains of implementation fidelity: adherence, classroom process, and perceived student acceptance of the program. Pre- and immediate posttest survey data were collected from 2331 students. Of the four composite indexes of implementation fidelity that were examined, only one (quality of delivery) showed a difference between specialists and teachers, with marginally higher ratings of specialists (p < .10). Both teachers and program specialists achieved effects on three of the five immediate outcome measures, including program-specific knowledge, addiction concern, and social self-control. Students’ posttest ratings of the program overall and the quality of program delivery failed to reveal differences between the teacher- and specialist-led classrooms. These results suggest that motivated, trained classroom teachers can implement evidence-based prevention programs with fidelity and achieve immediate effects. PMID:17180722
-
Implementation of Programmatic Quality and the Impact on Safety
NASA Astrophysics Data System (ADS)
Huls, Dale T.; Meehan, Kevin M.
2005-12-01
The implementation of an inadequate programmatic quality assurance discipline has the potential to adversely affect safety and mission success. This is best demonstrated in the lessons provided by the Apollo 1 Apollo 13 Challenger, and Columbia accidents; NASA Safety and Mission Assurance (S&MA) benchmarking exchanges; and conclusions reached by the Shuttle Return-to-Flight Task Group established following the Columbia Shuttle accident. Examples from the ISS Program demonstrate continuing issues with programmatic quality. Failure to adequately address programmatic quality assurance issues has a real potential to lead to continued inefficiency, increases in program costs, and additional catastrophic accidents.
-
Total Quality Management Simplified.
ERIC Educational Resources Information Center
Arias, Pam
1995-01-01
Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…
-
Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks
2017-12-14
This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.
-
Domitrovich, Celene E.; Bradshaw, Catherine P.; Poduska, Jeanne M.; Hoagwood, Kimberly; Buckley, Jacquelyn A.; Olin, Serene; Romanelli, Lisa Hunter; Leaf, Philip J.; Greenberg, Mark T.; Ialongo, Nicholas S.
2011-01-01
Increased availability of research-supported, school-based prevention programs, coupled with the growing national policy emphasis on use of evidence-based practices, has contributed to a shift in research priorities from efficacy to implementation and dissemination. A critical issue in moving research to practice is ensuring high-quality implementation of both the intervention model and the support system for sustaining it. The paper describes a three-level framework for considering the implementation quality of school-based interventions. Future directions for research on implementation are discussed. PMID:27182282
-
Shek, Daniel T. L.; Ma, Cecilia M. S.
2012-01-01
This paper integrates the evaluation findings based on program implementers in nine datasets collected from 2005 to 2009 (244 schools and 7,926 implementers). Using consolidated data with schools as the unit of analysis, results showed that program implementers generally had positive perceptions of the program, themselves, and benefits of the program, with more than four-fifths of the implementers regarding the program as beneficial to the program participants. The subjective outcome evaluation instrument was found to be internally consistent. Multiple regression analyses revealed that perceived qualities of the program and program implementers predicted perceived effectiveness of the program. In conjunction with evaluation findings based on other sources, the present study provides support for the effectiveness of the Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in Hong Kong. PMID:22629224
-
In 1999, the United States Environmental Protection Agency (EPA) initiated a major air quality program referred to as the Particulate Matter (PM) Supersites Program. The PM Supersites Program is a multi-year, $27 million air quality program consisting of eight (8) regional air q...
-
Standard Review Plan for Environmental Restoration Program Quality Management Plans. Revision 2
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1993-12-01
The Department of Energy, Richland Operations Office (RL) Manual Environmental Restoration Program Quality System Requirements (QSR) for the Hanford Site, defines all quality requirements governing Hanford Environmental Restoration (ER) Program activities. The QSR requires that ER Program participants develop Quality Management Plans (QMPs) that describe how the QSR requirements will be implemented for their assigned scopes of work. This standard review plan (SRP) describes the ER program participant responsibilities for submittal of QMPs to the RL Environmental Restoration Division for review and the RL methodology for performing the reviews of participant QMPS. The SRP serves the following functions: acts asmore » a guide in the development or revision of QMPs to assure that the content is complete and adequate; acts as a checklist to be used by the RL staff in their review of participant QMPs; acts as an index or matrix between the requirements of the QSR and implementing methodologies described in the QMPs; decreases the time and subjectivity of document reviews; and provides a formal, documented method for describing exceptions, modifications, or waivers to established ER Program quality requirements.« less
-
Friedel, Michael J.
1998-01-01
During the past 25 years, industry and government made large financial investments that resulted in better water quality across the Nation; however, many water-quality concerns remain. Following a 1986 pilot project, the U.S. Geological Survey began implementation of the National Water-Quality Assessment (NAWQA) Program in 1991. This program differs from other national water-quality assessment studies in that the NAWQA integrates monitoring of surface- and ground-water quality with the study of aquatic ecosystems. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers (water-bearing sediments and rocks), (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality.The Upper Illinois River Basin National Water- Quality Assessment (NAWQA) study will increase the scientific understanding of surface- and ground-water quality and the factors that affect water quality in the basin. The study also will provide information needed by water-resource managers to implement effective water-quality management actions and evaluate long-term changes in water quality.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
...-FRL-9754-7] Approval and Promulgation of Air Quality Implementation Plans; Massachusetts and New... (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve State Implementation Plan (SIP... repair network for an on-board diagnostic (OBD2) testing program for model year 1996 and newer vehicles...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-22
... Promulgation of Air Quality Implementation Plans; Rhode Island; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... geographic area (also referred to as the ``regional haze program''). DATES: Effective Date: This rule is...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-19
... Promulgation of Air Quality Implementation Plans; Delaware; Regional Haze State Implementation Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: EPA is approving the Delaware Regional Haze... visibility in mandatory Class I areas through a regional haze program. EPA is also approving this revision...
-
Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T
2012-07-01
Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.
-
SAN JUAN BAY ESTUARY PROGRAM IMPLEMENTATION REVIEW ATTACHMENTS
A compilation of attachments referenced in the San Juan Bay Estuary Program Implementation Review (2004). Materials include, entity reports, water and sediment quality action plans, progress reports, correspondence with local municipalities and Puerto Rican governmental agencies,...
-
Concept of Draft International Standard for a Unified Approach to Space Program Quality Assurance
NASA Astrophysics Data System (ADS)
Stryzhak, Y.; Vasilina, V.; Kurbatov, V.
2002-01-01
For want of the unified approach to guaranteed space project and product quality assurance, implementation of many international space programs has become a challenge. Globalization of aerospace industry and participation of various international ventures with diverse quality assurance requirements in big international space programs requires for urgent generation of unified international standards related to this field. To ensure successful fulfillment of space missions, aerospace companies should design and process reliable and safe products with properties complying or bettering User's (or Customer's) requirements. Quality of the products designed or processed by subcontractors (or other suppliers) should also be in compliance with the main user (customer)'s requirements. Implementation of this involved set of unified requirements will be made possible by creating and approving a system (series) of international standards under a generic title Space Product Quality Assurance based on a system consensus principle. Conceptual features of the baseline standard in this system (series) should comprise: - Procedures for ISO 9000, CEN and ECSS requirements adaptation and introduction into space product creation, design, manufacture, testing and operation; - Procedures for quality assurance at initial (design) phases of space programs, with a decision on the end product made based on the principle of independence; - Procedures to arrange incoming inspection of products delivered by subcontractors (including testing, audit of supplier's procedures, review of supplier's documentation), and space product certification; - Procedures to identify materials and primary products applied; - Procedures for quality system audit at the component part, primary product and materials supplier facilities; - Unified procedures to form a list of basic performances to be under configuration management; - Unified procedures to form a list of critical space product components, and unified procedures to define risks related to the specific component application and evaluate safety for the entire program implementation. In the eyes of the authors, those features together with a number of other conceptual proposals should constitute a unified standard-technical basis for implementing international space programs.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-10
... adopt and implement a SIP- approved Prevention of Significant Deterioration (PSD) permit program. We are...--Prevention of Significant Deterioration (PSD) Permit Program, PCAPCD Rule 518--Prevention of Significant Deterioration (PSD) Permit Program, and YSAQMD Rule 3.24-- Prevention of Significant Deterioration. The approval...
-
Van Bogaert, Peter; Van Heusden, Danny; Verspuy, Martijn; Wouters, Kristien; Slootmans, Stijn; Van der Straeten, Johnny; Van Aken, Paul; White, Mark
2017-03-01
Aim To investigate the impact of the quality improvement program "Productive Ward - Releasing Time to Care™" using nurses' and midwives' reports of practice environment, burnout, quality of care, job outcomes, as well as workload, decision latitude, social capital, and engagement. Background Despite the requirement for health systems to improve quality and the proliferation of quality improvement programs designed for healthcare, the empirical evidence supporting large-scale quality improvement programs impacting patient satisfaction, staff engagement, and quality care remains sparse. Method A longitudinal study was performed in a large 600-bed acute care university hospital at two measurement intervals for nurse practice environment, burnout, and quality of care and job outcomes and three measurement intervals for workload, decision latitude, social capital, and engagement between June 2011 and November 2014. Results Positive results were identified in practice environment, decision latitude, and social capital. Less favorable results were identified in relation to perceived workload, emotional exhaustion. and vigor. Moreover, measures of quality of care and job satisfaction were reported less favorably. Conclusion This study highlights the need to further understand how to implement large-scale quality improvement programs so that they integrate with daily practices and promote "quality improvement" as "business as usual."
-
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
-
2014-01-01
Hughes EFX, Boerstler H, O’Connor EJ. “Assessing the Impact of Continuous Quality Improvement/ Total Quality Management : Concept versus...facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Gery...RAND Program Manager’s Guide helps managers assess program performance, consider options for improvement, implement solutions, then assess whether the
-
Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.
ERIC Educational Resources Information Center
Advanced Technology, Inc., Reston, VA.
The purpose and direction of the Office of Student Financial Aid (OSFA) quality improvement program are described. The background and context for the Pell Grant quality control (QC) design study and the meaning of QC are reviewed. The general approach to quality improvement consists of the following elements: a strategic approach that enables OSFA…
-
Implementation Processes and Pay for Performance in Healthcare: A Systematic Review.
Kondo, Karli K; Damberg, Cheryl L; Mendelson, Aaron; Motu'apuaka, Makalapua; Freeman, Michele; O'Neil, Maya; Relevo, Rose; Low, Allison; Kansagara, Devan
2016-04-01
Over the last decade, various pay-for-performance (P4P) programs have been implemented to improve quality in health systems, including the VHA. P4P programs are complex, and their effects may vary by design, context, and other implementation processes. We conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of P4P. We searched PubMed, PsycINFO, and CINAHL through April 2014, and reviewed reference lists. We included trials and observational studies of P4P implementation. Two investigators abstracted data and assessed study quality. We interviewed P4P researchers to gain further insight. Among 1363 titles and abstracts, we selected 509 for full-text review, and included 41 primary studies. Of these 41 studies, 33 examined P4P programs in ambulatory settings, 7 targeted hospitals, and 1 study applied to nursing homes. Related to implementation, 13 studies examined program design, 8 examined implementation processes, 6 the outer setting, 18 the inner setting, and 5 provider characteristics. Results suggest the importance of considering underlying payment models and using statistically stringent methods of composite measure development, and ensuring that high-quality care will be maintained after incentive removal. We found no conclusive evidence that provider or practice characteristics relate to P4P effectiveness. Interviews with 14 KIs supported limited evidence that effective P4P program measures should be aligned with organizational goals, that incentive structures should be carefully considered, and that factors such as a strong infrastructure and public reporting may have a large influence. There is limited evidence from which to draw firm conclusions related to P4P implementation. Findings from studies and KI interviews suggest that P4P programs should undergo regular evaluation and should target areas of poor performance. Additionally, measures and incentives should align with organizational priorities, and programs should allow for changes over time in response to data and provider input.
-
Physician Peer Assessments for Compliance with Methadone Maintenance Treatment Guidelines
ERIC Educational Resources Information Center
Strike, Carol; Wenghofer, Elizabeth; Gnam, William; Hillier, Wade; Veldhuizen, Scott; Millson, Margaret
2007-01-01
Introduction: Medical associations and licensing bodies face pressure to implement quality assurance programs, but evidence-based models are lacking. To improve the quality of methadone maintenance treatment (MMT), the College of Physicians and Surgeons of Ontario, Canada, conducts an innovative quality assurance program on the basis of peer…
-
A novel Python program for implementation of quality control in the ELISA.
Wetzel, Hanna N; Cohen, Cinder; Norman, Andrew B; Webster, Rose P
2017-09-01
The use of semi-quantitative assays such as the enzyme-linked immunosorbent assay (ELISA) requires stringent quality control of the data. However, such quality control is often lacking in academic settings due to unavailability of software and knowledge. Therefore, our aim was to develop methods to easily implement Levey-Jennings quality control methods. For this purpose, we created a program written in Python (a programming language with an open-source license) and tested it using a training set of ELISA standard curves quantifying the Fab fragment of an anti-cocaine monoclonal antibody in mouse blood. A colorimetric ELISA was developed using a goat anti-human anti-Fab capture method. Mouse blood samples spiked with the Fab fragment were tested against a standard curve of known concentrations of Fab fragment in buffer over a period of 133days stored at 4°C to assess stability of the Fab fragment and to generate a test dataset to assess the program. All standard curves were analyzed using our program to batch process the data and to generate Levey-Jennings control charts and statistics regarding the datasets. The program was able to identify values outside of two standard deviations, and this identification of outliers was consistent with the results of a two-way ANOVA. This program is freely available, which will help laboratories implement quality control methods, thus improving reproducibility within and between labs. We report here successful testing of the program with our training set and development of a method for quantification of the Fab fragment in mouse blood. Copyright © 2017 Elsevier B.V. All rights reserved.
-
Stone, Mandy L.; Rasmussen, Teresa J.; Bennett, Trudy J.; Poulton, Barry C.; Ziegler, Andrew C.
2012-01-01
The city of Wichita, Kansas uses the Equus Beds aquifer, one of two sources, for municipal water supply. To meet future water needs, plans for artificial recharge of the aquifer have been implemented in several phases. Phase I of the Equus Beds Aquifer Storage and Recovery (ASR) Program began with injection of water from the Little Arkansas River into the aquifer for storage and subsequent recovery in 2006. Construction of a river intake structure and surface-water treatment plant began as implementation of Phase II of the Equus Beds ASR Program in 2010. An important aspect of the ASR Program is the monitoring of water quality and the effects of recharge activities on stream conditions. Physical, chemical, and biological data provide the basis for an integrated assessment of stream quality. This report describes protocols for collecting streamflow, water-quality, streambed-sediment, periphyton, macroinvertebrate, fish, and habitat data as part of the city of Wichita's hydrobiological monitoring program (HBMP). Following consistent and reliable methods for data collection and processing is imperative for the long-term success of the monitoring program.
-
ERIC Educational Resources Information Center
McCormick, Silvana
2017-01-01
Program evaluation can play a critical role in supporting high quality implementation of social programs to help them achieve their goal of social impact. Evaluation scholars have developed a wide range of strategies to help build programs' internal evaluation capacity in an effort to support meaningful use of evaluation. However, the evaluation…
-
Aviation Safety: Efforts to Implement Flight Operational Quality Assurance Programs
DOT National Transportation Integrated Search
1997-12-01
Flight Operational Quality Assurance (FOQA) programs seek to use flight data to : detect technical flaws, unsafe practices, or conditions outside of desired : operating procedures early enough to allow timely intervention to avert : accidents or inci...
-
Code of Federal Regulations, 2010 CFR
2010-01-01
... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM General Provisions... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...
-
Code of Federal Regulations, 2011 CFR
2011-01-01
... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM General Provisions... promote agricultural production, forest management, and environmental quality as compatible goals, and to... program are achieved by planning and implementing conservation practices on eligible land. (b) EQIP is...
-
LaChausse, Robert G; Clark, Kim R; Chapple, Sabrina
2014-03-01
To examine how teacher characteristics affected program fidelity in an impact evaluation study of the Positive Prevention PLUS program, and to propose a comprehensive teacher training and professional development structure to increase program fidelity. Curriculum fidelity logs, lesson observations, and teacher surveys were used to measure teacher characteristics and implementation fidelity including adherence, adaptation, and lesson quality. Compared with non-health credentialed teachers, credential health education teachers had greater comfort and self-efficacy regarding sex-related instruction. Teacher self-efficacy and comfort were significant predictors of adherence. Implementation fidelity may be linked to teacher characteristics that can be enhanced during curriculum training. A 2-day teacher training may not adequately address teacher facilitation skills or the maintenance of institutional supports for implementing a program with fidelity and quality. A new model of comprehensive teacher training and support is offered. This new training infrastructure is intended to contribute to the school district's institutionalization of higher-quality comprehensive sexual health education and increase program fidelity. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.
-
Ouslander, Joseph G; Bonner, Alice; Herndon, Laurie; Shutes, Jill
2014-03-01
Interventions to Reduce Acute Care Transfers (INTERACT) is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and accountable care organizations, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust quality assurance performance improvement program, which is being rolled out by the federal government over the next year. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
-
Design and Implementation of the Harvard Fellowship in Patient Safety and Quality.
Gandhi, Tejal K; Abookire, Susan A; Kachalia, Allen; Sands, Kenneth; Mort, Elizabeth; Bommarito, Grace; Gagne, Jane; Sato, Luke; Weingart, Saul N
2016-01-01
The Harvard Fellowship in Patient Safety and Quality is a 2-year physician-oriented training program with a strong operational orientation, embedding trainees in the quality departments of participating hospitals. It also integrates didactic and experiential learning and offers the option of obtaining a master's degree in public health. The program focuses on methodologically rigorous improvement and measurement, with an emphasis on the development and implementation of innovative practice. The operational orientation is intended to foster the professional development of future quality and safety leaders. The purpose of this article is to describe the design and development of the fellowship. © The Author(s) 2014.
-
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.
-
Ryan, Andrew M; Detsky, Allan S
2015-02-01
Public quality reporting programs have been widely implemented in hospitals in an effort to improve quality and safety. One such program is Hospital Compare, Medicare's national quality reporting program for US hospitals. The New York City sanitary grade inspection program is a parallel effort for restaurants. The aims of Hospital Compare and the New York City sanitary inspection program are fundamentally similar: to address a common market failure resulting from consumers' lack of information on quality and safety. However, by displaying easily understandable information at the point of service, the New York City sanitary inspection program is better designed to encourage informed consumer decision making. We argue that this program holds important lessons for public quality reporting of US hospitals. © 2014 Society of Hospital Medicine.
-
Participants' perceptions of the 1997-1998 Missouri State Parks Passport Program
Yi-Jin Ye; Jaclyn Card
2002-01-01
Service quality is increasingly important to park managers. Recreation and park evaluation measures the implementation and outcome of programs for decision-making. Decisions based on evaluations are often concerned with improving the quality of the program for participants. The purpose of the study was to evaluate the Missouri State Parks Passport Program (MSPPP) by...
-
Developing a quality assurance program for online services.
Humphries, A W; Naisawald, G V
1991-01-01
A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas. PMID:1909197
-
Developing a quality assurance program for online services.
Humphries, A W; Naisawald, G V
1991-07-01
A quality assurance (QA) program provides not only a mechanism for establishing training and competency standards, but also a method for continuously monitoring current service practices to correct shortcomings. The typical QA cycle includes these basic steps: select subject for review, establish measurable standards, evaluate existing services using the standards, identify problems, implement solutions, and reevaluate services. The Claude Moore Health Sciences Library (CMHSL) developed a quality assurance program for online services designed to evaluate services against specific criteria identified by research studies as being important to customer satisfaction. These criteria include reliability, responsiveness, approachability, communication, and physical factors. The application of these criteria to the library's existing online services in the quality review process is discussed with specific examples of the problems identified in each service area, as well as the solutions implemented to correct deficiencies. The application of the QA cycle to an online services program serves as a model of possible interventions. The use of QA principles to enhance online service quality can be extended to other library service areas.
-
A New Vision for Integrated Breast Care.
1998-09-01
Analysis tools to Mapping; and established counseling methods to Debriefing. We are now investigating how Neurolinguistic Programming to may help... programs and services for the benefit of the patient. Our Continuous Quality Improvement, Informatics and Education Cores are working together to help...streamline implementation of programs . This enables us to identify the quality improvements we hope to gain by changing a service and the quality
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-11
...) Prevention of Significant Deterioration (PSD) program updates the Arkansas SIP to incorporate by reference (IBR) requirements for the Federal PSD permitting program under EPA's November 29, 2005 Phase 2 8-hour Ozone Implementation rule. The November 6, 2012 proposed SIP revision to the Arkansas NSR PSD program...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-04-02
...) Prevention of Significant Deterioration (PSD) program updates the Arkansas SIP to incorporate by reference (IBR) requirements for the federal PSD permitting program under EPA's November 29, 2005 Phase 2 8-hour Ozone Implementation rule. The November 6, 2012, SIP revision to the Arkansas NSR PSD program provides...
-
Smith, Emilie Phillips; Osgood, D Wayne; Oh, Yoonkyung; Caldwell, Linda C
2018-02-01
This randomized trial tested a strategy originally developed for school settings, the Pax Good Behavior Game (PAX GBG), in the new context of afterschool programs. We examined this approach in afterschool since 70% of all juvenile crime occurs between the hours of 3-6 pm, making afterschool an important setting for prevention and promotion. Dual-career and working families need monitoring and supervision for their children in quality settings that are safe and appropriately structured. While substantial work has identified important features of afterschool programs, increasing attention is being given to how to foster quality. PAX GBG, with its focus on shared norms, cooperative teams, contingent activity rewards, and liberal praise, could potentially enhance not only appropriate structure and supportive relationships, but also youth self-regulation, co-regulation, and socio-emotional development. This study examined the PAX GBG among 76 afterschool programs, serving 811 youth ages 5-12, who were diverse in race-ethnicity, socio-economic status, and geographic locale. Demographically matched pairs of afterschool programs were randomized to PAX GBG or treatment-as-usual. Independent observers conducted ratings of implementation fidelity and program quality across time; along with surveys of children's problem and prosocial behavior. Interaction effects were found using hierarchical linear models such that experimental programs evidencing higher implementation fidelity demonstrated better program quality than controls, (i.e., less harshness, increased appropriate structure, support, and engagement), as well as reduced child-reported hyperactivity and intent-to-treat effects on prosocial behavior. This study demonstrates that best practices fostered by PAX GBG and implemented with fidelity in afterschool result in higher quality contexts for positive youth development.
-
NASA Astrophysics Data System (ADS)
Budiyono; Ginandjar, P.; Saraswati, L. D.; Pangestuti, D. R.; Martini; Jati, S. P.
2018-02-01
An area of 508.28 hectares in North Semarang is flooded by tidal inundation, including Bandarharjo village, which could affect water quality in the area. People in Bandarharjo use safe water from deep groundwater, without disinfection process. More than 90% of water samples in the Bandaharjo village had poor bacteriological quality. The aimed of the research was to describe the implementation of Water Safety Plans (WSPs) program in Bandarharjo village. This was a descriptive study with steps for implementations adopted the guidelines and tools of the World Health Organization. The steps consist of introducing WSPs program, team building, training the team, examination of water safety before risk assessment, risk assessment, minor repair I, examination of water safety risk, minor repair II (after monitoring). Data were analyzed using descriptive methods. WSPs program has been introduced and formed WSPs team, and the training of the team has been conducted. The team was able to conduct risks assessment, planned the activities, examined water quality, conduct minor repair and monitoring at the source, distribution, and households connection. The WSPs program could be implemented in the coastal area in Semarang, however regularly supervision and some adjustment are needed.
-
National Water-Quality Assessment Program - Red River of the North
Stoner, J.D.
1991-01-01
In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources, and to provide a sound scientific understanding of the primary natural and human factors affecting the quality of these resources. The program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels.
-
National Water-Quality Assessment program: The Trinity River Basin
Land, Larry F.
1991-01-01
In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels. A major design feature of the NAWQA program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which comprise the principal building blocks of the program on which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Trinity River basin study was among the first 20 NAWQA study units selected for study under the full-scale implementation plan.
-
Wu, R Ryanne; Kinsinger, Linda S; Provenzale, Dawn; King, Heather A; Akerly, Patricia; Barnes, Lottie K; Datta, Santanu K; Grubber, Janet M; Katich, Nicholas; McNeil, Rebecca B; Monte, Robert; Sperber, Nina R; Atkins, David; Jackson, George L
2014-12-01
Collaboration between policy, research, and clinical partners is crucial to achieving proven quality care. The Veterans Health Administration has expended great efforts towards fostering such collaborations. Through this, we have learned that an ideal collaboration involves partnership from the very beginning of a new clinical program, so that the program is designed in a way that ensures quality, validity, and puts into place the infrastructure necessary for a reliable evaluation. This paper will give an example of one such project, the Lung Cancer Screening Demonstration Project (LCSDP). We will outline the ways that clinical, policy, and research partners collaborated in design, planning, and implementation in order to create a sustainable model that could be rigorously evaluated for efficacy and fidelity. We will describe the use of the Donabedian quality matrix to determine the necessary characteristics of a quality program and the importance of the linkage with engineering, information technology, and clinical paradigms to connect the development of an on-the-ground clinical program with the evaluation goal of a learning healthcare organization. While the LCSDP is the example given here, these partnerships and suggestions are salient to any healthcare organization seeking to implement new scientifically proven care in a useful and reliable way.
-
Laboratory Innovation Towards Quality Program Sustainability.
Abimiku, Alash'le; Timperi, Ralph; Blattner, William
2016-08-01
Laboratory innovation significantly affects program sustainability of HIV programs in low and middle income countries (LMICs) far beyond its immediate sphere of impact. Innovation in rapid development of diagnostic technologies, improved quality management systems, strengthened laboratory management, affordable external quality assurance and accreditation schemes, and building local capacity have reduced costs, brought quality improvement to point-of-care testing, increased access to testing services, reduced treatment and prevention costs and opened the door to the real possibility of ending the AIDS epidemic. However, for effectively implemented laboratory innovation to contribute to HIV quality program sustainability, it must be implemented within the overall context of the national strategic plan and HIV treatment programs. The high quality of HIV rapid diagnostic test was a breakthrough that made it possible for more persons to learn their HIV status, receive counseling, and if infected to receive treatment. Likewise, the use of dried blood spots made the shipment of samples easier for the assessment of different variables of HIV infection-molecular diagnosis, CD4+ cell counts, HIV antibodies, drug resistance surveillance, and even antiretroviral drug level measurements. Such advancement is critical for to reaching the UNAIDS target of 90-90-90 and for bringing the AIDS epidemic to an end, especially in LMICs.
-
Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.
McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D
2018-04-01
Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.
-
76 FR 24846 - Approval and Promulgation of Air Quality Implementation Plans; Illinois
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-03
... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Douglas Aburano, Chief, Control Strategies Section, Air...
-
Water Quality Standards Handbook
The Water Quality Standards Handbook is a compilation of the EPA's water quality standards (WQS) program guidance including recommendations for states, authorized tribes, and territories in reviewing, revising, and implementing WQS.
-
2017-07-05
This final rule updates the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs based on the changes to Medicaid and the Children's Health Insurance Program (CHIP) eligibility under the Patient Protection and Affordable Care Act. This rule also implements various other improvements to the PERM program.
-
ERIC Educational Resources Information Center
Data Quality Campaign, 2016
2016-01-01
Every state can create secure, robust linkages between early childhood and K-12 data systems, and effectively use the information from these linkages to implement initiatives to support programs and children, answer key policy questions, and be transparent about how the state's early childhood investments prepare students for success in school and…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-24
.... Id. \\7\\ Consistent with EPA's definition of ``design value'' in 40 CFR 58.1, we use the term ``design... evaluations below. Carl Moyer Memorial Air Quality Standards Attainment Program The Contingency Measures SIP identifies a portion of the Carl Moyer Memorial Air Quality Standards Attainment Program (Carl Moyer Program...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-12
... approve South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... Rule 317, an equivalent alternative program, is not less stringent than the program required by section... equivalent alternative programs, and, if so, whether Rule 317 would constitute an approvable equivalent...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-12-14
... of South Coast Air Quality Management District (SCAQMD) Rule 317, ``Clean Air Act Non- Attainment Fee... determined that SCAQMD's alternative fee-equivalent program is not less stringent than the program required by section 185, and, therefore, is approvable as an equivalent alternative program, consistent with...
-
Dariotis, Jacinda K.; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar
2016-01-01
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators – students and their classroom teachers – merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings. PMID:28670007
-
Dariotis, Jacinda K; Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T; Mendelson, Tamar
2017-01-01
Identifying factors relevant for successful implementation of school-based interventions is essential to ensure that programs are provided in an effective and engaging manner. The perspectives of two key stakeholders critical for identifying implementation barriers and facilitators - students and their classroom teachers - merit attention in this context and have rarely been explored using qualitative methods. This study reports qualitative perspectives of fifth and sixth grade participants and their teachers of a 16-week school-based mindfulness and yoga program in three public schools serving low-income urban communities. Four themes related to program implementation barriers and facilitators emerged: program delivery factors, program buy-in, implementer communication with teachers, and instructor qualities. Feedback from students and teachers is discussed in the context of informing implementation, adaptation, and future development of school-based mindfulness and yoga programming in urban settings.
-
Introduction: the Interdisciplinary Nursing Quality Research Initiative.
Naylor, Mary D; Lustig, Adam; Kelley, Heather J; Volpe, Ellen M; Melichar, Lori; Pauly, Mark V
2013-04-01
The Robert Wood Johnson Foundation launched the Interdisciplinary Nursing Quality Research Initiative (INQRI) program in 2005 to generate, disseminate, and translate research to understand how nurses contribute to and can improve patient care quality. This special edition of Medical Care provides an overview of the program's strategy, goals, and impact, highlighting cross-cutting issues addressed by the initiative. INQRI's leadership and select grantees discuss the implications of a collection of studies on the following: advances in the science of nursing's contribution to quality, measurement of quality, interdisciplinary collaboration, implementation methodology, dissemination and translation of findings, and the business case for nursing. A comprehensive review of the scholarly literature published in 2004 and 2009 found that the evidence linking nursing to quality of care has grown. The second paper discusses INQRI's work on measurement of quality of care, revealing the need for additional comprehensive measures. The third paper examines INQRI's focus on interdisciplinary collaboration, finding that it can enhance methodological approaches and result in substantive changes in health delivery systems. The fourth paper presents methodological challenges faced in health care implementation, emphasizing the need for standardized terms and research designs. The fifth paper addresses INQRI's commitment to translating research into practice, illustrating dissemination strategies and lessons learned. The final paper discusses how the INQRI program has contributed to the current evidence regarding the business case for nursing. This supplement describes the accomplishments of the INQRI program, discusses current issues in research design and implementation, and places INQRI research within the larger context regarding advances in nursing science.
-
Brundage, Michael D; Hart, Margaret; O'Donnell, Jennifer; Reddeman, Lindsay; Gutierrez, Eric; Foxcroft, Sophie; Warde, Padraig
Peer review of radiation oncology treatment plans is increasingly recognized as an important component of quality assurance in radiation treatment planning and delivery. Peer review of treatment plans can directly improve the quality of those plans and can also have indirect effects on radiation treatment programs. We undertook a systematic, qualitative approach to describing the indirect benefits of peer review, factors that were seen to facilitate or act as barriers to the implementation of peer review, and strategies to address these barriers across a provincial jurisdiction of radiation oncology programs (ROPs). Semistructured qualitative interviews were held with radiation oncology department heads and radiation therapy managers (or delegates) in all 14 ROPs in Ontario, Canada. We used a theoretically guided phenomenological qualitative approach to design and analyze the interview content. Themes were recorded by 2 independent reviewers, and any discordance was resolved by consensus. A total of 28 interviews were completed with 32 interviewees. Twenty-two unique themes addressed perceived benefits of peer review, relating to either peer review structure (n = 3), process (n = 9), or outcome (n = 10). Of these 22 themes, 19 related to indirect benefits to ROPs. In addition, 18 themes related to factors that facilitated peer review activities and 30 themes related to key barriers to implementing peer review were identified. Findings were consistent with, and enhanced the understanding of, previous survey-based assessments of the benefits and challenges of implementing peer review programs. Although challenges and concerns regarding the implementation of peer review were evident, the indirect benefits to radiation programs are numerous, far outweigh the implementation challenges, and strongly complement the direct individual-patient benefits that result from peer review quality assurance of radiation treatment plans. Copyright © 2016. Published by Elsevier Inc.
-
Hamilton, Alison B; Farmer, Melissa M; Moin, Tannaz; Finley, Erin P; Lang, Ariel J; Oishi, Sabine M; Huynh, Alexis K; Zuchowski, Jessica; Haskell, Sally G; Bean-Mayberry, Bevanne
2017-11-07
The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women's Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women's Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation. EMPOWER includes three projects designed to improve women Veterans' engagement and retention in evidence-based care for high-priority health conditions, i.e., prediabetes, cardiovascular, and mental health. The three proposed projects will be conducted in VA primary care clinics that serve women Veterans including general primary care and women's health clinics. The first project is a 1-year quality improvement project targeting diabetes prevention. Two multi-site research implementation studies will focus on cardiovascular risk prevention and collaborative care to address women Veterans' mental health treatment needs respectively. All projects will use the evidence-based Replicating Effective Programs (REP) implementation strategy, enhanced with multi-stakeholder engagement and complexity theory. Mixed methods implementation evaluations will focus on investigating primary implementation outcomes of adoption, acceptability, feasibility, and reach. Program-wide organizational-, provider-, and patient-level measures and tools will be utilized to enhance synergy, productivity, and impact. Both implementation research studies will use a non-randomized stepped wedge design. EMPOWER represents a coherent program of women's health implementation research and quality improvement that utilizes cross-project implementation strategies and evaluation methodology. The EMPOWER Quality Enhancement Research Initiative (QUERI) will constitute a major milestone for realizing women Veterans' engagement and empowerment in the VA system. EMPOWER QUERI will be conducted in close partnership with key VA operations partners, such as the VA Office of Women's Health, to disseminate and spread the programs nationally. The two implementation research studies described in this protocol have been registered as required: Facilitating Cardiovascular Risk Screening and Risk Reduction in Women Veterans: Trial registration NCT02991534 , registered 9 December 2016. Implementation of Tailored Collaborative Care for Women Veterans: Trial registration NCT02950961 , registered 21 October 2016.
-
Margolis, Amy Lynn; Roper, Allison Yvonne
2014-03-01
After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-06
...] Approval and Promulgation of Air Quality Implementation Plans; Colorado; Construction Permit Program Fee Increases; Construction Permit Regulation of PM 2.5 ; Regulation 3 AGENCY: Environmental Protection Agency... construction permit processing fees. EPA proposes approval of Colorado's May 25, 2011 submittal, which...
-
NRCS-EQIP Tree Fruit IPM Program
USDA-ARS?s Scientific Manuscript database
In 2008, the WVU Extension Service partnered with the Natural Resources Conservation Service (NRCS) to develop and implement a cost-share IPM program for the commercial tree fruit growers in West Virginia. Fifty percent of implementation costs were paid by NRCS through the Environmental Quality Ince...
-
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.
-
Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A
2012-02-10
To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.
-
Barty, Rebecca L; Gagliardi, Kathleen; Owens, Wendy; Lauzon, Deborah; Scheuermann, Sheena; Liu, Yang; Wang, Grace; Pai, Menaka; Heddle, Nancy M
2015-07-01
Benchmarking is a quality improvement tool that compares an organization's performance to that of its peers for selected indicators, to improve practice. Processes to develop evidence-based benchmarks for red blood cell (RBC) outdating in Ontario hospitals, based on RBC hospital disposition data from Canadian Blood Services, have been previously reported. These benchmarks were implemented in 160 hospitals provincewide with a multifaceted approach, which included hospital education, inventory management tools and resources, summaries of best practice recommendations, recognition of high-performing sites, and audit tools on the Transfusion Ontario website (http://transfusionontario.org). In this study we describe the implementation process and the impact of the benchmarking program on RBC outdating. A conceptual framework for continuous quality improvement of a benchmarking program was also developed. The RBC outdating rate for all hospitals trended downward continuously from April 2006 to February 2012, irrespective of hospitals' transfusion rates or their distance from the blood supplier. The highest annual outdating rate was 2.82%, at the beginning of the observation period. Each year brought further reductions, with a nadir outdating rate of 1.02% achieved in 2011. The key elements of the successful benchmarking strategy included dynamic targets, a comprehensive and evidence-based implementation strategy, ongoing information sharing, and a robust data system to track information. The Ontario benchmarking program for RBC outdating resulted in continuous and sustained quality improvement. Our conceptual iterative framework for benchmarking provides a guide for institutions implementing a benchmarking program. © 2015 AABB.
-
Ollenschläger, Günter; Lelgemann, Monika; Kopp, Ina
2007-07-15
In Germany, physicians enrolled in disease management programs are legally obliged to follow evidence-based clinical practice guidelines. That is why a Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 aiming at implementation of best-practice evidence-based recommendations for nationwide as well as regional disease management programs. Against this background the article reviews programs, methods and tools for implementing DM-CPGs via clinical pathways as well as regional guidelines for outpatient care. Special reference is given to the institutionalized program of adapting DM-CPGs for regional use by primary-care physicians in the State of Hesse.
-
Development of a multihospital pharmacy quality assurance program.
Hoffmann, R P; Ravin, R; Colaluca, D M; Gifford, R; Grimes, D; Grzegorczyk, R; Keown, F; Kuhr, F; McKay, R; Peyser, J; Ryan, R; Zalewski, C
1980-07-01
Seven community hospitals have worked cooperatively for 18 months to develop an initial hospital pharmacy quality assurance program. Auditing criteria were developed for nine service areas corresponding to the model program developed by the American Society of Hospital Pharmacists. Current plans are to implement and modify this program as required at each participating hospital. Follow-up programs will also be essential to a functional, ongoing program, and these will be developed in the future.
-
Final Guidance on Awards of Grants to Indian Tribes under Section 106 of the Clean Water Act
Guidance to help tribal water quality program managers, staff, and other tribal environmental decision makers design and implement effective and successful water quality programs. Also assists EPA Regions to award and administer tribal grants.
-
Total Quality Management in Logistics: A Case Study from the Trucking Industry
1992-06-01
Quality Management (TQM) movement on the logistics industry as a whole, and, more specifically, its impact within the trucking industry. Its focus then narrows to study the practical aspects of implementing a W. Edwards Deming-based quality program within a particular trucking company, Mason Transporters, Inc. The effectiveness of the company’s implementation effort is assessed using data collected from a survey questionnaire, formal interviews, and personal observations during an on- site visit. Successes and shortcomings of the implementation process are highlighted
-
Implementing aeioTU: quality improvement alongside an efficacy study-learning while growing.
Nores, Milagros; Figueras-Daniel, Alexandra; Lopez, Maria Adelaida; Bernal, Raquel
2018-05-01
Effectiveness trials of increasing childhood development interventions across low- and middle-income countries have shown significant variability. The strength and consistency of benefits for children are dependent on program quality, and this requires paying attention to program implementation. In this paper, we summarize findings on program quality and teacher practices and perceptions for the aeioTU program, a center-based Reggio-inspired program in Colombia, now serving more than 13,000 children. The research found engaged, committed staff who valued the emergent approach and understood the children as requiring opportunities to express themselves, being the source for the curriculum, and having relationships with the materials around them. Although the average classroom quality was low in 2011, it increased significantly by 2014, particularly in the language and reasoning and interactions items. Indicator-level analyses showed that higher-order interactions and language processes were observed in a large proportion of classrooms by 2014. Teachers' self-reports on the environment and their teaching and learning showed high levels of quality by 2013. These findings illustrate the significance of process data for program improvement, especially when a program is young. Program quality can be raised after teachers improve their skills, have experience enacting a curriculum, and after training has been strengthened in response to information, while simultaneously scaling up the program. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.
-
ERIC Educational Resources Information Center
Horowitz, Michelle; Squires, Jim
2014-01-01
As the country quickly builds its efforts to enhance quality in early education and care classrooms, states are implementing Quality Rating and Improvement Systems (QRIS) to recognize and improve the quality of programs. QRIS also provides technical support and increased financial benefits for participating programs to attain higher levels of…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-27
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2010-0657; FRL-9205-7] Approval and Promulgation of Air Quality Implementation Plans; Michigan; PSD Regulations AGENCY: Environmental Protection... requirements of the prevention of significant deterioration (PSD) construction permit program in Michigan...
-
ERIC Educational Resources Information Center
Desimone Laura; Garet, Michael S.; Birman, Beatrice F.; Porter, Andrew; Yoon, Kwang Suk
2003-01-01
As part of national evaluation of Eisenhower Professional Development Program, examines management and implementation strategies contributing to high-quality inservice teacher professional development in mathematics and science. Finds higher quality professional development is related to management and implementation strategies such as continuous…
-
76 FR 27973 - Approval and Promulgation of Air Quality Implementation Plans; Indiana
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-13
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2010-0999; FRL-9304-9] Approval and Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION..., Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, Region 5...
-
77 FR 41954 - Approval and Promulgation of Air Quality Implementation Plans; Indiana
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-17
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2012-0406; FRL-9699-2] Approval and Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION..., Air Programs Branch (AR-18J), Environmental Protection Agency, Region 5, 77 West Jackson Boulevard...
-
75 FR 5514 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
2010-02-03
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2009-0771; FRL-9108-7] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Correction AGENCY: Environmental Protection Agency..., Environmental Engineer, Criteria Pollutant Section, Air Programs Branch (AR-18J), Environmental Protection...
-
76 FR 20906 - Approval and Promulgation of Air Quality Implementation Plans; Indiana
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-14
... Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION... Clean Air Act. Indiana submitted revisions to the particulate matter (PM) and sulfur dioxide (SO 2...: Douglas Aburano, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental...
-
2016-08-05
This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2017. In addition, it specifies a potentially preventable readmission measure for the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), and implements requirements for that program, including performance standards, a scoring methodology, and a review and correction process for performance information to be made public, aimed at implementing value-based purchasing for SNFs. Additionally, this final rule includes additional polices and measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). This final rule also responds to comments on the SNF Payment Models Research (PMR) project.
-
Implementation of the External Quality Assessment Program in Brazil.
Fleury, Marcos Kneip; Menezes, Maria Elizabeth; Correa, José Abol
2017-02-15
The External Quality Assessment (EQA) in Brazil is performed by the National Health Ministry for diseases that are under supervision of Public Health Department. In addition to the government program, the Brazilian Society of Clinical Analysis and the Brazilian Society of Medical Pathology are allowed to provide their programs under the Supervision of National Agency for Sanitary Surveillance (ANVISA) that regulates laboratories to perform EQA programs.
-
Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.
ERIC Educational Resources Information Center
Advanced Technology, Inc., Reston, VA.
The purpose and direction of the quality improvement program of the U.S. Department of Education's Office of Student Financial Aid (OSFA) are described. The improvement program was designed to develop a systematic approach to identify, measure, and correct errors in the student aid delivery system. Information is provided on the general approach…
-
Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho
Packard, F.A.
1996-01-01
To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality-assurance plan does not describe detailed technical activities that are commonly termed "quality-control procedures." Instead, it focuses on current policies, operations, and responsibilities that are implemented at the management level. Contents of the plan will be reviewed annually and updated as programs and operations change.
-
1998-06-01
quality management can have on the intermediate level of maintenance. Power quality management is a preventative process that focuses on identifying and correcting problems that cause bad power. Using cost-benefit analysis we compare the effects of implementing a power quality management program at AIMD Lemoore and AIMD Fallon. The implementation of power quality management can result in wide scale logistical support changes in regards to the life cycle costs of maintaining the DoD’s current inventory
-
2015-08-04
This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.
-
Todd, Christopher A; Sanchez, Ana M; Garcia, Ambrosia; Denny, Thomas N; Sarzotti-Kelsoe, Marcella
2014-07-01
The EQAPOL contract was awarded to Duke University to develop and manage global proficiency testing programs for flow cytometry-, ELISpot-, and Luminex bead-based assays (cytokine analytes), as well as create a genetically diverse panel of HIV-1 viral cultures to be made available to National Institutes of Health (NIH) researchers. As a part of this contract, EQAPOL was required to operate under Good Clinical Laboratory Practices (GCLP) that are traditionally used for laboratories conducting endpoint assays for human clinical trials. EQAPOL adapted these guidelines to the management of proficiency testing programs while simultaneously incorporating aspects of ISO/IEC 17043 which are specifically designed for external proficiency management. Over the first two years of the contract, the EQAPOL Oversight Laboratories received training, developed standard operating procedures and quality management practices, implemented strict quality control procedures for equipment, reagents, and documentation, and received audits from the EQAPOL Central Quality Assurance Unit. GCLP programs, such as EQAPOL, strengthen a laboratory's ability to perform critical assays and provide quality assessments of future potential vaccines. © 2013.
-
Florida First Start Program: Program Planning and Implementation Guide.
ERIC Educational Resources Information Center
Florida State Dept. of Education, Tallahassee. Office of Early Intervention and School Readiness.
This guide is designed to facilitate the implementation of the Florida First Start (FFS) program, created to help at-risk children from birth to 3 years of age have the best possible start in life and to support parents in their roles as their children's first teachers. Emphasis is on providing early, high-quality education and support services.…
-
NASA Technical Reports Server (NTRS)
Jamar, L. G.
1986-01-01
Quality and innovation are the hallmarks of the national space program. In programs that preceded the Shuttle Program the emphasis was on meeting the risks and technical challenges of space with safety, quality, reliability, and success. At United Technologies Aerospace Operations, Inc. (UTAO), the battle has developed along four primary fronts. These fronts include programs to motivate and reward people, development and construction of optimized processes and facilities, implementation of specifically tailored management systems, and the application of appropriate measurement and control systems. Each of these initiatives is described. However, to put this quality and productivity program in perspective, UTAO and its role in the Shuttle Program are described first.
-
Smith, Joanne A; Baker-Henningham, Helen; Brentani, Alexandra; Mugweni, Rose; Walker, Susan P
2018-05-01
Young children need nurturing care, which includes responsive caregiver-child interactions and opportunities to learn. However, there are few extant large-scale programs that build parents' abilities to provide this. We have developed an early childhood parenting training package, called Reach Up, with the aim of providing an evidence-based, adaptable program that is feasible for low-resource settings. Implementation of Reach Up was evaluated in Brazil and Zimbabwe to inform modifications needed and identify challenges that implementers and delivery agents encountered. Interview guides were developed to collect information on the program's appropriateness, acceptability, and feasibility from mothers, home visitors, and supervisors. Information on adaptation was obtained from country program leads and Reach Up team logs, as well as quality of visits from observations conducted by supervisors. The program was well accepted by mothers and visitors, who perceived benefits for the children; training was viewed as appropriate, and visitors felt well-prepared to conduct visits. A need for expansion of supervisor training was identified and the program was feasible to implement, although challenges were identified, including staff turnover; implementation was less feasible for staff with other work commitments (in Brazil). However, most aspects of visit quality were high. We conclude that the Reach Up program can expand capacity for parenting programs in low- and middle-income countries. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.
-
Monfils, M K
1995-05-01
1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.
-
Water Quality Trading Toolkit for Permit Writers
The Water Quality Trading Toolkit for Permit Writers is EPA’s first “how-to” manual on designing and implementing water quality trading programs. It helps NPDES permitting authorities incorporate trading provisions into permits.
-
A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan
Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko
2017-01-01
Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148
-
Maynard, Gregory A; Budnitz, Tina L; Nickel, Wendy K; Greenwald, Jeffrey L; Kerr, Kathleen M; Miller, Joseph A; Resnic, JoAnne N; Rogers, Kendall M; Schnipper, Jeffrey L; Stein, Jason M; Whitcomb, Winthrop F; Williams, Mark V
2012-07-01
The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource Rooms," as well as the mentor's own experience, provided best-practice definitions, practical implementation tips, measurement strategies, and other tools. E-mail interactions and mentoring were augmented by regularly scheduled teleconferences; group webinars; and, in some instances, a site visit. Performance was tracked in a centralized data tracking center. Preliminary data on all three MI programs show significant improvement in patient outcomes, as well as enhancements of communication and leadership skills of the hospitalists and their QI teams. Although objective data on outcomes and process measures for the MI program's efficacy remain preliminary at this time, the maturing data tracking system, multiple awards, and early results indicate that the MI programs are successful in providing QI training and accelerating improvement efforts.
-
Learnings From the Pilot Implementation of Mobile Medical Milestones Application.
Page, Cristen P; Reid, Alfred; Coe, Catherine L; Carlough, Martha; Rosenbaum, Daryl; Beste, Janalynn; Fagan, Blake; Steinbacher, Erika; Jones, Geoffrey; Newton, Warren P
2016-10-01
Implementation of the educational milestones benefits from mobile technology that facilitates ready assessments in the clinical environment. We developed a point-of-care resident evaluation tool, the Mobile Medical Milestones Application (M3App), and piloted it in 8 North Carolina family medicine residency programs. We sought to examine variations we found in the use of the tool across programs and explored the experiences of program directors, faculty, and residents to better understand the perceived benefits and challenges of implementing the new tool. Residents and faculty completed presurveys and postsurveys about the tool and the evaluation process in their program. Program directors were interviewed individually. Interviews and open-ended survey responses were analyzed and coded using the constant comparative method, and responses were tabulated under themes. Common perceptions included increased data collection, enhanced efficiency, and increased perceived quality of the information gathered with the M3App. Residents appreciated the timely, high-quality feedback they received. Faculty reported becoming more comfortable with the tool over time, and a more favorable evaluation of the tool was associated with higher utilization. Program directors reported improvements in faculty knowledge of the milestones and resident satisfaction with feedback. Faculty and residents credited the M3App with improving the quality and efficiency of resident feedback. Residents appreciated the frequency, proximity, and specificity of feedback, and faculty reported the app improved their familiarity with the milestones. Implementation challenges included lack of a physician champion and competing demands on faculty time.
-
Ryan, Gery W; Farmer, Carrie M; Adamson, David M; Weinick, Robin M
2014-01-01
Between 2001 and 2011, the U.S. Department of Defense has implemented numerous programs to support service members and their families in coping with the stressors from a decade of the longstanding conflicts in Iraq and Afghanistan. These programs, which address both psychological health and traumatic brain injury (TBI), number in the hundreds and vary in their size, scope, and target population. To ensure that resources are wisely invested and maximize the benefits of such programs, RAND developed a tool to help assess program performance, consider options for improvement, implement solutions, then assess whether the changes worked, with the intention of helping those responsible for managing or implementing programs to conduct assessments of how well the program is performing and to implement solutions for improving performance. Specifically, the tool is intended to provide practical guidance in program improvement and continuous quality improvement for all programs.
-
High Plains regional ground-water study
Dennehy, Kevin F.
2000-01-01
Over the last 25 years, industry and government have made large financial investments aimed at improving water quality across the Nation. Significant progress has been made; however, many water-quality concerns remain. In 1991, the U.S. Geological Survey (USGS) began implementing a full-scale National Water-Quality Assessment Program to provide consistent and scientifically sound information for managing the Nation's water resources. The goals of the NAWQA Program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams and aquifers, (2) describe how water quality is changing over time, and (3) improve our understanding of the primary natural and human factors affecting water quality. Assessing the quality of water in every location in the Nation would not be practical; therefore, NAWQA Program studies are conducted within a set of areas called study units (fig. 1). These study units are composed of more than 50 important river and aquifer systems that represent the diverse geography, water resources, and land and water uses of the Nation. The High Plains Regional Ground-Water Study is one such study area, designed to address issues relevant to the High Plains Aquifer system while supplementing water-quality information collected in other study units across the Nation. Implementation of the NAWQA Program for the High Plains Regional Ground-Water Study area began in 1998.
-
Development of a quality assurance program for ionizing radiation secondary calibration laboratories
DOE Office of Scientific and Technical Information (OSTI.GOV)
Heaton, H.T. II; Taylor, A.R. Jr.
For calibration laboratories, routine calibrations of instruments meeting stated accuracy goals are important. One method of achieving the accuracy goals is to establish and follow a quality assurance program designed to monitor all aspects of the calibration program and to provide the appropriate feedback mechanism if adjustments are needed. In the United States there are a number of organizations with laboratory accreditation programs. All existing accreditation programs require that the laboratory implement a quality assurance program with essentially the same elements in all of these programs. Collectively, these elements have been designated as a Measurement Quality Assurance (MQA) program. Thismore » paper will briefly discuss the interrelationship of the elements of an MQA program. Using the Center for Devices and Radiological Health (CDRH) X-ray Calibration Laboratory (XCL) as an example, it will focus on setting up a quality control program for the equipment in a Secondary Calibration Laboratory.« less
-
Rondeau, Kent V; Wagar, Terry H
2002-01-01
Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporAte culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.
-
An institutional review board-based clinical research quality assurance program.
Lad, Pramod M; Dahl, Rebecca
2013-01-01
Despite the acknowledged importance of quality assurance in the clinical research process, the problem of how such a program should be implemented at the level of an academic teaching hospital or a similar institution has not been addressed in the literature. Despite the fact that quality assurance is expected in programs which certify and accredit Institutional Review Boards (IRBs), very little is known about the role of the IRB in programs of clinical research quality assurance. In this article we consider the definition of clinical research quality assurance, and describe a program designed to achieve it. The key elements of such a program are education at the site level, which has both mandatory and voluntary components, and an auditing and monitoring program, which reinforces the education on quality assurance. The role of the IRB in achieving the program goals and the organizational placement of the quality assurance program within the IRB structure and function are important items of discussion.
-
Understanding barriers to implementing quality lunch and nutrition education.
Cho, Hyunyi; Nadow, Michelle Zbell
2004-10-01
Food services and nutrition education are priorities for the Coordinated School Health Program in Massachusetts, which is a CDC funded partnership between the Massachusetts Departments of Education and Public Health. Despite funding and resources provided by governmental and non-governmental agencies, schools are facing barriers in effectively creating a healthy nutritional environment. A qualitative survey was conducted to understand barriers to implementing quality lunch and nutrition education programs perceived by superintendents, principals, food service directors, nurses, and health educators in Massachusetts. The results suggest that while funding can initially enable schools to provide quality lunch, but without changes in students' preference for unhealthy food and parental and community involvement in fostering students' healthy eating behavior, the lunch programs cannot achieve a sustainable success. Lack of opportunity for communication among food service staff, health educators, and teachers appears to hinder the coordination necessary to promote school lunch as well as school-wide nutrition education. Respondents acknowledged that the state's academic assessment system is the priority issue in their schools, but expressed that the interests and initiatives of superintendents and principals in the lunch and nutrition education programs can be enhanced. Overall, the results suggest that successful implementation of quality lunch and nutrition education programs require not only the collaborative efforts of school administration and staff but also the support of parents, community, and the mass media.
-
EPA is proposing to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California SIP concerning the District's New Source Review (NSR) permitting program for new and modified sources of air pollution.
-
McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R
2012-10-01
To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management of the program.
-
Hahn, U; Bertram, B; Krummenauer, F; Reuscher, A; Fabian, E; Neuhann, T; Schmickler, S; Neuhann, I
2013-04-01
Cataract surgery is scheduled for a federal program for quality improvement across the different sectors of care (outpatient care and hospitals). In case of implementation not only ophthalmic surgeons but all ophthalmologists would have to contribute to the documentation. Urgency, potential benefits and limitations of a compulsory compared to a voluntary quality assessment system are analyzed.
-
Yao, Qiang; Zhou, George
2014-06-01
Improving the quality of peritoneal dialysis (PD) in areas with a rapid increase in PD patient numbers constitutes the most significant PD challenge in China. Here, we share our experience of implementing a quality improvement program in 8 PD centers, with guidance from matched experienced centers. Copyright © 2014 International Society for Peritoneal Dialysis.
-
Axon, Robert N; Penney, Fletcher T; Kyle, Thomas R; Zapka, Jane; Marsden, Justin; Zhao, Yumin; Mauldin, Patrick D; Moran, William P
2014-06-01
Discharge summaries are an important component of hospital care transitions typically completed by interns in teaching hospitals. However, these documents are often not completed in a timely fashion or do not include pertinent details of hospitalization. This report outlines the development and impact of a curriculum intervention to improve the quality of discharge summaries by interns and residents in Internal Medicine. A previous study demonstrated that a discharge summary curriculum featuring individualized feedback was associated with improved summary quality, but few subsequent studies have described implementation of similar curricula. No information exists on the utility of other strategies such as team-based feedback or academic detailing. Study participants were 96 Internal Medicine intern and resident physicians at an academic medical center-based training program. A comprehensive evidence-based discharge summary quality improvement program was developed and implemented that featured a discharge summary template to facilitate summary preparation, individual feedback, team-based feedback, academic detailing and an objective discharge summary evaluation instrument. The discharge summary evaluation instrument had moderate interrater reliability (κ = 0.72). Discharge summary scores improved from mean score of 70% to 82% (P = 0.05). Interns and residents participating in this program also reported increased confidence in producing and critiquing summaries. A comprehensive discharge summary curriculum can be feasibly implemented within the context of a residency program. Team-based feedback and academic detailing may serve to reinforce individual feedback and extend program reach.
-
Implementation Evaluation in a Private Nonprofit Setting: A Mixed-Methods Approach
ERIC Educational Resources Information Center
Walker, Jacquelyn Ann
2013-01-01
Demand for quality service provision in the human services industry requires that private nonprofit organizations have the administrative and management capacities to ensure successful implementation and sustain staff development programs. Unfamiliarity with implementation challenges, and limited awareness of implementation strategies, can trigger…
-
Reames, Bradley N.; Krell, Robert W.; Campbell, Darrell A.; Dimick, Justin B.
2015-01-01
Importance Previous studies of checklist-based quality improvement interventions have reported mixed results. Objective To evaluate whether implementation of a checklist-based quality improvement intervention, Keystone Surgery, was associated with improved outcomes in patients undergoing general surgery in large statewide population. Design, Setting and Exposure Retrospective longitudinal study examining surgical outcomes in Michigan patients using Michigan Surgical Quality Collaborative clinical registry data from the years 2006–2010 (n=64,891 patients in 29 hospitals). Multivariable logistic regression and difference-in-differences analytic approaches were used to evaluate whether Keystone Surgery program implementation was associated with improved surgical outcomes following general surgery procedures, apart from existing temporal trends toward improved outcomes during the study period. Main Outcome Measures Risk-adjusted rates of superficial surgical site infection, wound complications, any complication, and 30-day mortality. Results Implementation of Keystone Surgery in participating centers (n=14 hospitals) was not associated with improvements in surgical outcomes during the study period. Adjusted rates of superficial surgical site infection (3.2 vs. 3.2%, p=0.91), wound complications (5.9 vs. 6.5%, p=0.30), any complication (12.4 vs. 13.2%, p=0.26), and 30-day mortality (2.1 vs. 1.9%, p=0.32) at participating hospitals were similar before and after implementation. Difference-in-differences analysis accounting for trends in non-participating centers (n=15 hospitals), and sensitivity analysis excluding patients receiving surgery in the first 6- or 12-months after program implementation yielded similar results. Conclusions and Relevance Implementation of a checklist-based quality improvement intervention did not impact rates of adverse surgical outcomes among patients undergoing general surgery in participating Michigan hospitals. Additional research is needed to understand why this program was not successful prior to further dissemination and implementation of this model to other populations. PMID:25588183
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
Poncio, S.; Adkison, P.
Coating costs are escalating due to increased awareness of the environment and safety and health issues. Owners can reduce the overall cost of maintenance painting projects through the implementation of a total quality program. This program should encompass project pre-planning, evaluation of safety and quality assurance programs, and analysis of employee absenteeism and turnover. The information presented is a case history of one utility's experience managing a maintenance painting program during a five-year period.
-
Shek, Daniel T L; Chak, Yammy L Y
2010-01-01
To facilitate the implementation of the Secondary 1 to Secondary 3 program of the Project P.A.T.H.S. in Hong Kong, systematic training programs are designed for the potential program implementers. The rationales, objectives and design of the Secondary 1 to Secondary 3 training programs are outlined in this paper. The training programs cover theories of adolescent development, positive youth development, background and curricula of the Project P.A.T.H.S., factors affecting program implementation quality and evaluation of the project. Besides introducing the curriculum units, the training programs also focus on nature of learning and related theories (particularly experiential learning), teaching methods and instructional techniques, motivating students, and classroom management.
-
The National Oceanic and Atmospheric Administration (NOAA), in partnership with the United States Environmental Protection Agency (EPA), is operationally implementing an Air Quality Forecast (AQF) system. This program, which couples NOAA's North American Mesoscale (NAM) weather p...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-12
... Promulgation of Air Quality Implementation Plans; Michigan; PSD and NSR Regulations AGENCY: Environmental... the prevention of significant deterioration (PSD) construction permit program for the purpose of... approving Michigan's request to revise its SIP to add rule R. 336.2816 to be consistent with Federal PSD...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-18
... Promulgation of Air Quality Implementation Plans; Texas; Revisions to the Discrete Emission Credit Banking and... Rules, Subchapter H--Emissions Banking and Trading, Division 4--Discrete Emission Credit Banking and Trading, referred to elsewhere in this notice as the Discrete Emission Reduction Credit (DERC) Program...
-
Quality Assurance Framework Implementation Guide for Isolated Community Power Systems
DOE Office of Scientific and Technical Information (OSTI.GOV)
Esterly, Sean R.; Baring-Gould, Edward I.; Burman, Kari A.
This implementation guide is a companion document to the 'Quality Assurance Framework for Mini-Grids' technical report. This document is intended to be used by one of the many stakeholder groups that take part in the implementation of isolated power systems. Although the QAF could be applied to a single system, it was designed primarily to be used within the context of a larger national or regional rural electrification program in which many individual systems are being installed. This guide includes a detailed overview of the Quality Assurance Framework and provides guidance focused on the implementation of the Framework from themore » perspective of the different stakeholders that are commonly involved in expanding energy development within specific communities or regions. For the successful long-term implementation of a specific rural electrification program using mini-grid systems, six key stakeholders have been identified that are typically engaged, each with a different set of priorities 1. Regulatory agency 2. Governmental ministry 3. System developers 4. Mini-utility 5. Investors 6. Customers/consumers. This document is broken into two distinct sections. The first focuses on the administrative processes in the development and operation of community-based mini-grid programs, while the second focuses on the process around the installation of the mini-grid project itself.« less
-
Preparing health care organizations for successful case management programs.
Bonvissuto, C A; Kastens, J M; Atwell, S R
1997-01-01
This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.
-
Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav
2017-10-01
Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to each other, seeing the person, and, enhanced well-being, emerged. Namaste Care can enrich the quality of life of older people with advanced dementia in care homes. The program was welcomed by care home staff and families, and was achieved with only modest expenditure and no change in staffing levels. The positive impact on residents quality of life influenced the well-being of family carers. Care staff found the changes in care enjoyable and rewarding. Namaste Care was valued for the benefits seen in residents; the improvement in relationships; and the shift towards a person-centred, relationship-based culture of care brought about by introducing the program. Namaste Care deserves further exploration and investigation including a randomised controlled trial.
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
Seibert, J; Imbergamo, P
The expansion and integration of diagnostic imaging technologies such as On Board Imaging (OBI) and Cone Beam Computed Tomography (CBCT) into radiation oncology has required radiation oncology physicists to be responsible for and become familiar with assessing image quality. Unfortunately many radiation oncology physicists have had little or no training or experience in measuring and assessing image quality. Many physicists have turned to automated QA analysis software without having a fundamental understanding of image quality measures. This session will review the basic image quality measures of imaging technologies used in the radiation oncology clinic, such as low contrast resolution, highmore » contrast resolution, uniformity, noise, and contrast scale, and how to measure and assess them in a meaningful way. Additionally a discussion of the implementation of an image quality assurance program in compliance with Task Group recommendations will be presented along with the advantages and disadvantages of automated analysis methods. Learning Objectives: Review and understanding of the fundamentals of image quality. Review and understanding of the basic image quality measures of imaging modalities used in the radiation oncology clinic. Understand how to implement an image quality assurance program and to assess basic image quality measures in a meaningful way.« less
-
ERIC Educational Resources Information Center
Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa
2010-01-01
Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-16
...' health, safety, employment, mobility, and education; and 3. Neighborhood: Transform distressed, high..., high quality public schools and education programs, high quality early learning programs and services..., communities must develop and implement a comprehensive neighborhood revitalization strategy, or Transformation...
-
The Elementary Physical Education Program: Quality and Sustainability in Pennsylvania
ERIC Educational Resources Information Center
Weimer, Alison
2013-01-01
This study examined enabling conditions related to implementing and sustaining a high-quality physical education program at three elementary schools in Pennsylvania. Physical education is being reduced or removed from elementary curriculums because of reduced school budgets and a strong focus on academic standards. Furthermore, the lack of…
-
Standards for Implementing Quality Prekindergarten Education.
ERIC Educational Resources Information Center
Maryland State Dept. of Education, Baltimore. Div. of Instruction.
These standards are provided to promote the achievement of excellence in Maryland's public school prekindergarten programs. To that end, this document delineates standards of quality and provides a list of indicators that concretely describe what a program will look like if the standards are being met. The standards and indicators address seven…
-
78 FR 35936 - Agency Information Collection Activities: Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-14
... Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Under the Paperwork Reduction Act... Collection: Evaluation of the Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program; Use: The Physician Quality Reporting System (PQRS) was first implemented in 2007 as an...
-
A quality improvement approach to capacity building in low- and middle-income countries.
Bardfield, Joshua; Agins, Bruce; Akiyama, Matthew; Basenero, Apollo; Luphala, Patience; Kaindjee-Tjituka, Francina; Natanael, Salomo; Hamunime, Ndapewa
2015-07-01
To describe the HEALTHQUAL framework consisting of the following three components: performance measurement, quality improvement and the quality management program, representing an adaptive approach to building capacity in national quality management programs in low and middle-income countries. We present a case study from Namibia illustrating how this approach is adapted to country context. HEALTHQUAL partners with Ministries of Health to build knowledge and expertise in modern improvement methods, including data collection, analysis and reporting, process analysis and the use of data to implement quality improvement projects that aim to improve systems and processes of care. Clinical performance measures are selected in each country by the Ministry of Health on the basis of national guidelines. Patient records are sampled using a standardized statistical table to achieve a minimum confidence interval of 90%, with a spread of ±8% in participating facilities. Data are routinely reviewed to identify gaps in patient care, and aggregated to produce facility mean scores that are trended over time. A formal organizational assessment is conducted at facility and national levels to review the implementation progress. Aggregate mean rates of performance for 10 of 11 indicators of HIV care improved for adult HIV-positive patients between 2008 and 2013. Quality improvement is an approach to capacity building and health systems strengthening that offers adaptive methodology. Synergistic implementation of elements of a national quality program can lead to improvements in care, in parallel with systematic capacity development for measurement, improvement and quality management throughout the healthcare delivery system.
-
Developing Quality Schools: A Handbook.
ERIC Educational Resources Information Center
Barlosky, Martin; Lawton, Stephen
This handbook combines the outcomes of the "Symposium on Quality Schools" (April 14, 15 and June 2, 3, 1994, Toronto, Canada) with a continuing presentation of the quality philosophy. It is designed to guide the development and implementation of quality-driven educational programs. Quality schools are committed to creating enhanced…
-
The Effect of the MassHealth Hospital Pay-for-Performance Program on Quality
Ryan, Andrew M; Blustein, Jan
2011-01-01
Objective To test the effect of Massachusetts Medicaid's (MassHealth) hospital-based pay-for-performance (P4P) program, implemented in 2008, on quality of care for pneumonia and surgical infection prevention (SIP). Data Hospital Compare process of care quality data from 2004 to 2009 for acute care hospitals in Massachusetts (N = 62) and other states (N = 3,676) and American Hospital Association data on hospital characteristics from 2005. Study Design Panel data models with hospital fixed effects and hospital-specific trends are estimated to test the effect of P4P on composite quality for pneumonia and SIP. This base model is extended to control for the completeness of measure reporting. Further sensitivity checks include estimation with propensity-score matched control hospitals, excluding hospitals in other P4P programs, varying the time period during which the program was assumed to have an effect, and testing the program effect across hospital characteristics. Principal Findings Estimates from our preferred specification, including hospital fixed effects, trends, and the control for measure completeness, indicate small and nonsignificant program effects for pneumonia (−0.67 percentage points, p>.10) and SIP (−0.12 percentage points, p>.10). Sensitivity checks indicate a similar pattern of findings across specifications. Conclusions Despite offering substantial financial incentives, the MassHealth P4P program did not improve quality in the first years of implementation. PMID:21210796
-
NASA Technical Reports Server (NTRS)
Eidenshink, J. C.; Schmer, F. A.
1979-01-01
The Lake Herman watershed in southeastern South Dakota has been selected as one of seven water resources systems in the United States for involvement in the National Model Implementation Program (MIP). MIP is a pilot program initiated to illustrate the effectiveness of existing water resources quality improvement programs. The Remote Sensing Institute (RSI) at South Dakota State University has produced a computerized geographic information system for the Lake Herman watershed. All components necessary for the monitoring and evaluation process were included in the data base. The computerized data were used to produce thematic maps and tabular data for the land cover and soil classes within the watershed. These data are being utilized operationally by SCS resource personnel for planning and management purposes.
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
Novak, J.H.
1984-05-01
Model design, implementation and quality assurance procedures can have a significant impact on the effectiveness of long term utility of any modeling approach. The Regional Oxidant Modeling System (ROMS) is exceptionally complex because it treats all chemical and physical processes thought to affect ozone concentration on a regional scale. Thus, to effectively illustrate useful design and implementation techniques, this paper describes the general modeling framework which forms the basis of the ROMS. This framework is flexible enough to allow straightforward update or replacement of the chemical kinetics mechanism and/or any theoretical formulations of the physical processes. Use of the Jacksonmore » Structured Programming (JSP) method to implement this modeling framework has not only increased programmer productivity and quality of the resulting programs, but also has provided standardized program design, dynamic documentation, and easily maintainable and transportable code. A summary of the JSP method is presented to encourage modelers to pursue this technique in their own model development efforts. In addition, since data preparation is such an integral part of a successful modeling system, the ROMS processor network is described with emphasis on the internal quality control techniques.« less
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-29
..., published on March 22, 2012, that approved revisions to the Puerto Rico Regulations for the Control of Atmospheric Pollution. Those revisions were submitted to EPA by the Puerto Rico Environmental Quality Board on...] Approval and Promulgation of Implementation Plans and Operating Permits Program; Commonwealth of Puerto...
-
Integrating research, policy, and practice in juvenile justice education.
Blomberg, Thomas G; Waldo, Gordon P
2002-06-01
This article provides an overview of the history and context leading to Florida's efforts to implement an evaluation-driven research and associated quality assurance system for its juvenile justice education policies and practices. The Juvenile Justice Educational Enhancement Program began implementing Florida's evaluation research and quality assurance system to juvenile justice education in 1998. The article includes a brief summary of articles comprising this special issue of Evaluation Review that address the Juvenile Justice Educational Enhancement Program's various functions, methodological components, data, preliminary findings, continuing evaluation research efforts, and impediments.
-
Kuo, Yi-Wei; Lu, I-Cheng; Yang, Hui-Ying; Chiu, Shun-Li; Hsu, Hung-Te; Cheng, Kuang-I
2016-12-01
Perioperative dental injury (PDI) is a common adverse event associated with anesthesia that can easily lead to medicolegal litigation. A quality improvement program was conducted with the electronic, standardized dental chart to document dentition before anesthesia and dentist consultation when necessary. This study aimed to reduce PDIs through execution of a quality improvement program. We reviewed the 42-month interval anesthetic records of 64,718 patients who underwent anesthesia. A standardized electronic dental chart was designed to identify any dental prosthetics, fixed and removable dentures, and degree of loose teeth. The incidence of dental injuries associated with anesthesia was separated into three time periods: baseline, initiative (Phase I), and execution (Phase II). Primary outcome measurement was the incidence of PDIs related to anesthesia. The overall incidence of dental injury related to anesthesia was 0.059% (38/64,718 patients). During the baseline period, the dental injury rate was 0.108% (26/24,137 patients), and it decreased from 0.051% in the initiative period (10/19,711 patients) to 0.009% in the execution period (2/20,870 patients) during implementation of the quality improvement program. Most dental injuries were associated with laryngeal mask airway (42.1%) and laryngoscopy (28.9%). The most commonly involved teeth were the upper incisors. Dental injury incidence was significantly reduced and remained at low levels after implementation of the quality improvement program. We suggest the implementation of a standardized dental examination into the preoperative evaluation system adding pathologic teeth fixed or protected devices to minimize dental injury associated with anesthesia. Copyright © 2016. Published by Elsevier Taiwan LLC.
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vile, D; Zhang, L; Cuttino, L
2016-06-15
Purpose: To create a quality assurance program based upon a risk-based assessment of a newly implemented SirSpheres Y-90 procedure. Methods: A process map was created for a newly implemented SirSpheres procedure at a community hospital. The process map documented each step of this collaborative procedure, as well as the roles and responsibilities of each member. From the process map, different potential failure modes were determined as well as any current controls in place. From this list, a full failure mode and effects analysis (FMEA) was performed by grading each failure mode’s likelihood of occurrence, likelihood of detection, and potential severity.more » These numbers were then multiplied to compute the risk priority number (RPN) for each potential failure mode. Failure modes were then ranked based on their RPN. Additional controls were then added, with failure modes corresponding to the highest RPNs taking priority. Results: A process map was created that succinctly outlined each step in the SirSpheres procedure in its current implementation. From this, 72 potential failure modes were identified and ranked according to their associated RPN. Quality assurance controls and safety barriers were then added for failure modes associated with the highest risk being addressed first. Conclusion: A quality assurance program was created from a risk-based assessment of the SirSpheres process. Process mapping and FMEA were effective in identifying potential high-risk failure modes for this new procedure, which were prioritized for new quality assurance controls. TG 100 recommends the fault tree analysis methodology to design a comprehensive and effective QC/QM program, yet we found that by simply introducing additional safety barriers to address high RPN failure modes makes the whole process simpler and safer.« less
-
Training in quality and safety: the current landscape.
Karasick, Andrew S; Nash, David B
2015-01-01
The current US health care environment requires and encourages the development and implementation of training programs focusing on quality improvement and patient safety. This article offers a new resource that details the basic characteristics of such physician-inclusive training programs. Specifically, program type, objectives, eligibility, cost, training length, and modality are aggregated and displayed to provide health care professionals with a new tool to facilitate individual education in the field of quality improvement and patient safety. © The Author(s) 2014.
-
1986-01-01
Factors influencing the implementation of a monitoring program This article outlines the principal factors that should be taken into account in a quality assurance program for rodents used in biomedical research. PMID:17422623
-
Implementing a patient safety and quality program across two merged pediatric institutions.
Abramson, Erika; Hyman, Daniel; Osorio, S Nena; Kaushal, Rainu
2009-01-01
Academic centers are among the health care organizations that have used consolidation as a strategy to improve efficiency and reduce costs. In 1997, the New York Hospital and The Presbyterian Hospital underwent a full-asset merger to become New York City's largest medical center, known as the New York-Presbyterian Hospital (NYPH). In 2006, recognition of the challenges of the Children's Service Line at NYPH led to the formation of a Patient Safety and Quality Program to deliver consistently safe and effective health care. Each campus has a children's quality council, an interdisciplinary group that discusses and prioritizes safety and quality issues. The quality councils from each campus report directly to a bicampus children's quality steering committee formed to ensure that similar safety practices and standards are implemented across both children's hospitals. A safety subcommittee, which primarily coordinates and follows up on leadership safety walk rounds, and a significant-events subcommittee, which reviews morbidities and mortalities, report to each hospital's quality council. The bicampus pediatric quality and safety program is organized around five broad themes: improving the culture of safety, reducing the frequency of health care-acquired infections, reducing harm in the health care setting, using information technology to improve the quality and safety of care provided to patients and families, and measuring the effectiveness of care in key areas. Two sample initiatives--building family engagement and prevention of adverse medication events--illustrate the program's successes and challenges. Developing a pediatric safety and quality program across two campuses has been challenging but has led to important improvements at both organizations.
-
Conte, Kathleen P; Marie Harvey, S; Turner Goins, R
2017-12-01
The need to scale-up effective arthritis self-management programs is pressing as the prevalence of arthritis increases. The CDC Arthritis Program funds state health departments to work with local delivery systems to embed arthritis programs into their day-to-day work. To encourage organizational ownership and sustainability of programs, funding is restricted to offset program start-up costs. The purpose of this study was to identify factors that impacted the success of implementing an evidence-based arthritis self-management program, funded by the CDC Arthritis Program, into the Oregon Extension Service. We interviewed staff and partners involved in implementation who had and had not successfully delivered Walk With Ease (N = 12) to identify barriers and facilitators to scaling-up. Document analysis of administrative records was used to triangulate and expand on findings. Delivery goals defined by the funder were not met in Year 1: only 3 of the expected 28 programs were delivered. Barriers to implementation included insufficient planning for implementation driven by pressure to deliver programs and insufficient resources to support staff time. Facilitators included centralized administration of key implementation activities and staffs' previous experience implementing new programs. The importance of planning and preparing for implementation cannot be overlooked. Funders, however, eager to see deliverables, continue to define implementation goals in terms of program reach, exclusive of capacity-building. Lack of capacity-building can jeopardize staff buy-in, implementation quality, and sustainability. Based on our findings coupled with support from implementation literature, we offer recommendations for future large-scale implementation efforts operating under such funding restrictions.
-
The Role of the School in Children's Out-of-School Time.
ERIC Educational Resources Information Center
Dryfoos, Joy G.
1999-01-01
Reports the prevalence of school-based after-school programs and discusses extracurricular activities, child care, extended-day programs, enrichment programs, and efforts to make the schools community hubs. Outlines implementation challenges to program expansion: governance, space, program quality, funding, and accountability. (SLD)
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-10
... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R03-OAR-2009-0599; FRL-9125-2] Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revision to Clean Air Interstate Rule Sulfur Dioxide Trading Program Correction In final rule document 2010-5105 beginning on page 11738 in the issue...
-
40 CFR 51.190 - Ambient air quality monitoring requirements.
Code of Federal Regulations, 2013 CFR
2013-07-01
... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Ambient air quality monitoring... PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Ambient Air Quality Surveillance § 51.190 Ambient air quality monitoring requirements. The requirements for monitoring ambient air...
-
40 CFR 51.190 - Ambient air quality monitoring requirements.
Code of Federal Regulations, 2014 CFR
2014-07-01
... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Ambient air quality monitoring... PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Ambient Air Quality Surveillance § 51.190 Ambient air quality monitoring requirements. The requirements for monitoring ambient air...
-
40 CFR 51.190 - Ambient air quality monitoring requirements.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Ambient air quality monitoring... PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Ambient Air Quality Surveillance § 51.190 Ambient air quality monitoring requirements. The requirements for monitoring ambient air...
-
40 CFR 51.190 - Ambient air quality monitoring requirements.
Code of Federal Regulations, 2012 CFR
2012-07-01
... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Ambient air quality monitoring... PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Ambient Air Quality Surveillance § 51.190 Ambient air quality monitoring requirements. The requirements for monitoring ambient air...
-
40 CFR 51.190 - Ambient air quality monitoring requirements.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Ambient air quality monitoring... PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Ambient Air Quality Surveillance § 51.190 Ambient air quality monitoring requirements. The requirements for monitoring ambient air...
-
Are you good enough for your patients? The European certification model in laparoscopic surgery
Campo, R.; Molinas, C.R.; De Wilde, R.L.; Brolmann, H.; Brucker, S.; Mencaglia, L.; Odonovan, P.; Wallwiener, D.; Wattiez, A.
2012-01-01
Quality control, training and education in gynaecological surgery are challenged and urgent measures are emerging. The implementation of a structured and validated program for training and quality control seems the most urgent measurement to be taken. The European Academy of Gynaecological Surgery has made a first attempt to do so. Through a practical and theoretical tests system, the skills of an individual surgeon is measured and the conditions to enter the different level of expertise are clearly defined. This certification system based on the best possible level of scientific evidence provides a first practical tool, universally implementable for a decent quality control and structured training program in Gynaecological laparoscopic surgery. PMID:24753896
-
Systems Engineering, Quality and Testing
NASA Technical Reports Server (NTRS)
Shepherd, Christena C.
2015-01-01
AS9100 has little to say about how to apply a Quality Management System (QMS) to aerospace test programs. There is little in the quality engineering Body of Knowledge that applies to testing, unless it is nondestructive examination or some type of lab or bench testing. If one examines how the systems engineering processes are implemented throughout a test program; and how these processes can be mapped to AS9100, a number of areas for involvement of the quality professional are revealed.
-
Lazarus, J M; Wick, G; Borella, L
1999-01-01
This is a brief review of the history of utilization of quality indicators by a major dialysis provider and how those indicators have been modified in response to the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI). Fresenius Medical Care North America (FMCNA) has monitored adequacy of dialysis, anemia management, and nutrition therapy for a number of years, using a self-directed continuous quality improvement program. FMCNA supports the NKF-DOQI Guidelines and has used the DOQI as it continues to enhance its patient quality care program. Specific goals and action thresholds of that program are delineated.
-
78 FR 53991 - Applications for New Awards; Race to the Top-Early Learning Challenge
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-30
... gaps for Children with High Needs.\\1\\ This program focuses on improving early learning and development... disadvantaged children in each age group of infants, toddlers, and preschoolers who are enrolled in high-quality... implement an integrated system of high-quality Early Learning and Development Programs and services. \\1...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-01
... the enhanced program performance standard evaluations to address: (1) A different attainment year for... the enhanced program performance standard evaluations, we concluded that the 2009 I/M Revision met the... national ambient air quality standards (NAAQSs) or any other applicable requirement of the Act. In so doing...
-
Quality as Critique: Promoting Critical Reflection among Youth in Structured Encounter Programs
ERIC Educational Resources Information Center
Ross, Karen
2015-01-01
In this manuscript, I interrogate the concept of "quality" encounter programs for youth in conflict zones. I focus on two Israeli organizations implementing encounters for Jewish and Palestinian citizens, and draw upon narratives of former participants as articulated during life history narratives to illustrate divergent emphases in each…
-
Nyangara, Florence M; Hai, Tajrina; Zalisk, Kirsten; Ozor, Lynda; Ufere, Joy; Isiguzo, Chinwoke; Abubakar, Ibrahim Ndaliman
2018-05-01
Decision makers are searching for reliable data and best practices to support the implementation and scale-up of the integrated community case management (iCCM) programs in underserved areas to reduce under-five mortality in low-income countries. This study assesses data quality and reporting systems of the World Health Organization supported Rapid Access Expansion program implementing iCCM in Abia and Niger States, Nigeria. This cross-sectional study used data from 16 primary health facilities in both states. Data were collected through review of registers and monthly summary reports of 140 community-oriented resource persons (CORPs), assessments of the five dimensions of the data reporting systems and 46 key informant interviews with stakeholders. Data quality was assessed by availability, completeness and consistency. Each component of the reporting system was assessed on a 3-point scale (weak, satisfactory and strong). Results show that both the structure, functions and capabilities, as well as data collection and reporting tools dimensions of the reporting system were strong, scoring (2.80, 2.73) for Abia and (2.88, 2.75) for Niger, respectively. Data management processes and links with national reporting system components scored low 2 s, indicating fair strength. Data availability, completeness and consistency were found to be good, an indication of adequate training and supervision of CORPs and community health extension workers. Indicator definitions and reporting guidelines were the weakest dimension of the system due to lack of data reporting guidelines in both states. In conclusion, the results indicate satisfactory data reporting systems and good quality data during early implementation of iCCM programs in the two states. Hence, countries planning to adopt and implement iCCM programs should first develop structures, establish national standardized tools for collecting and reporting data, provide for adequate training and supervision of community health workers and develop reporting guidelines for all reporting levels to ensure data quality.
-
Re-evaluation of Montana's air quality program.
DOT National Transportation Integrated Search
2013-08-01
This project examined the Montana DOTs current methods for determining projects for the Montana Air and Congestion Initiative (MACI) program, and made recommendations to improve and implement this program. A major project objective was to keep the...
-
ASE Program Certification Standards for Automobile Technician Training Programs.
ERIC Educational Resources Information Center
National Automotive Technicians Education Foundation, Herndon, VA.
This document presents and explains the development and application of the National Institute for Automotive Service Excellence (ASE) program certification standards that were developed to improve the quality of secondary- and postsecondary-level automobile technician training by implementing a certification program that certifies programs in…
-
Management of government quality assurance functions for NASA contracts
NASA Technical Reports Server (NTRS)
1993-01-01
This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.
-
Management of government quality assurance functions for NASA contracts
NASA Astrophysics Data System (ADS)
1993-04-01
This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.
-
NASA Technical Reports Server (NTRS)
House, G.
1980-01-01
Methods are defined for implementing quality assurance policy and requirements for life sciences laboratory equipment, experimental hardware, integration and test support equipment, and integrated payloads.
-
Coulam, Robert; Kralewski, John; Dowd, Bryan; Gans, David
2016-01-01
Although there are numerous studies of the factors influencing the adoption of quality assurance (QA) programs by medical group practices, few have focused on the role of group practice administrators. To gain insights into the role these administrators play in QA programs, we analyzed how medical practices adopted and implemented the Medicare Physician Quality Reporting System (PQRS), the largest physician quality reporting system in the United States. We conducted focus group interviews in 2011 with a national convenience sample of 76 medical group practice administrators. Responses were organized and analyzed using the innovation decision framework of Van de Ven and colleagues. Administrators conducted due diligence on PQRS, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations. Virtually, all who attempted it agreed that PQRS was straightforward to implement. However, the complexities of Medicare's PQRS reports impeded use of the data by administrators to support quality management. Group practice administrators are playing a prominent role in activities related to the quality of patient care--they are not limited to the business side of the practice. Especially, as PQRS becomes more nearly universal after 2014, Medicare should take account of the role that administrators play, by more actively engaging administrators in shaping these programs and making it easier for administrators to use the results. More research is needed on the rapidly evolving role of nonphysician administration in medical group practices. Practice administrators have a larger role than commonly understood in how quality reporting initiatives are adopted and used and are in an exceptional position to influence the more appropriate use of these resources if supported by more useful forms of quality reporting.
-
Yin, Yu-Chun
2013-06-01
The Taiwan Joint Commission on Hospital Accreditation (TJCHA) authorized the Teaching Quality Improvement Program for Teaching Hospitals as a way for the Department of Health to plan and implement improvements. The program assists medical and paramedical professionals to establish a postgraduate clinical training system. The two-year postgraduate training program for nurses is one of the program's regular activities, divided into three phases that include location-based curriculum training (3 months), core curriculum training (9 months), and professional courses training (12 months). This paper describes the origin, current implementation status, and efficacy / key problems of this two-year post graduate training program, Information regarding the opinions of new nurses, preceptors, and nursing managers on the three aspects is drawn from the author's relevant professional experience, interactions with nurses, and a review of the literature. Findings include: (1) nursing departments should operate in accordance with TJCHA guidelines; (2) department training should be adequate to promote the ability and willingness of nurses to train a new generation of clinical preceptors; and (3) participant opinions on project execution progress and difficulties. Findings may be referenced to better achieve Teaching Quality Improvement Program for Teaching Hospital objectives.
-
What Implementation Components Predict Positive Outcomes in a Parenting Program?
ERIC Educational Resources Information Center
Álvarez, Míriam; Rodrigo, María José; Byrne, Sonia
2018-01-01
Objectives: To examine the components affecting the quality of the implementation and their impact on the outcomes of the "Growing Up Happily in the Family" program targeted at parents with children aged 0-5. Method: At-risk and non-at-risk parents (N = 196) participated in 26 groups in local social services. Adherence, adaptations,…
-
78 FR 68367 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio NOX
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-14
... Clean Air Act, which allows for Ohio's Clean Air Interstate Rule (CAIR) NO X Ozone Season Trading Program rules to supersede Ohio's nitrogen oxides (NO X ) State Implementation Plan (SIP) Call Budget Trading Program rules, but leave other requirements of the NO X SIP Call in place for units not covered by...
-
ERIC Educational Resources Information Center
Arthur, Michael W.; Hawkins, J. David; Brown, Eric C.; Briney, John S.; Oesterle, Sabrina; Abbott, Robert D.
2010-01-01
Although advances in prevention science over the past two decades have produced a growing list of tested and effective programs and policies for preventing adolescent delinquency and drug use, widespread dissemination and high-quality implementation of effective programs and policies in communities has not been achieved. The Community Youth…
-
75 FR 9103 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; NOX
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-01
... State Implementation Plan (SIP) that would terminate the provisions of the Nitrogen Oxides (NO X ) Budget Trading Program that apply to electric generating units. EPA is no longer operating the NO X Budget Trading Program as a compliance option under the NO X SIP Call. These sources are now subject to...
-
75 FR 9146 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; NOX
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-01
... Illinois State Implementation Plan (SIP) that would terminate the provisions of the Nitrogen Oxides (NO X ) Budget Trading Program that apply to electric generating units. EPA is no longer operating the NO X Budget Trading Program as a compliance option under the NO X SIP Call. These sources are now subject to...
-
Template for success: using a resident-designed sign-out template in the handover of patient care.
Clark, Clancy J; Sindell, Sarah L; Koehler, Richard P
2011-01-01
Report our implementation of a standardized handover process in a general surgery residency program. The standardized handover process, sign-out template, method of implementation, and continuous quality improvement process were designed by general surgery residents with support of faculty and senior hospital administration using standard work principles and business models of the Virginia Mason Production System and the Toyota Production System. Nonprofit, tertiary referral teaching hospital. General surgery residents, residency faculty, patient care providers, and hospital administration. After instruction in quality improvement initiatives, a team of general surgery residents designed a sign-out process using an electronic template and standard procedures. The initial implementation phase resulted in 73% compliance. Using resident-driven continuous quality improvement processes, real-time feedback enabled residents to modify and improve this process, eventually attaining 100% compliance and acceptance by residents. The creation of a standardized template and protocol for patient handovers might eliminate communication failures. Encouraging residents to participate in this process can establish the groundwork for successful implementation of a standardized handover process. Integrating a continuous quality-improvement process into such an initiative can promote active participation of busy general surgery residents and lead to successful implementation of standard procedures. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
-
Reyes, J F; Wood, J G; Beutels, P; Macartney, K; McIntyre, P; Menzies, R; Mealing, N; Newall, A T
2017-01-05
Universal vaccination against rotavirus was included in the funded Australian National Immunisation Program in July 2007. Predictive cost-effectiveness models assessed the program before introduction. We conducted a retrospective economic evaluation of the Australian rotavirus program using national level post-implementation data on vaccine uptake, before-after measures of program impact and published estimates of excess intussusception cases. These data were used as inputs into a multi-cohort compartmental model which assigned cost and quality of life estimates to relevant health states, adopting a healthcare payer perspective. The primary outcome was discounted cost per quality adjusted life year gained, including or excluding unspecified acute gastroenteritis (AGE) hospitalisations. Relative to the baseline period (1997-2006), over the 6years (2007-2012) after implementation of the rotavirus program, we estimated that ∼77,000 hospitalisations (17,000 coded rotavirus and 60,000 unspecified AGE) and ∼3 deaths were prevented, compared with an estimated excess of 78 cases of intussusception. Approximately 90% of hospitalisations prevented were in children <5years, with evidence of herd protection in older age groups. The program was cost-saving when observed changes (declines) in both hospitalisations coded as rotavirus and as unspecified AGE were attributed to the rotavirus vaccine program. The adverse impact of estimated excess cases of intussusception was far outweighed by the benefits of the program. The inclusion of herd impact and declines in unspecified AGE hospitalisations resulted in the value for money achieved by the Australian rotavirus immunisation program being substantially greater than predicted bypre-implementation models, despite the potential increased cases of intussusception. This Australian experience is likely to be relevant to high-income countries yet to implement rotavirus vaccination programs. Copyright © 2016. Published by Elsevier Ltd.
-
An investigation of perceptions of programme quality support of adult basic education programmes.
Udouj, Gary; Grover, Kenda; Belcher, Greg; Kacirek, Kit
2017-04-01
This study was designed to identify the degree to which the directors of adult basic education programs perceive they have program quality support, as evidenced by a well-defined mission and role in the community, a management system, human resources management, and a suitable learning environment. NSCALL's Evidence-based program self-assessment (2006) was modified and administered electronically to administrators of adult education programs in a mid-southern state. Findings indicated that most directors perceive they are implementing the indicators of program quality support in all of the areas surveyed. A research-based annual self-study that considers the quality indicators is recommended, leaving a need for an update to the NCSALL assessment for use as a program assessment instrument. Copyright © 2016 Elsevier Ltd. All rights reserved.
-
Abry, Tashia; Rimm-Kaufman, Sara E; Curby, Timothy W
2017-02-01
School-based social and emotional learning (SEL) programs are presented to educators with little understanding of the program components that have the greatest leverage for improving targeted outcomes. Conducted in the context of a randomized controlled trial, the present study used variation in treatment teachers' (N = 143) implementation of four core components of the Responsive Classroom approach to examine relations between each component and the quality of teachers' emotional, organizational, and instructional interactions in third, fourth, and fifth grade classrooms (controlling for pre-intervention interaction quality and other covariates). We also examined the extent to which these relations varied as a function of teachers' baseline levels of interaction quality. Indices of teachers' implementation of Morning Meeting, Rule Creation, Interactive Modeling, and Academic Choice were derived from a combination of teacher-reported surveys and classroom observations. Ratings of teacher-student classroom interactions were aggregated across five observations conducted throughout the school year. Structural path models indicated that teachers' use of Morning Meeting and Academic Choice related to higher levels of emotionally supportive interactions; Academic Choice also related to higher levels of instructional interactions. In addition, teachers' baseline interaction quality moderated several associations such that the strongest relations between RC component use and interaction quality emerged for teachers with the lowest baseline interaction quality. Results highlight the value of examining individual program components toward the identification of program active ingredients that can inform intervention optimization and teacher professional development.
-
Ireys, Henry T; Brach, Cindy; Anglin, Grace; Devers, Kelly J; Burton, Rachel
2018-02-01
Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program's legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children's health care provided through Medicaid and CHIP. As part of the program's multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states' CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects' intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state's Medicaid environment, implementation partners' resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states' CHIPRA quality demonstration projects provides insight into the fates of the "promising ideas" that the grant program was designed to examine. As a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children.
-
Acosta, Joie; Ebener, Patricia; Driver, Jennifer; Keith, Jamie; Peebles, Dana
2013-01-01
Abstract Translational research is expanding, in part, because Evidence‐Based Programs or Practices (EBPs) are not adopted in many medical domains. However, little translational research exists on EBPs that are prevention programs delivered in nonclinical, community‐based settings. These organizations often have low capacity, which undermines implementation quality and outcomes. Rigorous translational research is needed in these settings so within a single study, capacity, implementation quality, and outcomes are measured and links between them tested. This paper overviews the study Enhancing Quality Interventions Promoting Healthy Sexuality (EQUIPS), which tests how well a community‐based setting (Boys & Girls Clubs) conducts an EBP called Making Proud Choices that aims to prevent teen pregnancy and sexually transmitted infections, with and without an implementation support intervention called Getting To Outcomes. The study design is novel as it assesses: Getting To Outcomes’ impact on capacity, implementation quality, and outcomes simultaneously and in both study conditions; will assess sustainability by measuring capacity and fidelity a year after the Getting To Outcomes support ends; and will operate on a large scale similar to many national initiatives. Many studies have not incorporated all these elements and thus EQUIPS could serve as a model for translational research in many domains. PMID:23751031
-
ERIC Educational Resources Information Center
Smith, Bradley H.; Gahagan, James; McQuillin, Samuel; Haywood, Benjamin; Cole, Caroline Pender; Bolton, Clay; Wampler, Mary Katherine
2011-01-01
We describe six hallmarks of high quality service-learning and explain how these considerations guided the development of a Transitional Coaching Program (TCP) during the first three years of implementation. We have demonstrated that the TCP is acceptable, feasible, and sustainable. Improvements have been seen in the degree of impact on learning…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-09-19
...EPA is approving a state implementation plan (SIP) revision submitted by the Wisconsin Department of Natural Resources on June 7, 2012, concerning the state's vehicle inspection and maintenance (I/M) program in southeast Wisconsin. The revision amends I/M program requirements in the active control measures portion of the ozone SIP to reflect changes that have been implemented at the state level since EPA fully approved the I/M program on August 16, 2001. The submittal also includes a demonstration under section 110(l) of the Clean Air Act (CAA) addressing lost emission reductions associated with the program changes.
-
Tappen, Ruth M; Wolf, David G; Rahemi, Zahra; Engstrom, Gabriella; Rojido, Carolina; Shutes, Jill M; Ouslander, Joseph G
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.
-
Initiating Improvements: The HR Department as the Architect of Quality-of-Life Initiatives.
ERIC Educational Resources Information Center
Reis, Frank William
2002-01-01
Describes how a wellness program, campus safety and security program, and institutional knowledge management program are succeeding at Cuyahoga Community College after the human resources (HR) department won administrative support for their implementation. (EV)
-
Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.
Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah
2016-08-01
Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.
-
Prior to initiation of the Arizona Border Survey, a quality systems implementation plan (QSIP) addressing all aspects of the project was developed by the investigating consortium composed of researchers from The University of Arizona (UA), Battelle Memorial Institute (BMI), and t...
-
USDA-ARS?s Scientific Manuscript database
The Chesapeake Stormwater Network hosted a workshop on July, 2012 to discuss the potential nutrient reductions from emerging stormwater technologies including algal flow-way technologies (AFTs). Workshop participants recommended the Chesapeake Bay Program’s Water Quality Goal Implementation Team(WQ...
-
Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A
2017-07-01
This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.
-
Pay for performance in thoracic surgery.
Varela, Gonzalo
2007-08-01
In the context of improving the quality of the medical practice, PFP programs have been developed to reward best medical practice. Early studies showed little gain in quality after implementing PFP family practice programs and some unintended consequences, like excluding high-risk patients from medical services when good outcomes were linked to payment. To date, no PFP programs have been implemented in surgical practice, but it is expected that value-based purchasing philosophy will be extended to surgical specialties in the near future. Quality initiatives in surgery can be based on outcome or process measures. Outcomes-focused quality approaches rely on accurate information obtained from multiinstitutional clinical databases for calculation of risk-adjusted models. Primary outcomes such surgical mortality are uncommon in modern thoracic surgery and outcome measures should rely on more prevalent intermediate outcomes such as specific postoperative morbidities or emergency readmission. Process-based quality approaches need to be based on scientific evidence linking process to outcomes. It is our responsibility to develop practice guidelines or international practice consensus to facilitate the parameters to be evaluated in the near future.
-
Robertson, Dale M.; Saad, D.A.
1996-01-01
To fulfill the goals of the NAWQA program, the USGS plans to examine 60 areas (study units) across the United States during full implementation of the program. In 1991, the NAWQA program went into full implementation with the intensive investigation of 20 of these study units; one of these study units is the Western Lake Michigan Drainages (WMIC) study unit.
-
Quality/Performance Circles Three Years after Implementation.
ERIC Educational Resources Information Center
Ladwig, Dennis J.
An overview is provided of the development of quality/performance circles at Lakeshore Technical Institute (LTI), Wisconsin, and of the projects undertaken through the quality/performance circle program during its 3-year history. First, background information is provided on the use of quality circles in Japan and the United States, including…
-
42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.
Code of Federal Regulations, 2013 CFR
2013-10-01
... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...
-
42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.
Code of Federal Regulations, 2014 CFR
2014-10-01
... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...
-
42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.
Code of Federal Regulations, 2012 CFR
2012-10-01
... quality improvement and patient safety, including the reduction of medical errors, is defined, implemented... address priorities for improved quality of care and patient safety; and that all improvement actions are... incorporate quality indicator data including patient care data, and other relevant data, for example...
-
40 CFR 194.22 - Quality assurance.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Quality assurance. 194.22 Section 194... General Requirements § 194.22 Quality assurance. (a)(1) As soon as practicable after April 9, 1996, the Department shall adhere to a quality assurance program that implements the requirements of ASME NQA-1-1989...
-
EVALUATING POINT-NONPOINT SOURCE WATER QUALITY TRADING IN A RARITAN RIVER BASIN SUB-WATERSHED
This project addresses water quality issues in the Raritan River Basin of New Jersey. It will build upon an existing study that determined the technical feasibility of implementing a point-nonpoint source water quality trading program in the Basin. Water quality trading is ...
-
Bradshaw, Kelsey M.; Donohue, Brad; Wilks, Chelsey
2014-01-01
Errors have been found to frequently occur in the management of case records within mental health service systems. In cases involving interpersonal violence, such errors have been found to negatively impact service implementation and lead to significant trauma and fatalities. In an effort to ensure adherence to specified standards of care, quality assurance programs (QA) have been developed to monitor and enhance service implementation. These programs have generally been successful in facilitating record management. However, these systems are rarely disseminated, and not well integrated. Therefore, within the context of interpersonal violence, we provide an extensive review of evidence supported record keeping practices, and methods to assist in assuring these practices are implemented with adherence. PMID:24976786
-
Quality assurance, an administrative means to a managerial end: Part I. A historical overview.
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.
-
... Air Toxics Website Rules and Implementation Related Information Air Quality Data and Tools Clean Air Act Criteria Air ... Resources Visibility and Haze Voluntary Programs for Improving Air Quality Contact Us to ask a question, provide feedback, ...
-
Canal, David F; Torbeck, Laura; Djuricich, Alexander M
2007-05-01
Surgery residents can learn continuous quality improvement (CQI) principles within a structured curriculum and propose quality improvement projects. Curriculum within a surgical residency program. A university surgical residency program with multiple hospital training sites. Fifteen surgical residents during the dedicated research year. A curriculum in CQI that focuses on devising a quality improvement project. Resident self-reported attitudes about quality improvement and implementation of resident-initiated quality improvement projects. Resident survey data demonstrated an improvement in knowledge, self-efficacy, and experiences within CQI. Fifteen individual residents, within smaller teams, created 4 quality improvement projects worthy of implementation. A structured CQI curriculum can be successfully integrated into a general surgery residency program. Residents can learn the skill of constructing CQI project ideas within the framework of the plan-do-study-act cycle. Residents are eager to make improvements in their local system of residency. By giving them the tools to critically investigate systems improvement and a much needed ear to hear their concerns and suggestions for improvement, we found ways to potentially enhance patient care and developed ideas to improve the education of future surgeons. In doing so, we provided the residents with "buy-in" into their residency program, while addressing the competency of practice-based learning and improvement required by the Accreditation Council for Graduate Medical Education for resident education.
-
Chamnan, Parinya; Boonlert, Kittipa; Pasi, Wanit; Yodsiri, Songkran; Pong-on, Sirinya; Khansa, Bhoonsab; Yongkulwanitchanan, Pichapat
2010-03-01
Despite the availability of effective medical treatment and disease management guidelines, asthma remains a poorly controlled disease in developing countries. There is little evidence of the effectiveness of disease management guidelines in rural clinical practice. The effect of disease management guidelines on clinical outcomes and quality of life in asthmatic patients in a rural community hospital was examined. Fifty-seven patients aged > or = 16 years with physician-diagnosed asthma from a hospital outpatient clinic in Ubon-ratchathani, Thailand, were recruited. Asthma diagnosis was confirmed by reviewing clinical records. We implemented a 12-week disease management program, including the use of written asthma treatment plan and asthma action plan tailored to individual patients. Using one-group pre- and post-intervention design, we compared the average number of emergency visits and hospitalizations from acute asthmatic attacks before and after the implementation of interventions using the Wilcoxon matched-pairs signed-rank test. We also compared patient's asthma quality of life (AQL) scores, measured using the 7-point scaled Mini Asthma Quality of Life Questionnaire. It was found that among the 57 patients, 38 (67%) were women, and the mean age (SD) of the patients was 47.6 (17.0) years. Sixteen patients (28%) had a family history of asthma. Emergency visits decreased from 0.48 (SD = 0.83) per patient before implementation of interventions to 0.11 (0.37) per patient after implementation of interventions (p = 0.003). Hospitalizations with acute asthma attacks reduced from 0.14 (0.35) per patient to 0.04 (0.27) per patient (p = 0.034). Overall AQL scores increased significantly from 3.7 to 5.4 (p < 0.001), with most improvement observed in symptoms and emotions. It was concluded that implementation of a 12-week asthma disease management program could reduce emergency visits and hospitalizations, and improve patients' quality of life in a rural practice setting.
-
Barriers to Implementing the ACGME Outcome Project: A Systematic Review of Program Director Surveys.
Malik, Mohammad U; Diaz Voss Varela, David A; Stewart, Charles M; Laeeq, Kulsoom; Yenokyan, Gayane; Francis, Howard W; Bhatti, Nasir I
2012-12-01
The Accreditation Council for Graduate Medical Education (ACGME) introduced the Outcome Project in July 2001 to improve the quality of resident education through competency-based learning. The purpose of this systematic review is to determine and explore the perceptions of program directors regarding challenges to implementing the ACGME Outcome Project. We used the PubMed and Web of Science databases and bibliographies for English-language articles published between January 1, 2001, and February 17, 2012. Studies were included if they described program directors' opinions on (1) barriers encountered when attempting to implement ACGME competency-based education, and (2) assessment methods that each residency program was using to implement competency-based education. Articles meeting the inclusion criteria were screened by 2 researchers. The grading criterion was created by the authors and used to assess the quality of each study. The survey-based data reported the opinions of 1076 program directors. Barriers that were encountered include: (1) lack of time; (2) lack of faculty support; (3) resistance of residents to the Outcome Project; (4) insufficient funding; (5) perceived low priority for the Outcome Project; (6) inadequate salary incentive; and (7) inadequate knowledge of the competencies. Of the 6 competencies, those pertaining to patient care and medical knowledge received the most responses from program directors and were given highest priority. The reviewed literature revealed that time and financial constraints were the most important barriers encountered when implementing the ACGME Outcome Project.
-
Experience with Designing and Implementing a Bundled Payment Program for Total Hip Replacement.
Whitcomb, Winthrop F; Lagu, Tara; Krushell, Robert J; Lehman, Andrew P; Greenbaum, Jordan; McGirr, Joan; Pekow, Penelope S; Calcasola, Stephanie; Benjamin, Evan; Mayforth, Janice; Lindenauer, Peter K
2015-09-01
Bundled payments, also known as episode-based payments, are intended to contain health care costs and promote quality. In 2011 a bundled payment pilot program for total hip replacement was implemented by an integrated health care delivery system in conjunction with a commercial health plan subsidiary. In July 2015 the Centers for Medicare & Medicaid Services (CMS) proposed the Comprehensive Care for Joint Replacement Model to test bundled payment for hip and knee replacement. Stakeholders were identified and a structure for program development and implementation was created. An Oversight Committee provided governance over a Clinical Model Subgroup and a Financial Model Subgroup. The pilot program included (1) a clinical model of care encompassing the period from the preoperative evaluation through the third postoperative visit, (2) a pricing model, (3) a program to share savings, and (4) a patient engagement and expectation strategy. Compared to 32 historical controls-patients treated before bundle implementation-45 post-bundle-implementation patients with total hip replacement had a similar length of hospital stay (3.0 versus 3.4 days, p=.24), higher rates of discharge to home or home with services than to a rehabilitation facility (87% versus 63%), similar adjusted median total payments ($22,272 versus $22,567, p=.43), and lower median posthospital payments ($704 versus $1,121, p=.002), and were more likely to receive guideline-consistent care (99% versus 95%, p=.05). The bundled payment pilot program was associated with similar total costs, decreased posthospital costs, fewer discharges to rehabilitation facilities, and improved quality. Successful implementation of the program hinged on buy-in from stakeholders and close collaboration between stakeholders and the clinical and financial teams.
-
Challenges and Opportunities of Air Quality Management in Mexico City
NASA Astrophysics Data System (ADS)
Paramo, V.
2013-05-01
The Mexico City Metropolitan Area (MCMA) is located in the central plateau of Mexico and is the capital of the country. Its natural characteristics present favorable conditions for air pollution formation and accumulation: mountains surrounding the city, frequent thermal inversions, high isolation all around the year and weak winds. To these natural conditions, a population of more than 20 million inhabitants, a fleet of 4.5 million vehicles and more than 4 thousands industries, make air quality management a real challenge for governments of the region. Intensive air quality improvement actions and programs began at the end of the 1980's and continued nowadays. Since then criteria air pollutants concentrations have decreased in such a way that currently most of pollutants meet the Mexican air quality standards, except for ozone and particulate matter. Applied measures comprised of fuel quality improvements, fuel replacements, regulations for combustion processes, closing of high polluting refineries and industries, regulations of emissions for new and on road vehicles, mandatory I/M programs for vehicles, circulation restrictions for vehicles (Day without car program), alert program for elevated air pollution episodes, improvement of public transportation, among others. Recent researches (MILAGRO 2006 campaign) found that currently it is necessary to implement emissions reduction actions for Volatile Organic Compounds, particulate matter with a diameter of less than 2.5 micrometers PM2.5 and Nitrogen Oxides, in order to reduce concentrations of ozone and fine particulate matter. Among the new measures to be implemented are: regulations for VOCs emissions in the industry and commercial sectors; regulation of the diesel fleet that includes fleets renewal, filters and particulate traps for in use vehicles and regulation of the cargo fleet; new schemes for reducing the number of vehicles circulating in the city; implementation of non-motorized mobility programs; among others.
-
ERIC Educational Resources Information Center
Swanson, Richard A.; Sleezer, Catherine M.
The AMSCO culture survey instrument was developed to obtain specific information about the changing employee values resulting from the implementation of the new quality programs at AMSCO, Rice Lake, Wisconsin. The culture dimensions measured in the survey included job evaluation/job satisfaction, work efficiency, training and development,…
-
ERIC Educational Resources Information Center
Barczyk, Casimir; Buckenmeyer, Janet; Feldman, Lori
2010-01-01
This article presents a four-stage model for mentoring faculty in higher education to deliver high quality online instruction. It provides a timeline that shows the stages of program implementation. Known as the Distance Education Mentoring Program, its major outcomes include certified instructors, student achievement, and the attainment of a…
-
Going the Distance: Delivery of High School Drug Prevention via Distance Education
ERIC Educational Resources Information Center
Wyrick, David L.; Fearnow-Kenney, Melodie; Wyrick, Cheryl Haworth; Orsini, Muhsin Michael; Strack, Robert W.; Milroy, Jeffrey J.
2010-01-01
The purpose of this project was to develop a technology that can be used in schools where there are insufficient resources to implement a quality drug prevention program. The specific technology--distance education via teleconferencing--allows a highly qualified teacher to deliver programs in such settings with increased quality. A promising high…
-
Internet Service Cognition and Use, and Their Promotion of Quality of Life in Taiwan
ERIC Educational Resources Information Center
Liang, Te-Hsin
2011-01-01
The "e-Taiwan Program" implemented by Taiwan government is aimed at showing the e-advantage in people's life and bring about essential benefits. This research follows the e-Life indicators of the Quality of Life measurement system developed by "e-Taiwan Program", which including four major dimensions of e-Daily Life,…
-
Developing a Quality Improvement Process to Optimize Faculty Success
ERIC Educational Resources Information Center
Merillat, Linda; Scheibmeir, Monica
2016-01-01
As part of a major shift to embed quality improvement processes within a School of Nursing at a medium-sized Midwestern university, a faculty enrichment program using a Plan-Do-Act-Study design was implemented. A central focus for the program was the development and maintenance of an online faculty resource center identified as "My Faculty…
-
ERIC Educational Resources Information Center
Mattern, Janet A.
2015-01-01
Participation in high quality early intervention programs is critical for eligible young children who experience atypical development for their future academic success. High quality programs promote access to services, incorporate instructional strategies that encourage children's participation, and advocate public policy that supports…
-
Andragogical Methods to Sustain Quality Adult Education in Ethiopia
ERIC Educational Resources Information Center
Seyoum, Yilfashewa; Basha, Garkebo
2017-01-01
This study aims to analyse the extent andragogy serves as a means to secure quality in adult education programs. It attempts to scrutinize how active learning methods are implemented effectively in adult education program in the Eastern part of Ethiopia. A survey research design was adapted as a method of the study. Stratified and purposive…
-
Unisys' experience in software quality and productivity management of an existing system
NASA Technical Reports Server (NTRS)
Munson, John B.
1988-01-01
A summary of Quality Improvement techniques, implementation, and results in the maintenance, management, and modification of large software systems for the Space Shuttle Program's ground-based systems is provided.
-
Maurer, Marsha; Browall, Pamela; Phelan, Cynthia; Sanchez, Sandra; Sulmonte, Kimberlyann; Wandel, Jane; Wang, Allison
2018-04-01
A daily management system (DMS) can be used to implement continuous quality improvement and advance employee engagement. It can empower staff to identify problems in the care environment that impact quality or work flow and to address them on a daily basis. Through a DMS, improvement becomes the work of everyone, every day. The authors of this 2-part series describe their work to develop a DMS. Part 2 describes the implementation and outcomes of the program.
-
FEASIBILITY STUDY ON EXECUTIVE PROGRAM DEVELOPMENT FOR BASIN ECOSYSTEMS MODELING
The project was undertaken in order to provide a feasibility study in developing and implementing a complete executive program to interface automatically various basin-wide water quality models for use by relatively inexperienced modelers. This executive program should ultimately...
-
Marketing Education Program Management Guide.
ERIC Educational Resources Information Center
Blair, Betty; And Others
This guide was designed for use by marketing education teacher-coordinators and administrators in implementing marketing education programs. The document includes the following: an overall picture of administrative responsibilities related to high quality programs, guidelines and forms needed to deliver effective instruction, resources and…
-
Implementation Differences of Two Staffing Models in the German Home Visiting Program "Pro Kind"
ERIC Educational Resources Information Center
Brand, Tilman; Jungmann, Tanja
2012-01-01
As different competencies or professional backgrounds may affect the quality of program implementation, staffing is a critical issue in home visiting. In this study, N = 430 women received home visits delivered either by a tandem of a midwife and a social worker or by only one home visitor (primarily midwives, continuous model). The groups were…
-
Barefield, Amanda C.; Meyer, John D.
2013-01-01
The proliferation of online education programs creates a myriad of challenges for those charged with implementation and delivery of these programs. Although creating and sustaining quality education is a shared responsibility of faculty, staff, and academic leaders, this article focuses on the pivotal role of leadership in securing the necessary resources, developing the organizational structures, and influencing organizational culture. The vital foundation for a successful outcome when implementing online education programs is the role of leadership in providing adequate and appropriate support. Abundant literature extols the roles of leadership in project management; however, there is a dearth of models or systematic methods for leaders to follow regarding how to implement and sustain online programs. Research conducted by the authors culminated in the development of an Administrative Support Matrix, thus addressing the current gap in the literature. PMID:23346030
-
Spahr, Norman E.; Driver, Nancy E.; Stephens, Verlin C.
1996-01-01
The U.S. Geological Survey began full implementation of the National Water-Quality Assessment (NAWQA) program in 1991. The long-term goals of the NAWQA program are to (1) describe current water-quality conditions for a large part of the Nation's freshwater streams, rivers, and aquifers; (2) describe how water quality is changing over time; and (3) improve understanding of the primary natural and human factors that affect water-quality conditions (Leahy and others, 1990). To meet these goals, 60 study units representing the Nation's most important river basins and aquifers are being investigated. The program design balances the unique assessment requirements of individual study units with a nationally consistent design structure that incorporates a multiscale, interdisciplinary approach for assessment of surface and ground water.
-
Prach, Lisa M; Puren, Adrian; Lippman, Sheri A; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott; Liegler, Teri
2015-03-01
An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
-
Weist, Mark D.; Youngstrom, Eric A.; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly
2013-01-01
Objective Reviews the progression of a research program designed to develop, implement and study the implementation of “achievable” evidence-based practices (EBPs) in schools. Reviews challenges encountered and ideas to overcome them to enhance this avenue of research. Method Presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on Personal Wellness. In both studies primary aims focused on changes in clinician attitudes and behavior, including the delivery of high quality, evidence-based practices and secondary aims focused on student level impacts. Results A number of challenges, many not reported in the literature are reviewed, and ideas for overcoming them are presented. Conclusions Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health (SMH) services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians. PMID:24063310
-
Weist, Mark D; Youngstrom, Eric A; Stephan, Sharon; Lever, Nancy; Fowler, Johnathan; Taylor, Leslie; McDaniel, Heather; Chappelle, Lori; Paggeot, Samantha; Hoagwood, Kimberly
2014-01-01
This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.
-
Busch, Alisa B; Huskamp, Haiden A; Normand, Sharon-Lise T; Young, Alexander S; Goldman, Howard; Frank, Richard G
2006-06-01
Since the 1990s, parity laws have been implemented to reduce inequities in mental health coverage compared with that for general medical conditions. It is unclear if parity under managed care is associated with improvements in mental health treatment quality. Major depressive disorder (MDD) is a prevalent but often undetected and undertreated and thus could potentially benefit from parity implementation. The objective of this study was to examine the association between parity implementation and changes in MDD treatment quality in the Federal Employees' Health Benefits (FEHB) Program. We conducted retrospective analyses of insurance claims data. Logistic regression models estimated quality changes for MDD-diagnosed enrollees from pre- to postparity. Subjects included MDD-diagnosed FEHB insured enrollees, aged 18-64, across multiple states and 6 FEHB plans before (1999-2000) and after (2001-2002) parity implementation. Measures included receipt of any antidepressant or psychotherapy within a given calendar year of diagnosis; receipt of appropriate psychotherapy frequency/intensity and duration; and pharmacotherapy duration during acute-phase treatment episodes. Postparity, several plans improved significantly in the likelihood of receiving antidepressant medication. In the acute-phase episodes, the greatest improvement was seen in the likelihood of follow up >or=4 months. Few or no other changes were observed in the acute-phase treatment intensity or duration quality measures. Parity under managed care was associated with modest improvements. The observed improvements were consistent with secular trends in MDD treatment. Whereas mental health parity is an important policy goal, these results highlight its limitations: improving the financing of care may not be sufficient to improve quality.
-
Implementation of a Quality Assurance Review System for the Scalable Development of Online Courses
ERIC Educational Resources Information Center
Ozdemir, Devrim; Loose, Rich
2014-01-01
With the growing demand for quality online education in the US, developing quality online courses and online programs, and more importantly maintaining this quality, have been an inevitable concern for higher education institutes. Current literature on quality assurance in online education mostly focuses on the development of review models and…
-
ERIC Educational Resources Information Center
Rucker, Ryan; Edwards, Karen; Frass, Lydia R.
2015-01-01
To ensure that online courses match traditional classes' quality, some institutions are implementing internal standards for online course design and quality review. The University of South Carolina created the Distributed Learning Quality Review program, based on "Quality Matters'" standards. It was designed to be faculty-guided, as…
-
Translational Research in South Africa: Evaluating Implementation Quality Using a Factorial Design
Smith, Edward A.; Collins, Linda M.; Graham, John W.; Lai, Mary; Wegner, Lisa; Vergnani, Tania; Matthews, Catherine; Jacobs, Joachim
2012-01-01
Background HealthWise South Africa: Life Skills for Adolescents (HW) is an evidence-based substance use and sexual risk prevention program that emphasizes the positive use of leisure time. Since 2000, this program has evolved from pilot testing through an efficacy trial involving over 7,000 youth in the Cape Town area. Beginning in 2011, through 2015, we are undertaking a new study that expands HW to all schools in the Metro South Education District. Objective This paper describes a research study designed in partnership with our South African collaborators that examines three factors hypothesized to affect the quality and fidelity of HW implementation: enhanced teacher training; teacher support, structure and supervision; and enhanced school environment. Methods Teachers and students from 56 schools in the Cape Town area will participate in this study. Teacher observations are the primary means of collecting data on factors affecting implementation quality. These factors address the practical concerns of teachers and schools related to likelihood of use and cost-effectiveness, and are hypothesized to be “active ingredients” related to high-quality program implementation in real-world settings. An innovative factorial experimental design was chosen to enable estimation of the individual effect of each of the three factors. Results Because this paper describes the conceptualization of our study, results are not yet available. Conclusions The results of this study may have both substantive and methodological implications for advancing Type 2 translational research. PMID:22707870
-
Italian quality assurance in mental health.
Rossi, Giovanni; Agnetti, Germana; Bosio, Roberto; De Luca, Pasquale; Erlicher, Arcadio; Morganti, Carla; Neri, Giovanni; Re, Edoardo; Semisa, Domenico; Fioritti, Angelo
2014-06-01
Since the radical changes in Italian mental health law in the 1970s, quality assurance models have gained consensus as the most suitable service assessment tool. In the 1990s, the whole Italian National Health System changed into a corporate model, and an accreditation system was implemented.The Italian Association for Quality and Accreditation in Mental Health (Associazione Italiana per la Qualità e l'Accreditamento in Salute Mentale [QUASM]) was founded in 1984, and since then, it offers consultation and support for Mental Health Departments and Regional Governments to help them to develop psychiatric programs, self-evaluation, educational programs, and professional peer-model accreditation. The QUASM accreditation manual has now gone through several revisions, the last in 2008. Until 2008, QUASM was successful in promoting quality and facilitating both institutional and professional accreditation. However, radical changes triggered by financial crisis have jeopardized quality assurance implementation. Nowadays, the challenge for QUASM is to maintain quality and accreditation geared to excellence against prevailing leveling trends.
-
Paying physician group practices for quality: A statewide quasi-experiment.
Conrad, Douglas A; Grembowski, David; Perry, Lisa; Maynard, Charles; Rodriguez, Hector; Martin, Diane
2013-12-01
This article presents the results of a unique quasi-experiment of the effects of a large-scale pay-for-performance (P4P) program implemented by a leading health insurer in Washington state during 2001-2007. The authors received external funding to provide an objective impact evaluation of the program. The program was unique in several respects: (1) It was designed dynamically, with two discrete intervention periods-one in which payment incentives were based on relative performance (the "contest" period) and a second in which payment incentives were based on absolute performance compared to achievable benchmarks. (2) The program was designed in collaboration with large multispecialty group practices, with an explicit run-in period to test the quality metrics. Public reporting of the quality scorecard for all participating medical groups was introduced 1 year before the quality incentive payment program's inception, and continued throughout 2002-2007. (3) The program was implemented in stages with distinct medical groups. A control group of comparable group practices also was assembled, and difference-in-differences methodology was applied to estimate program effects. Case mix measures were included in all multivariate analyses. The regression design permitted a contrast of intervention effects between the "contest" approach in the sub-period of 2003-2004 and the absolute standard, "achievable benchmarks of care" approach in sub-period 2005-2007. Most of the statistically significant quality incentive program coefficients were small and negative (opposite to program intent). A consistent pattern of differential intervention impact in the sub-periods did not emerge. Cumulatively, the probit regression estimates indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. Based on key informant interviews with medical leaders, practicing physicians, and administrators of the participating groups, the authors conclude that several factors likely combined to dampen program effects: (1) modest size of the incentive; (2) use of rewards only, rather than a balance of rewards and penalties; (3) targeting incentive payments to the group, thus potentially weakening incentive effects at the individual level. Copyright © 2013 Elsevier Inc. All rights reserved.
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
DiRenzo, J.F.; Rubin, R.B.
1978-03-01
The report was prepared in accordance with Section 108(f) of the Clean Air Act, as amended, August 1977. It is intended to assist urban areas in developing State Implementation Plans and integrating their transportation system management and air quality planning programs as required by FHWA, UMTA, and EPA. The report analyzes the air quality, travel, energy consumption, economic, and cost impacts of three types of transportation programs: priority treatment for high occupancy vehicles on freeways and arterials; areawide carpool and vanpool programs; and transit fare reductions and service improvements. Important factors (e.g., meteorological conditions, traffic volumes and speeds, and changesmore » in modal choice) likely to influence air quality and emissions for the above programs are also analyzed.« less
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-08-08
...EPA is finalizing a limited approval and limited disapproval of a state implementation plan (SIP) revision submitted by the State of California on November 17, 2007, to address the ``transport SIP'' provisions of Clean Air Act (CAA) section 110(a)(2)(D)(i) for the 1997 8-hour ozone National Ambient Air Quality Standards (NAAQS or standards) and the 1997 fine particulate matter (PM2.5) NAAQS. Section 110(a)(2)(D)(i) of the CAA requires that each SIP contain, among other things, adequate measures prohibiting emissions of air pollutants in amounts which will interfere with any other State's measures required under title I, part C of the CAA to prevent significant deterioration of air quality. EPA is approving California's SIP revision with respect to those Districts that implement SIP- approved permit programs meeting the approval criteria and simultaneously disapproving California's SIP revision with respect to those Districts that do not implement SIP-approved permit programs meeting the approval criteria, as discussed in our May 31, 2011 proposed rule (76 FR 31263).
-
Coaching to Enhance Quality of Implementation in Prevention
ERIC Educational Resources Information Center
Dusenbury, Linda; Hansen, William B.; Jackson-Newsom, Julia; Pittman, Donna S.; Wilson, Cicely V.; Nelson-Simley, Kathleen; Ringwalt, Chris; Pankratz, Melinda; Giles, Steven M.
2010-01-01
Purpose: The purpose of this paper is to describe the topics covered by coaches assisting teachers implementing a research-based drug prevention program and explore how coaching affects student outcomes. Design/methodology/approach: The All Stars drug prevention curriculum is implemented by 16 urban teachers who received four coaching sessions.…
-
Steps for Implementing a State-Level Professional Development Plan for Secondary Transition
ERIC Educational Resources Information Center
Mazzotti, Valerie L.; Rowe, Dawn A.; Simonsen, Monica; Boaz, Bonnie; VanAvery, Cynthia
2018-01-01
To scale up and sustain the use of evidence-based practices, it is imperative that state education agencies systematically implement professional development that represents best practice. By delivering quality professional development to local districts, it is more likely that transition personnel will implement transition programs and practices…
-
Day, Sara W.; McKeon, Leslie M.; Garcia, Jose; Wilimas, Judith A.; Carty, Rita M.; de Alarcon, Pedro; Antillon, Federico; Howard, Scott C.
2017-01-01
Background Inadequate nursing care is a major impediment to development of effective programs for treatment of childhood cancer in low-income countries. When the International Outreach Program at St. Jude Children’s Research Hospital established partner sites in low-income countries, few nurses had pediatric oncology skills or experience. A comprehensive nursing program was developed to promote the provision of quality nursing care, and in this manuscript we describe the program’s impact on 20 selected Joint Commission International (JCI) quality standards at the National Pediatric Oncology Unit in Guatemala. We utilized JCI standards to focus the nursing evaluation and implementation of improvements. These standards were developed to assess public hospitals in low-income countries and are recognized as the gold standard of international quality evaluation. Methods We compared the number of JCI standards met before and after the nursing program was implemented using direct observation of nursing care; review of medical records, policies, procedures, and job descriptions; and interviews with staff. Results In 2006, only 1 of the 20 standards was met fully, 2 partially, and 17 not met. In 2009, 16 were met fully, 1 partially, and 3 not met. Several factors contributed to the improvement. The pre-program quality evaluation provided objective and credible findings and an organizational framework for implementing change. The medical, administrative, and nursing staff worked together to improve nursing standards. Conclusion A systematic approach and involvement of all hospital disciplines led to significant improvement in nursing care that was reflected by fully meeting 16 of 20 standards. PMID:23015363
-
ERIC Educational Resources Information Center
Silver, Edward A.; Lane, Suzanne
Issues of educational equity and quality are explored in the context of the Quantitative Understanding: Amplifying Student Achievement and Reasoning (QUASAR) project, a national educational reform project aimed at fostering and studying the development and implementation of enhanced mathematics instructional programs for students attending middle…
-
Bradley, W G; Daube, J; Mendell, J R; Posner, J; Richman, D; Troost, B T; Swift, T R
1997-11-01
The neurology residency programs in the United States are facing a crisis of quality. The Association of University Professors of Neurology (AUPN) approved the Quality Improvement Committee to examine this situation and make recommendations, which have been accepted by the AUPN. The recommendations are (1) that the educational goals of neurology residency training be dissociated from patient-care needs in academic medical centers and (2) that minimum levels of quality be applied to residents in neurology residency programs and to these programs themselves. These minimum criteria should include minimum educational criteria for entry into the program, minimum criteria for advancement from one year to the next in the program, and minimum criteria for performance of the graduates of neurology residency programs for program accreditation. The implementation of these recommendations will require a shift of funding of the care of indigent patients from the graduate medical education budget to direct patient-care sources. These recommendations will significantly improve the quality of neurologists and neurologic care in the United States.
-
Total quality management in the hospital setting.
Ernst, D F
1994-01-01
With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-07
... ``its Draft Economic Incentives Program Guidance is relevant to this rulemaking.'' Sierra Club states... Economic Incentive Program Guidance and in program-specific guidance that more directly addresses specific... Economic Incentives Program Guidance. Comment: Sierra Club comments that, ``the emission limits proposed by...
-
Home-Start between Childhood and Maturity: A Programme Evaluation.
ERIC Educational Resources Information Center
Terpstra, Linda; van Dijke, Anke
A crucial question for evaluating nationally or internationally implemented programs is whether local adaptations detract from program quality and effectiveness. An evaluation examined the program successes and challenges encountered in the first 5 years of Home-Start in the Netherlands, a home-based family support program for families with young…
-
Development and Operation of a Voluntary Audit Program.
ERIC Educational Resources Information Center
Murphy, Jerome R.
This report describes a voluntary audit program implemented by the Educational Testing Service (ETS). The comprehensive audit program was developed to assure that all corporate programs adhere to the ETS Standards for Quality and Fairness. The standards address issues which relate to all ETS activities such as accountability, confidentiality of…
-
Vocational Education Administration Handbook. Edition #2.
ERIC Educational Resources Information Center
Cropley, Russell, Ed.; Doherty, Susan Sloan, Ed.
This handbook clarifies the elements of a vocational education program and provides direction to help the administrators of Alaska's vocational programs to plan and implement high quality programs. The handbook provides information on the regulations and standards for vocational programs. The handbook is organized in three parts. Part 1 provides…
-
A Systems Engineering Approach to Quality Assurance for Aerospace Testing
NASA Technical Reports Server (NTRS)
Shepherd, Christena C.
2014-01-01
On the surface, it appears that AS9100 has little to say about how to apply a Quality Management System (QMS) to major aerospace test programs (or even smaller ones). It also appears that there is little in the quality engineering Body of Knowledge (BOK) that applies to testing, unless it is nondestructive examination (NDE), or some type of lab or bench testing associated with the manufacturing process. However, if one examines: a) how the systems engineering (SE) processes are implemented throughout a test program; and b) how these SE processes can be mapped to the requirements of AS9100, a number of areas for involvement of the quality professional are revealed. What often happens is that quality assurance during a test program is limited to inspections of the test article; what could be considered a manufacturing al fresco approach. This limits the quality professional and is a disservice to the programs and projects, since there are a number of ways that quality can enhance critical processes, and support efforts to improve risk reduction, efficiency and effectiveness. The Systems Engineering (SE) discipline is widely used in aerospace to ensure the progress from Stakeholder Expectations (the President, Congress, the taxpayers) to a successful, delivered product or service. Although this is well known, what is not well known is that these same SE processes are implemented in varying complexity, to prepare for and implement test projects that support research, development, verification and validation, qualification, and acceptance test projects. Although the test organization's terminology may vary from the SE terminology, and from one test service provider to another, the basic process is followed by successful, reliable testing organizations. For this analysis, NASA Procedural Requirements (NPR) 7123.1, NASA Systems Engineering Processes and Requirements is used to illustrate the SE processes that are used for major aerospace testing. Many of these processes are also implemented for smaller test projects, and this set of processes will also look familiar to those who have participated in launch site activation and flight demonstrations.
-
Napa River Sediment TMDL Implementation and Habitat Enhancement Project
Information about the SFBWQP Napa River Sediment TMDL Implementation and Habitat Enhancement Project, part of an EPA competitive grant program to improve SF Bay water quality focused on restoring impaired waters and enhancing aquatic resources.
-
40 CFR 131.42 - Antidegradation Implementation Methods for the Commonwealth of Puerto Rico.
Code of Federal Regulations, 2011 CFR
2011-07-01
... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality... antidegradation review shall be initiated as part of the Section 401—“Water Quality Certification Process” of the... February 2, 1989 Resolution R-89-2-2 of the Governing Board of the Puerto Rico Environmental Quality Board...
-
40 CFR 131.42 - Antidegradation Implementation Methods for the Commonwealth of Puerto Rico.
Code of Federal Regulations, 2014 CFR
2014-07-01
... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality... antidegradation review shall be initiated as part of the Section 401—“Water Quality Certification Process” of the... February 2, 1989 Resolution R-89-2-2 of the Governing Board of the Puerto Rico Environmental Quality Board...
-
40 CFR 131.42 - Antidegradation Implementation Methods for the Commonwealth of Puerto Rico.
Code of Federal Regulations, 2012 CFR
2012-07-01
... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality... antidegradation review shall be initiated as part of the Section 401—“Water Quality Certification Process” of the... February 2, 1989 Resolution R-89-2-2 of the Governing Board of the Puerto Rico Environmental Quality Board...
-
40 CFR 131.42 - Antidegradation Implementation Methods for the Commonwealth of Puerto Rico.
Code of Federal Regulations, 2013 CFR
2013-07-01
... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality... antidegradation review shall be initiated as part of the Section 401—“Water Quality Certification Process” of the... February 2, 1989 Resolution R-89-2-2 of the Governing Board of the Puerto Rico Environmental Quality Board...
-
40 CFR 131.42 - Antidegradation Implementation Methods for the Commonwealth of Puerto Rico.
Code of Federal Regulations, 2010 CFR
2010-07-01
... PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Federally Promulgated Water Quality... antidegradation review shall be initiated as part of the Section 401—“Water Quality Certification Process” of the... February 2, 1989 Resolution R-89-2-2 of the Governing Board of the Puerto Rico Environmental Quality Board...
-
Eliopoulos, Charlotte
2013-01-01
A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.
-
Integrated Analysis Tools for the NERRS System-Wide Monitoring Program Data
Standardized monitoring programs have vastly improved the quantity and quality of data that form the basis of environmental decision-making. One example is the NOAA-funded National Estuarine Research Reserve System (NERRS) System-wide Monitoring Program (SWMP) that was implement...
-
National water-quality assessment program : the Albemarle- Pamlico drainage
Lloyd, O.B.; Barnes, C.R.; Woodside, M.D.
1991-01-01
In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. Long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water quality information that will be useful to policy makers and managers at the national, State, and local levels. Study-unit investigations constitute a major component of the NAWQA program, forming the principal building blocks on which national-level assessment activities are based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Albemarle-Pamlico drainage was among the first 20 NAWQA study units selected for study under the full-scale implementation plan. The Albemarle-Pamlico drainage study will examine the physical, chemical, and biological aspects of water quality issues in a coordinated investigation of surface water and ground water in the Albemarle-Pamlico drainage basin. The quantity and quality of discharge from the Albemarle-Pamlico drainage basin contribute to some water quality problems in the biologically sensitive waters of Albemarle and Pamlico Sounds. A retrospective analysis of existing water quality data will precede a 3-year period of intensive data-collection and analysis activities. The data resulting from this study and the improved understanding of important processes and issues in the upstream part of the study unit will enhance understanding of the quality of water in Albemarle-Pamlico Sounds, the second largest estuarine system in the United States.
-
ERIC Educational Resources Information Center
Dumont, Richard G.; And Others
A multiple-indicator and multiple-design approach for evaluating the quality of basic skills programs in reading, writing, and mathematics that has been implemented within a statewide system of higher education in the southeastern United States was assessed. Several of the evaluation methodologies are compared in order to determine whether results…
-
ERIC Educational Resources Information Center
McClanahan, Wendy; Hartmann, Tracey A.
2017-01-01
As part of an ongoing, multi-million dollar Wallace Foundation initiative to improve and expand arts learning opportunities for young people, the Wallace Foundation, in partnership with the Boys & Girls Clubs of America (BGCA), developed the Youth Arts Initiative (YAI) to deliver otherwise inaccessible high-quality arts programs to low-income…
-
Begnaud, Abbie; Hall, Thomas; Allen, Tadashi
2016-01-01
Screening for lung cancer with low-dose CT has evolved rapidly in recent years since the National Lung Screening Trial (NLST) results. Subsequent professional and governmental organization guidelines have shaped policy and reimbursement for the service. Increasingly available guidance describes eligible patients and components necessary for a high-quality lung cancer screening program; however, practical instruction and implementation experience is not widely reported. We launched a lung cancer screening program in the face of reimbursement and guideline uncertainties at a large academic health center. We report our experience with implementation, including challenges and proposed solutions. Initially, we saw less referrals than expected for screening, and many patients referred for screening did not clearly meet eligibility guidelines. We educated primary care providers and implemented system tools to encourage referral of eligible patients. Moreover, in response to the Centers for Medicare & Medicaid Services (CMS) final coverage determination, we report our programmatic adaptation to meet these requirements. In addition to the components common to all quality programs, individual health delivery systems will face unique barriers related to patient population, available resources, and referral patterns.
-
Hallfors, D; Godette, D
2002-08-01
This study examines adoption and implementation of the US Department of Education's new policy, the 'Principles of Effectiveness', from a diffusion of innovations theoretical framework. In this report, we evaluate adoption in relation to Principle 3: the requirement to select research-based programs. Results from a sample of 104 school districts in 12 states indicate that many districts appear to be selecting research-based curricula, but that the quality of implementation is low. Only 19% of the responding district coordinators indicated that schools were implementing a research-based curriculum with fidelity. Common problems included lack of teacher training, lack of requisite materials, use of some but not all of the required lessons and teaching strategies, and failure to deliver lessons to age-appropriate student groups. This study represents the first attempt to assess the quality of implementation of research-based programs as required by the Principles of Effectiveness. We conclude that low levels of funding, inadequate infrastructure, decentralized decision making and lack of program guidance have contributed to the slow progress in improving school-based prevention.
-
Paranoia.Ada: Sample output reports
NASA Technical Reports Server (NTRS)
1986-01-01
Paranoia.Ada is a program to diagnose floating point arithmetic in the context of the Ada programming language. The program evaluates the quality of a floating point arithmetic implementation with respect to the proposed IEEE Standards P754 and P854. Paranoia.Ada is derived from the original BASIC programming language version of Paranoia. The Paranoia.Ada replicates in Ada the test algorithms originally implemented in BASIC and adheres to the evaluation criteria established by W. M. Kahan. Paranoia.Ada incorporates a major structural redesign and employs applicable Ada architectural and stylistic features.
-
Meerhoff, Guus A; van Dulmen, Simone A; Maas, Marjo J M; Heijblom, Karin; Nijhuis-van der Sanden, Maria W G; Van der Wees, Philip J
2017-08-01
In 2013, the Royal Dutch Society for Physical Therapy launched the program "Quality in Motion." This program aims to collect data from electronic health record systems in a registry that is fed back to physical therapists, facilitating quality improvement. The purpose of this study was to describe the development of an implementation strategy for the program and to evaluate the feasibility of building a registry and implementing patient-reported outcome measures (PROMs) in physical therapist practices. A stepwise approach using mixed methods was established in 3 consecutive pilots with 355 physical therapists from 66 practices. Interim results were evaluated using quantitative data from a self-assessment questionnaire and the registry and qualitative data from 21 semistructured interviews with physical therapists. Descriptive statistics and McNemar's symmetry chi-squared test were used to summarize the feasibility of implementing PROMs. PROMs were selected for the 5 most prevalent musculoskeletal conditions in Dutch physical therapist practices. A core component of the implementation strategy was the introduction of knowledge brokers to support physical therapists in establishing the routine use of PROMs in clinical practice and to assist in executing peer assessment workshops. In February 2013, 30.3% of the physical therapist practices delivered 4.4 completed treatment episodes per physical therapist to the registry; this increased to 92.4% in November 2014, delivering 54.1 completed patient episodes per physical therapist. Pre- and posttreatment PROM use increased from 12.2% to 39.5%. It is unclear if the participating physical therapists reflect a representative sample of Dutch therapists. Building a registry and implementing PROMs in physical therapist practices are feasible. The routine use of PROMs needs to increase to ensure valid feedback of outcomes. Using knowledge brokers is promising for implementing the program via peer assessment workshops. © 2017 American Physical Therapy Association
-
40 CFR 130.5 - Continuing planning process.
Code of Federal Regulations, 2010 CFR
2010-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...
-
40 CFR 132.1 - Scope, purpose, and availability of documents.
Code of Federal Regulations, 2012 CFR
2012-07-01
... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...
-
40 CFR 132.1 - Scope, purpose, and availability of documents.
Code of Federal Regulations, 2011 CFR
2011-07-01
... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...
-
40 CFR 132.1 - Scope, purpose, and availability of documents.
Code of Federal Regulations, 2014 CFR
2014-07-01
... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...
-
40 CFR 132.1 - Scope, purpose, and availability of documents.
Code of Federal Regulations, 2013 CFR
2013-07-01
... PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.1 Scope, purpose, and availability of documents. (a) This part constitutes the Water Quality Guidance for the Great Lakes System (Guidance... identifies minimum water quality standards, antidegradation policies, and implementation procedures for the...
-
Quality Assurance in Online Content Literacy Methods Courses
ERIC Educational Resources Information Center
Marsh, Josephine P.; Lammers, Jayne C.; Alvermann, Donna E.
2012-01-01
As institutions offer more online courses in their teacher certification and literacy master's programs, research is needed to address issues of quality assurance in online instruction. This multicase study analyzes qualitatively elements for addressing quality assurance of the implementation of an online content literacy teacher education course…
-
40 CFR 130.5 - Continuing planning process.
Code of Federal Regulations, 2011 CFR
2011-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...
-
40 CFR 130.5 - Continuing planning process.
Code of Federal Regulations, 2014 CFR
2014-07-01
... QUALITY PLANNING AND MANAGEMENT § 130.5 Continuing planning process. (a) General. Each State shall... the Act. Each State is responsible for managing its water quality program to implement the processes... quality standards in effect under authority of section 303 of the Act. (2) The process for incorporating...
-
Resident duty hours: a survey of internal medicine program directors.
Garg, Megha; Drolet, Brian C; Tammaro, Dominick; Fischer, Staci A
2014-10-01
In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards. A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey. Contact information was identified for 323 IMPDs. Three individualized emails were sent to each director over a 6-week period, requesting participation in the survey. Outcomes measured included approval of duty hours regulations, as well as perceptions of changes in graduate medical education and patient care resulting from the revised ACGME standards. A total of 237 surveys were returned (73% response rate). More than half of the IMPDs (52%) reported "overall" approval of the 2011 duty hour regulations, with greater than 70% approval of all individual regulations except senior resident daily duty periods (49% approval) and 16-hour intern shifts (17% approval). Although a majority feel resident quality of life has improved (55%), most IMPDs believe that resident education (60%) is worse. A minority report that quality (8%) or safety (11%) of patient care has improved. One year after implementation of new ACGME duty hour requirements, IMPDs report overall approval of the standards, but strong disapproval of 16-hour shift limits for interns. Few program directors perceive that the duty hour restrictions have resulted in better care for patients or education of residents. Although resident quality of life seems improved, most IMPDs report that their own workload has increased. Based on these results, the intended benefits of duty hour regulations may not yet have been realized.
-
Akins, Ralitsa B.; Handal, Gilbert A.
2009-01-01
Objective Although there is an expectation for outcomes-oriented training in residency programs, the reality is that few guidelines and examples exist as to how to provide this type of education and training. We aimed to improve patient care outcomes in our pediatric residency program by using quality improvement (QI) methods, tools, and approaches. Methods A series of QI projects were implemented over a 3-year period in a pediatric residency program to improve patient care outcomes and teach the residents how to use QI methods, tools, and approaches. Residents experienced practice-based learning and systems-based assessment through group projects and review of their own patient outcomes. Resident QI experiences were reviewed quarterly by the program director and were a mandatory part of resident training portfolios. Results Using QI methodology, we were able to improve management of children with obesity, to achieve high compliance with the national patient safety goals, improve the pediatric hotline service, and implement better patient flow in resident continuity clinic. Conclusion Based on our experiences, we conclude that to successfully implement QI projects in residency programs, QI techniques must be formally taught, the opportunities for resident participation must be multiple and diverse, and QI outcomes should be incorporated in resident training and assessment so that they experience the benefits of the QI intervention. The lessons learned from our experiences, as well as the projects we describe, can be easily deployed and implemented in other residency programs. PMID:21975995
-
ERIC Educational Resources Information Center
Li, Jennifer; Steele, Jennifer; Slater, Robert; Bacon, Michael; Miller, Trey
2016-01-01
Many educators and policy makers look to two-way dual language immersion as one of the most promising options to close achievement gaps for English learners. However, the programs' effectiveness depends on the quality of their implementation. This article reports on a large-scale study of the implementation of dual language immersion across a…
-
ERIC Educational Resources Information Center
Ayala, Gabriela Cota; Real, Francia Angélica Karlos; Ivan, Ramirez Alvarado Edqar
2016-01-01
The research was conducted to determine if the study program of the career of industrial processes Technological University of Chihuahua, 1 year after that it was certified by CACEI, continues achieving the established indicators and ISO 9001: 2008, implementing quality tools, monitoring of essential indicators are determined, flow charts are…
-
ERIC Educational Resources Information Center
Valentine, Kylie; Thomson, Cathy
2009-01-01
This paper describes the facilitators and barriers to implementing an attachment-based intervention in early education and care settings, the Partnerships in Early Childhood program (PIEC), based on findings from the process evaluation of its first year of implementation. The paper focuses on four areas: the nature of the partnership and program…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-25
..., revisions to the State of Iowa's State Implementation Plan (SIP), Title V program, and Clean Air Act (CAA..., subject to the requirements of sections 111(d) and 129 of the CAA, do not exist in the State; and... changes to the Title V program, pursuant to section 500 of the CAA. DATES: This rule is effective December...
-
Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.
Vandenberg, Ann E; Stevens, Melissa; Echt, Katharina V; Hastings, S Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P
2016-04-01
The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs.
-
75 FR 18788 - Malcolm Baldrige National Quality Award Panel of Judges and Board of Overseers
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-13
... the fields of quality, innovation, and performance management and appointed by the Secretary of..., Baldrige Program Changes in 2010 and 2011, and Implementation of the Strategic Plan Actions. DATES: The...
-
Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts
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.
-
ERIC Educational Resources Information Center
Robinson, Daniel J.
2017-01-01
Quality measurement tools such as the Rubric for Online Instruction (ROI) and Quality Matters (QM) have developed guidelines by providing research based educational criteria for planning, creating, and implementing quality online education courses. This dissertation reviews QM program standards and identifies the primary characteristics of…
-
Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando
2014-01-01
Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.
-
Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando
2014-01-01
Introduction Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. Objective To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Results Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases. PMID:24896168
-
Radiation protection program for early detection of breast cancer in a mammography facility
NASA Astrophysics Data System (ADS)
Villagomez Casimiro, Mariana; Ruiz Trejo, Cesar; Espejo Fonseca, Ruby
2014-11-01
Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1-4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)- presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.
-
The impact of the TelEmergency program on rural emergency care: An implementation study.
Sterling, Sarah A; Seals, Samantha R; Jones, Alan E; King, Melissa H; Galli, Robert L; Isom, Kristen C; Summers, Richard L; Henderson, Kristi A
2017-07-01
Introduction Timely, appropriate intervention is key to improving outcomes in many emergent conditions. In rural areas, it is particularly challenging to assure quality, timely emergency care. The TelEmergency (TE) program, which utilizes a dual nurse practitioner and emergency medicine-trained, board-certified physician model, has the potential to improve access to quality emergency care in rural areas. The objective of this study was to examine how the implementation of the TE program impacts rural hospital Emergency Department (ED) operations. Methods Methods included a before and after study of the effect of the TE program on participating rural hospitals between January 2007 and December 2008. Data on ED and hospital operations were collected one year prior to and one year following the implementation of TE. Data from participating hospitals were combined and compared for the two time periods. Results Nine hospitals met criteria for inclusion and participated in the study. Total ED volumes did not significantly change with TE implementation, but ED admissions to the same rural hospital significantly increased following TE implementation (6.7% to 8.1%, p-value = 0.02). Likewise, discharge rates from the ED declined post-initiation (87.1% to 80.0%, p-value = 0.003). ED deaths and transfer rates showed no significant change, while the rate of patient discharge against medical advice significantly increased with TE use. Discussion In this analysis, we found a significant increase in the rate of ED admissions to rural hospitals with TE use. These findings may have important implications for the quality of emergency care in rural areas and the sustainability of rural hospitals' EDs.
-
Jaime, M C D; Stocking, M; Freire, K; Perkinson, L; Ciaravino, S; Miller, E
2016-12-01
'Coaching Boys into Men' is an evidence-based dating violence prevention program for coaches to implement with male athletes. A common adaptation of this program is delivery by domestic violence and sexual violence prevention advocates instead of coaches. We explored how this implementer adaptation may influence athlete uptake of program messages and outcomes. Randomly, one school received the program delivered by an advocate while another school received the program delivered by coaches. Athletes completed baseline and follow-up surveys (n = 148), and a subset who received the advocate-led program participated in focus groups (four groups; n = 26). We compared changes in athlete attitudes and behaviors and conducted thematic analyses with qualitative data. We found no significant differences between athletes who received the program from the advocate versus their coaches. Athletes highlighted the advocate's delivery and role as a non-judgmental adult ally as qualities that influenced their uptake of program messages. The acceptability of the advocate-led program may be related to the implementer type along with specific implementer characteristics and delivery methods. Using advocates together with coaches as implementers could increase the reach of this program. Further study of best practices for Coaching Boys into Men adaptation is needed to guide program dissemination and sustainability. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
-
Indoor Air Quality: Maryland Public Schools.
ERIC Educational Resources Information Center
Maryland State Dept. of Education, College Park. Office of Administration and Finance.
Less than adequate indoor air quality in schools can lead to a higher risk of health problems, an increase in student and teacher absenteeism, diminished learning, and even hazardous conditions. An indoor air quality program that addresses the planning, design, maintenance, and operation of public school buildings should be implemented at the…
-
Implementation Science: Understanding and Finding Solutions to Variation in Program Implementation
ERIC Educational Resources Information Center
Nordstrum, Lee E.; LeMahieu, Paul G.; Berrena, Elaine
2017-01-01
Purpose: This paper is one of seven in this volume elaborating upon different approaches to quality improvement in education. This paper aims to delineate a methodology called Implementation Science, focusing on methods to enhance the reach, adoption, use and maintenance of innovations and discoveries in diverse education contexts.…
-
ERIC Educational Resources Information Center
Mincic, Melissa; Smith, Barbara J.; Strain, Phil
2009-01-01
Implementing the Pyramid Model with fidelity and achieving positive outcomes for children and their families requires that administrators understand their roles in the implementation process. Every administrative decision impacts program quality and sustainability. This Policy Brief underscores the importance of facilitative administrative…
-
ERIC Educational Resources Information Center
Wenz-Gross, Melodie; Upshur, Carole
2012-01-01
Research Findings: Preschool behavior problems are of increasing concern to early childhood educators. Preventive interventions are being developed, but implementation in underresourced child care programs is challenging. This study describes the implementation of an adapted Second Step curriculum to increase children's social skills and decrease…
-
Crossing the quality chasm in resource-limited settings.
Maru, Duncan Smith-Rohrberg; Andrews, Jason; Schwarz, Dan; Schwarz, Ryan; Acharya, Bibhav; Ramaiya, Astha; Karelas, Gregory; Rajbhandari, Ruma; Mate, Kedar; Shilpakar, Sona
2012-11-30
Over the last decade, extensive scientific and policy innovations have begun to reduce the "quality chasm"--the gulf between best practices and actual implementation that exists in resource-rich medical settings. While limited data exist, this chasm is likely to be equally acute and deadly in resource-limited areas. While health systems have begun to be scaled up in impoverished areas, scale-up is just the foundation necessary to deliver effective healthcare to the poor. This perspective piece describes a vision for a global quality improvement movement in resource-limited areas. The following action items are a first step toward achieving this vision: 1) revise global health investment mechanisms to value quality; 2) enhance human resources for improving health systems quality; 3) scale up data capacity; 4) deepen community accountability and engagement initiatives; 5) implement evidence-based quality improvement programs; 6) develop an implementation science research agenda.
-
Experience with Designing and Implementing a Bundled Payment Program for Total Hip Replacement
Whitcomb, Winthrop F.; Lagu, Tara; Krushell, Robert J.; Lehman, Andrew P.; Greenbaum, Jordan; McGirr, Joan; Pekow, Penelope S.; Calcasola, Stephanie; Benjamin, Evan; Mayforth, Janice; Lindenauer, Peter K.
2015-01-01
Background Bundled payments, also known as episode-based payments, are intended to contain health care costs and promote quality. In 2011 a bundled payment pilot program for total hip replacement was implemented by an integrated health care delivery system in conjunction with a commercial health plan subsidiary. In July 2015 the Centers for Medicare & Medicaid Services (CMS) proposed the Comprehensive Care for Joint Replacement Model to test bundled payment for hip and knee replacement. Methods Stakeholders were identified and a structure for program development and implementation was created. An Oversight Committee provided governance over a Clinical Model Subgroup and a Financial Model Subgroup. Results The pilot program included (1) a clinical model of care encompassing the period from the preoperative evaluation through the third postoperative visit, (2) a pricing model, (3) a program to share savings, and (4) a patient engagement and expectation strategy. Compared to 32 historical controls— patients treated before bundle implementation—45 post-bundle-implementation patients with total hip replacement had a similar length of hospital stay (3.0 versus 3.4 days, p = .24), higher rates of discharge to home or home with services than to a rehabilitation facility (87% versus 63%), similar adjusted median total payments ($22,272 versus $22,567, p = .43), and lower median posthospital payments ($704 versus $1,121, p = .002), and were more likely to receive guideline-consistent care (99% versus 95%, p = .05). Discussion The bundled payment pilot program was associated with similar total costs, decreased posthospital costs, fewer discharges to rehabilitation facilities, and improved quality. Successful implementation of the program hinged on buy-in from stakeholders and close collaboration between stakeholders and the clinical and financial teams. PMID:26289235
-
Measuring Teachers and Learners' Perceptions of the Quality of Their Online Learning Experience
ERIC Educational Resources Information Center
Gómez-Rey, Pilar; Barbera, Elena; Fernández-Navarro, Francisco
2016-01-01
This article explores the quality of the online learning experience based on the Sloan-C framework and the Online Learning Consortium's (OLC) quality scorecard. The OLC index has been implemented to evaluate quality in online programs from different perspectives. Despite this, the opinions of learners are ignored, and it is built using feedback…
-
40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures
Code of Federal Regulations, 2013 CFR
2013-07-01
... aquatic life criteria or values may be developed when: i. The local water quality characteristics such as... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Great Lakes Water Quality Initiative... (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. F Appendix F to...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-12
... devices necessary to collect data on ambient air quality, and programs to enforce the limitations. General...-hour ozone NAAQS, based on the most recent three years of complete, quality assured monitoring data... air quality monitoring data for the 3-year period must meet a data completeness requirement. The...
-
Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs
Freeman, Richard K.; Krasna, Mark J.
2015-01-01
Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed. PMID:26380186
-
Implementing effective and sustainable multidisciplinary clinical thoracic oncology programs.
Osarogiagbon, Raymond U; Freeman, Richard K; Krasna, Mark J
2015-08-01
Three models of care are described, including two models of multidisciplinary care for thoracic malignancies. The pros and cons of each model are discussed, the evidence supporting each is reviewed, and the need for more (and better) research into care delivery models is highlighted. Key stakeholders in thoracic oncology care delivery outcomes are identified, and the need to consider stakeholder perspectives in designing, validating and implementing multidisciplinary programs as a vehicle for quality improvement in thoracic oncology is emphasized. The importance of reconciling stakeholder perspectives, and identify meaningful stakeholder-relevant benchmarks is also emphasized. Metrics for measuring program implementation and overall success are proposed.
-
Wangsness, David J.
1997-01-01
In the 1980s it was determined that existing ambient and compliance-monitoring data could not satisfactorily evaluate the results of hundreds of billions of dollars spent for water-pollution abatement in the United States. At the request of the US Congress, a new programme, the National Water-Quality Assessment, was designed and implemented by government agency, the US Geological Survey (USGS). The Assessment has reported status and trends in surface- and ground-water quality at national, regional, and local scales since 1991. The legislative basis for US monitoring and data-sharing policies are identified as well as the successive phases of the design and implementation of the USGS Assessment. Application to the Danube Basin is suggested. Much of the water-quality monitoring conducted in the United States is designed to comply with Federal and State laws mandated primarily by the Clean Water Act of 1987 and the Safe Drinking Water Act of 1986. Monitoring programs generally focus on rivers upstream and downstream of point-source discharges and at water-supply intakes. Few data are available for aquifer systems, and chemical analyses are often limited to those constituents required by law. In most cases, the majority of the available chemical and streamflow data have provided the information necessary to meet the objectives of the compliance-monitoring programs, but do not necessarily provide the information requires for basin-wide assessments of the water quality at the local, regional, or national scale.
-
Sanchez, Michael A.; Rimer, Barbara K.; Samet, Jonathan M.; Glasgow, Russell E.
2014-01-01
Implementation Science is a set of tools, principles and methodologies that can be used to bring scientific evidence into action, improve health care quality and delivery and improve public health. As the burden of cancer increases in low- and middle-income countries, it is important to plan cancer control programs that are both evidence-based and delivered in ways that are feasible, cost-effective, contextually appropriate and sustainable. This review presents a framework for using implementation science for cancer control planning and implementation and discusses potential areas of focus for research and programs in low and middle-income countries interested in integrating research into practice and policy. PMID:25178984
-
78 FR 32652 - Agency Information Collections Activities: Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-31
... Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program: Survey Data Collection.'' In accordance... Grant Program: Survey Data Collection. The Children's Health Insurance Program Reauthorization Act of... other States in designing and implementing their projects. Of the 10 grantee States selected, six are...
-
Janssens, Sarah; Beckmann, Michael; Bonney, Donna
2015-08-01
Simulation training in laparoscopic surgery has been shown to improve surgical performance. To describe the implementation of a laparoscopic simulation training and credentialing program for gynaecology registrars. A pilot program consisting of protected, supervised laparoscopic simulation time, a tailored curriculum and a credentialing process, was developed and implemented. Quantitative measures assessing simulated surgical performance were measured over the simulation training period. Laparoscopic procedures requiring credentialing were assessed for both the frequency of a registrar being the primary operator and the duration of surgery and compared to a presimulation cohort. Qualitative measures regarding quality of surgical training were assessed pre- and postsimulation. Improvements were seen in simulated surgical performance in efficiency domains. Operative time for procedures requiring credentialing was reduced by 12%. Primary operator status in the operating theatre for registrars was unchanged. Registrar assessment of training quality improved. The introduction of a laparoscopic simulation training and credentialing program resulted in improvements in simulated performance, reduced operative time and improved registrar assessment of the quality of training. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
-
SO2 NAAQS Implementation Training and Assistance for State and Local Air Agencies
Presentations and training help air agencies understand the National Ambient Air Quality Standards (NAAQS) for sulfur dioxide, how to engage the public in local emissions reduction programs, successful state implementation plan (SIP) development, and more.
-
The Clean Water Act (CWA) Action Plan Implementation Priorities describes the new approaches to revamp the National Pollutant Discharge Elimination System (NPDES) permitting, compliance and enforcement program.Issued May 11, 2011
-
Implementation of high performance concrete in Louisiana bridges : interim report.
DOT National Transportation Integrated Search
1998-02-01
The report contains a research plan to assist in the implementation of high performance concrete in the Charenton Canal Bridge in Louisiana. The research involves a literature review, plan review, development of a quality control program for the conc...
-
Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments
Vandenberg, Ann E.; Stevens, Melissa; Echt, Katharina V.; Hastings, S. Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P.
2016-01-01
The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs. PMID:27773986
-
Implementation of Interdisciplinary Cancer Rehabilitation
ERIC Educational Resources Information Center
Cromes, G. Fred, Jr.
1978-01-01
Describes an interdisciplinary cancer-rehabilitation program composed of rehabilitation teams that evaluate patients and suggest or provide treatment with the goal of improved quality of life. Issues, problems, and suggested solutions are discussed with implications for other programs. (Author)
-
ERIC Educational Resources Information Center
Cuticelli, Mari; Collier-Meek, Melissa; Coyne, Michael
2016-01-01
Recent data on reading achievement indicates that a majority of young students are reading below proficiency. However, current research has shown that providing students with quality, research-based reading instruction can help prevent many reading difficulties. Through the use of core reading programs, teachers have tools available to be able to…
-
The business case for quality.
Boehler, Richard; Hardesty, Daniel; Gonzales, Eva; Kasnetz, Karen
2009-10-01
Among the lessons St. Joseph Medical Center learned in implementing a diabetes care management program were that: There is a sound business case for quality with such a program. A sound business plan based on a track record of accomplishments by other organizations is key to gaining clinician buy-in. Deploying dwindling resources to simultaneously improve care and the organization's bottom line requires collaboration between clinicians and finance.
-
TU-C-201-02: Clinical Implementation of HDR: Afterloader and Applicator Selection
DOE Office of Scientific and Technical Information (OSTI.GOV)
Esthappan, J.
2015-06-15
Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less
-
TU-C-201-01: Clinical Implementation of HDR: A New User’s Perspective
DOE Office of Scientific and Technical Information (OSTI.GOV)
Al-Hallaq, H.
2015-06-15
Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less
-
TU-C-201-00: Clinical Implementation of HDR Brachytherapy
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
2015-06-15
Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less
-
Implementation of a laboratory quality assurance program: the Louisville experience.
Metz, Michael J; Abdel-Azim, Tamer; Miller, Cynthia J; Lin, Wei-Shao; ZandiNejad, Amirali; Oliveira, Gustavo M; Morton, Dean
2014-02-01
Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.
-
[Implementation and evaluation of case management in Catalonia: the ISP-SMD program].
Balsera Gómez, J; Rodríguez Medina, C; Caba Calvet, R; Vega Prada, R; Ruiz Ureña, H; Berruezo Ortiz, L; Clusa Gironella, D; Rodríguez Montes, M J; Haro Abad, J M
2002-01-01
The pilot study of the Individualized Service Program for people with Severe Mental Disorders (ISP-SMD) consists of the implementation of case management services in Catalonia. The ISP-SMD has been implemented in two health care sectors and will be expanded to the rest of Catalonia in the next years. The program serves people with persistent mental disorders who have serious social or family problems and/or who have inadequate mental health service use (high use of inpatient services, no use of community services). The ISP-SMD is a community intervention program that focuses its activities on direct care and coordination between services. Thirty patients have been included in the evaluation. The results of the pilot study have shown that, compared to the year before entering the program, the patients show better clinical status, they decrease their unmet need level, they have more appropriate use of health services and have lower treatment costs. Satisfaction of the patients, family members and professionals with the program is very high. It is possible to adapt and implement case management services in Catalonia. When implemented, they improve patient quality of life.
-
The Effect of Pay-for-Performance in Nursing Homes: Evidence from State Medicaid Programs
Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel
2013-01-01
Objective Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting—the implementation of P4P for nursing homes by state Medicaid agencies. Data Sources/Study Setting 2001–2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Study Design Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Principal Findings Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Conclusions Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. PMID:23398330
-
The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs.
Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel
2013-08-01
Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting-the implementation of P4P for nursing homes by state Medicaid agencies. 2001-2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. © Health Research and Educational Trust.
-
Pay for performance: will dentistry follow?
Voinea-Griffin, Andreea; Fellows, Jeffrey L; Rindal, Donald B; Barasch, Andrei; Gilbert, Gregg H; Safford, Monika M
2010-04-28
"Pay for performance" is an incentive system that has been gaining acceptance in medicine and is currently being considered for implementation in dentistry. However, it remains unclear whether pay for performance can effect significant and lasting changes in provider behavior and quality of care. Provider acceptance will likely increase if pay for performance programs reward true quality. Therefore, we adopted a quality-oriented approach in reviewing those factors which could influence whether it will be embraced by the dental profession. The factors contributing to the adoption of value-based purchasing were categorized according to the Donabedian quality of care framework. We identified the dental insurance market, the dental profession position, the organization of dental practice, and the dental patient involvement as structural factors influencing the way dental care is practiced and paid for. After considering variations in dental care and the early stage of development for evidence-based dentistry, the scarcity of outcome indicators, lack of clinical markers, inconsistent use of diagnostic codes and scarcity of electronic dental records, we concluded that, for pay for performance programs to be successfully implemented in dentistry, the dental profession and health services researchers should: 1) expand the knowledge base; 2) increase considerably evidence-based clinical guidelines; and 3) create evidence-based performance measures tied to existing clinical practice guidelines. In this paper, we explored factors that would influence the adoption of value-based purchasing programs in dentistry. Although none of these factors were essential deterrents for the implementation of pay for performance programs in medicine, the aggregate seems to indicate that significant changes are needed before this type of program could be considered a realistic option in dentistry.
-
Low, Walton H.
1997-01-01
In 1991, the U.S. Geological Survey (USGS) began a full-scale National Water-Quality Assessment (NAWQA) Program. The long-term goals of the NAWQA Program are to describe the status and trends in the water quality of a large part of the Nation's rivers and aquifers and to improve understanding of the primary natural and human factors that affect water-quality conditions. In meeting these goals, the program will produce water-quality, ecological, and geographic information that will be useful to policy makers and managers at the national, State, and local levels. A major component of the program is study-unit investigations, upon which national-level assessment activities are based. The program's 60 study-unit investigations are associated with principal river basins and aquifer systems throughout the Nation. Study units encompass areas from 1,200 to more than 65,000 mi2 (square miles) and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the upper Snake River Basin was among the first 20 NAWQA study units selected for implementation. From 1991 to 1995, a high-intensity data-collection phase of the upper Snake River Basin study unit (fig. 1) was implemented and completed. Components of this phase are described in a report by Gilliom and others (1995). In 1997, a low-intensity phase of data collection began, and work continued on data analysis, report writing, and data documentation and archiving activities that began in 1996. Principal data-collection activities during the low-intensity phase will include monitoring of surface-water and ground-water quality, assessment of aquatic biological conditions, and continued compilation of environmental setting information.
-
A policy analysis of the implementation of a Reproductive Health Vouchers Program in Kenya.
Abuya, Timothy; Njuki, Rebecca; Warren, Charlotte E; Okal, Jerry; Obare, Francis; Kanya, Lucy; Askew, Ian; Bellows, Ben
2012-07-23
Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government's role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies.
-
A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya
2012-01-01
Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies. PMID:22823923
-
Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena
2015-09-01
Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.
-
Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine Ea
2017-06-27
Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices-evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings.Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth Program were pending publication in another journal. After the impact findings have been published, we will update this article with a reference to the impact findings. © Kara et al.
-
Daniel, Donna M; Casey, Donald E; Levine, Jeffrey L; Kaye, Susan T; Dardik, Raquel B; Varkey, Prathibha; Pierce-Boggs, Kimberly
2009-12-01
The Accreditation Council for Graduate Medical Education recently emphasized the importance of systems-based practice and systems-based learning; however, successful models of collaborative quality improvement (QI) initiatives in residency training curricula are not widely available. Atlantic Health successfully conceptualized and implemented a QI collaborative focused on medication safety across eight residency training programs representing 219 residents. During a six-month period, key faculty and resident leaders from 8 (of 10) Atlantic Health residency training programs participated in three half-day collaborative learning sessions focused on improving medication reconciliation. Each session included didactic presentations from a multidisciplinary team of clinical experts as well as the application of principles that identified challenges, barriers, and solutions to QI initiatives. The learning sessions emphasized the fundamental principles of medication reconciliation, its critical importance as a vital part of patient handoff in all health care settings, and the challenges of achieving successful medication reconciliation improvement in light of work hours restrictions and patient loads. Each residency program developed a detailed implementation and measurement plan for individual "action learning" projects, using the Plan-Do-Study-Act method of improvement. Each program then implemented its QI project, and expert faculty (e.g., physicians, nurses, pharmacists, QI staff) provided mentoring between learning sessions. Several projects resulted in permanent changes in medication reconciliation processes, which were then adopted by other programs. The structure, process, and outcomes of this effort are described in detail.
-
[Design, implementation and evaluation of a health education program for the elderly].
Pino, Margarita; Ricoy, Maria Carmen; Portela, Julio
2010-09-01
The objective was to design, implement and evaluate a health education program, using the analysis of the habits that harm the health of people over 65 years old. An evaluative research was carried out from a multiple case study in the North-West area of Spain, combining both the quantitative and the qualitative approach. A questionnaire and interview were used as tools for data collection. The elderly take a lot of medicines and also treat themselves. A small group smoke and drink alcohol. Over 25% have sedentary habits and their average body mass rate was 30.55. The implementation of the programme has significantly influenced their quality of life. Elderly people have deep rooted unhealthy habits. The achievement of educational contents improved their quality of life. However, they are reluctant to assume new habits, even though they are healthy.
-
ERIC Educational Resources Information Center
Utah State Univ., Logan. Center for Persons with Disabilities.
This project studied the effects of implementing a computerized management information system developed for special education administrators. The Intelligent Administration Support Program (IASP), an expert system and database program, assisted in information acquisition and analysis pertaining to the district's quality of decisions and procedures…
-
40 CFR 52.2732 - Small business technical and environmental compliance assistance program.
Code of Federal Regulations, 2014 CFR
2014-07-01
... (CONTINUED) Puerto Rico § 52.2732 Small business technical and environmental compliance assistance program. On November 16, 1992, the Puerto Rico Environmental Quality Board submitted a plan for the... Assistance Program for incorporation in the Puerto Rico state implementation plan. This plan meets the...
-
40 CFR 52.2732 - Small business technical and environmental compliance assistance program.
Code of Federal Regulations, 2011 CFR
2011-07-01
... (CONTINUED) Puerto Rico § 52.2732 Small business technical and environmental compliance assistance program. On November 16, 1992, the Puerto Rico Environmental Quality Board submitted a plan for the... Assistance Program for incorporation in the Puerto Rico state implementation plan. This plan meets the...
-
40 CFR 52.2732 - Small business technical and environmental compliance assistance program.
Code of Federal Regulations, 2010 CFR
2010-07-01
... (CONTINUED) Puerto Rico § 52.2732 Small business technical and environmental compliance assistance program. On November 16, 1992, the Puerto Rico Environmental Quality Board submitted a plan for the... Assistance Program for incorporation in the Puerto Rico state implementation plan. This plan meets the...
-
Essays on Education Programs in Developing Countries
ERIC Educational Resources Information Center
He, Fang
2010-01-01
This dissertation evaluates programs seeking to address educational access and quality in developing countries. Chapter 1 examines the impact of two school feeding programs on enrollment in Sri Lanka. Chapter 2 assesses the relative productivity of several modes of implementing an Indian English education curriculum in India. Finally, chapter 3…
-
ERIC Educational Resources Information Center
Jozwik, Sara L.; Cahill, Alice; Sánchez, Gilberto
2018-01-01
Individualized education programs (IEPs) reflect the spirit of individualized instruction that lies at the heart of special education. Quality annual goal statements, which propel the implementation of special education programming, use clear language to communicate measurable, meaningful, and standards-aligned expectations to all members of the…
-
Complying with physician gain-sharing restrictions.
O'Hare, P K
1998-05-01
Many IDSs are considering implementing gain-sharing programs as a way to motivate their physicians to provide high-quality, cost-effective services. Before embarking on such programs, however, IDSs need to understand the legal requirements associated with such programs to ensure that the gain-sharing arrangement is in compliance with Federal law.
-
ERIC Educational Resources Information Center
Crouch, J. Michael
This book explains how to implement a Total Quality Management (TQM) program within an organization focusing in particular on ways to sustain the effort. Part 1 of five offers an overview of the TQM approach and the rationale for adopting it. Topics of discussion include signs of the need for change, what TQM is and what it is not, the basics of…
-
Code of Federal Regulations, 2010 CFR
2010-01-01
... REGULATIONS (CONTINUED) GENERAL Environmental Program § 1940.302 Definitions. Following is a list of definitions that apply to the implementation of this subpart. Please note that § 1940.301(b) of this subpart refers to the Council on Environmental Quality's Regulations for Implementing the Procedural Provisions...
-
PARAMS is a Windows-based computer program that implements 30 methods for estimating the parameters in indoor emissions source models, which are an essential component of indoor air quality (IAQ) and exposure models. These methods fall into eight categories: (1) the properties o...
-
Fall Prevention for Older Adults Receiving Home Healthcare.
Bamgbade, Sarah; Dearmon, Valorie
2016-02-01
Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.
-
40 CFR 130.9 - Designation and de-designation.
Code of Federal Regulations, 2014 CFR
2014-07-01
... Section 130.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER... continue water quality planning activities within the designated boundaries. (c) Impact of de-designation... responsibility for continued water quality planning and oversight of implementation within the area. (d...
-
Accountability and Other CAUSES of Total Quality Management.
ERIC Educational Resources Information Center
Aamot, Karen; Piotrowski, Craig
1995-01-01
Describes Total Quality Management (TQM) techniques implemented at Waukesha County Technical College (Wisconsin). The CAUSES program focuses on customers, accountability, understanding, self-improvement, education, and searching. Describes application of TQM to the fixed-asset team project. Four figures are included. (LMI)
-
Assuring Quality in Collaborative Provision.
ERIC Educational Resources Information Center
Bocock, Jean; Edwards, Judith
1998-01-01
This bulletin is intended to help British further education colleges clarify their rationale for entering into collaborative programs, assess prospective partners, define and implement good practice at all stages of provision, and establish rigorous quality assurance procedures. Following an introduction, Further Education Funding Council…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-06-06
...-day window allowed under the prior approved SIP. This SIP revision affects forty-two counties in... inspection stations in the forty-two non-I/M counties. The quality assurance program established a window...
-
Quality Assurance in School Health
ERIC Educational Resources Information Center
Newell, Susan; Schoenike, Sumner L.; Lisko, Elaine A.
2003-01-01
School nurses need to become more influential administrators, managers, and entrepreneurs. They must learn to lead and collaborate effectively in designing, implementing, and evaluating coordinated school health programs. Quality assurance is an essential ingredient in this process that requires accurate, timely, and confidential incident…
-
Johnson, Stacy R; Pas, Elise T; Bradshaw, Catherine P; Ialongo, Nicholas S
2018-05-01
There is growing awareness of the importance of implementation fidelity and the supports, such as coaching, to optimize it. This study examined how coaching activities (i.e., check-ins, needs assessment, modeling, and technical assistance) related directly and indirectly to implementation dosage and quality of the PAX Good Behavior Game, via a mediating pathway through working relationship. Mediation analyses of 138 teachers revealed direct effects of modeling and working relationship on implementation dosage, whereas needs assessment was associated with greater dosage indirectly, by higher ratings of the working relationship. Understanding how coaching activities promote implementation fidelity elements has implications for improving program effectiveness.
-
Importance of Data Management in a Long-Term Biological Monitoring Program
NASA Astrophysics Data System (ADS)
Christensen, Sigurd W.; Brandt, Craig C.; McCracken, Mary K.
2011-06-01
The long-term Biological Monitoring and Abatement Program (BMAP) has always needed to collect and retain high-quality data on which to base its assessments of ecological status of streams and their recovery after remediation. Its formal quality assurance, data processing, and data management components all contribute to meeting this need. The Quality Assurance Program comprehensively addresses requirements from various institutions, funders, and regulators, and includes a data management component. Centralized data management began a few years into the program when an existing relational database was adapted and extended to handle biological data. The database's main data tables and several key reference tables are described. One of the most important related activities supporting long-term analyses was the establishing of standards for sampling site names, taxonomic identification, flagging, and other components. The implemented relational database supports the transmittal of data to the Oak Ridge Environmental Information System (OREIS) as the permanent repository. We also discuss some limitations to our implementation. Some types of program data were not easily accommodated in the central systems, and many possible data-sharing and integration options are not easily accessible to investigators. From our experience we offer data management advice to other biologically oriented long-term environmental sampling and analysis programs.
-
1981-05-01
first Quality Circle was registered with the Japanese Union of Scientists and Engineers (JUSE) in 1962. The concept was conceived by Dr. Kaoru ... Ishikawa , a professor of engineering at Tokyo University, and developed under the sponsorship of . JUSE. Quality Circles fuse the quality sciences
-
Alternative Pathways in Family Child Care Quality Rating and Improvement Systems
ERIC Educational Resources Information Center
Kelton, Robyn E.; Talan, Teri N.; Bloom, Paula J.
2013-01-01
As research continues to underscore the positive impact high-quality early childhood programs have on young children, numerous states have implemented quality rating and improvement systems (QRIS) to measure and improve the services young children receive across a wide range of early learning settings. These state systems range from two to five…
-
A Blueprint for Early Care and Education Quality Improvement Initiatives. Publication #2015-07
ERIC Educational Resources Information Center
Tout, Kathryn; Epstein, Dale; Soli, Meg; Lowe, Claire
2015-01-01
As Quality Rating and Improvement Systems (QRIS) continue to launch and mature across states, questions emerge from stakeholders about how to design and implement effective quality improvement (QI) initiatives that accompany a QRIS. Funders, policymakers, and program developers with limited resources are looking to invest in activities that will…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-23
... Protection, State Office Building, 79 Elm Street, Hartford, CT 06106- 1630; the Bureau of Air Quality Control... evaluation of the States' submittals? A. Emission Limits and Other Control Measures B. Ambient Air Quality Monitoring/Data System C. Program for Enforcement of Control Measures D. Interstate Transport E. Adequate...
-
ERIC Educational Resources Information Center
Ikegami, Kiiko; Agbenyega, Joseph Seyram
2014-01-01
The quality of early childhood education has dominated current debates in the ways educators develop and implement learning programs for children yet conceptions of quality vary contextually and culturally. This qualitative case study explored the insider perspectives of six early childhood educators in Sapporo, Japan regarding their conceptions…
-
GLOBE Mission Earth: The evaluation of the first year's implementation.
NASA Astrophysics Data System (ADS)
Adaktylou, N. E.; Hedley, M. L.; Darche, S.; Harris-Stefanakis, E.; Silberglitt, M. D.; Struble, J.; Bingham, P.; Czajkowski, K.
2017-12-01
Here we present the evaluation findings for the first year of implementation of the `Mission Earth' Program.`Mission Earth' proposes the systematic embedding of GLOBE (Global Learning and Observations to Benefit the Environment) resources and NASA assets into the curricula of schools along the K-12 continuum, leveraging existing partnerships and networks. The main goal of the program is to create developmentally appropriate, vertically-integrated K-12 materials and activities,, supported by high quality professional development and ongoing support, engaging teachers from all grades. Its team consists of 5 geographically distributed universities and research institutions that have developed a curriculum progression following research-based best practices, have conducted the year's trainings for selected cohorts of teachers. The evaluation is a continuous process over the program's five year duration to examine implementation and opportunities for improvement. A broad set of data collection tools include a diagnostic component (needs assessment for teachers, capacity assessment for the school environment) and an assessment of implementation component (surveys for teachers and trainers, pre- and post tests for students, classroom observations, teacher interviews, portfolios). The tools used are validated instruments or ones modified to serve the program needs. The patterns emerging from the data provided information on: i) the quality of the intervention as to its design and content, ii) the alignment with the needs of the participants, iii) the implementation phase, iii) changes in the content knowledge of the students and their attitudes toward science, iv) changes in the facility of teachers to teach science in their classrooms after the professional development and materials provided, v) challenges and facilitators of implementation. Based on findings the program evaluation identifies additions/adjustments to be adopted in the following year.
-
Dale, Allan P; Vella, Karen; Gooch, Margaret; Potts, Ruth; Pressey, Robert L; Brodie, Jon; Eberhard, Rachel
2017-10-04
Water quality outcomes affecting Australia's Great Barrier Reef (GBR) are governed by multi-level and multi-party decision-making that influences forested and agricultural landscapes. With international concern about the GBR's declining ecological health, this paper identifies and focuses on implementation failure (primarily at catchment scale) as a systemic risk within the overall GBR governance system. There has been limited integrated analysis of the full suite of governance subdomains that often envelop defined policies, programs and delivery activities that influence water quality in the GBR. We consider how the implementation of separate purpose-specific policies and programs at catchment scale operate against well-known, robust design concepts for integrated catchment governance. We find design concerns within ten important governance subdomains that operate within GBR catchments. At a whole-of-GBR scale, we find a weak policy focus on strengthening these delivery-oriented subdomains and on effort integration across these subdomains within catchments. These governance problems when combined may contribute to failure in the implementation of major national, state and local government policies focused on improving water quality in the GBR, a lesson relevant to landscapes globally.
-
ERIC Educational Resources Information Center
Carlson, Kathy Lynn
2012-01-01
Over the last several decades, Continuous Improvement (CI) type initiatives have been implemented in companies across the United States to improve quality, reduce process variation, eliminate waste and ultimately reduce costs. Approximately five years ago, one particular Fortune 500 company implemented CI in its manufacturing facilities. A key…
-
Sleep hygiene education: efficacy on sleep quality in working women.
Chen, Pao-Hui; Kuo, Hung-Yu; Chueh, Ke-Hsin
2010-12-01
Although sleep hygiene education represents a promising approach for patients with poor sleep quality, little research has been devoted in understanding the sleep hygiene behavior and knowledge of working women. The purpose of this study was to investigate the efficacy of a short-term sleep hygiene education program on working women with poor sleep quality. This pilot study was a prospective and an exploratory intervention study. The intervention was tested on 37 selected working women with poor sleep quality in the community. The Pittsburgh Sleep Quality Index (score > 5) was used to identify working women with poor sleep quality. After a pretest to assess sleep quality, researchers implemented a 5-week sleep hygiene education program that addressed good sleep environments/habits, emotional stress, the influence of diet/alcohol/tobacco on sleep, exercise, and alternative therapies. Tests administered midway through the program and after program completion provided the data used to analyze effective sleep quality changes. Results showed sleep hygiene education to improve participant sleep quality significantly (p < .001). The sleep quality of all participants improved over both the 3- and the 5-week education program. The six components of the Pittsburgh Sleep Quality Index (i.e., subjective sleep quality, sleep latency, sleep duration, sleep disturbances, use of sleeping medication, and daytime dysfunction) also improved. A brief and effective sleep hygiene education program delivered by a nurse can improve sleep quality in working women with sleeping problems.
-
The American College of Surgeons: an enduring commitment to quality and patient care.
Hoyt, David B; Schneidman, Diane S
2015-03-01
This paper describes the American College of Surgeons' 100-plus-year commitment to improving quality and patient care. It summarizes programs that the College established a century ago to improve patient care, including the Hospital Standardization Program, and new initiatives, such as the ACS National Surgical Quality Improvement Program. The College's longstanding experience with quality improvement programs is enabling the organization to play a critical and influential role in helping to ensure that health care reforms, including those in the Affordable Care Act, are implemented in a way that best serves that interests of the surgical patient. Through a combination of these data analysis systems and the application of a finely tuned set of values, the College has become a respected voice in quality and patient safety. The ultimate goal is to create an environment where high value and high reliability take precedence over high volume and where all health care professionals play an active leadership role in delivering optimal, coordinated care. This article further describes how the surgical culture can be reshaped to meet these evolving needs and demands. The American College of Surgeons (ACS) has a longstanding commitment to improving the quality of surgical care through outcome measurement, standards setting, accreditation, and educational activities. This legacy has enabled the ACS to play an influential role in recent developments related to implementation of the Affordable Care Act (ACA) and Medicare physician payment reform. Copyright © 2015 Elsevier Inc. All rights reserved.
-
Reilly, Rachel; Evans, Katharine; Gomersall, Judith; Gorham, Gillian; Peters, Micah D J; Warren, Steven; O'Shea, Rebekah; Cass, Alan; Brown, Alex
2016-04-06
Indigenous peoples in Australia, New Zealand and Canada carry a greater burden of chronic kidney disease (CKD) than the general populations in each country, and this burden is predicted to increase. Given the human and economic cost of dialysis, understanding how to better manage CKD at earlier stages of disease progression is an important priority for practitioners and policy-makers. A systematic review of mixed evidence was undertaken to examine the evidence relating to the effectivness, cost-effectiveness and acceptability of chronic kidney disease management programs designed for Indigenous people, as well as barriers and enablers of implementation of such programs. Published and unpublished studies reporting quantitative and qualitative data on health sector-led management programs and models of care explicitly designed to manage, slow progression or otherwise improve the lives of Indigenous people with CKD published between 2000 and 2014 were considered for inclusion. Data on clinical effectiveness, ability to self-manage, quality of life, acceptability, cost and cost-benefit, barriers and enablers of implementation were of interest. Quantitative data was summarized in narrative and tabular form and qualitative data was synthesized using the Joanna Briggs Institute meta-aggregation approach. Ten studies were included. Six studies provided evidence of clinical effectiveness of CKD programs designed for Indigenous people, two provided evidence of cost and cost-effectiveness of a CKD program, and two provided qualitative evidence of barriers and enablers of implementation of effective and/or acceptable CKD management programs. Common features of effective and acceptable programs were integration within existing services, nurse-led care, intensive follow-up, provision of culturally-appropriate education, governance structures supporting community ownership, robust clinical systems supporting communication and a central role for Indigenous Health Workers. Given the human cost of dialysis and the growing population of people living with CKD, there is an urgent need to draw lessons from the available evidence from this and other sources, including studies in the broader population, to better serve this population with programs that address the barriers to receiving high-quality care and improve quality of life.
-
ERIC Educational Resources Information Center
Delmont, Tim
2011-01-01
Applied Master's Degree and doctoral programs have been criticized widely for their lack of relevance, rigor and quality. New graduate degree programs have responded to these criticisms by implementing innovative academic policies, program curriculum, and student services. A case study of the Metropolitan State University Doctor of Business…
-
A summary of the U.S. Geological Survey National Water-Quality Assessment program
Hirsch, R.M.; Alley, W.M.; Wilber, W.G.
1988-01-01
Beginning in 1986, the Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water Quality Assessment Program. At present, the program is in a pilot phase with field studies occurring in seven areas around the Nation. In 1990, a committee of the National Academy of Sciences will complete an evaluation of the design and potential utility of the program. A decision about moving to full-scale implementation will be made upon completion of this evaluation. The program is intended to address a wide range of national water quality issues that include chemical contamination, acidification, eutrophication, salinity, sedimentation, and sanitary quality. The goals of the program are to: (1) provide nationally consistent descriptions of current water quality conditions for a large part of the Nation 's water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify and describe the relations of both current conditions and trends in water quality to natural and human factors. This information will be provided to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water quality management programs and for predicting the likely effects of contemplated changes in land- and water-management practices. (USGS)
-
DOE Office of Scientific and Technical Information (OSTI.GOV)
Witte, M.C.
1994-10-01
In July of 1991, the Nuclear Regulatory Commission published a Final Rule in the Federal Register amending regulations governing medical therapeutic administrations of byproduct material and certain uses of radioactive sodium iodide. These amendments required implementation of a Quality Management Program (QMP) to provide high confidence that the byproduct material -- or radiation from byproduct material -- will be administered as directed by an authorized user physician. Herein, this rule is referred to as the QM rule. The Final Rule was published after two proposed rules had been published in the Federal Register.
-
Improved productivity through interactive communication
NASA Technical Reports Server (NTRS)
Marino, P. P.
1985-01-01
New methods and approaches are being tried and evaluated with the goal of increasing productivity and quality. The underlying concept in all of these approaches, methods or processes is that people require interactive communication to maximize the organization's strengths and minimize impediments to productivity improvement. This paper examines Bendix Field Engineering Corporation's organizational structure and experiences with employee involvement programs. The paper focuses on methods Bendix developed and implemented to open lines of communication throughout the organization. The Bendix approach to productivity and quality enhancement shows that interactive communication is critical to the successful implementation of any productivity improvement program. The paper concludes with an examination of the Bendix methodologies which can be adopted by any corporation in any industry.
-
McClellan, Sean R; Snowden, Lonnie
2015-01-01
This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-02
... Emissions From Industrial Process Operations New Castle County.'' 12. Regulation 1112 ``Control of Nitrogen... the State Implementation Plans.'' 25. Regulation 1139 ``Nitrogen Oxides (NO X ) Budget Trading Program... by reference, Intergovernmental relations, Lead, Nitrogen dioxide, Ozone, Particulate matter...
-
Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention
ERIC Educational Resources Information Center
Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.
2017-01-01
Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…
-
Implementation and evaluation of PM2.5 source contribution analysis in a photochemical model
Source culpability assessments are useful for developing effective emissions control programs. The Integrated Source Apportionment Method (ISAM) has been implemented in the Community Multiscale Air Quality (CMAQ) model to track contributions from source groups and regions to ambi...
-
Brach, Cindy; Anglin, Grace; Devers, Kelly J.; Burton, Rachel
2018-01-01
Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program’s legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children’s health care provided through Medicaid and CHIP. As part of the program’s multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states’ CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects’ intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state’s Medicaid environment, implementation partners’ resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states’ CHIPRA quality demonstration projects provides insight into the fates of the “promising ideas” that the grant program was designed to examine. As a result of the federal government’s investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children. PMID:29119478
-
Radiation protection program for early detection of breast cancer in a mammography facility
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mariana, Villagomez Casimiro, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx; Cesar, Ruiz Trejo, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx; Ruby, Espejo Fonseca
Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1–4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systemsmore » (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)– presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.« less
-
Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L
A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of TeamSTEPPS efforts.
-
Rosa, Rossana; Zavala, Bruno; Cain, Natalie; Anjan, Shweta; Aragon, Laura; Abbo, Lilian M
2018-03-01
Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.
-
Tools to Help the NPDES Program Adapt to Fluctuating Environmental Conditions
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.
-
DOT National Transportation Integrated Search
2007-02-14
This final rule revises the regulations governing the development of metropolitan transportation plans and programs for urbanized areas, State transportation plans and programs and the regulations for Congestion Management Systems. The revision resul...
-
15 CFR 996.1 - Purpose and scope.
Code of Federal Regulations, 2014 CFR
2014-01-01
... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.1 Purpose and scope. The National Oceanic and Atmospheric Administration (NOAA) was mandated to develop and implement a quality assurance program that is...
-
15 CFR 996.1 - Purpose and scope.
Code of Federal Regulations, 2011 CFR
2011-01-01
... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.1 Purpose and scope. The National Oceanic and Atmospheric Administration (NOAA) was mandated to develop and implement a quality assurance program that is...
-
15 CFR 996.1 - Purpose and scope.
Code of Federal Regulations, 2012 CFR
2012-01-01
... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.1 Purpose and scope. The National Oceanic and Atmospheric Administration (NOAA) was mandated to develop and implement a quality assurance program that is...
-
15 CFR 996.1 - Purpose and scope.
Code of Federal Regulations, 2013 CFR
2013-01-01
... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.1 Purpose and scope. The National Oceanic and Atmospheric Administration (NOAA) was mandated to develop and implement a quality assurance program that is...
-
Wetherbee, Gregory A.; Martin, RoseAnn
2017-02-06
The U.S. Geological Survey Branch of Quality Systems operates the Precipitation Chemistry Quality Assurance Project (PCQA) for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN) and National Atmospheric Deposition Program/Mercury Deposition Network (NADP/MDN). Since 1978, various programs have been implemented by the PCQA to estimate data variability and bias contributed by changing protocols, equipment, and sample submission schemes within NADP networks. These programs independently measure the field and laboratory components which contribute to the overall variability of NADP wet-deposition chemistry and precipitation depth measurements. The PCQA evaluates the quality of analyte-specific chemical analyses from the two, currently (2016) contracted NADP laboratories, Central Analytical Laboratory and Mercury Analytical Laboratory, by comparing laboratory performance among participating national and international laboratories. Sample contamination and stability are evaluated for NTN and MDN by using externally field-processed blank samples provided by the Branch of Quality Systems. A colocated sampler program evaluates the overall variability of NTN measurements and bias between dissimilar precipitation gages and sample collectors.This report documents historical PCQA operations and general procedures for each of the external quality-assurance programs from 2007 to 2016.
-
Beaulac, Julie; Olavarria, Marcela; Kristjansson, Elizabeth
2010-05-01
Participation in physical activity is important for the positive development and well-being of youth. A community- academic partnership was formed to improve access to physical activity for youth in one disadvantaged community in Ottawa, Canada. After consulting this community, a new hip-hop dance intervention was implemented. Adolescents aged 11 to 16 years participated in one of two 3-month sessions. A girls-only and a boys-and-girls format were offered both sessions. This article investigates the implementation of the intervention from the perspective of the youth participants, parents, staff, and researchers. Multiple methods were used, including document review, observation, questionnaire, focus groups, and interviews. Overall, the consistency and quality of program implementation were moderately satisfactory; however, important concerns were noted and this program appeared to be only partially delivered as planned. These findings will be discussed in terms of suggestions for improving the implementation of this intervention and similar recreation programs prioritizing disadvantaged communities.
-
Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie
2012-01-01
Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time. Copyright © 2012 Elsevier Inc. All rights reserved.
-
Diky, Vladimir; Chirico, Robert D; Muzny, Chris D; Kazakov, Andrei F; Kroenlein, Kenneth; Magee, Joseph W; Abdulagatov, Ilmutdin; Frenkel, Michael
2013-12-23
ThermoData Engine (TDE) is the first full-scale software implementation of the dynamic data evaluation concept, as reported in this journal. The present article describes the background and implementation for new additions in latest release of TDE. Advances are in the areas of program architecture and quality improvement for automatic property evaluations, particularly for pure compounds. It is shown that selection of appropriate program architecture supports improvement of the quality of the on-demand property evaluations through application of a readily extensible collection of constraints. The basis and implementation for other enhancements to TDE are described briefly. Other enhancements include the following: (1) implementation of model-validity enforcement for specific equations that can provide unphysical results if unconstrained, (2) newly refined group-contribution parameters for estimation of enthalpies of formation for pure compounds containing carbon, hydrogen, and oxygen, (3) implementation of an enhanced group-contribution method (NIST-Modified UNIFAC) in TDE for improved estimation of phase-equilibrium properties for binary mixtures, (4) tools for mutual validation of ideal-gas properties derived through statistical calculations and those derived independently through combination of experimental thermodynamic results, (5) improvements in program reliability and function that stem directly from the recent redesign of the TRC-SOURCE Data Archival System for experimental property values, and (6) implementation of the Peng-Robinson equation of state for binary mixtures, which allows for critical evaluation of mixtures involving supercritical components. Planned future developments are summarized.
-
Strategies from a nationwide health information technology implementation: the VA CART story.
Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S
2010-01-01
The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.
-
Quality assurance program requirements, Amendment 5 (9-26-79) to August 1973 issue
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
This standard sets forth general requirements for planning, managing, conducting, and evaluating quality assurance programs for reactor development and test facility projects and associated processes, structures, components, and systems. These quality assurance requirements are based on proven practices and provide the means of control and verification whereby those responsible fo poject management can assure that the quality required for safe, reliable, and economical operation will be achieved. The objective of the program of the programs covered by this standard is to assure that structures, components, systems, and facilities are designed, developed, manufactured, constructed, operated, and maintained in compliance with establishedmore » engineering criteria. To achieve this objective, controls are to be established and implemented at predetermined points, and necessary action taken to prevent, detect, and correct any deficiencies.« less
-
Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M.; Golden, Sherita Hill
2013-01-01
Background Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. Conceptual Model Components The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staff while incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Outcomes Overall the average patient-day–weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Conclusion Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives. PMID:22649859
-
Munoz, Miguel; Pronovost, Peter; Dintzis, Joanne; Kemmerer, Theresa; Wang, Nae-Yuh; Chang, Yi-Ting; Efird, Leigh; Berenholtz, Sean M; Golden, Sherita Hill
2012-05-01
Strategies for successful implementation of hospitalwide glucose control efforts were addressed in a conceptual model for the development and implementation of an institutional inpatient glucose management program. CONCEPTUAL MODEL COMPONENTS: The Glucose Steering Committee incrementally developed and implemented hospitalwide glucose policies, coupled with targeted education and clinical decision support to facilitate policy acceptance and uptake by staffwhile incorporating process and outcome measures to objectively assess the effectiveness of quality improvement efforts. The model includes four components: (1) engaging staff and hospital executives in the importance of inpatient glycemic management, (2) educating staff involved in the care of patients with diabetes through structured knowledge dissemination, (3) executing evidence-based inpatient glucose management through development of policies and clinical decision aids, and (4) evaluating intervention effectiveness through assessing process measures, intermediary glucometric outcomes, and clinical and economic outcomes. An educational curriculum for nursing, provider, and pharmacist diabetes education programs and current glucometrics were also developed. Overall the average patient-day-weighted mean blood glucose (PDWMBG) was below the currently recommended maximum of 180 mg/dL in patients with diabetes and hyperglycemia, with a significant decrease in PDWMBG of 7.8 mg/dL in patients with hyperglycemia. The program resulted in an 18.8% reduction in hypoglycemia event rates, which was sustained. Inpatient glucose management remains an important area for patient safety, quality improvement, and clinical research, and the implementation model should guide other hospitals in their glucose management initiatives.
-
Konstantinidis, Agathoklis; Fogel, Sandy; Jones, James; Gilliam, Brenda; Kundzins, John; Baker, Christopher
2014-09-01
The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data at our institution indicated that surgical mortality was significantly higher than expected. This study examines the effect of implementation of a strict, intensive preoperative screening and intervention process on postoperative mortality at our institution, as measured by the NSQIP. Carilion Roanoke Memorial Hospital (CRMH) is a 763-bed tertiary care hospital serving a population of one million people in southwest Virginia. Data were collected for NSQIP at CRMH from July 2007 to December 2012. In January 2010, a new preoperative process was implemented to include risk assessment and intervention for hypertension, cardiac disease, pulmonary disease, diabetes, renal disease, and obstructive sleep apnea. Before initiation of our preoperative program (July 2007 to January 2010), odds ratios (ORs) for 30-day mortality in general and vascular cases were significantly higher than expected (1.40, 1.43, 1.58, and 1.56 in successive reporting periods). Beginning with the first report after implementation of the preoperative screening program, CRMH showed a progressively decreasing OR for overall 30-day mortality (1.26, 1.19, 1.14, 0.86, 0.82, 0.84, 0.89) with similar reductions in both general (0.92) and vascular (0.92) surgery. The implementation of an intensive preoperative screening and intervention process in our institution was accompanied by a significant decrease in the 30-day mortality for general surgery and vascular procedures, as measured by the NSQIP.
-
The quest for quality blood banking program in the new millennium the American way.
Kim, Dae Un
2002-08-01
For an industry to succeed and satisfy its customers, "QUALITY" must be a primary goal. Quality has been central to blood banking from its inception, with the evolution of a Quality Program since the opening of the first blood bank in U.S. at the Cook County Hospital in 1937. Over the ensuing decades, continuous scientific progress in blood preservation, filters, viral and blood group testing, crossmatching, automation, and computerization including bar coding, etc. has contributed to the quality and safety of the blood products and transfusion service. However, with the advent of the AIDS era, an increasingly sensitized and informed public is continuously demanding that the highest level of quality be achieved and maintained in all processes involved in providing all blood products. The Food and Drug Administration (FDA) introduced the concept of a "zero risk blood supply" as the industry goal. Furthermore, the cost containment and resource-constrained environment have changed the complexity of the quality practice. Both regulatory agencies such as the FDA, the Health Care Financing Administration [HCFA, which was recently renamed as the Centers for Medicare and Medicaid Services (CMS) in July, 2001], and the State Department of Health, and accrediting agencies, such as the American Association of Blood Banks (AABB), the College of American Pathologists (CAP), and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), require blood banks and transfusion services to establish and follow a Quality Control and Quality Assurance Program for their licensing, certification and accreditation. Every laboratory has to comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) quality requirements being implemented by the CMS. The FDA guidelines assist facilities in compliance with Current Good Manufacturing Practices (cGMP). The AABB's Quality System Essentials (QSE) are based on these specifications and provide additional guidance in implementing practices that assure quality and compliance with cGMP. AABB and CAP are granted "deemed status" as accrediting organizations under the CLIA '88 program by CMS, as well as JCAHO and some states. The International Standards Organization (ISO) has established international standards in most fields. The U.S. is represented in ISO by the American National Standards Institute (ANSI), and the National Committee for Clinical Laboratory Standards (NCCLS), as a global organization headquartered in the U.S., is a member of ANSI. The FDA and the AABB had begun incorporating many ISO principles into their own regulations and standards. The AABB's 10 QSEs are rooted in the 20 clauses of ISO 9000 series and compatible with their standards. In a Maslow-type model quality hierarchy by Tsiakals, so far the bottom three of the five progressive levels, Quality Control for method control, Quality Assurance for process control, and Quality System for system control have been implemented just to meet the regulatory and accrediting requirements. The next higher level, Quality Management for financial control, and the ultimate highest level, Total Quality Management for strategic control, should be our quest in this new millennium, and with the help of the AABB, ISO, FDA and all other organizations, we will achieve it. We should change our approach to quality issues from detection to prevention. We should improve the quality in transfusion practice itself by effective utilization of blood as a therapeutic resource with clear indication, maximum surgical blood order schedule, alternative transfusion such as autologous transfusion, hemodilution, and intra/post-operative blood salvage, surgical hemostasis, pharmacological hemostasis, and synthetic erythropoietin. Most importantly, implementation of the Quality Program should be something that we want to do rather than simply a burden that we have to do. A well-managed Quality Program is an effective and cost-efficient operation for the blood banks and transfusion services, and will enable us to better serve the patients for whom we exist.
-
Implementing Physical Best in Higher Education Courses
ERIC Educational Resources Information Center
Ayers, Suzan F.; Martinez, Ray D.
2007-01-01
Since the emphases of physical education teacher education (PETE) programs can be linked to quality K-12 instruction, embedding Physical Best (PB) materials into existing PETE curricula can be a practical means of addressing the obesity crisis in the public schools. The PB program is a comprehensive, health-related fitness education program that…
-
A vision detailing enhancements made to the Clean Water Act 303(d) Program informed by the experience gained over the past two decades in assessing and reporting on water quality and in developing approximately 65,000 TMDLs.
-
Assessing the Quality of the Business and Management Education in Higher Education
ERIC Educational Resources Information Center
Lee, Lung-Sheng; Ko, Hui-Min; Wang, Mei-Tyng; Pan, Ying-Ju
2014-01-01
As the third-party planner and implementer of higher education institutional and program evaluations, the Higher Education Evaluation and Accreditation Council of Taiwan (HEEACT) completed program evaluations for all 145 undergraduate business and management (B&M) programs in 43 universities/colleges from 2006 to 2010. In the 145 programs…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-27
... for the prevention of significant deterioration (PSD) areas in West Virginia. This action will also add the Federally equivalent provisions to the rules for the PSD program as they pertain to... (CUs) to make the West Virginia PSD program consistent with the Federal PSD program. This action is...
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-01
... permit program for pre- construction review of certain new and modified major stationary sources in... program as required by section 165 of the CAA for certain new and modified major stationary sources... the CAA requires states to adopt a pre-construction permitting program for certain new and modified...
-
Promoting Quality of Program Delivery via an Internet Message Delivery System
ERIC Educational Resources Information Center
Bishop, Dana C.; Dusenbury, Linda; Pankratz, Melinda M.; Hansen, William B.
2013-01-01
This article presents results from a study that evaluated an online message system designed to improve the delivery of prevention programs. We conducted a quasi-experimental study with 32 agencies and schools that implemented substance use prevention programs and examined differences between the comparison and intervention groups. We also examined…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-01-24
... Vehicle Program, which adopts California's second generation low emission vehicle program for light- duty... listed in the electronic docket, some information is not publicly available, i.e., confidential business....regulations.gov or in hard copy for public inspection during normal business hours at the Air Protection...
-
The measurement of quality of care in the Veterans Health Administration.
Halpern, J
1996-03-01
The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the databases.
-
Jongen, Crystal Sky; McCalman, Janya; Bainbridge, Roxanne Gwendalyn
2017-01-01
Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.
-
COUNCIL FOR REGULATORY ENVIRONMENTAL MODELING (CREM) PILOT WATER QUALITY MODEL SELECTION TOOL
EPA's Council for Regulatory Environmental Modeling (CREM) is currently supporting the development of a pilot model selection tool that is intended to help the states and the regions implement the total maximum daily load (TMDL) program. This tool will be implemented within the ...
-
40 CFR 52.677 - Original identification of plan section.
Code of Federal Regulations, 2014 CFR
2014-07-01
... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.677 Original identification of plan section. (a) This section identifies the original “Idaho Air Quality Implementation Plan” and all revisions submitted by Idaho that were federally approved prior to November 12, 2004. (b) The...
-
40 CFR 52.677 - Original identification of plan section.
Code of Federal Regulations, 2013 CFR
2013-07-01
... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.677 Original identification of plan section. (a) This section identifies the original “Idaho Air Quality Implementation Plan” and all revisions submitted by Idaho that were federally approved prior to November 12, 2004. (b) The...
-
40 CFR 52.677 - Original identification of plan section.
Code of Federal Regulations, 2012 CFR
2012-07-01
... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.677 Original identification of plan section. (a) This section identifies the original “Idaho Air Quality Implementation Plan” and all revisions submitted by Idaho that were federally approved prior to November 12, 2004. (b) The...
-
40 CFR 52.677 - Original identification of plan section.
Code of Federal Regulations, 2011 CFR
2011-07-01
... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS Idaho § 52.677 Original identification of plan section. (a) This section identifies the original “Idaho Air Quality Implementation Plan” and all revisions submitted by Idaho that were federally approved prior to November 12, 2004. (b) The...
-
This Paper covers the basics of passive sampler design, compares passive samplers to conventional methods of air sampling, and discusses considerations when implementing a passive sampling program. The Paper also discusses field sampling and sample analysis considerations to ensu...
-
ERIC Educational Resources Information Center
Warner-Richter, Mallory; Lowe, Claire; Tout, Kathryn; Epstein, Dale; Li, Weilin
2016-01-01
The Success By 6® (SB6) initiative is designed to support early care and education centers in improving and sustaining quality in Pennsylvania's Keystone STARS Quality Rating and Improvement System (QRIS). The SB6 evaluation report examines implementation and outcomes. The findings have implications for SB6 continous quality improvement process…
-
ERIC Educational Resources Information Center
Kaimal, Girija; Jordan, Will J.
2016-01-01
Context: Policymakers have increasingly advocated for incentive-based approaches for improving urban schools. Purpose of the study: Few studies have examined the implementation of incentive based approaches in the urban charter school context. This paper presents research findings from a 4-year longitudinal study of the implementation of a…
-
Groundwater studies: principal aquifer surveys
Burow, Karen R.; Belitz, Kenneth
2014-01-01
In 1991, the U.S. Congress established the National Water-Quality Assessment (NAWQA) program within the U.S. Geological Survey (USGS) to develop nationally consistent long-term datasets and provide information about the quality of the Nation’s streams and groundwater. The USGS uses objective and reliable data, water-quality models, and systematic scientific studies to assess current water-quality conditions, to identify changes in water quality over time, and to determine how natural factors and human activities affect the quality of streams and groundwater. NAWQA is the only non-regulatory Federal program to perform these types of studies; participation is voluntary. In the third decade (Cycle 3) of the NAWQA program (2013–2023), the USGS will evaluate the quality and availability of groundwater for drinking supply, improve our understanding of where and why water quality is degraded, and assess how groundwater quality could respond to changes in climate and land use. These goals will be addressed through the implementation of a new monitoring component in Cycle 3: Principal Aquifer Surveys.
-
Total Quality Management and Media Services: The Deming Method.
ERIC Educational Resources Information Center
Richie, Mark L.
1992-01-01
W. Edwards Deming built a 40-year record of quality management in Japan known as Total Quality Management (TQM). His 14 points require a change in the belief system of managers and media directors, but their implementation in government agencies and schools will produce increased time for better services, better communications, and new programs.…
-
40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures
Code of Federal Regulations, 2010 CFR
2010-07-01
... use of this methodology may be found in the Great Lakes Water Quality Initiative Technical Support... (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. F Appendix F to... that is freely dissolved in the ambient water is different than that used to derive the system-wide...
-
40 CFR Appendix F to Part 132 - Great Lakes Water Quality Initiative Implementation Procedures
Code of Federal Regulations, 2011 CFR
2011-07-01
... use of this methodology may be found in the Great Lakes Water Quality Initiative Technical Support... (CONTINUED) WATER PROGRAMS WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. F Appendix F to... that is freely dissolved in the ambient water is different than that used to derive the system-wide...
-
ERIC Educational Resources Information Center
Ros, Soveacha
2010-01-01
Quality Assurance in higher education has been an ongoing international issue for discussion. As higher education institutions move toward an era of accountability and accreditation, groups of stakeholders require proof of high-quality academic programs and services from higher education providers. Since the mid-1990s, most providers have strived…
-
ERIC Educational Resources Information Center
Chen, Karen Hui-Jung; Hou, Angela Yung-Chi
2016-01-01
In 2012, Taiwan implemented a dual-track quality assurance system comprising accreditation and self-accreditation in higher education institutions. Self-accrediting institutions can accredit their programs without requiring approval from external quality assurance agencies. In contrast to other countries, the Ministry of Education of Taiwan…
-
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-25
... and New Hampshire. The revised programs in Massachusetts and New Hampshire include a test and repair..., EPA New England Regional Office, Office of Ecosystem Protection, Air Quality Planning Unit, 5 Post... Protection, Air Quality Planning Unit, 5 Post Office Square--Suite 100, (Mail code OEP05-2), Boston, MA 02109...
-
Implementing the patient-centered medical home in residency education.
Doolittle, Benjamin R; Tobin, Daniel; Genao, Inginia; Ellman, Matthew; Ruser, Christopher; Brienza, Rebecca
2015-01-01
In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training. Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.
-
NASA Astrophysics Data System (ADS)
Carles, Guillem; Ferran, Carme; Carnicer, Artur; Bosch, Salvador
2012-01-01
A computational imaging system based on wavefront coding is presented. Wavefront coding provides an extension of the depth-of-field at the expense of a slight reduction of image quality. This trade-off results from the amount of coding used. By using spatial light modulators, a flexible coding is achieved which permits it to be increased or decreased as needed. In this paper a computational method is proposed for evaluating the output of a wavefront coding imaging system equipped with a spatial light modulator, with the aim of thus making it possible to implement the most suitable coding strength for a given scene. This is achieved in an unsupervised manner, thus the whole system acts as a dynamically selfadaptable imaging system. The program presented here controls the spatial light modulator and the camera, and also processes the images in a synchronised way in order to implement the dynamic system in real time. A prototype of the system was implemented in the laboratory and illustrative examples of the performance are reported in this paper. Program summaryProgram title: DynWFC (Dynamic WaveFront Coding) Catalogue identifier: AEKC_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEKC_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 10 483 No. of bytes in distributed program, including test data, etc.: 2 437 713 Distribution format: tar.gz Programming language: Labview 8.5 and NI Vision and MinGW C Compiler Computer: Tested on PC Intel ® Pentium ® Operating system: Tested on Windows XP Classification: 18 Nature of problem: The program implements an enhanced wavefront coding imaging system able to adapt the degree of coding to the requirements of a specific scene. The program controls the acquisition by a camera, the display of a spatial light modulator and the image processing operations synchronously. The spatial light modulator is used to implement the phase mask with flexibility given the trade-off between depth-of-field extension and image quality achieved. The action of the program is to evaluate the depth-of-field requirements of the specific scene and subsequently control the coding established by the spatial light modulator, in real time.
-
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
... standards for which EPA has issued the waiver. CARB has as long a history of enforcement of vehicle/engine... program. The history and rigor of CARB's enforcement program lends assurance to California SIP revisions...
-
The Challenge: Overcoming the Pitfalls.
ERIC Educational Resources Information Center
Lozier, G. Gregory; Teeter, Deborah J.
1993-01-01
Some organizations are having difficulty with the Total Quality Management (TQM) approach. Problems appear to come from reliance on prepackaged TQM programs, large-scale, diffuse implementation, mass training programs, measurement paralysis, overemphasis on tools, process selection, outmoded reward structures, and simplistic views of change and…
-
The USEPA Beaches Environmental Assessment and Coastal Health Act (BEACH Act) requires states to develop monitoring and notification programs for recreational waters using approved bacterial indicators. Implementation of an appropriate monitoring program can, under some circumsta...
-
Biological Profiling of Endocrine Related Effects of Chemicals in ToxCast
The Food Quality Protection Act of 1996 mandates that EPA implement a validated screening program for detecting estrogenic chemicals, as well as other endocrine targets deemed appropriate by the Administrator. EPA’s Endocrine Disruptor Screening Program (EDSP) has been developing...
-
Biological Profiling of Endocrine Related Effects of Chemicals Using ToxCast
The Food Quality Protection Act of 1996 mandates that EPA implement a validated screening program for detecting estrogenic chemicals, as well as other endocrine targets deemed appropriate by the Administrator. EPA’s Endocrine Disruptor Screening Program (EDSP) has been developing...
-
Instructional Design Processes and Traditional Colleges
ERIC Educational Resources Information Center
Vasser, Nichole
2010-01-01
Traditional colleges who have implemented distance education programs would benefit from using instructional design processes to develop their courses. Instructional design processes provide the framework for designing and delivering quality online learning programs in a highly-competitive educational market. Traditional college leaders play a…
-
Pilot education and safety awareness programs
NASA Technical Reports Server (NTRS)
Shearer, M.; Reynard, W. D.
1984-01-01
Guidelines necessary for the implementation of safety awareness programs for commuter airlines are discussed. A safety office can be viewed as fulfilling either an education and training function or a quality assurance function. Issues such as management structure, motivation, and cost limitations are discussed.
-
Episode-Based Payment for Perinatal Care in Medicaid: Implications for Practice and Policy.
Jarlenski, Marian; Borrero, Sonya; La Charité, Trey; Zite, Nikki B
2016-06-01
Medicaid is an important source of health insurance coverage for low-income pregnant women and covers nearly half of all deliveries in the United States. In the face of budgetary pressures, several state Medicaid programs have implemented or are considering implementing episode-based payments for perinatal care. Under the episode-based payment model, Medicaid programs make a single payment for all pregnancy-related medical services provided to women with low- and medium-risk pregnancies from 40 weeks before delivery through 60 days postpartum. The health care provider who delivers a live birth is assigned responsibility for all care and must meet certain quality metrics and stay within delineated cost-per-episode parameters. Implementation of cost- and quality-dependent episode-based payments for perinatal care is notable because there is no published evidence about the effects of such initiatives on pregnancy or birth outcomes. In this article, we highlight challenges and potential adverse consequences related to defining the perinatal episode and assigning a responsible health care provider. We also describe concerns that perinatal care quality metrics may not address the most pressing health care issues that are likely to improve health outcomes and reduce costs. In their current incarnations, Medicaid programs' episode-based payments for perinatal care may not improve perinatal care delivery and subsequent health outcomes. Rigorous evaluation of the new episode-based payment initiatives is critically needed to inform policymakers about the intended and unintended consequences of implementing episode-based payments for perinatal care.
-
2012-11-15
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).
-
TIME-RELEVANT BEACH AND RECREATIONAL WATER QUALITY AND MONITORING AND REPORTING
This handbook provides information on how to design and implement a time-relevant water quality monitoring program for beaches and other recreational waters. It was developed to help interested communities learn more about the beach monitoring projects associated with EPA's Envir...
-
Brody, Abraham A; Guan, Carrie; Cortes, Tara; Galvin, James E
2016-01-01
Home health care agencies are increasingly taking care of sicker, older patients with greater comorbidities. However, they are unequipped to appropriately manage these older adults, particular persons living with dementia (PLWD). We therefore developed the Dementia Symptom Management at Home (DSM-H) Program, a bundled interprofessional intervention, to improve the care confidence of providers, and quality of care delivered to PLWD and their caregivers. We implemented the DSM-H with 83 registered nurses, physical therapists, and occupational therapists. Overall, there was significant improvement in pain knowledge (5.9%) and confidence (26.5%), depression knowledge (14.8%) and confidence (36.1%), and neuropsychiatric symptom general knowledge (16.8%), intervention knowledge (20.9%), attitudes (3.4%) and confidence (27.1%) at a statistical significance of (P < .0001). We also found significant differences between disciplines. Overall, this disseminable program proved to be implementable and improve clinician's knowledge and confidence in caring for PLWD, with the potential to improve quality of care and quality of life, and decrease costs. Published by Elsevier Inc.
-
The quest to standardize hemodialysis care.
Hegbrant, Jörgen; Gentile, Giorgio; Strippoli, Giovanni F M
2011-01-01
A large global dialysis provider's core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence-based guidelines and clinical protocols; consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner, incorporating information on interclinic and intercountry variations; and revising targets, guidelines and clinical protocols based on sound scientific data. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice; and auditing of clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety. Copyright © 2011 S. Karger AG, Basel.
-
Russell, David; Rosenfeld, Peri; Ames, Sylvia; Rosati, Robert J
2010-01-01
There is a growing recognition among health services researchers and policy makers that Health Information Technology (HIT) has the potential to address challenging issues that face patients and providers of healthcare. The Visiting Nurse Service of New York (VNSNY), a large not-for-profit home healthcare agency, has integrated technology applications into the service delivery model of several programs. Case studies, including the development and implementation, of three informatics initiatives at VNSNY are presented on: (1) Quality Scorecards that utilize process, outcomes, cost, and satisfaction measures to assess performance among clinical staff and programs; (2) a tool to identify patients at risk of being hospitalized, and (3) a predictive model that identifies patients who are eligible for physical rehabilitation services. Following a description of these initiatives, we discuss their impact on quality and process indicators, as well as the opportunities and challenges to implementation. © 2010 National Association for Healthcare Quality.
-
Reyes, Cynthia; Greenbaum, Alissa; Porto, Catherine; Russell, John C
2017-03-01
Accurate clinical documentation (CD) is necessary for many aspects of modern health care, including excellent communication, quality metrics reporting, and legal documentation. New requirements have mandated adoption of ICD-10-CM coding systems, adding another layer of complexity to CD. A clinical documentation improvement (CDI) and ICD-10 training program was created for health care providers in our academic surgery department. We aimed to assess the impact of our CDI curriculum by comparing quality metrics, coding, and reimbursement before and after implementation of our CDI program. A CDI/ICD-10 training curriculum was instituted in September 2014 for all members of our university surgery department. The curriculum consisted of didactic lectures, 1-on-1 provider training, case reviews, e-learning modules, and CD queries from nurse CDI staff and hospital coders. Outcomes parameters included monthly documentation completion rates, severity of illness (SOI), risk of mortality (ROM), case-mix index (CMI), all-payer refined diagnosis-related groups (APR-DRG), and Surgical Care Improvement Program (SCIP) metrics. Financial gain from responses to CDI queries was determined retrospectively. Surgery department delinquent documentation decreased by 85% after CDI implementation. Compliance with SCIP measures improved from 85% to 97%. Significant increases in surgical SOI, ROM, CMI, and APR-DRG (all p < 0.01) were found after CDI/ICD-10 training implementation. Provider responses to CDI queries resulted in an estimated $4,672,786 increase in charges. Clinical documentation improvement/ICD-10 training in an academic surgery department is an effective method to improve documentation rates, increase the hospital estimated reimbursement based on more accurate CD, and provide better compliance with surgical quality measures. Copyright © 2016 American College of Surgeons. All rights reserved.