Quality of medicines in Canada: a retrospective review of risk communication documents (2005–2013)

PubMed Central

Almuzaini, Tariq; Sammons, Helen; Choonara, Imti

2014-01-01

Objective To explore the quality and safety of medicines in Canada. Design A retrospective review of drug recalls and risk communication documents conveying issues relating to defective (ie, substandard and falsified) medicines. Setting The Health Canada website search for drug recalls and risk communication documents issued between 2005 and 2013. Eligibility criteria Drug recalls and risk communication documents related to quality defect in medicinal products. Main outcome measure Relevant data about defective medicines reported in drug recalls and risk communication documents, including description of the defect, type of formulation, year of the recall and category of the recall or the document. Results There were 653 defective medicines of which 649 were substandard. The number of defective medicines reported by Health Canada increased from 42 in 2005 to 143 in 2013. The two most frequently reported types of defects were stability (205 incidents) and contamination issues (139 incidents). Some of these defects were found to be more prominent and repetitive over other types within some manufacturers. Tablet formulation (251 incidents) was the formulation most frequently compromised. No significant differences were observed between the manufacturers and distributors in the number of substandard medicines reported under each defect type. There were only four falsified medicines reported over the 9-year period. Conclusions Substandard medicines are a problem in Canada and have resulted in an increasing number of recalled medicines. Most of the failures were related to stability issues, raising the need to investigate the root causes and for stringent preventative measures to be implemented by manufacturers. PMID:25361839

Corrective Action Decision Document/Closure Report for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada, Revision 1

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

Matthews, Patrick

2014-01-01

The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that no further corrective action is needed for CAU 105 based on the implementation of the corrective actions. Corrective action investigation (CAI) activities were performed from October 22, 2012, through May 23, 2013, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices.

Aviation System Analysis Capability Quick Response System Report Server User’s Guide.

DTIC Science & Technology

1996-10-01

primary data sources for the QRS Report Server are the following: ♦ United States Department of Transportation airline service quality per- formance...and to cross-reference sections of this document. is used to indicate quoted text messages from WWW pages. is used for WWW page and section titles...would link the user to another document or another section of the same document. ALL CAPS is used to indicate Report Server variables for which the

A Documentation System to Save Time and Ensure Proper Application of the Fiberoptic Endoscopic Evaluation of Swallowing (FEES®)

PubMed Central

Hey, Christiane; Pluschinski, Petra; Stanschus, Soenke; Euler, Harald A.; Sader, Robert A.; Langmore, Susan; Neumann, Katrin

2011-01-01

A properly performed fiberoptic endoscopic evaluation of swallowing (FEES®) is comprehensive and time-consuming. Editing times of FEES protocols and attempts for efficiency maximization are unknown. Here, the protocol editing times of completed FEES examinations were determined. The present study reports the time savings and quality gains of a newly developed documentation system tailored to the FEES standard of Langmore. Four independent examiners analyzed twelve videos of FEES procedures, six without and six with the documentation system. Effectiveness of the documentation system was evaluated according to the times for total evaluation, interpretation, documentation, report writing, and for report completeness. The documentation system reduced editing times and increased report completeness with large effect sizes. Averaged total evaluation time decreased from 42 to 27 min, report completeness increased from 55 to 80%. The use of the documentation system facilitates and improves the assessment of the swallowing process. PMID:20938202

The Setup Phase of Project Open Book: A Report to the Commission on Preservation and Access on the Status of an Effort to Convert Microfilm to Digital Imagery.

ERIC Educational Resources Information Center

Conway, Paul; Weaver, Shari

1994-01-01

This report documents the second phase of Yale University's Project Open Book, which explored the uses of digital technology for preservation of and access to deteriorating documents. Highlights include preconditions for project implementation; quality digital conversion; characteristics of source materials; digital document indexing; workflow…

Audit and feedback intervention: An examination of differences in chiropractic record-keeping compliance.

PubMed

Homb, Nicole M; Sheybani, Shayan; Derby, Dustin; Wood, Kurt

2014-10-01

Objective : The objective of this study was to investigate the association of a clinical documentation quality improvement program using audit-feedback with clinical compliance to indicators of quality chart documentation. Methods : This was an analysis of differences between adherence to quality indicators of chiropractic record documentation and audit-feedback intervention (feedback report only vs. feedback report with one-on-one educational consultation) at different campuses. Comparisons among groups were analyzed using analysis of variance (ANOVA), Tukey or Dunnett post hoc tests, and Cohen's d effect size estimates. Results : There was a significant increase in the mean percentile compliance in 2 of 5 compliance areas and 1 of 11 compliance objectives. Campus B demonstrated significantly higher levels of compliance relative to campus A and/or campus C in 5 of 5 compliance areas and 7 of 11 compliance objectives. Across-campus comparisons indicated that the compliance area Review (Non-Medicare) Treatment Plan [F(2,18) = 17.537, p < .001] and compliance objective Treatment Plan Goals [F(2,26) = 5.653, p < .001] exhibited the highest practical importance for clinical compliance practice. Conclusions : Feedback of performance improved compliance to indicators of quality health record documentation, especially when baseline adherence is relatively low. Required educational consultations with clinicians combined with audit-feedback were no more effective at increasing compliance to indicators of quality health record documentation than audit-feedback alone.

Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

USGS Publications Warehouse

Rasmussen, Teresa J.; Bennett, Trudy J.; Foster, Guy M.; Graham, Jennifer L.; Putnam, James E.

2014-01-01

As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

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

Sailer, S.J.

This Quality Assurance Project Plan (QAPJP) specifies the quality of data necessary and the characterization techniques employed at the Idaho National Engineering Laboratory (INEL) to meet the objectives of the Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) Transuranic Waste Characterization Quality Assurance Program Plan (QAPP) requirements. This QAPJP is written to conform with the requirements and guidelines specified in the QAPP and the associated documents referenced in the QAPP. This QAPJP is one of a set of five interrelated QAPjPs that describe the INEL Transuranic Waste Characterization Program (TWCP). Each of the five facilities participating in the TWCPmore » has a QAPJP that describes the activities applicable to that particular facility. This QAPJP describes the roles and responsibilities of the Idaho Chemical Processing Plant (ICPP) Analytical Chemistry Laboratory (ACL) in the TWCP. Data quality objectives and quality assurance objectives are explained. Sample analysis procedures and associated quality assurance measures are also addressed; these include: sample chain of custody; data validation; usability and reporting; documentation and records; audits and 0385 assessments; laboratory QC samples; and instrument testing, inspection, maintenance and calibration. Finally, administrative quality control measures, such as document control, control of nonconformances, variances and QA status reporting are described.« less

Assessment Report Sandia National Laboratories Fuel Cycle Technologies Quality Assurance Evaluation of FY15 SNL FCT M2 Milestone Deliverables

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

Appel, Gordon John

Sandia National Laboratories (SNL) Fuel Cycle Technologies (FCT) program activities are conducted in accordance with FCT Quality Assurance Program Document (FCT-QAPD) requirements. The FCT-QAPD interfaces with SNL approved Quality Assurance Program Description (SNL-QAPD) as explained in the Sandia National Laboratories QA Program Interface Document for FCT Activities (Interface Document). This plan describes SNL's FY16 assessment of SNL's FY15 FCT M2 milestone deliverable's compliance with program QA requirements, including SNL R&A requirements. The assessment is intended to confirm that SNL's FY15 milestone deliverables contain the appropriate authenticated review documentation and that there is a copy marked with SNL R&A numbers.

Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

PubMed

Martin, Krystle; Ham, Elke; Hilton, Zoe

2018-05-12

To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

40 CFR 160.35 - Quality assurance unit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating... LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.35 Quality assurance unit. (a) A testing...

Quality of narrative operative reports in pancreatic surgery

PubMed Central

Wiebe, Meagan E.; Sandhu, Lakhbir; Takata, Julie L.; Kennedy, Erin D.; Baxter, Nancy N.; Gagliardi, Anna R.; Urbach, David R.; Wei, Alice C.

2013-01-01

Background Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. Methods We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. Results We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13–54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. Conclusion The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care. PMID:24067527

Quality of narrative operative reports in pancreatic surgery.

PubMed

Wiebe, Meagan E; Sandhu, Lakhbir; Takata, Julie L; Kennedy, Erin D; Baxter, Nancy N; Gagliardi, Anna R; Urbach, David R; Wei, Alice C

2013-10-01

Quality in health care can be evaluated using quality indicators (QIs). Elements contained in the surgical operative report are potential sources for QI data, but little is known about the completeness of the narrative operative report (NR). We evaluated the completeness of the NR for patients undergoing a pancreaticoduodenectomy. We reviewed NRs for patients undergoing a pancreaticoduodenectomy over a 1-year period. We extracted 79 variables related to patient and narrator characteristics, process of care measures, surgical technique and oncology-related outcomes by document analysis. Data were coded and evaluated for completeness. We analyzed 74 NRs. The median number of variables reported was 43.5 (range 13-54). Variables related to surgical technique were most complete. Process of care and oncology-related variables were often omitted. Completeness of the NR was associated with longer operative duration. The NRs were often incomplete and of poor quality. Important elements, including process of care and oncology-related data, were frequently missing. Thus, the NR is an inadequate data source for QI. Development and use of alternative reporting methods, including standardized synoptic operative reports, should be encouraged to improve documentation of care and serve as a measure of quality of surgical care.

Volume 2 - Point Sources

EPA Pesticide Factsheets

Point source emission reference materials from the Emissions Inventory Improvement Program (EIIP). Provides point source guidance on planning, emissions estimation, data collection, inventory documentation and reporting, and quality assurance/quality contr

Annual National Report of the Australian Vocational Education and Training System, 2001. Volume 1: National Overview; Volume 2: Commonwealth, State & Territory Reports.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

This document contains the first two volumes of a three-volume annual national report on Australia's vocational education and training (VET) system. Volume 1, which constitutes approximately 30% of the document, details progress in achieving the following national priorities: (1) a quality national training system that provides value for money…

Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

PubMed

Grundmeier, Robert W; Masino, Aaron J; Casper, T Charles; Dean, Jonathan M; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M; Alpern, Elizabeth R

2016-11-09

Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English "stop words" and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available software, offers quality improvement teams new opportunities to extract information from narrative documents.

Quality expectations and tolerance limits of trial master files (TMF) – Developing a risk-based approach for quality assessments of TMFs

PubMed Central

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B.

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs. PMID:26693218

Quality expectations and tolerance limits of trial master files (TMF) - Developing a risk-based approach for quality assessments of TMFs.

PubMed

Hecht, Arthur; Busch-Heidger, Barbara; Gertzen, Heiner; Pfister, Heike; Ruhfus, Birgit; Sanden, Per-Holger; Schmidt, Gabriele B

2015-01-01

This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete. This is directly reflected in the number of inspection findings reported and published by the EMA in 2014. Based on quality risk management principles in clinical trials the authors defined the quality expectations for the different document types in a TMF and furthermore defined tolerance limits for missing documents. This publication provides guidance on what type of documents and processes are most important, and in consequence, indicates on which documents and processes trial team staff should focus in order to achieve a high-quality TMF. The members of this working group belong to the CQAG Group (Clinical Quality Assurance Germany) and are QA (quality assurance) experts (auditors or compliance functions) with long-term experience in the practical handling of TMFs.

BASINs 4.0 Climate Assessment Tool (CAT): Supporting ...

EPA Pesticide Factsheets

EPA announced the availability of the report, BASINS 4.0 Climate Assessment Tool (CAT): Supporting Documentation and User's Manual. This report was prepared by the EPA's Global Change Research Program (GCRP), an assessment-oriented program, that sits within the Office of Research and Development, that focuses on assessing how potential changes in climate and other global environmental stressors may impact water quality, air quality, aquatic ecosystems, and human health in the United States. The Program’s focus on water quality is consistent with the Research Strategy of the U.S. Climate Change Research Program—the federal umbrella organization for climate change science in the U.S. government—and is responsive to U.S. EPA’s mission and responsibilities as defined by the Clean Water Act and the Safe Drinking Water Act. A central goal of the EPA GCRP is to provide EPA program offices, Regions, and other stakeholders with tools and information for assessing and responding to any potential future impacts of climate change. In 2007, the EPA Global Change Research Program (GCRP), in partnership with the EPA Office of Water, supported development of a Climate Assessment Tool (CAT) for version 4 of EPA’s BASINS modeling system. This report provides supporting documentation and user support materials for the BASINS CAT tool. The purpose of this report is to provide in a single document a variety of documentation and user support materials supporting the use

Toward Machine Understanding of Information Quality.

ERIC Educational Resources Information Center

Tang, Rong; Ng, K. B.; Strzalkowski, Tomek; Kantor, Paul B.

2003-01-01

Reports preliminary results of a study to develop and automate new metrics for assessment of information quality in text documents, particularly in news. Through focus group studies, quality judgment experiments, and textual feature extraction and analysis, nine quality aspects were generated and applied in human assessments. Experiments were…

Volume 3 - Area Sources and Area Source Method Abstracts

EPA Pesticide Factsheets

Nonpoint (area) source emission reference materials from the EIIP. Provides nonpoint source guidance on planning, emissions estimation, data collection, inventory documentation and reporting, and quality assurance/quality control.

Environmental Response Laboratory Network (ERLN) Laboratory Requirements

EPA Pesticide Factsheets

The Environmental Response Laboratory Network requires its member labs follow specified quality systems, sample management, data reporting, and general, in order to ensure consistent analytical data of known and documented quality.

Recommendations for a Standardized Pulmonary Function Report. An Official American Thoracic Society Technical Statement.

PubMed

Culver, Bruce H; Graham, Brian L; Coates, Allan L; Wanger, Jack; Berry, Cristine E; Clarke, Patricia K; Hallstrand, Teal S; Hankinson, John L; Kaminsky, David A; MacIntyre, Neil R; McCormack, Meredith C; Rosenfeld, Margaret; Stanojevic, Sanja; Weiner, Daniel J

2017-12-01

The American Thoracic Society committee on Proficiency Standards for Pulmonary Function Laboratories has recognized the need for a standardized reporting format for pulmonary function tests. Although prior documents have offered guidance on the reporting of test data, there is considerable variability in how these results are presented to end users, leading to potential confusion and miscommunication. A project task force, consisting of the committee as a whole, was approved to develop a new Technical Standard on reporting pulmonary function test results. Three working groups addressed the presentation format, the reference data supporting interpretation of results, and a system for grading quality of test efforts. Each group reviewed relevant literature and wrote drafts that were merged into the final document. This document presents a reporting format in test-specific units for spirometry, lung volumes, and diffusing capacity that can be assembled into a report appropriate for a laboratory's practice. Recommended reference sources are updated with data for spirometry and diffusing capacity published since prior documents. A grading system is presented to encourage uniformity in the important function of test quality assessment. The committee believes that wide adoption of these formats and their underlying principles by equipment manufacturers and pulmonary function laboratories can improve the interpretation, communication, and understanding of test results.

Development and evaluation of an aged care specific Advance Care Plan.

PubMed

Silvester, William; Parslow, Ruth A; Lewis, Virginia J; Fullam, Rachael S; Sjanta, Rebekah; Jackson, Lynne; White, Vanessa; Hudson, Rosalie

2013-06-01

To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets failed to adequately and clearly specify the resident's preferences as regards life prolonging medical treatment. The newly developed aged care specific Advance Care Plan template was met with approval by participating RACFs. Of 203 Advance Care Plans completed on the template throughout the project period, 49% included the appointment of a Medical Enduring Power of Attorney. Requests concerning medical treatment were specified in almost all completed documents (97%), with 73% nominating the option of refusal of life-prolonging treatment. Over 90% of plans included information concerning residents' values and beliefs, and future health situations that the resident would find to be unacceptable were specified in 78% of completed plans. Standardised procedures and documentation are needed to improve the quality of processes, documents and outcomes of ACP in the residential aged care sector.

Quality assurance for health and environmental chemistry: 1990

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

Gautier, M.A.; Gladney, E.S.; Koski, N.L.

1991-10-01

This report documents the continuing quality assurance efforts of the Health and Environmental Chemistry Group (HSE-9) at the Los Alamos National Laboratory. The philosophy, methodology, computing resources, and laboratory information management system used by the quality assurance program to encompass the diversity of analytical chemistry practiced in the group are described. Included in the report are all quality assurance reference materials used, along with their certified or consensus concentrations, and all analytical chemistry quality assurance measurements made by HSE-9 during 1990.

Methods and Sources of Data Used to Develop Selected Water-Quality Indicators for Streams and Ground Water for the 2007 Edition of The State of the Nation's Ecosystems Report with Comparisons to the 2002 Edition

USGS Publications Warehouse

Wilson, John T.; Baker, Nancy T.; Moran, Michael J.; Crawford, Charles G.; Nowell, Lisa H.; Toccalino, Patricia L.; Wilber, William G.

2008-01-01

The U.S. Geological Survey (USGS) was one of numerous governmental, private, and academic entities that provided input to the report The State of the Nation?s Ecosystems published periodically by the Heinz Center. This report describes the sources of data and methods used by the USGS to develop selected water?quality indicators for the 2007 edition of the Heinz Center report and documents modifications in the data sources and interpretations between the 2002 and 2007 editions of the Heinz Center report. Stream and ground?water quality data collected nationally as part of the USGS National Water-Quality Assessment Program were used to develop the ecosystem indicators for the Heinz Center report, including Core National indicators for the Movement of Nitrogen and Chemical Contamination and for selected ecosystems classified as Farmlands, Forest, Grasslands and Shrublands, Freshwater, and Urban and Suburban. In addition, the USGS provided water?quality and streamflow data collected as part of the National Stream Water Quality Accounting Network and the Federal?State Cooperative Program. The documentation provided herein serves not only as a reference for current and future editions of The State of the Nation?s Ecosystems but also provides critical information for future assessments of changes in contaminant occurrence in streams and ground water of the United States.

External Quality Arrangements for Scotland's Colleges

ERIC Educational Resources Information Center

Her Majesty's Inspectorate of Education, 2008

2008-01-01

This document represents an innovative and radical landmark in the development of external quality arrangements for Scotland's colleges. The quality framework and arrangements for annual engagement, subject-based aspect reports, and external review reflect new thinking nationally, within HMIE, in the Scottish Further and Higher Education Funding…

Comparison of provider-documented and patient-reported brief intervention for unhealthy alcohol use in VA outpatients.

PubMed

Lapham, Gwen T; Rubinsky, Anna D; Shortreed, Susan M; Hawkins, Eric J; Richards, Julie; Williams, Emily C; Berger, Douglas; Chavez, Laura J; Kivlahan, Daniel R; Bradley, Katharine A

2015-08-01

Performance measures for brief alcohol interventions (BIs) are currently based on provider documentation of BI. However, provider documentation may not be a reliable measure of whether or not patients are offered clinically meaningful BIs. In particular, BI documented with clinical decision support in an electronic medical record (EMR) could appear identical irrespective of the quality of BI provided. We hypothesized that differences in how BI was implemented across health systems could lead to differences in the proportion of documented BI recalled and reported by patients across health systems. Male outpatients with unhealthy alcohol use identified by confidential satisfaction surveys (2009-2012) were assessed for whether they reported receiving BI in the past year (patient-reported BI) and whether they had BI documented in the EMR during the same period (documented BI). We evaluated and compared the prevalence of documented BI to patient-reported BI across 21 VA networks to determine whether documented BI had a variable association with patient-reported BI across the networks. Of 9896 eligible male outpatients with unhealthy alcohol use, 59.0% (95% CI 57.4-60.5%) reported BI (50.4-64.9% across networks) and 37.4% (95% CI 36.0-38.9%) had BI documented in the EMR (28.0-44.2% across networks). Overall, 72.9% (95% CI 70.8-75.5%) of patients with documented BI also reported BI. The association between documented BI and patient-reported BI did not vary across VA networks in adjusted logistic regression models. Performance measures of BI that rely on provider documentation in EMRs appear comparable to patient report for comparing care across VA networks. Published by Elsevier Ireland Ltd.

Evaluation and use of the Materials and Test (MATT) Data System for quality of construction and management review : final report.

DOT National Transportation Integrated Search

1985-12-01

This report documents the review of the MATerials and Test (MATT) Data System to check the validity of data within the system. A computer program to generate the quality level of a construction material was developed. Programs were also developed to ...

Fish and other aquatic resource trends in the United States

Treesearch

Andrew J. Loftus; Curtis H. Flather

2000-01-01

This report documents the general trends in fisheries and aquatic resources for the nation as required by the Renewable Resources Planning Act (RPA) of 1974. The report highlights major trends in water quality, specific fish populations, resource utilization, and imperiled aquatic fauna. Relationships between land use, water quality, and aquatic species conditions are...

Quality and correlates of medical record documentation in the ambulatory care setting

PubMed Central

Soto, Carlos M; Kleinman, Kenneth P; Simon, Steven R

2002-01-01

Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians) at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83) but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75). Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of characteristics correlated with medical record documentation, but no pattern emerged. Further study could lead to targeted interventions to improve documentation. PMID:12473161

SU-F-T-234: Quality Improvements in the Electronic Medical Record of Patients Treated with High Dose-Rate Brachytherapy

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

Diener, T; Wilkinson, D

Purpose: To improve workflow efficiency and patient safety by assessing the quality control documentation for HDR brachytherapy within our Electronic Medical Record System (Mosaiq). Methods: A list of parameters based on NRC regulations, our quality management program (QMP), recommendations of the ACR and the American Brachytherapy Society, and HDR treatment planning risks identified in our previous FMEA study was made. Next, the parameter entries were classified according to the type of data input—manual, electronic, or both. Manual entry included the electronic Brachytherapy Treatment Record (BTR) and pre-treatment Mosaiq Assessments list. Oncentra Treatment Reports (OTR) from the Oncentra Treatment Control Systemmore » constituted the electronic data. The OTR includes a Pre-treatment Report for each fraction, and a Treatment Summary Report at the completion of treatment. Each entry was then examined for appropriateness and completeness of data; adjustments and additions as necessary were then made. Results: Ten out of twenty-one recorded treatment parameters were identified to be documented within both the BTR and OTR. Of these ten redundancies, eight were changed from recorded values to a simple checklist in the BTR to avoid recording errors. The other redundancies were kept in both documents due to their value to ensuring patient safety. An edit was made to the current BTR quality assessment; this change revises the definition of a medical event in accordance with ODH Regulation 3701:1-58-101. One addition was made to the current QMP documents regarding HDR. This addition requires a physician to be present through the duration of HDR treatment in accordance with ODH Regulation 3701:1-58-59; Paragraph (F); Section (2); Subsection (a). Conclusion: Careful examination of HDR documentation that originates from different sources can help to improve the accuracy and reliability of the documents. In addition, there may be a small improvement in efficiency due to elimination of unnecessary redundancies.« less

Maintenance quality assurance peer exchange 2.

DOT National Transportation Integrated Search

2009-04-01

This report documents a comprehensive study of twenty three maintenance quality assurance : (MQA) programs throughout the United States and Canada. The policies and standards of : each program were synthesized to create a general assessment on the co...

48 CFR 1446.670 - Inspection, receiving and acceptance reports.

Code of Federal Regulations, 2014 CFR

2014-10-01

... each commercial shipping document or packing list, whether by manual or electronic means, for supplies... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1446.670...

48 CFR 1446.670 - Inspection, receiving and acceptance reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... each commercial shipping document or packing list, whether by manual or electronic means, for supplies... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1446.670...

48 CFR 1446.670 - Inspection, receiving and acceptance reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... each commercial shipping document or packing list, whether by manual or electronic means, for supplies... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1446.670...

48 CFR 1446.670 - Inspection, receiving and acceptance reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... each commercial shipping document or packing list, whether by manual or electronic means, for supplies... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1446.670...

48 CFR 1446.670 - Inspection, receiving and acceptance reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... each commercial shipping document or packing list, whether by manual or electronic means, for supplies... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports 1446.670...

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1982)

EPA Science Inventory

This document is an evaluation and assessment of scientific information relative to determining the health and welfare effects associated with exposure to various concentrations of nitrogen oxides in ambient air. The document is not intended as a complete, detailed literature rev...

Data Assessment and Reporting-Supplement to Section 106 Tribal Guidance

EPA Pesticide Factsheets

This document is intended to complement the Tribal 106 Guidance and provide additional detail to tribes concerning the reporting information requested by EPA. It addresses the water quality assessment component of a Tribal Assessment Report.

AFT-QuEST Consortium Yearbook. Proceedings of the AFT-QuEST Consortium (April 22-26, 1973).

ERIC Educational Resources Information Center

American Federation of Teachers, Washington, DC.

This document is a report on the proceedings of the 1973 American Federation of Teachers-Quality Educational Standards in Teaching (AFT-QuEST) consortium sponsored by the AFT. Included in this document are the texts of speeches and outlines of workshops and iscussions. The document is divided into the following sections: goals, major proposals,…

Air Quality Criteria for Ozone and Related Photochemical Oxidants (Final Report, 2006)

EPA Science Inventory

In February 2006, EPA released the final document, Air Quality Criteria for Ozone and Other Photochemical Oxidants. Tropospheric or surface-level ozone (O3) is one of six major air pollutants regulated by National Ambient Air Quality Standards (NAAQS) under the U.S...

Quality Control Study of the GSL Reinsurance System. Final Report.

ERIC Educational Resources Information Center

Advanced Technology, Inc., Reston, VA.

A quality control plan for the U.S. Department of Education's Guaranteed Student Loan (GSL) reinsurance process was developed. To identify existing errors, systems documentation and past analyses of the reinsurance system were analyzed, and interviews were conducted. Corrective actions were proposed, and a quality control checklist was developed…

Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to Support Healthcare Quality Improvement

PubMed Central

Masino, Aaron J.; Casper, T. Charles; Dean, Jonathan M.; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M.; Alpern, Elizabeth R.

2016-01-01

Summary Background Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. Objective To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Methods Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English “stop words” and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. Results There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). Conclusions NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available software, offers quality improvement teams new opportunities to extract information from narrative documents. PMID:27826610

The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

PubMed

Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

2013-01-01

This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P < .01) but not at discharge (baseline, 14.9%; postintervention, 21.8%; P = .41). Residents cited the importance of PCP communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

Brief Report: Longitudinal Improvements in the Quality of Joint Attention in Preschool Children with Autism

ERIC Educational Resources Information Center

Lawton, Kathy; Kasari, Connie

2012-01-01

Children with autism exhibit deficits in their quantity and quality of joint attention. Early autism intervention studies rarely document improvement in joint attention quality. The purpose of this study was to determine whether there was a change in joint attention quality for preschoolers with autism who were randomized to a joint attention…

Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature

PubMed Central

Goodman, Daisy; Ogrinc, Greg; Davies, Louise; Baker, G Ross; Barnsteiner, Jane; Foster, Tina C; Gali, Kari; Hilden, Joanne; Horwitz, Leora; Kaplan, Heather C; Leis, Jerome; Matulis, John C; Michie, Susan; Miltner, Rebecca; Neily, Julia; Nelson, William A; Niedner, Matthew; Oliver, Brant; Rutman, Lori; Thomson, Richard

2016-01-01

Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org. PMID:27076505

Using Modeling and Simulation to Examine the Benefits of a Network Tasking Order

DTIC Science & Technology

2010-01-01

Without careful planning, the topolo- gies that form can suffer from poor Quality of Service (QoS). The networks could have bottlenecks, or worse, be... quality of service Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to...mission type include: • expected communications partners; • type of data transmitted; • bandwidth required (average, burst); • quality of service

A diagnostic expert system for structured reports, quality assessment, and training of residents in sonography.

PubMed

Huettig, Matthias; Buscher, Georg; Menzel, Thomas; Scheppach, Wolfgang; Puppe, Frank; Buscher, Hans-Peter

2004-03-15

The quality of medical reports on diagnostic procedures has a considerable impact on the quality of medical care. Handwritten or otherwise unstructured reports tend to be incomplete, whereas structured questionnaires are of limited flexibility and not considered case-adequate. Thus, medical reports of this kind may promote an incomplete and misleading documentation and, therefore, be problematic with respect to their reliability. SonoConsult (SC), an expert system for structured and case-adequate documentation of sonographic findings with an additional diagnostic component, was evaluated with respect to user acceptance and suitability for enhancing the quality of reports and supporting sonographic beginners. The expectations and the attitudes of the users toward the program were evaluated by anonymous questionnaires. The documentation of findings and the diagnostic conclusions in 103 free text reports made by experienced examiners were evaluated by subjecting their information to a subsequent input into SC. Free text reports were checked for information that was asked by SC but not mentioned in the reports. In a series of 150 cases, the system diagnoses were blinded during input of findings into SC-questionnaires and the examiners' diagnostic conclusions were compared with the uncovered SC-diagnoses with respect to forgotten diagnoses. The structured and data-driven acquisition of information by the program was well accepted by the users. However, only a medium interest in the system-delivered diagnoses was noted. The program-generated reports were characterized by a more detailed description of the findings and a higher number of diagnoses in comparison to the unstructured reports before introduction of SC as the only documentation system. When unaware of the system diagnoses, information was entered into the questionnaires, and SC generated some diagnoses which were not mentioned by the examiners in their conclusions. The possibility to inspect the system diagnoses led to an enhancement of the number of diagnoses the examiners mentioned in their conclusions. By contrast, the examiners meant that the influence of the program on their conclusions was minimal or dispensable. Beginners in sonography acknowledged that the program led them to perform a complete examination in an adequate sequence. An expert system for the data-driven, case-adequate information acquisition of abdominal ultrasound examinations may enhance the quality of the reports and, potentially, of the examinations at the same time. In addition, it may help beginners to learn a structured problem- and finding-adequate examination sequence.

Implementing the EuroFIR Document and Data Repositories as accessible resources of food composition information.

PubMed

Unwin, Ian; Jansen-van der Vliet, Martine; Westenbrink, Susanne; Presser, Karl; Infanger, Esther; Porubska, Janka; Roe, Mark; Finglas, Paul

2016-02-15

The EuroFIR Document and Data Repositories are being developed as accessible collections of source documents, including grey literature, and the food composition data reported in them. These Repositories will contain source information available to food composition database compilers when selecting their nutritional data. The Document Repository was implemented as searchable bibliographic records in the Europe PubMed Central database, which links to the documents online. The Data Repository will contain original data from source documents in the Document Repository. Testing confirmed the FoodCASE food database management system as a suitable tool for the input, documentation and quality assessment of Data Repository information. Data management requirements for the input and documentation of reported analytical results were established, including record identification and method documentation specifications. Document access and data preparation using the Repositories will provide information resources for compilers, eliminating duplicated work and supporting unambiguous referencing of data contributing to their compiled data. Copyright © 2014 Elsevier Ltd. All rights reserved.

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

48 CFR 1446.671 - Inspection, receiving and acceptance certification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... INTERIOR CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports § 1446.671... documentation shall be completed via manual or electronic means for each delivery of supplies or services in... except as noted below or on attached documents. ______ Signature and typed name of authorized Government...

Enhancing Quality of Life for Breast Cancer Patients with Bone Metastases

DTIC Science & Technology

2008-04-01

Army position, policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188...Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT See Next Page . 15. SUBJECT TERMS Breast...CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a. REPORT U b. ABSTRACT U c. THIS PAGE U

Standard procedures and quality-control practices for the U.S. Geological Survey National Field Quality Assurance Program from 1982 through 1993

USGS Publications Warehouse

Stanley, D.L.

1995-01-01

The U.S. Geological Survey operates the National Field Quality Assurance Program to provide quality- assurance reference samples to field personnel who make water-quality field measurements. The program monitors the accuracy and precision of pH, specific conductance, and alkalinity field measurements. This report documents the operational procedures and quality-control techniques used in operating the quality-assurance program.

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis.

PubMed

Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L; Ruderman, Eric M; Carter, Jeffrey D; Patel, Barry; Moreo, Kathleen

2015-12-01

In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve performance on national quality measures for RA.

Air Quality Criteria for Lead (Final Report, 1986)

EPA Science Inventory

The Air Quality Criteria documents evaluate and assesse scientific information on the health and welfare effects associated with exposure to various concentrations of lead in ambient air. The literature through 1985 has been reviewed thoroughly for information relevant to air qua...

How Students Rate the Quality Service Climate on Campus. National Research Report, 2012

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2012

2012-01-01

How satisfied are students with the service they receive--and how important is it to them? This report documents significant strides that colleges and universities have made in recent years to improve service quality and their overall campus climate, yet also finds that campuses still have room for improvement. A few highlights: (1) While progress…

How Students Rate the Quality Service Climate on Campus. National Research Report, 2011

ERIC Educational Resources Information Center

Noel-Levitz, Inc, 2011

2011-01-01

How satisfied are students with the service they receive--and how important is it to them? This report documents significant strides that colleges and universities have made in recent years to improve service quality and their overall campus climate, yet also finds that campuses still have room for improvement. A few highlights: (1) While progress…

Sources and summaries of water-quality information for the Rapid Creek basin, western South Dakota

USGS Publications Warehouse

Zogorski, John S.; Zogorski, E.M.; McKallip, T.E.

1990-01-01

This report provides a compilation of water quality information for the Rapid Creek basin in western South Dakota. Two types of information are included: First, past and current water quality monitoring data collected by the South Dakota Department of Water and Natural Resources, U.S. Forest Service, U.S. Geological Survey, and others are described. Second, a summary is included for all past water quality reports, publications, and theses that could be located during this study. A total of 62 documents were abstracted and included journal articles, abstracts, Federal agency reports and publications, university and State agency reports, local agency reports, and graduate theses. The report should be valuable to water resources managers, regulators, and others contemplating water quality research, monitoring, and regulatory programs in the Rapid Creek basin. (USGS)

The Savannah River Site's Groundwater Monitoring Program

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted during the first quarter of 1992. It includes the analytical data, field data, data review, quality control, and other documentation for this program; provides a record of the program's activities; and serves as an official document of the analytical results.

Title V Applicability of One-time Reporting Provisions for Nonmajor Sources

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Semiannual Title V Permit Data Report (TOPS) and Instructions

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Los Alamos National Laboratory Meteorology Monitoring Program: 2016 Data Completeness/ Quality Report

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

Bruggeman, David Alan

This report summarizes data completeness by tower and by instrument for 2016 and compares that data with the Los Alamos National Laboratory (LANL) and American National Standards Institute (ANSI) 2015 standards. This report is designed to make data users aware of data completeness and any data quality issues. LANL meteorology monitoring goals include 95% completeness for all measurements. The ANSI 2015 standard requires 90% completeness for all measurements. This report documents instrument/tower issues as they impact data completeness.

Monitoring the effects of highway construction in the Sedgefield Lakes watershed.

DOT National Transportation Integrated Search

2007-09-04

This report summarizes the results of a water quality monitoring project to document the effects of the : construction of the I40 bypass around Greensboro on the water quality of residential lakes in the Sedgefield and : Kings Mill communities. Th...

Closing the Personalized Medicine Information Gap: HER2 Test Documentation Practice

PubMed Central

Ferrusi, Ilia L.; Earle, Craig C.; Trudeau, Maureen; Leighl, Natasha B.; Pullenayegum, Eleanor; Khong, Hoa; Hoch, Jeffrey S.; Marshall, Deborah A.

2013-01-01

Background Uncertainty about human epidermal growth factor receptor-2 (HER2) testing practice in Canada continues to hinder efforts to improve personalized medicine. Pathologists routinely perform HER2 assessment for all tumors > 1 cm, and pathology is reported centrally to the provincial cancer registry. Objectives To understand patterns of HER2 test documentation for early-stage breast cancer (BC) patients in Ontario’s centralized pathology reporting system. Study Design Retrospective cohort study of central HER2 test documentation in early-stage BC patients diagnosed in 2006–2007. Methods Cohort and staging information was derived from cancer registry and admissions data. Linkage across administrative databases provided data on surgical and radiologic treatment, sociodemographic factors, diagnosis setting, and comorbidities. Pathology reports from the provincial cancer registry were reviewed for HER2 testing, hormone receptor, and grade. Unadjusted and adjusted odds ratios were calculated to determine factors related to HER2 documentation. Results A HER2 test was documented for 66% of 13,396 patients. HER2 documentation was associated with stage, hormone receptor, and tumor grade documentation. Higher stage and grade at diagnosis were also associated with HER2 documentation. All models suggested variable regional documentation patterns. Documentation did not differ by sociodemographic factors, presence of comorbidities, or surgical procedure. Conclusions Despite a universal testing policy, the rate of centralized HER2 test documentation was lower than expected and related to disease severity. Differences in regional reporting likely reflect ascertainment bias inherent to centralized pathology reporting rather than testing access. Improved HER2 reporting is encouraged for cancer registration, quality-of-care measurement, and program evaluation. PMID:23379747

No Further Remedial Action Planned Decision Document for Site 3.

DTIC Science & Technology

1998-04-01

INSTALLATION RESTORATION PROGRAM No FURTHER REMEDIAL ACTION PLANNED DECISION DOCUMENT FOR SITE 3 FINAL MICHIGAN AIR NATIONAL GUARD ALPENA ...COMBAT READINESS TRAINING CENTER ALPENA , MICHIGAN April 1998 Air National Guard Andrews AFB, Maryland &nc QUALITY IMSmm«^ 19980519 204 XA REPORT...Document for Site 3 at Alpena CRTC, Alpena , MI. 6. AUTHOR(S) N/A 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Montgomery

S.T.A.R.S @ Glance (Student Teacher Accountability Reporting System)

ERIC Educational Resources Information Center

New Mexico Public Education Department, 2006

2006-01-01

This document introduces the Student Teacher Accountability Reporting System (STARS), the educational data collection and reporting model selected by the New Mexico Public Education Department (NMPED) to improve the quality and timeliness of data, analysis, and information in meeting increased reporting and analysis requirements. The STARS model…

A Systemwide Approach to Improving Early Childhood Program Quality in the Detroit Metropolitan Area. Final Report.

ERIC Educational Resources Information Center

Shouse, A. Clay; Epstein, Ann S.

This document is the final report of the McGregor-funded High/Scope training initiative, a system-wide approach to improving the quality of early childhood programs in the Detroit metropolitan area. The 3-year project was based on the validated High/Scope educational approach and training model, which advocates hands-on active learning for both…

The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study.

PubMed

Schutte, Tim; van Eekeren, Rike; Richir, Milan; van Staveren, Jojanneke; van Puijenbroek, Eugène; Tichelaar, Jelle; van Agtmael, Michiel

2018-01-01

In a new prescribing qualification course for specialist oncology nurses, we thought that it is important to emphasize pharmacovigilance and adverse drug reaction (ADR) reporting. We aimed to develop and evaluate an ADR reporting assignment for specialist oncology nurses. The quality of report documentation was assessed with the "Clinical Documentation tool to assess Individual Case Safety Reports" (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses' opinions of the assignment were evaluated using an E-survey. Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were "serious" according to CIOMS criteria. In five cases (15%), the suspect drugs were listed for additional monitoring by EMA and in seven cases (21%), the ADR was not mentioned in the Summary of Product Characteristics. Twenty-five (78.1%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%) and had extensive clinical experience (6-33 years). All agreed or completely agreed that the reporting assignment was useful, that it fitted in daily practice and that it increased their attention for medication/patient safety. A large majority (84.0%) agreed the assignment changed how they dealt with ADRs. Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

Monitoring the effects of highway construction over the Little River and Crane Creek.

DOT National Transportation Integrated Search

2005-09-08

This report summarizes the results of a two-year water quality monitoring project to document the effects of : the construction of the Highway 1 bypass on the water quality of Crane (Crains) Creek and the Little River. : Automated monitoring equipmen...

Documentation for the 2003-04 Schools and Staffing Survey. NCES 2007-337

ERIC Educational Resources Information Center

Tourkin, Steven C.; Warner, Toni; Parmer, Randall; Cole, Cornette; Jackson, Betty; Zukerberg, Andrew; Cox, Shawna; Soderberg, Andrew

2007-01-01

This report serves as the survey documentation for the design and implementation of the 2003-04 Schools and Staffing Survey. Topics covered include the sample design, survey methodology, data collection procedures, data processing, response rates, imputation procedures, weighting and variance estimation, review of the quality of data, the types of…

Outcomes Assessment in Postsecondary Occupational Programs: A Consortial Approach. Project Report.

ERIC Educational Resources Information Center

State Univ. of New York, Albany. Two Year Coll. Development Center.

Outcome assessment has come to mean documentation, beyond grades and numbers of graduates, of higher education's results as proof of quality and evidence of improving undergraduate education. This document describes a consortium formed by the Two-Year College Development Center of the State University of New York, the Bureau of Postsecondary…

International Council for Standardization in Haematology (ICSH) Recommendations for Laboratory Measurement of Direct Oral Anticoagulants.

PubMed

Gosselin, Robert C; Adcock, Dorothy M; Bates, Shannon M; Douxfils, Jonathan; Favaloro, Emmanuel J; Gouin-Thibault, Isabelle; Guillermo, Cecilia; Kawai, Yohko; Lindhoff-Last, Edelgard; Kitchen, Steve

2018-03-01

This guidance document was prepared on behalf of the International Council for Standardization in Haematology (ICSH) for providing haemostasis-related guidance documents for clinical laboratories. This inaugural coagulation ICSH document was developed by an ad hoc committee, comprised of international clinical and laboratory direct acting oral anticoagulant (DOAC) experts. The committee developed consensus recommendations for laboratory measurement of DOACs (dabigatran, rivaroxaban, apixaban and edoxaban), which would be germane for laboratories assessing DOAC anticoagulation. This guidance document addresses all phases of laboratory DOAC measurements, including pre-analytical (e.g. preferred time sample collection, preferred sample type, sample stability), analytical (gold standard method, screening and quantifying methods) and post analytical (e.g. reporting units, quality assurance). The committee addressed the use and limitations of screening tests such as prothrombin time, activated partial thromboplastin time as well as viscoelastic measurements of clotting blood and point of care methods. Additionally, the committee provided recommendations for the proper validation or verification of performance of laboratory assays prior to implementation for clinical use, and external quality assurance to provide continuous assessment of testing and reporting method. Schattauer GmbH Stuttgart.

Changes in self-reported knee function and health-related quality of life after knee injury in female athletes.

PubMed

McGuine, Timothy A; Winterstein, Andrew; Carr, Kathleen; Hetzel, Scott; Scott, Jessica

2012-07-01

To document the changes in self-reported health-related quality of life and knee function in a cohort of young female athletes who have sustained a knee injury. Prospective cohort. An outpatient sports medicine clinic and university student health service. A convenience sample of 255 females (age = 17.4 ± 2.4 years) who injured their knee participating in sport or recreational activities. Injuries were categorized as anterior cruciate ligament tears, anterior knee pain, patellar instability, meniscus tear, collateral ligament sprain, and other. Knee function was assessed with the 2000 International Knee Documentation Committee (IKDC) knee survey. Health-related quality of life was assessed with the SF-12 version 2.0 (acute) survey (SF-12). Dependent variables included the paired differences in the 2000 IKDC and SF-12 subscales, and composite scores from preinjury to diagnosis. Paired differences were assessed with paired t tests (P < 0.05) reported as the mean ± SD. International Knee Documentation Committee scores at diagnosis were significantly lower than preinjury scores (P < 0.001). SF-12 scores were lower (P < 0.001) at diagnosis for each subscale (physical functioning, role physical, bodily pain, general health, vitality, social function, role emotional, and mental health) as well as the physical and mental composite scores. In addition to negatively affecting knee function, sport medicine providers should be aware that knee injuries can negatively impact the health-related quality of life in these athletes immediately after injury.

Assessment of the quality of fall detection and management in primary care in the Netherlands based on the ACOVE quality indicators.

PubMed

Askari, M; Eslami, S; van Rijn, M; Medlock, S; Moll van Charante, E P; van der Velde, N; de Rooij, S E; Abu-Hanna, A

2016-02-01

We determined adherence to nine fall-related ACOVE quality indicators to investigate the quality of management of falls in the elderly population by general practitioners in the Netherlands. Our findings demonstrate overall low adherence to these indicators, possibly indicating insufficiency in the quality of fall management. Most indicators showed a positive association between increased risk for functional decline and adherence, four of which with statistical significance. This study aims to investigate the quality of detection and management of falls in the elderly population by general practitioners in the Netherlands, using the Assessing Care of Vulnerable Elders (ACOVE) quality indicators. Community-dwelling persons aged 70 years or above, registered in participating general practices, were asked to fill in a questionnaire designed to determine general practitioner (GP) adherence to fall-related indicators. We used logistic regression to estimate the association between increased risk for functional decline-quantified by the Identification of Seniors At Risk for Primary Care score-and adherence. We then cross-validated the self-reported falls with medical records. Of the 950 elders responding to our questionnaire, only 10.6 % reported that their GP proactively asked them about falls. Of the 160 patients who reported two or more falls, or one fall for which they visited the GP, only 23.1 % had fall documentation in their records. Adherence ranged between 13.6 and 48.6 %. There was a significant positive association between the ISAR-PC scores and adherence in four QIs. Documentation of falls was highest (36.7 %) in patients whom the GP had proactively asked about falls. Based on patient self-reports, adherence to the ACOVE fall-related indicators was poor, suggesting that the quality of evaluation and management of falls in community-dwelling older persons in the Netherlands is poor. The documentation of falls and fall-related risk factors was also poor. However, for most QIs, adherence to them increased with the increase in the risk of functional decline.

THE LAKE MICHIGAN MASS BALANCE PROJECT: QUALITY ASSURANCE PLAN FOR MATHEMATICAL MODELLING

EPA Science Inventory

This report documents the quality assurance process for the development and application of the Lake Michigan Mass Balance Models. The scope includes the overall modeling framework as well as the specific submodels that are linked to form a comprehensive synthesis of physical, che...

Urban airshed modeling of air quality impacts of alternative transportation fuel use in Los Angeles and Atlanta

DOT National Transportation Integrated Search

1997-12-01

This report documents a photochemical modeling study of the potential impacts on air quality of future emissions from alternative fuel vehicles (AFVs). The main objective of the National Renewable Energy Laboratory (NREL) in supporting this study is ...

Comfort, Indoor Air Quality, and Energy Consumption in Low Energy Homes

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

Englemann, P.; Roth, K.; Tiefenbeck, V.

2013-01-01

This report documents the results of an in-depth evaluation of energy consumption and thermal comfort for two potential net zero-energy homes (NZEHs) in Massachusetts, as well as an indoor air quality (IAQ) evaluation performed in conjunction with Lawrence Berkeley National Laboratory (LBNL).

Distribution of Report on Procedures to Estimate Nitrogen Oxides (NOx) Emission Increases from Mobile and Area Sources for Prevention of Significant Deterioration (PSD) Increment Analyses

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Implementation Guidance on Annual Compliance Certification Reporting and Statement of Basis Requirements for Title V Operating Permits

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Overview of Clean Air Title V Financial Management and Reporting: A Handbook for Financial Officers and Program Managers

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Corrective Action Decision Document/Closure Report for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada, Revision 0

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

Matthews, Patrick

2013-09-01

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 105: Area 2 Yucca Flat Atmospheric Test Sites, Nevada National Security Site, Nevada. CAU 105 comprises the following five corrective action sites (CASs): -02-23-04 Atmospheric Test Site - Whitney Closure In Place -02-23-05 Atmospheric Test Site T-2A Closure In Place -02-23-06 Atmospheric Test Site T-2B Clean Closure -02-23-08 Atmospheric Test Site T-2 Closure In Place -02-23-09 Atmospheric Test Site - Turk Closure In Place The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation that nomore » further corrective action is needed for CAU 105 based on the implementation of the corrective actions. Corrective action investigation (CAI) activities were performed from October 22, 2012, through May 23, 2013, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 105: Area 2 Yucca Flat Atmospheric Test Sites; and in accordance with the Soils Activity Quality Assurance Plan, which establishes requirements, technical planning, and general quality practices.« less

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center

PubMed Central

Pourdeyhimi, R.; Wolf, B.J.; Simpson, A.N.; Martz, G.U.

2014-01-01

Introduction Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Methods Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Results Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. Discussion This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. Conclusion The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. PMID:25171260

Use of Electronic Documentation for Quality Improvement in Hospice

PubMed Central

Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

2015-01-01

Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

The Lincoln Training System: A Summary Report.

ERIC Educational Resources Information Center

Butman, Robert C.; Frick, Frederick C.

The current status of the Lincoln Training System (LTS) is reported. This document describes LTS as a computer supported microfiche system which: 1) provides random access to voice quality audio and to graphics; 2) supports student-controlled interactive processes; and 3) functions in a variety of environments. The report offers a detailed…

Using the U.S. Geological Survey National Water Quality Laboratory LT-MDL to Evaluate and Analyze Data

USGS Publications Warehouse

Bonn, Bernadine A.

2008-01-01

A long-term method detection level (LT-MDL) and laboratory reporting level (LRL) are used by the U.S. Geological Survey?s National Water Quality Laboratory (NWQL) when reporting results from most chemical analyses of water samples. Changing to this method provided data users with additional information about their data and often resulted in more reported values in the low concentration range. Before this method was implemented, many of these values would have been censored. The use of the LT-MDL and LRL presents some challenges for the data user. Interpreting data in the low concentration range increases the need for adequate quality assurance because even small contamination or recovery problems can be relatively large compared to concentrations near the LT-MDL and LRL. In addition, the definition of the LT-MDL, as well as the inclusion of low values, can result in complex data sets with multiple censoring levels and reported values that are less than a censoring level. Improper interpretation or statistical manipulation of low-range results in these data sets can result in bias and incorrect conclusions. This document is designed to help data users use and interpret data reported with the LTMDL/ LRL method. The calculation and application of the LT-MDL and LRL are described. This document shows how to extract statistical information from the LT-MDL and LRL and how to use that information in USGS investigations, such as assessing the quality of field data, interpreting field data, and planning data collection for new projects. A set of 19 detailed examples are included in this document to help data users think about their data and properly interpret lowrange data without introducing bias. Although this document is not meant to be a comprehensive resource of statistical methods, several useful methods of analyzing censored data are demonstrated, including Regression on Order Statistics and Kaplan-Meier Estimation. These two statistical methods handle complex censored data sets without resorting to substitution, thereby avoiding a common source of bias and inaccuracy.

Developing a system to track meaningful outcome measures in head and neck cancer treatment.

PubMed

Walters, Ronald S; Albright, Heidi W; Weber, Randal S; Feeley, Thomas W; Hanna, Ehab Y; Cantor, Scott B; Lewis, Carol M; Burke, Thomas W

2014-02-01

The health care industry, including consumers, providers, and payers of health care, recognize the importance of developing meaningful, patient-centered measures. This article describes our experience using an existing electronic medical record largely based on free text formats without structured documentation, in conjunction with tumor registry abstraction techniques, to obtain and analyze data for use in clinical improvement and public reporting. We performed a retrospective analysis of 2467 previously untreated patients treated with curative intent who presented with laryngeal, pharyngeal, or oral cavity cancer in order to develop a system to monitor and report meaningful outcome metrics of head and neck cancer treatment. Patients treated between 1995 and 2006 were analyzed for the primary outcomes of survival at 1 and 2 years, the ability to speak at 1 year posttreatment, and the ability to swallow at 1 year posttreatment. We encountered significant limitations in clinical documentation because of the lack of standardization of meaningful measures, as well limitations with data abstraction using a retrospective approach to reporting measures. Almost 5000 person-hours were required for data abstraction, quality review, and reporting, at a cost of approximately $134,000. Our multidisciplinary teams document extensive patient information; however, data is not stored in easily accessible formats for measurement, comparison, and reporting. We recommend identifying measures meaningful to patients, providers, and payers to be documented throughout the patients' entire treatment cycle, and significant investment in the improvements to electronic medical records and tumor registry reporting in order to provide meaningful quality measures for the future. Copyright © 2013 Wiley Periodicals, Inc.

Document Preparation (for Filming). ERIC Processing Manual, Appendix B.

ERIC Educational Resources Information Center

Brandhorst, Ted, Ed.; And Others

The technical report or "fugitive" literature collected by ERIC is produced using a wide variety of printing techniques, many formats, and variable degrees of quality control. Since the documents processed by ERIC go on to be microfilmed and reproduced in microfiche and paper copy for sale to users, it is essential that the ERIC document…

Development and Exchange of Instructional Resources in Water Quality Control Programs, II: Instructional Materials Available.

ERIC Educational Resources Information Center

Austin, John H.

This document is one in a series of reports which reviews instructional materials and equipment for water and wastewater treatment plant personnel. Approximately 900 items are listed in this document along with guidelines for the production of instructional materials. Information is provided regarding the source, type of material, intended…

The Savannah River Site's groundwater monitoring program

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program's activities and rationale, and serves as an official document of the analytical results.

The Savannah River Site`s Groundwater Monitoring Program. First quarter 1992

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted during the first quarter of 1992. It includes the analytical data, field data, data review, quality control, and other documentation for this program; provides a record of the program`s activities; and serves as an official document of the analytical results.

75 FR 71694 - Science Advisory Board Staff Office; Notification of Two Public Quality Review Teleconferences of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... review of EPA's ``Toxicological Review of Trichloroethylene'' on December 15, 2010 and (b) a quality... of Trichloroethylene'' (October 2009), and (2) a draft report peer reviewing EPA's draft document... draft assessment entitled ``Toxicological Review of Trichloroethylene'' (October 2009). EPA's Office of...

DEVELOPMENT OF GUIDELINES FOR CALIBRATING, VALIDATING, AND EVALUATING HYDROLOGIC AND WATER QUALITY MODELS: ASABE ENGINEERING PRACTICE 621

USDA-ARS?s Scientific Manuscript database

Information to support application of hydrologic and water quality (H/WQ) models abounds, yet modelers commonly use arbitrary, ad hoc methods to conduct, document, and report model calibration, validation, and evaluation. Consistent methods are needed to improve model calibration, validation, and e...

Air Quality Criteria for Particulate Matter (Final Report, 2004)

EPA Science Inventory

EPA has completed the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic revi...

INDOOR AIR QUALITY MODEL VERSION 1.0 DOCUMENTATION

EPA Science Inventory

The report presents a multiroom model for estimating the impact of various sources on indoor air quality (IAQ). The model is written for use on IBM-PC and compatible microcomputers. It is easy to use with a menu-driven user interface. Data are entered using a fill-in-a-form inter...

78 FR 12052 - Agency Information Collection Activities: Proposed Collection; Comment Request; Ambient Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

... pollution control agencies, and tribal entities which collect and report ambient air quality data for the..., documenting episodes and initiating episode controls, air quality trends assessment, and air pollution.... Although the state and local air pollution control agencies and tribal entities are responsible for the...

Youth and Work: The Incidence of the Economic Situation on the Access of Young People to Education, Culture and Work. Report, Recommendations and Documents of a European Regional Meeting, Venice, 7-11 November, 1977.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

This document contains materials from a Unesco European regional meeting held in Venice (November 7-11, 1977) to discuss the problem of youth unemployment. The final report of the meeting is composed of (1) a summary of the discussions on background and nature of the problem, remedies, action, education and training, creating jobs, quality of…

Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature.

PubMed

Goodman, Daisy; Ogrinc, Greg; Davies, Louise; Baker, G Ross; Barnsteiner, Jane; Foster, Tina C; Gali, Kari; Hilden, Joanne; Horwitz, Leora; Kaplan, Heather C; Leis, Jerome; Matulis, John C; Michie, Susan; Miltner, Rebecca; Neily, Julia; Nelson, William A; Niedner, Matthew; Oliver, Brant; Rutman, Lori; Thomson, Richard; Thor, Johan

2016-12-01

Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Research Notes - Openness and Evolvability - Documentation Quality Assessment

DTIC Science & Technology

2016-08-01

UNCLASSIFIED UNCLASSIFIED Notes – Openness and Evolvability – Documentation Quality Assessment Michael Haddy* and Adam Sbrana...Methods and Processes. This set of Research Notes focusses on Documentation Quality Assessment. This work was undertaken from the late 1990s to 2007...1 2. DOCUMENTATION QUALITY ASSESSMENT ......................................................... 1 2.1 Documentation Quality Assessment

Implementation of a Clinical Documentation Improvement Curriculum Improves Quality Metrics and Hospital Charges in an Academic Surgery Department.

PubMed

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.

NASA software documentation standard software engineering program

NASA Technical Reports Server (NTRS)

1991-01-01

The NASA Software Documentation Standard (hereinafter referred to as Standard) can be applied to the documentation of all NASA software. This Standard is limited to documentation format and content requirements. It does not mandate specific management, engineering, or assurance standards or techniques. This Standard defines the format and content of documentation for software acquisition, development, and sustaining engineering. Format requirements address where information shall be recorded and content requirements address what information shall be recorded. This Standard provides a framework to allow consistency of documentation across NASA and visibility into the completeness of project documentation. This basic framework consists of four major sections (or volumes). The Management Plan contains all planning and business aspects of a software project, including engineering and assurance planning. The Product Specification contains all technical engineering information, including software requirements and design. The Assurance and Test Procedures contains all technical assurance information, including Test, Quality Assurance (QA), and Verification and Validation (V&V). The Management, Engineering, and Assurance Reports is the library and/or listing of all project reports.

Identifying Falls Risk Screenings Not Documented with Administrative Codes Using Natural Language Processing

PubMed Central

Zhu, Vivienne J; Walker, Tina D; Warren, Robert W; Jenny, Peggy B; Meystre, Stephane; Lenert, Leslie A

2017-01-01

Quality reporting that relies on coded administrative data alone may not completely and accurately depict providers’ performance. To assess this concern with a test case, we developed and evaluated a natural language processing (NLP) approach to identify falls risk screenings documented in clinical notes of patients without coded falls risk screening data. Extracting information from 1,558 clinical notes (mainly progress notes) from 144 eligible patients, we generated a lexicon of 38 keywords relevant to falls risk screening, 26 terms for pre-negation, and 35 terms for post-negation. The NLP algorithm identified 62 (out of the 144) patients who falls risk screening documented only in clinical notes and not coded. Manual review confirmed 59 patients as true positives and 77 patients as true negatives. Our NLP approach scored 0.92 for precision, 0.95 for recall, and 0.93 for F-measure. These results support the concept of utilizing NLP to enhance healthcare quality reporting. PMID:29854264

Hanford Internal Dosimetry Project manual. Revision 1

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

Carbaugh, E.H.; Bihl, D.E.; MacLellan, J.A.

1994-07-01

This document describes the Hanford Internal Dosimetry Project, as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy and its Hanford contractors. Project services include administrating the bioassay monitoring program, evaluating and documenting assessment of potential intakes and internal dose, ensuring that analytical laboratories conform to requirements, selecting and applying appropriate models and procedures for evaluating radionuclide deposition and the resulting dose, and technically guiding and supporting Hanford contractors in matters regarding internal dosimetry. Specific chapters deal with the following subjects: practices of the project, including interpretation of applicable DOE Orders, regulations, andmore » guidance into criteria for assessment, documentation, and reporting of doses; assessment of internal dose, including summary explanations of when and how assessments are performed; recording and reporting practices for internal dose; selection of workers for bioassay monitoring and establishment of type and frequency of bioassay measurements; capability and scheduling of bioassay monitoring services; recommended dosimetry response to potential internal exposure incidents; quality control and quality assurance provisions of the program.« less

21 CFR 58.35 - Quality assurance unit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the corrective actions taken. (5) Determine that no deviations from approved protocols or standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating procedures, and...

21 CFR 58.35 - Quality assurance unit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the corrective actions taken. (5) Determine that no deviations from approved protocols or standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating procedures, and...

21 CFR 58.35 - Quality assurance unit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the corrective actions taken. (5) Determine that no deviations from approved protocols or standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating procedures, and...

21 CFR 58.35 - Quality assurance unit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the corrective actions taken. (5) Determine that no deviations from approved protocols or standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating procedures, and...

21 CFR 58.35 - Quality assurance unit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the corrective actions taken. (5) Determine that no deviations from approved protocols or standard operating procedures were made without proper authorization and documentation. (6) Review the final study report to assure that such report accurately describes the methods and standard operating procedures, and...

Topical Reports: Sustainable Design for Schools.

ERIC Educational Resources Information Center

Fox, Anne W.

This document presents several reports on the practical applications of sustainable design and schools; it includes information about student performance and sustainable design features involving lighting, acoustics, air quality, and student well-being. Three case studies (Washington's Bainbridge Island School District, Texas' Roy Lee Walker…

Effective Documentation Tools

NASA Technical Reports Server (NTRS)

Sleboda, Claire

1997-01-01

Quality assurance programs provide a very effective means to monitor and evaluate medical care. Quality assurance involves: (1) Identify a problem; (2) Determine the source and nature of the problem; (3) Develop policies and methods to effect improvement; (4) Implement those polices; (5) Monitor the methods applied; and (6) Evaluate their effectiveness. Because this definition of quality assurance so closely resembles the Nursing Process, the health unit staff was able to use their knowledge of the nursing process to develop many forms which improve the quality of patient care. These forms include the NASA DFRC Service Report, the occupational injury form (Incident Report), the patient survey (Pre-hospital Evaluation/Care Report), the Laboratory Log Sheet, the 911 Run Sheet, and the Patient Assessment Stamp. Examples and steps which are followed to generate these reports are described.

Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation

PubMed Central

Hammond, Kenric W.; Efthimiadis, Efthimis N.; Weir, Charlene R.; Embi, Peter J.; Thielke, Stephen M.; Laundry, Ryan M.; Hedeen, Ashley

2010-01-01

Background: Concerns exist about the quality of electronic health care documentation. Prior studies have focused on physicians. This investigation studied document quality perceptions of practitioners (including physicians), nurses and administrative staff. Methods: An instrument developed from staff interviews and literature sources was administered to 110 practitioners, nurses and administrative staff. Short, long and original versions of records were rated. Results: Length transformation did not affect quality ratings. On several scales practitioners rated notes less favorably than administrators or nurses. The original source document was associated with the quality rating, as was tf·idf, a relevance statistic computed from document text. Tf·idf was strongly associated with practitioner quality ratings. Conclusion: Document quality estimates were not sensitive to modifying redundancy in documents. Some perceptions of quality differ by role. Intrinsic document properties are associated with staff judgments of document quality. For practitioners, the tf·idf statistic was strongly associated with the quality dimensions evaluated. PMID:21346983

Methods and Sources of Data Used to Develop Selected Water-Quality Indicators for Streams and Ground Water for EPA's 2007 Report on the Environment: Science Report

USGS Publications Warehouse

Baker, Nancy T.; Wilson, John T.; Moran, Michael J.

2008-01-01

The U.S. Geological Survey (USGS) was one of numerous governmental agencies, private organizations, and the academic community that provided data and interpretations for the U.S. Environmental Protection Agency?s (USEPA) 2007 Report on the Environment: Science Report. This report documents the sources of data and methods used to develop selected water?quality indicators for the 2007 edition of the report compiled by USEPA. Stream and ground?water?quality data collected nationally in a consistent manner as part of the USGS?s National Water?Quality Assessment Program (NAWQA) were provided for several water?quality indicators, including Nitrogen and Phosphorus in Streams in Agricultural Watersheds; Pesticides in Streams in Agricultural Watersheds; and Nitrate and Pesticides in Shallow Ground Water in Agricultural Watersheds. In addition, the USGS provided nitrate (nitrate plus nitrite) and phosphorus riverine load estimates calculated from water?quality and streamflow data collected as part of its National Stream Water Quality Accounting Network (NASQAN) and its Federal?State Cooperative Program for the Nitrogen and Phosphorus Discharge from Large Rivers indicator.

Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement

DTIC Science & Technology

2011-01-03

six contracts. Interceptor Body Armor – Vest Components IBA is a modular body armor system that consists of an OTV, ceramic plates , and components...Armor - Vest Components Need Improvement Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...Ballistic Testing and Product Quality Surveillance for the Interceptor Body Armor - Vest Components Need Improvement 5a. CONTRACT NUMBER 5b. GRANT

A guide to the proper selection and use of federally approved sediment and water-quality samplers

USGS Publications Warehouse

Davis, Broderick E.; ,

2005-01-01

As interest in the health of rivers and streams increases3, and new water-quality regulations4 are promulgated, interest in sediment and water-quality sampling equipment and technologies has increased. While much information on the subject exists, a comprehensive summary document of sediment sampling equipment and technology is lacking. This report seeks to provide such a summary.

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

The CERCA School Report Card: Communities Creating Education Quality. Final Report

ERIC Educational Resources Information Center

Florez Guio, Ana; Chesterfield, Ray; Siri, Carmen

2006-01-01

The CERCA (Civic Engagement for Education Reform in Central America) school report card (SRC) model was developed with schools in the Dominican Republic, El Salvador, Guatemala, Honduras, and Nicaragua in 2004 and 2005. This document summarizes the major findings, successful procedures, and implications of the experience for the region. The SRC…

Global Grid Telemedicine System: Expert Consult Manager

DTIC Science & Technology

2000-10-01

Department of the Army position, policy or decision unless so designated by other documentation. DTIC QUALITY iw^^rxi 20010122 014 REPORT DOCUMENTATION...processes and personnel for collecting, processing, storing, disseminating and managing information on demand to warfighters, policy makers, and...to be responsive to and incorporate current and future policy decisions. (7) Be continuously aware, along with Network and Bandwidth managers, of

The Savannah River Site`s groundwater monitoring program. First quarter 1991

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

Not Available

This report summarizes the Savannah River Site (SRS) groundwater monitoring program conducted by EPD/EMS in the first quarter of 1991. In includes the analytical data, field data, data review, quality control, and other documentation for this program, provides a record of the program`s activities and rationale, and serves as an official document of the analytical results.

Documentation of quality improvement exposure by internal medicine residency applicants.

PubMed

Kolade, Victor O; Sethi, Anuradha

2016-01-01

Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown. To document the reporting of QI training or experience in residency applications. Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules. Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement. Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.

Flow Quality Survey of the NASA Ames 11-by 11-Ft Transonic Wind Tunnel

NASA Technical Reports Server (NTRS)

Amaya, Max A.

2011-01-01

New baseline turbulence levels have been measured using a new CTA and new hot-wire sensors. Levels remain the same as measured in 1999. Data and methodology documented (almost). New baseline acoustics levels have been measured up to Mach 1.35. -Levels are higher than reported in 1999. -Data and methodology documented (almost). Application of fairings to the strut trailing edge showed up to a 10% reduction in the tunnel background noise. Data analysis and documentation for publishing is ongoing.

NASA Publications Guide for Authors. Revised

NASA Technical Reports Server (NTRS)

2005-01-01

This document presents guidelines for use by NASA authors for preparing and publishing their scientific and technical information (STI). Section 1 gives an overview. Section 2 describes each type of report in the NASA STI Report Series and other forms of publications. It also discusses dissemination and safeguarding of STI. Section 3 gives technical, data quality, and dissemination reviews, including the mandatory review via NASA Form 1676, NASA Scientific and Technical Information (STI) Document Availability Authorization (DAA). It also describes handling unlimited and limited/restricted STI. Section 4 provides recommended standards for document format, composition, and organization and element of a typical report. Section 5 presents miscellaneous preparation recommendations. Section 6 discusses two required forms, Standard Form 298 and NF-1676. The guide cites additional sources of information of standards, guidelines, and review and approval requirements.

Efficiency of Support Services within the Arizona Universities.

ERIC Educational Resources Information Center

Davis, George H.

One of the working papers in the final report of the Arizona Board of Regents' Task Force on Excellence, Efficiency and Competitiveness, this document discusses the efficiency of the Arizona state universities' support services. Faculty, staff, and students were asked to rate the quality, importance, and change in quality of the services provided…

Air Quality Conformity Determination Of the Constrained Long Range Plan And The FY99-2004 Transportation Improvement Program For The Washington Metropolitan Region

DOT National Transportation Integrated Search

1998-07-15

This report documents the assessment of the Constrained Long Range Plan (CLRP) and the FY99-2004 Transportation Improvement Program (TIP) with respect to air quality conformity requirements under the 1990 Clean Air Act Amendments. The assessment used...

EVALUATION OF THE REAL-TIME AIR-QUALITY MODEL USING THE RAPS (REGIONAL AIR POLLUTION STUDY) DATA BASE. VOLUME 1. OVERVIEW

EPA Science Inventory

The theory and programming of statistical tests for evaluating the Real-Time Air-Quality Model (RAM) using the Regional Air Pollution Study (RAPS) data base are fully documented in four report volumes. Moreover, the tests are generally applicable to other model evaluation problem...

Quality of life and antireflux medication use following laparoscopic Nissen fundoplication.

PubMed

Bloomston, M; Zervos, E; Gonzalez, R; Albrink, M; Rosemurgy, A

1998-06-01

With the advent of minimally invasive techniques, the surgical treatment of gastroesophageal reflux disease has received renewed interest. The efficacy of laparoscopic Nissen fundoplication in eliminating reflux has been documented. This study was undertaken to determine changes in quality of life and cost of antireflux medications after laparoscopic Nissen fundoplication. One hundred patients undergoing laparoscopic Nissen fundoplication between 1992 and 1997 completed questionnaires assessing changes in pre- and postoperative cost and number of antireflux medications, reflux symptoms, and quality of life. The average number of antireflux medications was significantly reduced (1.8 versus 0.3, P < 0.0001) as was the average monthly cost ($170 versus $30, P < 0.0001). Patients reported significant (P < 0.05) symptomatic improvement in postprandial heartburn, nocturnal heartburn, postprandial nausea, postprandial vomiting, dysphagia, and gas/bloating. Patients in this series noted fewer symptoms and used fewer antireflux medications at less cost after laparoscopic Nissen fundoplication. Symptoms commonly thought of as complications of fundoplication (vomiting, dysphagia, gas/bloating) were less common after fundoplication. This report documents the efficacy of laparoscopic fundoplication in improving quality of life and reducing use and cost of antireflux medications.

Adherence to outpatient epilepsy quality indicators at a tertiary epilepsy center.

PubMed

Pourdeyhimi, R; Wolf, B J; Simpson, A N; Martz, G U

2014-10-01

Quality indicators for the treatment of people with epilepsy were published in 2010. This is the first report of adherence to all measures in routine care of people with epilepsy at a level 4 comprehensive epilepsy center in the US. Two hundred patients with epilepsy were randomly selected from the clinics of our comprehensive epilepsy center, and all visits during 2011 were abstracted for documentation of adherence to the eight quality indicators. Alternative measures were constructed to evaluate failure of adherence. Detailed descriptions of all equations are provided. Objective measures (EEG, imaging) showed higher adherence than counseling measures (safety). Initial visits showed higher adherence. Variations in the interpretation of the quality measure result in different adherence values. Advanced practice providers and physicians had different adherence patterns. No patient-specific patterns of adherence were seen. This is the first report of adherence to all the epilepsy quality indicators for a sample of patients during routine care in a level 4 epilepsy center in the US. Overall adherence was similar to that previously reported on similar measures. Precise definitions of adherence equations are essential for accurate measurement. Complex measures result in lower adherence. Counseling measures showed low adherence, possibly highlighting a difference between practice and documentation. Adherence to the measures as written does not guarantee high quality care. The current quality indicators have value in the process of improving quality of care. Future approaches may be refined to eliminate complex measures and incorporate features linked to outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on specific indications, processes, or parameters of care for which high level of evidence data and Class I or Class III guideline recommendations may be lacking but are addressed in ACCF appropriate use criteria documents. Structure/safety measures represent measures developed to address structural aspects of the use of healthcare technology (e.g., laboratory accreditation, personnel training, and credentialing) or quality issues related to patient safety when there are neither guidelines recommendations nor appropriate use criteria. Although the strength of evidence for appropriate use measures and structure/safety measures may not be as strong as that for formal performance measures, they are quality measures that are otherwise rigorously developed, reviewed, tested, and approved in the same manner as ACCF/AHA performance measures. The ultimate goal of the present document is to provide direction in defining and measuring the appropriate use-avoiding not only underuse but also overuse and misuse-and proper application of cardiovascular technology and to describe how such appropriate use measures and structure/safety measures might be developed for the purposes of quality improvement and public reporting. It is anticipated that this effort will help focus the national dialogue on the use of cardiovascular technology and away from the current concerns about volume and cost alone to a more holistic emphasis on value.

HDTS 2017.1 Testing and Verification Document

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

Whiteside, T.

2017-12-01

This report is a continuation of the series of Hunter Dose Tracking System (HDTS) Quality Assurance documents including (Foley and Powell, 2010; Dixon, 2012; Whiteside, 2017b). In this report we have created a suite of automated test cases and a system to analyze the results of those tests as well as documented the methodology to ensure the field system performs within specifications. The software test cases cover all of the functions and interactions of functions that are practical to test. With the developed framework, if software defects are discovered, it will be easy to create one or more test casesmore » to reproduce the defect and ensure that code changes correct the defect.« less

Sustained Assessment Metadata as a Pathway to Trustworthiness of Climate Science Information

NASA Astrophysics Data System (ADS)

Champion, S. M.; Kunkel, K.

2017-12-01

The Sustained Assessment process has produced a suite of climate change reports: The Third National Climate Assessment (NCA3), Regional Surface Climate Conditions in CMIP3 and CMIP5 for the United States: Differences, Similarities, and Implications for the U.S. National Climate Assessment, Impacts of Climate Change on Human Health in the United States: A Scientific Assessment, The State Climate Summaries, as well as the anticipated Climate Science Special Report and Fourth National Climate Assessment. Not only are these groundbreaking reports of climate change science, they are also the first suite of climate science reports to provide access to complex metadata directly connected to the report figures and graphics products. While the basic metadata documentation requirement is federally mandated through a series of federal guidelines as a part of the Information Quality Act, Sustained Assessment products are also deemed Highly Influential Scientific Assessments, which further requires demonstration of the transparency and reproducibility of the content. To meet these requirements, the Technical Support Unit (TSU) for the Sustained Assessment embarked on building a system for not only collecting and documenting metadata to the required standards, but one that also provides consumers unprecedented access to the underlying data and methods. As our process and documentation have evolved, the value of both continue to grow in parallel with the consumer expectation of quality, accessible climate science information. This presentation will detail the how the TSU accomplishes the mandated requirements with their metadata collection and documentation process, as well as the technical solution designed to demonstrate compliance while also providing access to the content for the general public. We will also illustrate how our accessibility platforms guide consumers through the Assessment science at a level of transparency that builds trust and confidence in the report content.

Quality-assurance and data management plan for groundwater activities by the U.S. Geological Survey in Kansas, 2014

USGS Publications Warehouse

Putnam, James E.; Hansen, Cristi V.

2014-01-01

As the Nation’s principle earth-science information agency, the U.S. Geological Survey (USGS) is depended on to collect data of the highest quality. This document is a quality-assurance plan for groundwater activities (GWQAP) of the Kansas Water Science Center. The purpose of this GWQAP is to establish a minimum set of guidelines and practices to be used by the Kansas Water Science Center to ensure quality in groundwater activities. Included within these practices are the assignment of responsibilities for implementing quality-assurance activities in the Kansas Water Science Center and establishment of review procedures needed to ensure the technical quality and reliability of the groundwater products. In addition, this GWQAP is intended to complement quality-assurance plans for surface-water and water-quality activities and similar plans for the Kansas Water Science Center and general project activities throughout the USGS. This document provides the framework for collecting, analyzing, and reporting groundwater data that are quality assured and quality controlled. This GWQAP presents policies directing the collection, processing, analysis, storage, review, and publication of groundwater data. In addition, policies related to organizational responsibilities, training, project planning, and safety are presented. These policies and practices pertain to all groundwater activities conducted by the Kansas Water Science Center, including data-collection programs, interpretive and research projects. This report also includes the data management plan that describes the progression of data management from data collection to archiving and publication.

Evaluation of a mHealth Data Quality Intervention to Improve Documentation of Pregnancy Outcomes by Health Surveillance Assistants in Malawi: A Cluster Randomized Trial

PubMed Central

Joos, Olga; Silva, Romesh; Amouzou, Agbessi; Moulton, Lawrence H.; Perin, Jamie; Bryce, Jennifer; Mullany, Luke C.

2016-01-01

Background While community health workers are being recognized as an integral work force with growing responsibilities, increased demands can potentially affect motivation and performance. The ubiquity of mobile phones, even in hard-to-reach communities, has facilitated the pursuit of novel approaches to support community health workers beyond traditional modes of supervision, job aids, in-service training, and material compensation. We tested whether supportive short message services (SMS) could improve reporting of pregnancies and pregnancy outcomes among community health workers (Health Surveillance Assistants, or HSAs) in Malawi. Methods and Findings We designed a set of one-way SMS that were sent to HSAs on a regular basis during a 12-month period. We tested the effectiveness of the cluster-randomized intervention in improving the complete documentation of a pregnancy. We defined complete documentation as a pregnancy for which a specific outcome was recorded. HSAs in the treatment group received motivational and data quality SMS. HSAs in the control group received only motivational SMS. During baseline and intervention periods, we matched reported pregnancies to reported outcomes to determine if reporting of matched pregnancies differed between groups and by period. The trial is registered as ISCTRN24785657. Conclusions Study results show that the mHealth intervention improved the documentation of matched pregnancies in both the treatment (OR 1.31, 95% CI: 1.10–1.55, p<0.01) and control (OR 1.46, 95% CI: 1.11–1.91, p = 0.01) groups relative to the baseline period, despite differences in SMS content between groups. The results should be interpreted with caution given that the study was underpowered. We did not find a statistically significant difference in matched pregnancy documentation between groups during the intervention period (OR 0.94, 95% CI: 0.63–1.38, p = 0.74). mHealth applications have the potential to improve the tracking and data quality of pregnancies and pregnancy outcomes, particularly in low-resource settings. PMID:26731401

Use of speech-to-text technology for documentation by healthcare providers.

PubMed

Ajami, Sima

2016-01-01

Medical records are a critical component of a patient's treatment. However, documentation of patient-related information is considered a secondary activity in the provision of healthcare services, often leading to incomplete medical records and patient data of low quality. Advances in information technology (IT) in the health system and registration of information in electronic health records (EHR) using speechto- text conversion software have facilitated service delivery. This narrative review is a literature search with the help of libraries, books, conference proceedings, databases of Science Direct, PubMed, Proquest, Springer, SID (Scientific Information Database), and search engines such as Yahoo, and Google. I used the following keywords and their combinations: speech recognition, automatic report documentation, voice to text software, healthcare, information, and voice recognition. Due to lack of knowledge of other languages, I searched all texts in English or Persian with no time limits. Of a total of 70, only 42 articles were selected. Speech-to-text conversion technology offers opportunities to improve the documentation process of medical records, reduce cost and time of recording information, enhance the quality of documentation, improve the quality of services provided to patients, and support healthcare providers in legal matters. Healthcare providers should recognize the impact of this technology on service delivery.

Concept Development Modular Hybrid Pier (MHP)

DTIC Science & Technology

2000-02-01

rated FRP composite bridge or bridge deck is commercially available from Creative Pultrusions, Kansas Structural Systems, Martin - Marietta , Hardcore...NAVAL FACILITIES ENGINEERING SERVICE CENTER Port Hueneme, California 93043-4370 Contract Report CR 00-001-SHR FINAL REPORT PHASE 1 - CONCEPT...20000301 043 Approved for public release; distribution is unlimited. DTIC QUALITY IMWSOfBD 4 ^^ Printed on recycled paper REPORT DOCUMENTATION PAGE

Clean Water State Revolving Fund (CWSRF) Results

EPA Pesticide Factsheets

The Clean Water State Revolving provides significant environmental benefits by maintaining and improving the nation's water quality. Reports on financial performance document CWSRF progress and account for the use of federal funds.

Review and comparison of quality standards, guidelines and regulations for laboratories.

PubMed

Datema, Tjeerd A M; Oskam, Linda; Klatser, Paul R

2012-01-01

The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents) makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services . Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory processes.

What Makes a Good Summary?

NASA Astrophysics Data System (ADS)

Zhao, Qunhua; Santos, Eugene; Nguyen, Hien; Mohamed, Ahmed

One of the biggest challenges for intelligence analysts who participate in prevention or response to a terrorism act is to quickly find relevant information from massive amounts of data. Along with research on information retrieval and filtering, text summarization is an effective technique to help intelligence analysts shorten their time to find critical information and make timely decisions. Multi-document summarization is particularly useful as it serves to quickly describe a collection of information. The obvious shortcoming lies in what it cannot capture especially in more diverse collections. Thus, the question lies in the adequacy and/or usefulness of such summarizations to the target analyst. In this chapter, we report our experimental study on the sensitivity of users to the quality and content of multi-document summarization. We used the DUC 2002 collection for multi-document summarization as our testbed. Two groups of document sets were considered: (I) the sets consisting of closely correlated documents with highly overlapped content; and (II) the sets consisting of diverse documents covering a wide scope of topics. Intuitively, this suggests that creating a quality summary would be more difficult for the latter case. However, human evaluators were discovered to be fairly insensitive to this difference. This occurred when they were asked to rank the performance of various automated summarizers. In this chapter, we examine and analyze our experiments in order to better understand this phenomenon and how we might address it to improve summarization quality. In particular, we present a new metric based on document graphs that can distinguish between the two types of document sets.

Implementation of a multi-professional standardized care plan in electronic health records for the care of stroke patients.

PubMed

Pöder, Ulrika; Fogelberg-Dahm, Marie; Wadensten, Barbro

2011-09-01

To compare staff opinions about standardized care plans and self-reported habits with regard to documentation, and their perceived knowledge about the evidence-based guidelines in stroke care before and after implementation of an evidence-based-standardized care plan (EB-SCP) and quality standard for stroke care. The aim was also to describe staff opinions about, and their use of, the implemented EB-SCP. To facilitate evidence-based practice (EBP), a multi-professional EB-SCP and quality standard for stroke care was implemented in the electronic health record (EHR). Quantitative, descriptive and comparative, based on questionnaires completed before and after implementation. Perceived knowledge about evidence-based guidelines in stroke care increased after implementation of the EB-SCP. The majority agreed that the EB-SCP is useful and facilitates their work. There was no change between before and after implementation with regard to opinions about standardized care plans, self-reported documentation habits or time spent on documentation. An evidence-based SCP seems to be useful in patient care and improves perceived knowledge about evidence-based guidelines in stroke care. For nursing managers, introduction of evidence-based SCP in the EHR may improve the prerequisites for promoting high-quality EBP in multi-professional care. 2011 Blackwell Publishing Ltd.

Council of Ontario Universities--Responding to the Challenges of Change. 1995-1996 Review.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

This report documents five objectives for the Canadian post-secondary education system: (1) quality; (2) access for all qualified applicants; (3) differentiation (diversity of educational opportunity); (4) accountability; and (5) responsiveness to changing student and labor market requirements. The report also discusses the changing political…

30 CFR 210.204 - How do I submit facility data?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 210.204 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT FORMS AND REPORTS Production and Royalty Reports-Solid Minerals § 210.204 How do I submit facility...) Output quality or product grades. (5) Your submitted facility data may be internally generated documents...

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

ERIC Educational Resources Information Center

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

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

County-Level Estimates of the Effects of a Universal Preschool Program in California

ERIC Educational Resources Information Center

Karoly, Lynn A.

2005-01-01

Growing interest in universal preschool education has prompted researchers to examine the potential costs and benefits of making high-quality preschool available for all children one or two years before kindergarten entry. The analysis reported in this document builds on a previous RAND study which estimated that a high-quality, one-year,…

Frameworks for Change: Four Recurrent Themes for Quality in Early Childhood Curriculum Initiatives

ERIC Educational Resources Information Center

Burgess, Jennifer; Fleet, Alma

2009-01-01

This paper reports on the first phase of a case study that investigated how early childhood teachers experience organisational change. As one of three levels of quality improvement, State government-funded curriculum initiatives were developed with an aim to promote change. Three curriculum documents, one each focusing on literacy, pedagogy and…

Medical record keeping and system performance in orthopaedic trauma patients.

PubMed

Cosic, Filip; Kimmel, Lara; Edwards, Elton

2016-01-01

Objective The medical record is critical for documentation and communication between healthcare professionals. The aim of the present study was to evaluate important aspects of the orthopaedic medical record and system performance to determine whether any deficiencies exist in these areas. Methods Review of 200 medical records of surgically treated traumatic lower limb injury patients was undertaken. The operative report, discharge summary and first and second outpatient reviews were evaluated. Results In all cases, an operative report was completed by a senior surgeon. Weight-bearing status was adequately documented in 91% of reports. Discharge summaries were completed for 82.5% of admissions, with 87.3% of these having instructions reflective of those in the operative report. Of first and second outpatient reviews, 69% and 73%, respectively, occurred within 1 week of the requested time. Previously documented management plans were changed in 30% of reviews. At 6-months post-operatively, 42% of patients had been reviewed by a member of their operating team. Discussion Orthopaedic medical record documentation remains an area for improvement. In addition, hospital out-patient systems perform suboptimally and may affect patient outcomes. What is known about the topic? Medical records are an essential tool in modern medical practice. Despite the importance of comprehensive documentation in the medical record, numerous examples of poor documentation have been demonstrated, including substandard documentation during consultant ward rounds by junior doctors leading to a breakdown in healthcare professional communication and potential patient mismanagement. Further inadequacies of medical record documentation have been demonstrated in surgical discharge notes, with complete and correct documentation reported to be as low as 65%. What does this paper add? Standards of patient care should be constantly monitored and deficiencies identified in order to implement a remedy and close the quality loop. The present study has highlighted that the standard of orthopaedic trauma medical record keeping at an Australian Level 1 trauma centre is below what is expected and several key areas of documentation require improvement. This paper further evaluates the system performance of the out-patient system, an area where, to the authors knowledge, there is no previous work published. The findings show that the performance was below what is expected for surgical review, with many patients failing to be reviewed by their operating surgeon. What are the implications for practitioners? The present study shows that there is a poor level of documentation and a standard of out-patient review below what is expected. The implications of these findings will be to highlight current deficiencies to practitioners and promote change in current practice to improve the quality of medical record documentation among medical staff. Further, the findings of poor system performance will promote change in the current system of delivering out-patient care to patients.

Development of an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes: the Q-DIO.

PubMed

Müller-Staub, Maria; Lunney, Margaret; Odenbreit, Matthias; Needham, Ian; Lavin, Mary Ann; van Achterberg, Theo

2009-04-01

This paper aims to report the development stages of an audit instrument to assess standardised nursing language. Because research-based instruments were not available, the instrument Quality of documentation of nursing Diagnoses, Interventions and Outcomes (Q-DIO) was developed. Standardised nursing language such as nursing diagnoses, interventions and outcomes are being implemented worldwide and will be crucial for the electronic health record. The literature showed a lack of audit instruments to assess the quality of standardised nursing language in nursing documentation. A qualitative design was used for instrument development. Criteria were first derived from a theoretical framework and literature reviews. Second, the criteria were operationalized into items and eight experts assessed face and content validity of the Q-DIO. Criteria were developed and operationalized into 29 items. For each item, a three or five point scale was applied. The experts supported content validity and showed 88.25% agreement for the scores assigned to the 29 items of the Q-DIO. The Q-DIO provides a literature-based audit instrument for nursing documentation. The strength of Q-DIO is its ability to measure the quality of nursing diagnoses and related interventions and nursing-sensitive patient outcomes. Further testing of Q-DIO is recommended. Based on the results of this study, the Q-DIO provides an audit instrument to be used in clinical practice. Its criteria can set the stage for the electronic nursing documentation in electronic health records.

Development of performance-based evaluation methods and specifications for roadside maintenance.

DOT National Transportation Integrated Search

2011-01-01

This report documents the work performed during Project 0-6387, Performance Based Roadside : Maintenance Specifications. Quality assurance methods and specifications for roadside performance-based : maintenance contracts (PBMCs) were developed ...

Research Grants Guidance and Policies

EPA Pesticide Factsheets

These pages are designed to assist prospective applicants as well as recent recipients by conveying key documents that describe the quality assurance, reporting requirements, forms, and FAQs for the NCER STAR grant application and implementation process.

Water-quality trends using sediment cores from White Rock Lake, Dallas, Texas

USGS Publications Warehouse

Van Metre, Peter C.; Land, Larry F.; Braun, C.L.

1996-01-01

The purpose of this fact sheet is to summarize the principal findings documented in a report on water-quality trends in White Rock Creek Basin using dated sediment cores from White Rock Lake (Van Metre and Callender, in press). The study used dated sediment cores to reconstruct water-quality conditions. More specifically, the changes in water quality associated with the watershed’s change from agricultural to urban land use and with the implementation of environmental regulations were identified.

Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents.

PubMed

Gehring, Nicole D; McGrath, Patrick; Wozney, Lori; Soleimani, Amir; Bennett, Kathryn; Hartling, Lisa; Huguet, Anna; Dyson, Michele P; Newton, Amanda S

2017-06-21

Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0-18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues' implementation outcomes-acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability-and grouped separately for studies and documents. Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6), and low (n = 1). These documents focused on cost (100%, n = 9), penetration (89%, n = 8), feasibility (78%, n = 7), and sustainability (67%, n = 6) of implementing eMental healthcare technology. To date, research studies have largely focused on acceptability and appropriateness, while government/organizational documents state goals and recommendations regarding costs, feasibility, and sustainability of eMental healthcare technologies. These differences suggest that the research evidence available for pediatric eMental healthcare technologies does not reflect the focus of governments and organizations. Partnerships between researchers, healthcare planners, and policymakers may help to align implementation research with policy development, decision-making, and funding foci.

Approaches to 30 Percent Energy Savings at the Community Scale in the Hot-Humid Climate

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

Thomas-Rees, S.; Beal, D.; Martin, E.

2013-03-01

BA-PIRC has worked with several community-scale builders within the hot humid climate zone to improve performance of production, or community scale, housing. Tommy Williams Homes (Gainesville, FL), Lifestyle Homes (Melbourne, FL), and Habitat for Humanity (various locations, FL) have all been continuous partners of the Building America program and are the subjects of this report to document achievement of the Building America goal of 30% whole house energy savings packages adopted at the community scale. Key aspects of this research include determining how to evolve existing energy efficiency packages to produce replicable target savings, identifying what builders' technical assistance needsmore » are for implementation and working with them to create sustainable quality assurance mechanisms, and documenting the commercial viability through neutral cost analysis and market acceptance. This report documents certain barriers builders overcame and the approaches they implemented in order to accomplish Building America (BA) Program goals that have not already been documented in previous reports.« less

Suitability of Public Records for Evaluating Health Effects of Treated Sewage Sludge in North Carolina

PubMed Central

Keil, Alexander; Wing, Steven; Lowman, Amy

2011-01-01

BACKGROUND Exposure to potentially harmful agents because of waste disposal practices is receiving increased attention. Treated sewage sludge (TSS), or biosolid material, is the solid waste generated during domestic sewage treatment after it has undergone processes to reduce the number of pathogens and vector attractants. Application of TSS to land, which is the most common method for disposal, is promoted as a soil amendment and fertilizer. Few studies have examined the effects of land application on the health and quality of life of neighboring populations. We describe and summarize publicly available records that could be used to study the public health impact of practices associated with land application in North Carolina. METHODS We abstracted public records from the North Carolina Department of Natural Resources Division of Water Quality, to determine the following activities associated with land application of TSS in 8 counties in central North Carolina: the process for obtaining permits, reported applications, violations, documented concerns of residents, and penalties assessed. RESULTS The Division of Water Quality routinely collects records of permits and approvals for land application of TSS, amounts applied, and reported pollutant levels. Documentation was useful in summarizing land application practices, but lack of standardization in reporting was a concern. Research into the public health impacts of the land application program is hindered by inconsistency in documenting inspections and resident concerns. LIMITATIONS We were not able to validate state records with direct observation of land application of TSS. CONCLUSIONS Records from the Division of Water Quality would be of limited use in epidemiologic studies of the health effects of land application of biosolids. Information about locations, amounts, and dates of application are relevant to exposure potential, but additional information is needed for health investigations. PMID:21721493

Suitability of public records for evaluating health effects of treated sewage sludge in North Carolina.

PubMed

Keil, Alexander; Wing, Steven; Lowman, Amy

2011-01-01

Exposure to potentially harmful agents because of waste disposal practices is receiving increased attention. Treated sewage sludge (TSS), or biosolid material, is the solid waste generated during domestic sewage treatment after it has undergone processes to reduce the number of pathogens and vector attractants. Application of TSS to land, which is the most common method for disposal, is promoted as a soil amendment and fertilizer. Few studies have examined the effects of land application on the health and quality of life of neighboring populations. We describe and summarize publicly available records that could be used to study the public health impact of practices associated with land application in North Carolina. We abstracted public records from the North Carolina Department of Natural Resources Division of Water Quality, to determine the following activities associated with land application of TSS in 8 counties in central North Carolina: the process for obtaining permits, reported applications, violations, documented concerns of residents, and penalties assessed. The Division of Water Quality routinely collects records of permits and approvals for land application of TSS, amounts applied, and reported pollutant levels. Documentation was useful in summarizing land application practices, but lack of standardization in reporting was a concern. Research into the public health impacts of the land application program is hindered by inconsistency in documenting inspections and resident concerns. We were not able to validate state records with direct observation of land application of TSS. Records from the Division of Water Quality would be of limited use in epidemiologic studies of the health effects of land application of biosolids. Information about locations, amounts, and dates of application are relevant to exposure potential, but additional information is needed for health investigations.

Availability and Quality of Size Estimations of Female Sex Workers, Men Who Have Sex with Men, People Who Inject Drugs and Transgender Women in Low- and Middle-Income Countries

PubMed Central

Sabin, Keith; Zhao, Jinkou; Garcia Calleja, Jesus Maria; Sheng, Yaou; Arias Garcia, Sonia; Reinisch, Annette; Komatsu, Ryuichi

2016-01-01

Objective To assess the availability and quality of population size estimations of female sex workers (FSW), men who have sex with men (MSM), people who inject drug (PWID) and transgender women. Methods Size estimation data since 2010 were retrieved from global reporting databases, Global Fund grant application documents, and the peer-reviewed and grey literature. Overall quality and availability were assessed against a defined set of criteria, including estimation methods, geographic coverage, and extrapolation approaches. Estimates were compositely categorized into ‘nationally adequate’, ‘nationally inadequate but locally adequate’, ‘documented but inadequate methods’, ‘undocumented or untimely’ and ‘no data.’ Findings Of 140 countries assessed, 41 did not report any estimates since 2010. Among 99 countries with at least one estimate, 38 were categorized as having nationally adequate estimates and 30 as having nationally inadequate but locally adequate estimates. Multiplier, capture-recapture, census and enumeration, and programmatic mapping were the most commonly used methods. Most countries relied on only one estimate for a given population while about half of all reports included national estimates. A variety of approaches were applied to extrapolate from sites-level numbers to national estimates in two-thirds of countries. Conclusions Size estimates for FSW, MSM, PWID and transgender women are increasingly available but quality varies widely. The different approaches present challenges for data use in design, implementation and evaluation of programs for these populations in half of the countries assessed. Guidance should be further developed to recommend: a) applying multiple estimation methods; b) estimating size for a minimum number of sites; and, c) documenting extrapolation approaches. PMID:27163256

Using Clinical Data Standards to Measure Quality: A New Approach.

PubMed

D'Amore, John D; Li, Chun; McCrary, Laura; Niloff, Jonathan M; Sittig, Dean F; McCoy, Allison B; Wright, Adam

2018-04-01

 Value-based payment for care requires the consistent, objective calculation of care quality. Previous initiatives to calculate ambulatory quality measures have relied on billing data or individual electronic health records (EHRs) to calculate and report performance. New methods for quality measure calculation promoted by federal regulations allow qualified clinical data registries to report quality outcomes based on data aggregated across facilities and EHRs using interoperability standards.  This research evaluates the use of clinical document interchange standards as the basis for quality measurement.  Using data on 1,100 patients from 11 ambulatory care facilities and 5 different EHRs, challenges to quality measurement are identified and addressed for 17 certified quality measures.  Iterative solutions were identified for 14 measures that improved patient inclusion and measure calculation accuracy. Findings validate this approach to improving measure accuracy while maintaining measure certification.  Organizations that report care quality should be aware of how identified issues affect quality measure selection and calculation. Quality measure authors should consider increasing real-world validation and the consistency of measure logic in respect to issues identified in this research. Schattauer GmbH Stuttgart.

A Screening Assessment of the Potential Impacts of Climate ...

EPA Pesticide Factsheets

EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy or determination. EPA will consider any public comments submitted in accordance with this notice when revising the document. The report is a screening level analysis intended to determine the scope and magnitude of global change impacts rather than a detailed assessment of specific impacts and adaptation measures.

International Metadata Standards and Enterprise Data Quality Metadata Systems

NASA Astrophysics Data System (ADS)

Habermann, T.

2016-12-01

Well-documented data quality is critical in situations where scientists and decision-makers need to combine multiple datasets from different disciplines and collection systems to address scientific questions or difficult decisions. Standardized data quality metadata could be very helpful in these situations. Many efforts at developing data quality standards falter because of the diversity of approaches to measuring and reporting data quality. The "one size fits all" paradigm does not generally work well in this situation. The ISO data quality standard (ISO 19157) takes a different approach with the goal of systematically describing how data quality is measured rather than how it should be measured. It introduces the idea of standard data quality measures that can be well documented in a measure repository and used for consistently describing how data quality is measured across an enterprise. The standard includes recommendations for properties of these measures that include unique identifiers, references, illustrations and examples. Metadata records can reference these measures using the unique identifier and reuse them along with details (and references) that describe how the measure was applied to a particular dataset. A second important feature of ISO 19157 is the inclusion of citations to existing papers or reports that describe quality of a dataset. This capability allows users to find this information in a single location, i.e. the dataset metadata, rather than searching the web or other catalogs. I will describe these and other capabilities of ISO 19157 with examples of how they are being used to describe data quality across the NASA EOS Enterprise and also compare these approaches with other standards.

Quality-assurance plan for groundwater activities, U.S. Geological Survey, Washington Water Science Center

USGS Publications Warehouse

Kozar, Mark D.; Kahle, Sue C.

2013-01-01

This report documents the standard procedures, policies, and field methods used by the U.S. Geological Survey’s (USGS) Washington Water Science Center staff for activities related to the collection, processing, analysis, storage, and publication of groundwater data. This groundwater quality-assurance plan changes through time to accommodate new methods and requirements developed by the Washington Water Science Center and the USGS Office of Groundwater. The plan is based largely on requirements and guidelines provided by the USGS Office of Groundwater, or the USGS Water Mission Area. Regular updates to this plan represent an integral part of the quality-assurance process. Because numerous policy memoranda have been issued by the Office of Groundwater since the previous groundwater quality assurance plan was written, this report is a substantial revision of the previous report, supplants it, and contains significant additional policies not covered in the previous report. This updated plan includes information related to the organization and responsibilities of USGS Washington Water Science Center staff, training, safety, project proposal development, project review procedures, data collection activities, data processing activities, report review procedures, and archiving of field data and interpretative information pertaining to groundwater flow models, borehole aquifer tests, and aquifer tests. Important updates from the previous groundwater quality assurance plan include: (1) procedures for documenting and archiving of groundwater flow models; (2) revisions to procedures and policies for the creation of sites in the Groundwater Site Inventory database; (3) adoption of new water-level forms to be used within the USGS Washington Water Science Center; (4) procedures for future creation of borehole geophysics, surface geophysics, and aquifer-test archives; and (5) use of the USGS Multi Optional Network Key Entry System software for entry of routine water-level data collected as part of long-term water-level monitoring networks.

Quality audit of colonoscopy reports amongst patients screened or surveilled for colorectal neoplasia.

PubMed

Beaulieu, Daphnée; Barkun, Alan; Martel, Myriam

2012-07-21

To complete a quality audit using recently published criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior colorectal neoplasia (CRN) by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional database providing pathological results. Required documentation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a standardized glossary with 10% independent data validation. Sample size calculations determined the number of reports needed. Two hundreds and fifty patients (63.2 ± 10.5 years, female: 42.8%, average risk: 38.5%, personal/family history of CRN: 43.3%/20.2%) were scoped in June 2009 by 8 gastroenterologists and 3 surgeons (mean practice: 17.1 ± 8.5 years). Procedural indication and informed consent were always documented. 14% provided a previous colonoscopy date (past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness). Most procedural indicators were recorded (exam date: 98.4%, medications: 99.2%, difficulty level: 98.8%, prep quality: 99.6%). All reports noted extent of visualization (cecum: 94.4%, with landmarks noted in 78.8% - photodocumentation: 67.2%). No procedural times were recorded. One hundred and eleven had polyps (44.4%) with anatomic location noted in 99.1%, size in 65.8%, morphology in 62.2%; removal was by cold biopsy in 25.2% (cold snare: 18%, snare cautery: 31.5%, unrecorded: 20.7%), 84.7% were retrieved. Adenomas were noted in 24.8% (advanced adenomas: 7.6%, cancer: 0.4%) in this population with varying previous colonic investigations. This audit reveals lacking reported items, justifying additional research to optimize quality of reporting.

Quality audit of colonoscopy reports amongst patients screened or surveilled for colorectal neoplasia

PubMed Central

Beaulieu, Daphnée; Barkun, Alan; Martel, Myriam

2012-01-01

AIM: To complete a quality audit using recently published criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS: Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior colorectal neoplasia (CRN) by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional database providing pathological results. Required documentation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a standardized glossary with 10% independent data validation. Sample size calculations determined the number of reports needed. RESULTS: Two hundreds and fifty patients (63.2 ± 10.5 years, female: 42.8%, average risk: 38.5%, personal/family history of CRN: 43.3%/20.2%) were scoped in June 2009 by 8 gastroenterologists and 3 surgeons (mean practice: 17.1 ± 8.5 years). Procedural indication and informed consent were always documented. 14% provided a previous colonoscopy date (past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness). Most procedural indicators were recorded (exam date: 98.4%, medications: 99.2%, difficulty level: 98.8%, prep quality: 99.6%). All reports noted extent of visualization (cecum: 94.4%, with landmarks noted in 78.8% - photodocumentation: 67.2%). No procedural times were recorded. One hundred and eleven had polyps (44.4%) with anatomic location noted in 99.1%, size in 65.8%, morphology in 62.2%; removal was by cold biopsy in 25.2% (cold snare: 18%, snare cautery: 31.5%, unrecorded: 20.7%), 84.7% were retrieved. Adenomas were noted in 24.8% (advanced adenomas: 7.6%, cancer: 0.4%) in this population with varying previous colonic investigations. CONCLUSION: This audit reveals lacking reported items, justifying additional research to optimize quality of reporting. PMID:22826619

Research Grants Guidance and Policies Resources

EPA Pesticide Factsheets

These pages are designed to assist prospective applicants as well as recent recipients by conveying key documents that describe the quality assurance, reporting requirements, forms, and FAQs for the NCER STAR grant application and implementation process.

1994 Transportation/ Air Quality Conformity Finding

DOT National Transportation Integrated Search

1993-10-01

The purpose of this report is to document the finding that the transportation : plans and programs for the Albuquerque Metropolitan Planning Area (AMPA) are in : conformity with the applicable Clean Air Act implementation plans for the : nonattainmen...

Technical Assistance in Evaluating Career Education Projects. Final Report. Volume II: Final Career Education Evaluation Report.

ERIC Educational Resources Information Center

Stenner, A. Jackson; And Others

This document contains the second of five volumes reporting the activities and results of a career education evaluation project conducted to accomplish the following two objectives: (1) to improve the quality of evaluations by career education projects funded by the United States Office of Career Education (OCE) through the provision of technical…

Using phrases and document metadata to improve topic modeling of clinical reports.

PubMed

Speier, William; Ong, Michael K; Arnold, Corey W

2016-06-01

Probabilistic topic models provide an unsupervised method for analyzing unstructured text, which have the potential to be integrated into clinical automatic summarization systems. Clinical documents are accompanied by metadata in a patient's medical history and frequently contains multiword concepts that can be valuable for accurately interpreting the included text. While existing methods have attempted to address these problems individually, we present a unified model for free-text clinical documents that integrates contextual patient- and document-level data, and discovers multi-word concepts. In the proposed model, phrases are represented by chained n-grams and a Dirichlet hyper-parameter is weighted by both document-level and patient-level context. This method and three other Latent Dirichlet allocation models were fit to a large collection of clinical reports. Examples of resulting topics demonstrate the results of the new model and the quality of the representations are evaluated using empirical log likelihood. The proposed model was able to create informative prior probabilities based on patient and document information, and captured phrases that represented various clinical concepts. The representation using the proposed model had a significantly higher empirical log likelihood than the compared methods. Integrating document metadata and capturing phrases in clinical text greatly improves the topic representation of clinical documents. The resulting clinically informative topics may effectively serve as the basis for an automatic summarization system for clinical reports. Copyright © 2016 Elsevier Inc. All rights reserved.

On the typography of flight-deck documentation

NASA Technical Reports Server (NTRS)

Degani, Asaf

1992-01-01

Many types of paper documentation are employed on the flight-deck. They range from a simple checklist card to a bulky Aircraft Flight Manual (AFM). Some of these documentations have typographical and graphical deficiencies; yet, many cockpit tasks such as conducting checklists, way-point entry, limitations and performance calculations, and many more, require the use of these documents. Moreover, during emergency and abnormal situations, the flight crews' effectiveness in combating the situation is highly dependent on such documentation; accessing and reading procedures has a significant impact on flight safety. Although flight-deck documentation are an important (and sometimes critical) form of display in the modern cockpit, there is a dearth of information on how to effectively design these displays. The object of this report is to provide a summary of the available literature regarding the design and typographical aspects of printed matter. The report attempts 'to bridge' the gap between basic research about typography, and the kind of information needed by designers of flight-deck documentation. The report focuses on typographical factors such as type-faces, character height, use of lower- and upper-case characters, line length, and spacing. Some graphical aspects such as layout, color coding, fonts, and character contrast are also discussed. In addition, several aspects of cockpit reading conditions such as glare, angular alignment, and paper quality are addressed. Finally, a list of recommendations for the graphical design of flight-deck documentation is provided.

Pressure ulcer prevention in long-term-care facilities: a pilot study implementing standardized nurse aide documentation and feedback reports.

PubMed

Horn, Susan D; Sharkey, Siobhan S; Hudak, Sandra; Gassaway, Julie; James, Roberta; Spector, William

2010-03-01

To design and facilitate implementation of practice-based evidence changes associated with decreases in pressure ulcer (PrU) development in long-term-care (LTC) facilities and promote these practices as part of routine care. Pre/post observational study. Frail older adult residents in 11 US LTC facilities. Project facilitators assisted frontline multidisciplinary teams (certified nurse aides [CNAs], nurses, and dietitians/dietary aides) to develop streamlined standardized CNA documentation and weekly reports to identify high-risk residents and to integrate clinical reports into day-to-day practice and clinical decision making. The program was called "Real-Time Optimal Care Plans for Nursing Home QI" (Real-Time). Prevalence of PrUs using Centers for Medicare & Medicaid Services (CMS) quality measures (QMs), number of in-house-acquired PrUs, and number and completeness of CNA documentation forms. Seven study LTC facilities that reported data to CMS experienced a combined 33% (SD, 36.1%) reduction in the CMS high-risk PrU QM in 18 months and reduction in newly occurring PrUs (number of ulcers in the fourth quarter of 2003: range, 2-19; and in the third quarter of 2005: range, 1-6). Five of these LTC facilities that fully implemented Real-Time experienced a combined 48.1% (SD, 23.4%) reduction in the CMS high-risk PrU QM. Ten facilities reduced by an average of 2 to 5 their number of CNA documentation forms; CNA weekly documentation completeness reached a consistent level of 90% to 95%, and 8 facilities integrated the use of 2 to 4 weekly project reports in routine clinical decision making. Quality improvement efforts that provide access to focused and timely clinical information, facilitate change, and promote staff working together in multidisciplinary teams impacted clinical outcomes. Prevention of PrUs showed a trend of improvement in facilities that fully integrated tools to identify high-risk residents into day-to-day practice. CNA documentation facilitated better information for clinical decision making. More than 70 additional LTC facilities across the United States are implementing this QI program.

Development of Methodology and Technology for Identifying and Quantifying Emission Products from Open Burning and Open Detonation Thermal Treatment Methods. BangBox Test Series. Volume 3. Quality Assurance and Quality Control

DTIC Science & Technology

1992-01-01

software. This document may not be cited for purposes of advertisement. I I I I I I I’ I , , I SECURITY CLASSIF!CATION 0a . T - S PAGE Form Aoprovea...8217, 3 DISTRIBUTION 1AVAILABSLITY OF REPORT N/A 2b DECLASSIFICATION/DOWNGRADING SCHEDULE Unlimited N/A 4 PERFORMING ORGANIZATION REPORT NUMBER( S ) S ...MONITORING ORGANIZATION REPORT NUMBER( S , 6a NAME OF PERFORMING ORGANIZATION 6b. OFFICE SYMBOL 7a NAME OF MONITORING ORGANIZATION Andrulis Research

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on specific indications, processes, or parameters of care for which high level of evidence data and Class I or Class III guideline recommendations may be lacking but are addressed in ACCF appropriate use criteria documents. Structure/safety measures represent measures developed to address structural aspects of the use of healthcare technology (e.g., laboratory accreditation, personnel training, and credentialing) or quality issues related to patient safety when there are neither guidelines recommendations nor appropriate use criteria. Although the strength of evidence for appropriate use measures and structure/safety measures may not be as strong as that for formal performance measures, they are quality measures that are otherwise rigorously developed, reviewed, tested, and approved in the same manner as ACCF/AHA performance measures. The ultimate goal of the present document is to provide direction in defining and measuring the appropriate use-avoiding not only underuse but also overuse and misuse-and proper application of cardiovascular technology and to describe how such appropriate use measures and structure/safety measures might be developed for the purposes of quality improvement and public reporting. It is anticipated that this effort will help focus the national dialogue on the use of cardiovascular technology and away from the current concerns about volume and cost alone to a more holistic emphasis on value. Copyright © 2011 American College of Cardiology Foundation and the American Heart Association, Inc. Published by Elsevier Inc. All rights reserved.

Dashboard report on performance on select quality indicators to cancer care providers.

PubMed

Stattin, Pär; Sandin, Fredrik; Sandbäck, Torsten; Damber, Jan-Erik; Franck Lissbrant, Ingela; Robinson, David; Bratt, Ola; Lambe, Mats

2016-01-01

Cancer quality registers are attracting increasing attention as important, but still underutilized sources of clinical data. To optimize the use of registers in quality assurance and improvement, data have to be rapidly collected, collated and presented as actionable, at-a-glance information to the reporting departments. This article presents a dashboard performance report on select quality indicators to cancer care providers. Ten quality indicators registered on an individual patient level in the National Prostate Cancer Register of Sweden and recommended by the National Prostate Cancer Guidelines were selected. Data reported to the National Prostate Cancer Register are uploaded within 24 h to the Information Network for Cancer Care platform. Launched in 2014, "What''s Going On, Prostate Cancer" provides rapid, at-a-glance performance feedback to care providers. The indicators include time to report to the National Prostate Cancer Register, waiting times, designated clinical nurse specialist, multidisciplinary conference, adherence to guidelines for diagnostic work-up and treatment, and documentation and outcome of treatment. For each indicator, three performance levels were defined. What's Going On, a dashboard performance report on 10 selected quality indicators to cancer care providers, provides an example of how data in cancer quality registers can be transformed into condensed, at-a-glance information to be used as actionable metrics for quality assurance and improvement.

SUPERFUND TREATABILITY CLEARINGHOUSE: SOIL STABILIZATION PILOT STUDY, UNITED CHROME NPL SITE PILOT STUDY AND HEALTH AND SAFETY PROGRAM, UNITED CHROME NPL SITE PILOT STUDY

EPA Science Inventory

This document is a project plan for a pilot study at the United Chrome NPL site, Corvallis, Oregon and includes the health and safety and quality assurance/quality control plans. The plan reports results of a bench-scale study of the treatment process as iieasured by the ...

Bridging the Research-to-Practice Gap in Education: A Software-Mediated Approach for Improving Classroom Instruction

ERIC Educational Resources Information Center

Weston, Mark E.; Bain, Alan

2015-01-01

This study reports findings from a matched-comparison, repeated-measure for intact groups design of the mediating effect of a suite of software on the quality of classroom instruction provided to students by teachers. The quality of instruction provided by teachers in the treatment and control groups was documented via observations that were…

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

ERIC Educational Resources Information Center

O'Mahony, Kim; Garavan, Thomas N.

2012-01-01

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

Work and the Quality of Life: Resource Papers for Work in America.

ERIC Educational Resources Information Center

O'Toole, James, Ed.

A sequel to Work in America, the volume of resource papers provides additional data on issues concerning the relationships of work to health, education, and welfare. The report is a planning document which focuses on how the institution of work can be changed to improve the quality of life, to contribute to a more just society, and to strengthen…

Application of ISO 9000 Standards to Education and Training. Interpretation and Guidelines in a European Perspective. CEDEFOP Document.

ERIC Educational Resources Information Center

Van den Berghe, Wouter

This report brings together European experience on the interpretation and implementation of ISO 9000 in education and training (ET) environments. Chapter 1 discusses the importance of quality concepts in ET and summarizes key concepts of total quality management (TQM) and its relevance for ET. Chapter 2 introduces the ISO 9000 standards. It…

Development and Exchange of Instructional Resources in Water Quality Control Programs, IV: Selecting Instructional Media and Instructional Systems.

ERIC Educational Resources Information Center

Durham, W. Harry; And Others

This document is one of a series of reports which reviews instructional materials and equipment for water and wastewater treatment plant personnel. A system is presented to assist in standardizing the production of lesson plans and instructional materials in the water quality control field. A procedure for selecting appropriate instructional media…

Brief Report: Influence of Physical Activity on Sleep Quality in Children with Autism

ERIC Educational Resources Information Center

Wachob, David; Lorenzi, David G.

2015-01-01

Sleep-related problems are often documented in children with Autism Spectrum Disorders (ASD). This study examined physical activity as a variable that might influence sleep quality in children with ASD. Ten children, ages 9-16 years, were asked to wear accelerometer devices for 7 days in order to track objective measures of activity and sleep…

Improving Educational Planning for Students with Severe Disabilities: An Evaluation of School-Based Professional Learning

ERIC Educational Resources Information Center

Stephenson, Jennifer; Carter, Mark

2015-01-01

The components of quality educational planning for students with moderate and severe intellectual disability are well established, but schools and special educators may not always achieve a desirable standard. This article reports on the change in quality of documentation related to individual planning and programming over a span of 4 years in a…

PEEEC [Project for Early Education of Exceptional Children] Outreach: Annual Report 1980-1981.

ERIC Educational Resources Information Center

Millican, Jerri; Kibler, Robert G.

The document consists of the final report of the PEEEC (Project for Early Education of Exceptional Children) Outreach program, a program to stimulate high quality programs for preschool handicapped children and families in Kentucky. Following a definition of terms are sections outlining goals, objectives, and activities of three program…

Quality Inservice Education: Final Report of the National Inservice Network, 1978-1981.

ERIC Educational Resources Information Center

Burrello, Leonard C.; And Others

The document comprises the final report of the National Inservice Network (NIN), a program to describe and distribute regular education inservice (REGI) project abstracts, products, and lessons aimed at more effectively working with handicapped students. Initial sections contain an executive summary and an overview explaining the NIN as a…

HDTS 2017.0 Testing and verification document

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

Whiteside, Tad S.

2017-08-01

This report is a continuation of the series of Hunter Dose Tracking System (HDTS) Quality Assurance documents including (Foley and Powell, 2010; Dixon, 2012). In this report we have created a suite of automated test cases and a system to analyze the results of those tests as well as documented the methodology to ensure the field system performs within specifications. The software test cases cover all of the functions and interactions of functions that are practical to test. With the developed framework, if software defects are discovered, it will be easy to create one or more test cases to reproducemore » the defect and ensure that code changes correct the defect. These tests con rm HDTS version 2017.0 performs according to its specifications and documentation and that its performance meets the needs of its users at the Savannah River Site.« less

Systematic review of the application of the plan–do–study–act method to improve quality in healthcare

PubMed Central

Taylor, Michael J; McNicholas, Chris; Nicolay, Chris; Darzi, Ara; Bell, Derek; Reed, Julie E

2014-01-01

Background Plan–do–study–act (PDSA) cycles provide a structure for iterative testing of changes to improve quality of systems. The method is widely accepted in healthcare improvement; however there is little overarching evaluation of how the method is applied. This paper proposes a theoretical framework for assessing the quality of application of PDSA cycles and explores the consistency with which the method has been applied in peer-reviewed literature against this framework. Methods NHS Evidence and Cochrane databases were searched by three independent reviewers. Empirical studies were included that reported application of the PDSA method in healthcare. Application of PDSA cycles was assessed against key features of the method, including documentation characteristics, use of iterative cycles, prediction-based testing of change, initial small-scale testing and use of data over time. Results 73 of 409 individual articles identified met the inclusion criteria. Of the 73 articles, 47 documented PDSA cycles in sufficient detail for full analysis against the whole framework. Many of these studies reported application of the PDSA method that failed to accord with primary features of the method. Less than 20% (14/73) fully documented the application of a sequence of iterative cycles. Furthermore, a lack of adherence to the notion of small-scale change is apparent and only 15% (7/47) reported the use of quantitative data at monthly or more frequent data intervals to inform progression of cycles. Discussion To progress the development of the science of improvement, a greater understanding of the use of improvement methods, including PDSA, is essential to draw reliable conclusions about their effectiveness. This would be supported by the development of systematic and rigorous standards for the application and reporting of PDSAs. PMID:24025320

Document-Level Classification of CT Pulmonary Angiography Reports based on an Extension of the ConText Algorithm

PubMed Central

Chapman, Brian E.; Lee, Sean; Kang, Hyunseok Peter; Chapman, Wendy W.

2011-01-01

In this paper we describe an application called peFinder for document-level classification of CT pulmonary angiography reports. peFinder is based on a generalized version of the ConText algorithm, a simple text processing algorithm for identifying features in clinical report documents. peFinder was used to answer questions about the disease state (pulmonary emboli present or absent), the certainty state of the diagnosis (uncertainty present or absent), the temporal state of an identified pulmonary embolus (acute or chronic), and the technical quality state of the exam (diagnostic or not diagnostic). Gold standard answers for each question were determined from the consensus classifications of three human annotators. peFinder results were compared to naive Bayes’ classifiers using unigrams and bigrams. The sensitivities (and positive predictive values) for peFinder were 0.98(0.83), 0.86(0.96), 0.94(0.93), and 0.60(0.90) for disease state, quality state, certainty state, and temporal state respectively, compared to 0.68(0.77), 0.67(0.87), 0.62(0.82), and 0.04(0.25) for the naive Bayes’ classifier using unigrams, and 0.75(0.79), 0.52(0.69), 0.59(0.84), and 0.04(0.25) for the naive Bayes’ classifier using bigrams. PMID:21459155

Aligning Documentation With Congenital Muscular Torticollis Clinical Practice Guidelines: Administrative Case Report.

PubMed

Gutierrez, Dennis; Kaplan, Sandra L

2016-01-01

A hospital-based pediatric outpatient center, wanting to weave evidence into practice, initiated an update of knowledge, skills, and documentation patterns with its staff physical therapists and occupational therapists who treat people with congenital muscular torticollis (CMT). This case report describes 2 cycles of implementation: (1) the facilitators and barriers to implementation and (2) selected quality improvement outcomes aligned with published clinical practice guidelines (CPGs). The Pediatric Therapy Services of St Joseph's Regional Medical Center in New Jersey has 4 full-time, 1 part-time, and 3 per diem staff. Chart audits in 2012 revealed variations in measurement, interventions, and documentation that led to quality improvement initiatives. An iterative process, loosely following the knowledge-to-action cycle, included a series of in-service training sessions to review the basic anatomy, pathokinesiology, and treatment strategies for CMT; reading assignments of the available CPGs; journal review; documentation revisions; and training on the recommended measurements to implement 2 published CPGs and measure outcomes. A previous 1-page generic narrative became a 3-page CMT-specific form aligned with the American Physical Therapy Association Section on Pediatrics CMT CPG recommendations. Staff training on the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, classification of severity, type of CMT, prognostication, measures of cervical range of motion, and developmental progression improved documentation consistency from 0% to 81.9% to 100%. Clinicians responded positively to using the longer initial evaluation form. Successful implementation of both clinical and documentation practices were facilitated by a multifaceted approach to knowledge translation that included a culture supportive of evidence-based practice, administrative support for training and documentation redesign, commitment by clinicians to embrace changes aimed at improved care, and clinical guidelines that provide implementable recommendations. © 2016 American Physical Therapy Association.

Management: A continuing literature survey with indexes, March 1976

NASA Technical Reports Server (NTRS)

1976-01-01

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

The National Shipbuilding Research Program. Strategies and Demonstrations for the Reduction of Government Regulations Related to Commercial Shipbuilding

DTIC Science & Technology

1996-09-01

inspecting storm water quality associated with storm water runoff or snowmelt: January through March; April through June: July through September and October...beyond those described in Part V.B. of this permit. 5. Monitoring and Reporting . Requirements Storm Water Quality . Facilities shall perform and document...event. (I) Examinations shall be conducted in each of the following periods for the purposes of visually inspecting storm water quality associated

AN ULTRAVIOLET-VISIBLE SPECTROPHOTOMETER AUTOMATION SYSTEM. PART III: PROGRAM DOCUMENTATION

EPA Science Inventory

The Ultraviolet-Visible Spectrophotometer (UVVIS) automation system accomplishes 'on-line' spectrophotometric quality assurance determinations, report generations, plot generations and data reduction for chlorophyll or color analysis. This system also has the capability to proces...

Streamlining air quality models in Alabama

DOT National Transportation Integrated Search

2004-07-01

This report documents a research project sponsored by the Alabama Department of Transportation (ALDOT) and conducted by the University of Central Florida (UCF) and the University of Alabama at Birmingham (UAB) to develop a user-friendly, Windows vers...

Approaches to 30% Energy Savings at the Community Scale in the Hot-Humid Climate

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

Thomas-Rees, S.; Beal, D.; Martin, E.

2013-03-01

BA-PIRC has worked with several community-scale builders within the hot humid climate zone to improve performance of production, or community scale, housing. Tommy Williams Homes (Gainesville, FL), Lifestyle Homes (Melbourne, FL), and Habitat for Humanity (various locations, FL) have all been continuous partners of the BA Program and are the subjects of this report to document achievement of the Building America goal of 30% whole house energy savings packages adopted at the community scale. The scope of this report is to demonstrate achievement of these goals though the documentation of production-scale homes built cost-effectively at the community scale, and modeledmore » to reduce whole-house energy use by 30% in the Hot Humid climate region. Key aspects of this research include determining how to evolve existing energy efficiency packages to produce replicable target savings, identifying what builders' technical assistance needs are for implementation and working with them to create sustainable quality assurance mechanisms, and documenting the commercial viability through neutral cost analysis and market acceptance. This report documents certain barriers builders overcame and the approaches they implemented in order to accomplish Building America (BA) Program goals that have not already been documented in previous reports.« less

NASA Software Documentation Standard

NASA Technical Reports Server (NTRS)

1991-01-01

The NASA Software Documentation Standard (hereinafter referred to as "Standard") is designed to support the documentation of all software developed for NASA; its goal is to provide a framework and model for recording the essential information needed throughout the development life cycle and maintenance of a software system. The NASA Software Documentation Standard can be applied to the documentation of all NASA software. The Standard is limited to documentation format and content requirements. It does not mandate specific management, engineering, or assurance standards or techniques. This Standard defines the format and content of documentation for software acquisition, development, and sustaining engineering. Format requirements address where information shall be recorded and content requirements address what information shall be recorded. This Standard provides a framework to allow consistency of documentation across NASA and visibility into the completeness of project documentation. The basic framework consists of four major sections (or volumes). The Management Plan contains all planning and business aspects of a software project, including engineering and assurance planning. The Product Specification contains all technical engineering information, including software requirements and design. The Assurance and Test Procedures contains all technical assurance information, including Test, Quality Assurance (QA), and Verification and Validation (V&V). The Management, Engineering, and Assurance Reports is the library and/or listing of all project reports.

Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial.

PubMed

Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

2015-11-03

Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted by ASR. Participants' average mood rating was 1.3 (SD 0.6) using ASR assistance compared to 1.6 (SD 0.7) without ASR assistance (P<.001). We conclude that medical documentation with the assistance of Web-based speech recognition leads to an increase in documentation speed, document length, and participant mood when compared to self-typing. Speech recognition is a meaningful and effective tool for the clinical documentation process.

Information on new drugs at market entry: retrospective analysis of health technology assessment reports versus regulatory reports, journal publications, and registry reports.

PubMed

Köhler, Michael; Haag, Susanne; Biester, Katharina; Brockhaus, Anne Catharina; McGauran, Natalie; Grouven, Ulrich; Kölsch, Heike; Seay, Ulrike; Hörn, Helmut; Moritz, Gregor; Staeck, Kerstin; Wieseler, Beate

2015-02-26

When a new drug becomes available, patients and doctors require information on its benefits and harms. In 2011, Germany introduced the early benefit assessment of new drugs through the act on the reform of the market for medicinal products (AMNOG). At market entry, the pharmaceutical company responsible must submit a standardised dossier containing all available evidence of the drug's added benefit over an appropriate comparator treatment. The added benefit is mainly determined using patient relevant outcomes. The "dossier assessment" is generally performed by the Institute for Quality and Efficiency in Health Care (IQWiG) and then published online. It contains all relevant study information, including data from unpublished clinical study reports contained in the dossiers. The dossier assessment refers to the patient population for which the new drug is approved according to the summary of product characteristics. This patient population may comprise either the total populations investigated in the studies submitted to regulatory authorities in the drug approval process, or the specific subpopulations defined in the summary of product characteristics ("approved subpopulations"). To determine the information gain from AMNOG documents compared with non-AMNOG documents for methods and results of studies available at market entry of new drugs. AMNOG documents comprise dossier assessments done by IQWiG and publicly available modules of company dossiers; non-AMNOG documents comprise conventional, publicly available sources-that is, European public assessment reports, journal publications, and registry reports. The analysis focused on the approved patient populations. Retrospective analysis. All dossier assessments conducted by IQWiG between 1 January 2011 and 28 February 2013 in which the dossiers contained suitable studies allowing for a full early benefit assessment. We also considered all European public assessment reports, journal publications, and registry reports referring to these studies and included in the dossiers. We assessed reporting quality for each study and each available document for eight methods and 11 results items (three baseline characteristics and eight patient relevant outcomes), and dichotomised them as "completely reported" or "incompletely reported (including items not reported at all)." For each document type we calculated the proportion of items with complete reporting for methods and results, for each item and overall, and compared the findings.Results 15 out of 27 dossiers were eligible for inclusion and contained 22 studies. The 15 dossier assessments contained 28 individual assessments of 15 total study populations and 13 approved subpopulations. European public assessment reports were available for all drugs. Journal publications were available for 14 out of 15 drugs and 21 out of 22 studies. A registry report in ClinicalTrials.gov was available for all drugs and studies; however, only 11 contained results. In the analysis of total study populations, the AMNOG documents reached the highest grade of completeness, with about 90% of methods and results items completely reported. In non-AMNOG documents, the rate was 75% for methods and 52% for results items; journal publications achieved the best rates, followed by European public assessment reports and registry reports. The analysis of approved subpopulations showed poorer complete reporting of results items, particularly in non-AMNOG documents (non-AMNOG versus AMNOG: 11% v 71% for overall results items and 5% v 70% for patient relevant outcomes). The main limitation of our analysis is the small sample size. Conventional, publicly available sources provide insufficient information on new drugs, especially on patient relevant outcomes in approved subpopulations. This type of information is largely available in AMNOG documents, albeit only partly in English. The AMNOG approach could be used internationally to develop a comprehensive publication model for clinical studies and thus represents a key open access measure. © Köhler et al 2015.

222-S Laboratory Quality Assurance Plan. Revision 1

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

Meznarich, H.K.

1995-07-31

This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A qualitymore » assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document.« less

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure.

PubMed

Garvin, Jennifer H; DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). An EF value of <40% can be accurately identified in VA echocardiogram reports. An automated information extraction system can be used to accurately extract EF for quality measurement.

Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho

USGS Publications Warehouse

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.

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. he document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic drai...

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. The document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic dr...

Documenting an ISO 9000 Quality System.

ERIC Educational Resources Information Center

Fisher, Barry

1995-01-01

Discusses six steps to follow when documenting an ISO 9000 quality system: using ISO 9000 to develop a quality system, identifying a company's business processes, analyzing the business processes; describing the procedures, writing the quality manual, and working to the documented procedures. (SR)

Information on new drugs at market entry: retrospective analysis of health technology assessment reports versus regulatory reports, journal publications, and registry reports

PubMed Central

Köhler, Michael; Haag, Susanne; Biester, Katharina; Brockhaus, Anne Catharina; McGauran, Natalie; Grouven, Ulrich; Kölsch, Heike; Seay, Ulrike; Hörn, Helmut; Moritz, Gregor; Staeck, Kerstin

2015-01-01

Background When a new drug becomes available, patients and doctors require information on its benefits and harms. In 2011, Germany introduced the early benefit assessment of new drugs through the act on the reform of the market for medicinal products (AMNOG). At market entry, the pharmaceutical company responsible must submit a standardised dossier containing all available evidence of the drug’s added benefit over an appropriate comparator treatment. The added benefit is mainly determined using patient relevant outcomes. The “dossier assessment” is generally performed by the Institute for Quality and Efficiency in Health Care (IQWiG) and then published online. It contains all relevant study information, including data from unpublished clinical study reports contained in the dossiers. The dossier assessment refers to the patient population for which the new drug is approved according to the summary of product characteristics. This patient population may comprise either the total populations investigated in the studies submitted to regulatory authorities in the drug approval process, or the specific subpopulations defined in the summary of product characteristics (“approved subpopulations”). Objective To determine the information gain from AMNOG documents compared with non-AMNOG documents for methods and results of studies available at market entry of new drugs. AMNOG documents comprise dossier assessments done by IQWiG and publicly available modules of company dossiers; non-AMNOG documents comprise conventional, publicly available sources—that is, European public assessment reports, journal publications, and registry reports. The analysis focused on the approved patient populations. Design Retrospective analysis. Data sources All dossier assessments conducted by IQWiG between 1 January 2011 and 28 February 2013 in which the dossiers contained suitable studies allowing for a full early benefit assessment. We also considered all European public assessment reports, journal publications, and registry reports referring to these studies and included in the dossiers. Data analysis We assessed reporting quality for each study and each available document for eight methods and 11 results items (three baseline characteristics and eight patient relevant outcomes), and dichotomised them as “completely reported” or “incompletely reported (including items not reported at all).” For each document type we calculated the proportion of items with complete reporting for methods and results, for each item and overall, and compared the findings. Results 15 out of 27 dossiers were eligible for inclusion and contained 22 studies. The 15 dossier assessments contained 28 individual assessments of 15 total study populations and 13 approved subpopulations. European public assessment reports were available for all drugs. Journal publications were available for 14 out of 15 drugs and 21 out of 22 studies. A registry report in ClinicalTrials.gov was available for all drugs and studies; however, only 11 contained results. In the analysis of total study populations, the AMNOG documents reached the highest grade of completeness, with about 90% of methods and results items completely reported. In non-AMNOG documents, the rate was 75% for methods and 52% for results items; journal publications achieved the best rates, followed by European public assessment reports and registry reports. The analysis of approved subpopulations showed poorer complete reporting of results items, particularly in non-AMNOG documents (non-AMNOG versus AMNOG: 11% v 71% for overall results items and 5% v 70% for patient relevant outcomes). The main limitation of our analysis is the small sample size. Conclusion Conventional, publicly available sources provide insufficient information on new drugs, especially on patient relevant outcomes in approved subpopulations. This type of information is largely available in AMNOG documents, albeit only partly in English. The AMNOG approach could be used internationally to develop a comprehensive publication model for clinical studies and thus represents a key open access measure. PMID:25722024

Science: Promising and Exemplary Programs and Materials in Elementary and Secondary Schools. [Science Education Information Report.

ERIC Educational Resources Information Center

Helgeson, Stanley L.; And Others

This document contains 36 programs and/or material listings that were nominated by at least three persons and for which there was evidence of the quality of the program or materials. Reviewers looked for positive evaluation data on the impact of the materials on students, or other information that assessed the quality of the program or materials,…

Quality Assurance in Education: Current Debates. A Report on a SOED-Sponsored Seminar (Stirling, Scotland, United Kingdom, June 1992).

ERIC Educational Resources Information Center

Stronach, Ian, Ed.

Proceedings of a workshop held at the University of Stirling, Scotland, to critically examine issues in quality assurance (QA) in education are provided in this document. QA is the generic title for a series of business-management models that have been applied to educational contexts to describe and promote school effectiveness. Five papers and…

Mathematics: Promising and Exemplary Programs and Materials in Elementary and Secondary Schools. [Mathematics Education Information Report.

ERIC Educational Resources Information Center

Mizer, Robert; And Others

This document contains 29 programs and/or material listings that were nominated by at least three persons and for which there was evidence of the quality of the program or materials. Reviewers looked for positive evaluation data on the impact of the materials on students, or other information that assessed the quality of the program or materials,…

Progress Made on a Plan To Integrate Planning, Budgeting, Assessment and Quality Principles To Achieve Institutional Improvement. First Year Report. AIR 1996 Annual Forum Paper.

ERIC Educational Resources Information Center

Griffith, Susan R.; And Others

This paper describes first year implementation efforts of Southwest Texas (SWT) State University to develop a system to integrate planning, budgeting, assessment, and quality to improve the delivery of education and other services to all the institution's customers. The document addresses the common situation when an organization already has…

Clarus quality checking algorithm documentation report.

DOT National Transportation Integrated Search

2010-12-21

With funding and support from the USDOT RITA IntelliDrive(SM) initiative and direction from the FHWA Road Weather Management Program, NCAR enhanced QCh algorithms that are a part of the current Clarus System. Moreover, NCAR developed new QCh algorith...

Critical review of ADOT's hot mix asphalt specifications : final report 630.

DOT National Transportation Integrated Search

2008-12-01

The Arizona Department of Transportation (ADOT) has developed specifications and procedures to : ensure the quality of the hot mix asphalt materials purchased by the Department. The document : recording these specifications and procedures is the Stan...

Transforming Clinical Documentation in EHRs for 2020: Recommendations from University of Minnesota's Big Data Conference Working Group.

PubMed

Weaver, Charlotte; O'Brien, Ann

2016-01-01

In 2014, a group of diverse informatics leaders from practice, academia, and the software industry formed to address how best to transform electronic documentation to provide knowledge at the point of care and to deliver value to front line nurses and nurse leaders. This presentation reports the recommendations from this Working Group geared towards a 2020 framework. The recommendations propose redesign to optimize nurses' documentation efficiency while contributing to knowledge generation and attaining a balance that ensures the capture of nursing's impact on safety, quality, yet minimizes "death by data entry."

Technical Assistance in Evaluating Career Education Projects. Final Report. Volume I: Summary Volume.

ERIC Educational Resources Information Center

Stenner, A. Jackson; And Others

This document contains the first of five volumes reporting the activities and results of a career education evaluation project conducted to accomplish the following two objectives: (1) to improve the quality of evaluations by career education projects funded by the United States Office of Career Education (OCE) through the provision of technical…

Delivering Quality and Choice. How Performance Indicators Help and How Performance Indicators Hinder. Research Report

ERIC Educational Resources Information Center

Perry, Adrian; Simpson, Matthew

2006-01-01

This document reports on a research project held in 2005, which looked to see how performance indicators related to area needs. It shows the results of research across four Learning and Skills Council (LSC) areas, with contributions also from national stakeholders and other witnesses. Findings include: (1) Performance indicators are regarded as…

Monitoring of Childcare Fees: Prices Surveillance Authority Monitoring Report No. 13.

ERIC Educational Resources Information Center

Prices Surveillance Authority, Melbourne (Australia).

This report documents a survey conducted to determine if Australian parents have benefited from an increase in child care assistance subsidies authorized in April 1993. A total of 281 day care centers across Australia responded to surveys mailed in July 1992, February 1993, and May 1993. Data was also collected about profit margins, quality of…

Ensuring the Quality of Data Packages in the LTER Network Provenance Aware Synthesis Tracking Architecture Data Management System and Archive

NASA Astrophysics Data System (ADS)

Servilla, M. S.; O'Brien, M.; Costa, D.

2013-12-01

Considerable ecological research performed today occurs through the analysis of data downloaded from various repositories and archives, often resulting in derived or synthetic products generated by automated workflows. These data are only meaningful for research if they are well documented by metadata, lest semantic or data type errors may occur in interpretation or processing. The Long Term Ecological Research (LTER) Network now screens all data packages entering its long-term archive to ensure that each package contains metadata that is complete, of high quality, and accurately describes the structure of its associated data entity and the data are structurally congruent to the metadata. Screening occurs prior to the upload of a data package into the Provenance Aware Synthesis Tracking Architecture (PASTA) data management system through a series of quality checks, thus preventing ambiguously or incorrectly documented data packages from entering the system. The quality checks within PASTA are designed to work specifically with the Ecological Metadata Language (EML), the metadata standard adopted by the LTER Network to describe data generated by their 26 research sites. Each quality check is codified in Java as part of the ecological community-supported Data Manager Library, which is a resource of the EML specification and used as a component of the PASTA software stack. Quality checks test for metadata quality, data integrity, or metadata-data congruence. Quality checks are further classified as either conditional or informational. Conditional checks issue a 'valid', 'warning' or 'error' response. Only an 'error' response blocks the data package from upload into PASTA. Informational checks only provide descriptive content pertaining to a particular facet of the data package. Quality checks are designed by a group of LTER information managers and reviewed by the LTER community before deploying into PASTA. A total of 32 quality checks have been deployed to date. Quality checks can be customized through a configurable template, which includes turning checks 'on' or 'off' and setting the severity of conditional checks. This feature is important to other potential users of the Data Manager Library who wish to configure its quality checks in accordance with the standards of their community. Executing the complete set of quality checks produces a report that describes the result of each check. The report is an XML document that is stored by PASTA for future reference.

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

Spectrum analysis on quality requirements consideration in software design documents.

PubMed

Kaiya, Haruhiko; Umemura, Masahiro; Ogata, Shinpei; Kaijiri, Kenji

2013-12-01

Software quality requirements defined in the requirements analysis stage should be implemented in the final products, such as source codes and system deployment. To guarantee this meta-requirement, quality requirements should be considered in the intermediate stages, such as the design stage or the architectural definition stage. We propose a novel method for checking whether quality requirements are considered in the design stage. In this method, a technique called "spectrum analysis for quality requirements" is applied not only to requirements specifications but also to design documents. The technique enables us to derive the spectrum of a document, and quality requirements considerations in the document are numerically represented in the spectrum. We can thus objectively identify whether the considerations of quality requirements in a requirements document are adapted to its design document. To validate the method, we applied it to commercial software systems with the help of a supporting tool, and we confirmed that the method worked well.

Quality in End User Documentation.

ERIC Educational Resources Information Center

Morrison, Ronald

1994-01-01

Discusses quality in end-user documentation for computer applications and explains four approaches to improving quality in end-user documents. Highlights include online help, usability testing, technical writing elements, statistical approaches, and concepts relating to software quality that are also applicable to user manuals. (LRW)

[Evaluation of external quality assurance in accordance with sect. 137 SGB V at the Carl Gustav Carus university hospital in Dresden].

PubMed

Petzold, Thomas; Steinwitz, Adrienne; Schmitt, Jochen; Eberlein-Gonska, Maria

2013-01-01

Obligatory external quality assurance is an established method used to ensure the quality of inpatient care in Germany. The comprehensive approach is unique in international comparison. In addition to the statutory requirement, the health insurance funds require this form of external quality control in order to foster quality-based competition between hospitals. Ever since its introduction, healthcare providers have scrutinised the effects of the mandatory use of this survey. The study was based on all patients in the University Hospital Dresden, for whom a quality assurance sheet (n = 45,639) had to be recorded between 2003 and 2011. The documentation of these sheets was carried out by specially trained personnel. For each performance area, the duration of the documentation quality sheets was assessed, and a descriptive analysis of all quality assurance sheets was conducted. In the presence of statistical significance the so-called "Structured Dialogues" were analysed. Over the whole period, 167 statistically noticeable problems occurred. Nine of these have been rated as noticeable problems in medical quality by the specialised working groups of the project office quality assurance (PGSQS) at the Saxon State Medical Association (SLÄK). The remaining 158 statistical anomalies included 25 documentation errors; 96 were classified as statistically significant, and only 37 were marked to indicate that re-observation by the PGSQS was required. The total effort estimate for the documentation of quality assurance sheets was approximately 1,420 working days in the observation period. As far as the quality of patient care is concerned, the results can be considered positive because only a small number of quality indicators indicate noticeable qualitative problems. This statement is based primarily on the comparison of the groups of Saxony and Germany, which are included in the quality report of external quality assurance in accordance with sect. 137 SGB V. The majority of noticeable statistical problems were due to documentation errors. Other noticeable statistical problems that are medically indicated, but without effect on the extramural care to patients, recurrently occur with the respective quality indicators. Examples include the postoperative mobility indicators of the implementation of endoprostheses which cannot be used to draw conclusions about patient outcomes. Information on the quality of life as well as the post-hospital course of disease would be important in this context, but is still lacking. The use of external quality assurance data in accordance with sect. 137 SGB V for evaluation research has so far been handled quite restrictively. Thus, in-depth analyses on the quality of treatment cannot be derived. Copyright © 2013. Published by Elsevier GmbH.

Toward an Operational Proxy for Acquisition Workforce Quality: Measuring Dynamic Knowledge and Performance at the Tactical Edges of Organizations

DTIC Science & Technology

2012-10-13

Business & Public Policy Naval Postgraduate School Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection...presented in this report was supported by the Acquisition Research Program of the Graduate School of Business & Public Policy at the Naval...Program GRADUATE SCHOOL OF BUSINESS & PUBLIC POLICY - iii - NAVAL POSTGRADUATE SCHOOL NPS-AM-12-206 ACQUISITION RESEARCH SPONSORED REPORT SERIES

Patient-reported outcomes in randomised controlled trials of colorectal cancer: an analysis determining the availability of robust data to inform clinical decision-making

PubMed Central

Whale, Katie; Fish, Daniel; Fayers, Peter; Cafaro, Valentina; Pusic, Andrea; Blazeby, Jane M.; Efficace, Fabio

2016-01-01

Purpose Randomised controlled trials (RCTs) are the most robust study design measuring outcomes of colorectal cancer (CRC) treatments, but to influence clinical practice trial design and reporting of patient-reported outcomes (PROs) must be of high quality. Objectives of this study were as follows: to examine the quality of PRO reporting in RCTs of CRC treatment; to assess the availability of robust data to inform clinical decision-making; and to investigate whether quality of reporting improved over time. Methods A systematic review from January 2004–February 2012 identified RCTs of CRC treatment describing PROs. Relevant abstracts were screened and manuscripts obtained. Methodological quality was assessed using International Society for Quality of Life Research—patient-reported outcome reporting standards. Changes in reporting quality over time were established by comparison with previous data, and risk of bias was assessed with the Cochrane risk of bias tool. Results Sixty-six RCTs were identified, seven studies (10 %) reported survival benefit favouring the experimental treatment, 35 trials (53 %) identified differences in PROs between treatment groups, and the clinical significance of these differences was discussed in 19 studies (29 %). The most commonly reported treatment type was chemotherapy (n = 45; 68 %). Improvements over time in key methodological issues including the documentation of missing data and the discussion of the clinical significance of PROs were found. Thirteen trials (20 %) had high-quality reporting. Conclusions Whilst improvements in PRO quality reporting over time were found, several recent studies still fail to robustly inform clinical practice. Quality of PRO reporting must continue to improve to maximise the clinical impact of PRO findings. PMID:25910987

Documenting the rationale and psychometric characteristics of patient reported outcomes for labeling and promotional claims: the PRO Evidence Dossier.

PubMed

Revicki, Dennis A; Gnanasakthy, Ari; Weinfurt, Kevin

2007-05-01

The Food and Drug Administration (FDA) and European Medicines Agency (EMEA) are willing to consider including information on patient reported outcomes (PROs) in product labeling and advertising. Pharmaceutical industry researchers must provide sufficient evidence supporting PRO benefit before an approval may be granted. This report describes the purpose and content of a PRO Evidence Dossier, which consists of important information supporting PRO claims. The dossier should be completed by pharmaceutical industry or other researchers to document the planning of the PRO assessment strategy, psychometric evidence, desired target labeling statements, and the clinical trial evidence of PRO benefits. The systematic reporting and documentation of information on the rationale for including PROs, rationale for the selection of specific PRO instruments, evidence on the psychometric qualities of the PRO measures, and guidelines for interpreting PRO findings will facilitate achieving a PRO labeling or promotional claim. Combining all the relevant information into a single document will facilitate the review and evaluation process for clinical and regulatory reviewers. The PRO Evidence Dossier may also be helpful to industry and academic researchers in identifying further information that will need to be developed to support the clinical development program and the PRO endpoints.

Impact of an Information Technology-Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

PubMed Central

Silveira, Patricia C.; Dunne, Ruth; Sainani, Nisha I.; Lacson, Ronilda; Silverman, Stuart G.; Tempany, Clare M.; Khorasani, Ramin

2015-01-01

Rationale and Objectives Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve. PMID:25863794

Space Shuttle Guidance, Navigation, and Rendezvous Knowledge Capture Reports. Revision 1

NASA Technical Reports Server (NTRS)

Goodman, John L.

2011-01-01

This document is a catalog and readers guide to lessons learned, experience, and technical history reports, as well as compilation volumes prepared by United Space Alliance personnel for the NASA/Johnson Space Center (JSC) Flight Dynamics Division.1 It is intended to make it easier for future generations of engineers to locate knowledge capture documentation from the Shuttle Program. The first chapter covers observations on documentation quality and research challenges encountered during the Space Shuttle and Orion programs. The second chapter covers the knowledge capture approach used to create many of the reports covered in this document. These chapters are intended to provide future flight programs with insight that could be used to formulate knowledge capture and management strategies. The following chapters contain descriptions of each knowledge capture report. The majority of the reports concern the Space Shuttle. Three are included that were written in support of the Orion Program. Most of the reports were written from the years 2001 to 2011. Lessons learned reports concern primarily the shuttle Global Positioning System (GPS) upgrade and the knowledge capture process. Experience reports on navigation and rendezvous provide examples of how challenges were overcome and how best practices were identified and applied. Some reports are of a more technical history nature covering navigation and rendezvous. They provide an overview of mission activities and the evolution of operations concepts and trajectory design. The lessons learned, experience, and history reports would be considered secondary sources by historians and archivists.

Audit, guidelines and standards: clinical governance for hip fracture care in Scotland.

PubMed

Currie, Colin T; Hutchison, James D

To report on experience of national-level audit, guidelines and standards for hip fracture care in Scotland. Scottish Hip Fracture Audit (from 1993) documents case-mix, process and outcomes of hip fracture care in Scotland. Evidence-based national guidelines on hip fracture care are available (1997, updated 2002). Hip fracture serves as a tracer condition by the health quality assurance authority for its work on older people, which reported in 2004. Audit data are used locally to document care and support and monitor service developments. Synergy between the guidelines and the audit provides a means of improving care locally and monitoring care nationally. External review by the quality assurance body shows to what extent guideline-based standards relating to A&E care, pre-operative delay, multidisciplinary care and audit participation are met. Three national-level initiatives on hip fracture care have delivered: Reliable and large-scale comparative information on case-mix, care and outcomes; evidence-based recommendations on care; and nationally accountable standards inspected and reported by the national health quality assurance authority. These developments are linked and synergistic, and enjoy both clinical and managerial support. They provide an evolving framework for clinical governance, with casemix-adjusted outcome assessment for hip fracture care as a next step.

48 CFR 4.803 - Contents of contract files.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Cost or price analysis. (20) Audit reports or reasons for waiver. (21) Record of negotiation. (22... them. (13) Documents supporting advance or progress payments. (14) Progressing, expediting, and production surveillance records. (15) Quality assurance records. (16) Property administration records. (17...

Qualitative Assessment of IVHS Emission and Air Quality Impacts

DOT National Transportation Integrated Search

2000-04-07

The purpose of this document is to present state-level statistics for the CVISN deployment described in the national report. These data will allow state stakeholders to evaluate their own deployment standings in relation to national averages. The nat...

Energy Audit of the Boston and Maine Railroad

DOT National Transportation Integrated Search

1981-04-01

This report documents an energy audit of the Boston and Maine (B&M) Railroad performed in support of a joint Government/industry program to determine means of conserving energy on railroads without reducing safety or service quality. The audit was pe...

42 CFR 493.1233 - Standard: Complaint investigations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing General Laboratory Systems § 493.1233 Standard: Complaint investigations. The laboratory must have a system in place to ensure that it documents all complaints and problems reported to the laboratory...

Final Draft of RACER Audit

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

Paige, Karen Schultz; Gomez, Penelope E.

This document describes the approach Waste and Environmental Services - Environmental Data and Analysis plans to take to resolve the issues presented in a recent audit of the WES-EDA Environmental Database relative to the RACER database. A majority of the issues discovered in the audit will be resolved in May 2011 when the WES-EDA Environmental Database, along with other LANL databases, are integrated and moved to a new vendor providing an Environmental Information Management (EIM) system that allows reporting capabilities for all users directly from the database. The EIM system will reside in a publicly accessible LANL cloud-based software system.more » When this transition occurs, the data quality, completeness, and access will change significantly. In the remainder of this document, this new structure will be referred to as the LANL Cloud System In general, our plan is to address the issues brought up in this audit in three ways: (1) Data quality issues such as units and detection status, which impinge upon data usability, will be resolved as soon possible so that data quality is maintained. (2) Issues requiring data cleanup, such as look up tables, legacy data, locations, codes, and significant data discrepancies, will be addressed as resources permit. (3) Issues associated with data feed problems will be eliminated by the LANL Cloud System, because there will be no data feed. As discussed in the paragraph above, in the future the data will reside in a publicly accessible system. Note that report writers may choose to convert, adapt, or simplify the information they receive officially through our data base, thereby introducing data discrepancies between the data base and the public report. It is not always possible to incorporate and/or correct these errors when they occur. Issues in the audit will be discussed in the order in which they are presented in the audit report. Clarifications will also be noted as the audit report was a draft document, at the time of this response.« less

Drivers of Dashboard Development (3-D): A Curricular Continuous Quality Improvement Approach.

PubMed

Shroyer, A Laurie; Lu, Wei-Hsin; Chandran, Latha

2016-04-01

Undergraduate medical education (UME) programs are seeking systematic ways to monitor and manage their educational performance metrics and document their achievement of external goals (e.g., Liaison Committee on Medical Education [LCME] accreditation requirements) and internal objectives (institution-specific metrics). In other continuous quality improvement (CQI) settings, summary dashboard reports have been used to evaluate and improve performance. The Stony Brook University School of Medicine UME leadership team developed and implemented summary dashboard performance reports in 2009 to document LCME standards/criteria compliance, evaluate medical student performance, and identify progress in attaining institutional curricular goals and objectives. Key performance indicators (KPIs) and benchmarks were established and have been routinely monitored as part of the novel Drivers of Dashboard Development (3-D) approach to curricular CQI. The systematic 3-D approach has had positive CQI impacts. Substantial improvements over time have been documented in KPIs including timeliness of clerkship grades, midclerkship feedback, student mistreatment policy awareness, and student satisfaction. Stakeholder feedback indicates that the dashboards have provided useful information guiding data-driven curricular changes, such as integrating clinician-scientists as lecturers in basic science courses to clarify the clinical relevance of specific topics. Gaining stakeholder acceptance of the 3-D approach required clear communication of preestablished targets and annual meetings with department leaders and course/clerkship directors. The 3-D approach may be considered by UME programs as a template for providing faculty and leadership with a CQI framework to establish shared goals, document compliance, report accomplishments, enrich communications, facilitate decisions, and improve performance.

Minding Our "P's" and "Q's": Indications of Productivity and Quality in South Carolina's Public Colleges and Universities. Reports on Act 255 of 1992 and Summary Report on Institutional Effectiveness.

ERIC Educational Resources Information Center

South Carolina Commission on Higher Education, Columbia.

The reports in this document assess the effectiveness of South Carolina's public postsecondary institutions for the 1995-96 academic year. Ten tables provide data as required by Act 255 on accreditation, graduation rates, percent change in enrollment, sources of undergraduate degrees, transfers, and professional examination rates. Summary reports…

Establishing the Reliability and Validity of the Perceptions of Flight Operations Quality Assurance (PFOQA) Questionnaire

DTIC Science & Technology

2011-04-01

Elaine M. Pfleiderer Thomas R. Chidester Civil Aerospace Medical Institute Federal Aviation Administration Oklahoma City, OK 73125 April 2011 Final...Aerospace Medical Institute’s publications Web site: www.faa.gov/library/reports/ medical /oamtechreports i Technical Report Documentation Page 1. Report...Work Unit No. (TRAIS) FAA Civil Aerospace Medical Institute P.O. Box 25082 11. Contract or Grant No. Oklahoma City, OK 73125

Flight-testing and frequency-domain analysis for rotorcraft handling qualities

NASA Technical Reports Server (NTRS)

Ham, Johnnie A.; Gardner, Charles K.; Tischler, Mark B.

1995-01-01

A demonstration of frequency-domain flight-testing techniques and analysis was performed on a U.S. Army OH-58D helicopter in support of the OH-58D Airworthiness and Flight Characteristics Evaluation and of the Army's development and ongoing review of Aeronautical Design Standard 33C, Handling Qualities Requirements for Military Rotorcraft. Hover and forward flight (60 kn) tests were conducted in 1 flight hour by Army experimental test pilots. Further processing of the hover data generated a complete database of velocity, angular-rate, and acceleration-frequency responses to control inputs. A joint effort was then undertaken by the Airworthiness Qualification Test Dirtectorate and the U.S. Army Aeroflightdynamics Directorate to derive handling-quality information from the frequency-domain database using a variety of approaches. This report documents numerous results that have been obtained from the simple frequency-domain tests; in many areas, these results provide more insight into the aircraft dynmamics that affect handling qualities than do traditional flight tests. The handling-quality results include ADS-33C bandwidth and phase-delay calculations, vibration spectral determinations, transfer-function models to examine single-axis results, and a six-degree-of-freedom fully coupled state-space model. The ability of this model to accurately predict responses was verified using data from pulse inputs. This report also documents the frequency-sweep flight-test technique and data analysis used to support the tests.

Examining the Quality of Rectal Cancer Operative Reports in Teaching Institutions: Is There an Opportunity for Resident Education?

PubMed

Parrish, Aaron B; Sanaiha, Yas; Petrie, Beverley A; Russell, Marcia M; Chen, Formosa

2016-10-01

The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed. Overall adherence to checklist items was 55 per cent, and was significantly higher in attending versus resident dictated reports (67% vs 51%, P < 0.01). Senior residents had significantly higher adherence to checklist items than junior residents (55% vs 44%, P < 0.01). However, overall adherence to rectal cancer checklist items was low. This represents an opportunity to improve the quality of operative documentation in rectal cancer surgery, which could also impact the technical quality of the operation itself.

Summary of inorganic compositional data for groundwater, soil-water, and surface-water samples collected at the Headgate Draw subsurface drip irrigation site, Johnson County, Wyoming

USGS Publications Warehouse

Geboy, Nicholas J.; Engle, Mark A.; Schroeder, Karl T.; Zupancic, John W.

2011-01-01

As part of a 5-year project on the impact of subsurface drip irrigation (SDI) application of coalbed-methane (CBM) produced waters, water samples were collected from the Headgate Draw SDI site in the Powder River Basin, Wyoming, USA. This research is part of a larger study to understand short- and long-term impacts on both soil and water quality from the beneficial use of CBM waters to grow forage crops through use of SDI. This document provides a summary of the context, sampling methodology, and quality assurance and quality control documentation of samples collected prior to and over the first year of SDI operation at the site (May 2008-October 2009). This report contains an associated database containing inorganic compositional data, water-quality criteria parameters, and calculated geochemical parameters for samples of groundwater, soil water, surface water, treated CBM waters, and as-received CBM waters collected at the Headgate Draw SDI site.

Water-quality investigation of the Caney Creek watershed, Northeast Arkansas

USGS Publications Warehouse

Lamb, T.E.; Newsom, G.

1979-01-01

The results of a 1-year study, in 1977-78, of surface-water quality in the Caney Creek watershed, northeast Arkansas, are presented to document conditions before implementation of Soil Conservation Service programs. The report includes a general description of the watershed 's topography, geology, and aquifers, and the results of several measurements at two sites of discharge, and a number of physical and chemical parameters. (USGS)

Soldier Quality of Life Assessment

DTIC Science & Technology

2016-09-01

ABSTRACT This report documents survey research and modeling of Soldier quality of life (QoL) on contingency base camps by the U.S. Army Natick...Science and Technology Objective Demonstration, was to develop a way to quantify QoL for camps housing fewer than 1000 personnel. A discrete choice survey ... Survey results were analyzed using hierarchical Bayesian logistic regression to develop a quantitative model for estimating QoL based on base camp

Variations in data collection methods between national databases affect study results: a comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures.

PubMed

Bohl, Daniel D; Russo, Glenn S; Basques, Bryce A; Golinvaux, Nicholas S; Fu, Michael C; Long, William D; Grauer, Jonathan N

2014-12-03

There has been an increasing use of national databases to conduct orthopaedic research. Questions regarding the validity and consistency of these studies have not been fully addressed. The purpose of this study was to test for similarity in reported measures between two national databases commonly used for orthopaedic research. A retrospective cohort study of patients undergoing lumbar spinal fusion procedures during 2009 to 2011 was performed in two national databases: the Nationwide Inpatient Sample and the National Surgical Quality Improvement Program. Demographic characteristics, comorbidities, and inpatient adverse events were directly compared between databases. The total numbers of patients included were 144,098 from the Nationwide Inpatient Sample and 8434 from the National Surgical Quality Improvement Program. There were only small differences in demographic characteristics between the two databases. There were large differences between databases in the rates at which specific comorbidities were documented. Non-morbid obesity was documented at rates of 9.33% in the Nationwide Inpatient Sample and 36.93% in the National Surgical Quality Improvement Program (relative risk, 0.25; p < 0.05). Peripheral vascular disease was documented at rates of 2.35% in the Nationwide Inpatient Sample and 0.60% in the National Surgical Quality Improvement Program (relative risk, 3.89; p < 0.05). Similarly, there were large differences between databases in the rates at which specific inpatient adverse events were documented. Sepsis was documented at rates of 0.38% in the Nationwide Inpatient Sample and 0.81% in the National Surgical Quality Improvement Program (relative risk, 0.47; p < 0.05). Acute kidney injury was documented at rates of 1.79% in the Nationwide Inpatient Sample and 0.21% in the National Surgical Quality Improvement Program (relative risk, 8.54; p < 0.05). As database studies become more prevalent in orthopaedic surgery, authors, reviewers, and readers should view these studies with caution. This study shows that two commonly used databases can identify demographically similar patients undergoing a common orthopaedic procedure; however, the databases document markedly different rates of comorbidities and inpatient adverse events. The differences are likely the result of the very different mechanisms through which the databases collect their comorbidity and adverse event data. Findings highlight concerns regarding the validity of orthopaedic database research. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Document-level classification of CT pulmonary angiography reports based on an extension of the ConText algorithm.

PubMed

Chapman, Brian E; Lee, Sean; Kang, Hyunseok Peter; Chapman, Wendy W

2011-10-01

In this paper we describe an application called peFinder for document-level classification of CT pulmonary angiography reports. peFinder is based on a generalized version of the ConText algorithm, a simple text processing algorithm for identifying features in clinical report documents. peFinder was used to answer questions about the disease state (pulmonary emboli present or absent), the certainty state of the diagnosis (uncertainty present or absent), the temporal state of an identified pulmonary embolus (acute or chronic), and the technical quality state of the exam (diagnostic or not diagnostic). Gold standard answers for each question were determined from the consensus classifications of three human annotators. peFinder results were compared to naive Bayes' classifiers using unigrams and bigrams. The sensitivities (and positive predictive values) for peFinder were 0.98(0.83), 0.86(0.96), 0.94(0.93), and 0.60(0.90) for disease state, quality state, certainty state, and temporal state respectively, compared to 0.68(0.77), 0.67(0.87), 0.62(0.82), and 0.04(0.25) for the naive Bayes' classifier using unigrams, and 0.75(0.79), 0.52(0.69), 0.59(0.84), and 0.04(0.25) for the naive Bayes' classifier using bigrams. Copyright © 2011 Elsevier Inc. All rights reserved.

Measuring Dynamic Knowledge and Performance at the Tactical Edges of Organizations: Assessing Acquisition Workforce Quality

DTIC Science & Technology

2013-04-01

report was supported by the Acquisition Research Program of the Graduate School of Business & Public Policy at the Naval Postgraduate School. To...in this report are those of the authors and do not reflect the official policy position of the Navy, the Department of Defense, or the federal...government. Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average

Federal Communications Commission (FCC) Transponder Loading Data Conversion Software. User's guide and software maintenance manual, version 1.2

NASA Technical Reports Server (NTRS)

Mallasch, Paul G.

1993-01-01

This volume contains the complete software system documentation for the Federal Communications Commission (FCC) Transponder Loading Data Conversion Software (FIX-FCC). This software was written to facilitate the formatting and conversion of FCC Transponder Occupancy (Loading) Data before it is loaded into the NASA Geosynchronous Satellite Orbital Statistics Database System (GSOSTATS). The information that FCC supplies NASA is in report form and must be converted into a form readable by the database management software used in the GSOSTATS application. Both the User's Guide and Software Maintenance Manual are contained in this document. This volume of documentation passed an independent quality assurance review and certification by the Product Assurance and Security Office of the Planning Research Corporation (PRC). The manuals were reviewed for format, content, and readability. The Software Management and Assurance Program (SMAP) life cycle and documentation standards were used in the development of this document. Accordingly, these standards were used in the review. Refer to the System/Software Test/Product Assurance Report for the Geosynchronous Satellite Orbital Statistics Database System (GSOSTATS) for additional information.

Portable Fuel Quality Analyzer

DTIC Science & Technology

2014-01-27

other transportation industries, such as trucking. The PFQA could also be used in fuel blending operations performed at petroleum, ethanol and biodiesel plants. ...Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per...24476 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The

Institutional Trial Quality Audit of the University of South Africa (UNISA)

ERIC Educational Resources Information Center

Commonwealth of Learning, 2007

2007-01-01

This report presents the findings of the Trial Audit Panel (TAP) after studying a range of documentation before and during the audit and discussing issues with a wide range of University of South Africa (Unisa) staff during their visit to the University in June 2007. The original intention was to produce two reports, one in the format and…

Model documentation for relations between continuous real-time and discrete water-quality constituents in Indian Creek, Johnson County, Kansas, June 2004 through May 2013

USGS Publications Warehouse

Stone, Mandy L.; Graham, Jennifer L.

2014-01-01

Johnson County is the fastest growing county in Kansas, with a population of about 560,000 people in 2012. Urban growth and development can have substantial effects on water quality, and streams in Johnson County are affected by nonpoint-source pollutants from stormwater runoff and point-source discharges such as municipal wastewater effluent. Understanding of current (2014) water-quality conditions and the effects of urbanization is critical for the protection and remediation of aquatic resources in Johnson County, Kansas and downstream reaches located elsewhere. The Indian Creek Basin is 194 square kilometers and includes parts of Johnson County, Kansas and Jackson County, Missouri. Approximately 86 percent of the Indian Creek Basin is located in Johnson County, Kansas. The U.S. Geological Survey, in cooperation with Johnson County Wastewater, operated a series of six continuous real-time water-quality monitoring stations in the Indian Creek Basin during June 2011 through May 2013; one of these sites has been operating since February 2004. Five monitoring sites were located on Indian Creek and one site was located on Tomahawk Creek. The purpose of this report is to document regression models that establish relations between continuously measured water-quality properties and discretely collected water-quality constituents. Continuously measured water-quality properties include streamflow, specific conductance, pH, water temperature, dissolved oxygen, turbidity, and nitrate. Discrete water-quality samples were collected during June 2011 through May 2013 at five new sites and June 2004 through May 2013 at a long-term site and analyzed for sediment, nutrients, bacteria, and other water-quality constituents. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physical properties to estimate concentrations of those constituents of interest that are not easily measured in real time because of limitations in sensor technology and fiscal constraints. Regression models for 28 water-quality constituents were developed and documented. The water-quality information in this report is important to Johnson County Wastewater because it allows the concentrations of many potential pollutants of interest, including nutrients and sediment, to be estimated in real time and characterized during conditions and time scales that would not be possible otherwise.

[Development and integration of the Oncological Documentation System ODS].

PubMed

Raab, G; van Den Bergh, M

2001-08-01

To simplify clinical routine and to improve medical quality without exceeding the existing resources. Intensifying communication and cooperation between all institutions of patients' health care. The huge amount of documentation work of physicians can no longer be done without modern tools of paperless data processing. The development of ODS was a tight cooperation between physician and technician which resulted in a mutual understanding and led to a high level of user convenience. - At present all cases of gynecology, especially gynecologic oncology can be documented and processed by ODS. Users easily will adopt the system as data entry within different program areas follows the same rules. In addition users can choose between an individual input of data and assistants guiding them through highly specific areas of documentation. ODS is a modern, modular structured and very fast multiuser database environment for in- and outpatient documentation. It automatically generates a lot of reports for clinical day to day business. Statistical routines will help the user reflecting his work and its quality. Documentation of clinical trials according to the GCP guidelines can be done by ODS using the internet or offline datasharing. As ODS is the synthesis of a computer based patient administration system and an oncological documentation database, it represents the basis for the construction of the electronical patient chart as well as the digital documentation of clinical trials. The introduction of this new technology to physicians and nurses has to be done slowly and carefully, in order to increase motivation and to improve the results.

Nontimber values of Louisiana's timberland

Treesearch

Victor A. Rudis

1988-01-01

As a companion publication to the Louisiana timber report (Rosson and others 1988), this document presents information about the other forest values associated with Louisiana's timberland. These "nontimber" values include water quality, soils, livestock potential, wildlife habitat, aesthetics, and dispersed recreation opportunities in timberland areas....

Observations concerning Research Literature on Neuro-Linguistic Programming.

ERIC Educational Resources Information Center

Einspruch, Eric L.; Forman, Bruce D.

1985-01-01

Identifies six categories of design and methodological errors contained in the 39 empirical studies of neurolinguistic programming (NLP) documented through April 1984. Representative reports reflecting each category are discussed. Suggestions are offered for improving the quality of research on NLP. (Author/MCF)

HeatWurx patching at two locations in San Antonio.

DOT National Transportation Integrated Search

2012-06-01

Patching asphalt pavement is an important, necessary part of TxDOT operations. Cracked and failed areas : need to be replaced by high quality, sound pavement in order to meet the needs of the traveling public. This : report documents the placing, cos...

Next level of board accountability in health care quality.

PubMed

Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B

2018-03-19

Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.

Degraded character recognition based on gradient pattern

NASA Astrophysics Data System (ADS)

Babu, D. R. Ramesh; Ravishankar, M.; Kumar, Manish; Wadera, Kevin; Raj, Aakash

2010-02-01

Degraded character recognition is a challenging problem in the field of Optical Character Recognition (OCR). The performance of an optical character recognition depends upon printed quality of the input documents. Many OCRs have been designed which correctly identifies the fine printed documents. But, very few reported work has been found on the recognition of the degraded documents. The efficiency of the OCRs system decreases if the input image is degraded. In this paper, a novel approach based on gradient pattern for recognizing degraded printed character is proposed. The approach makes use of gradient pattern of an individual character for recognition. Experiments were conducted on character image that is either digitally written or a degraded character extracted from historical documents and the results are found to be satisfactory.

PACS quality control and automatic problem notifier

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice C.; Jones, Douglas; Frost, Meryll M.; Staab, Edward V.

1997-05-01

One side effect of installing a clinical PACS Is that users become dependent upon the technology and in some cases it can be very difficult to revert back to a film based system if components fail. The nature of system failures range from slow deterioration of function as seen in the loss of monitor luminance through sudden catastrophic loss of the entire PACS networks. This paper describes the quality control procedures in place at the University of Florida and the automatic notification system that alerts PACS personnel when a failure has happened or is anticipated. The goal is to recover from a failure with a minimum of downtime and no data loss. Routine quality control is practiced on all aspects of PACS, from acquisition, through network routing, through display, and including archiving. Whenever possible, the system components perform self and between platform checks for active processes, file system status, errors in log files, and system uptime. When an error is detected or a exception occurs, an automatic page is sent to a pager with a diagnostic code. Documentation on each code, trouble shooting procedures, and repairs are kept on an intranet server accessible only to people involved in maintaining the PACS. In addition to the automatic paging system for error conditions, acquisition is assured by an automatic fax report sent on a daily basis to all technologists acquiring PACS images to be used as a cross check that all studies are archived prior to being removed from the acquisition systems. Daily quality control is preformed to assure that studies can be moved from each acquisition and contrast adjustment. The results of selected quality control reports will be presented. The intranet documentation server will be described with the automatic pager system. Monitor quality control reports will be described and the cost of quality control will be quantified. As PACS is accepted as a clinical tool, the same standards of quality control must be established as are expected on other equipment used in the diagnostic process.

Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews.

PubMed

Rethlefsen, Melissa L; Farrell, Ann M; Osterhaus Trzasko, Leah C; Brigham, Tara J

2015-06-01

To determine whether librarian and information specialist authorship was associated with better reported systematic review (SR) search quality. SRs from high-impact general internal medicine journals were reviewed for search quality characteristics and reporting quality by independent reviewers using three instruments, including a checklist of Institute of Medicine Recommended Standards for the Search Process and a scored modification of the Peer Review of Electronic Search Strategies instrument. The level of librarian and information specialist participation was significantly associated with search reproducibility from reported search strategies (Χ(2) = 23.5; P < 0.0001). Librarian co-authored SRs had significantly higher odds of meeting 8 of 13 analyzed search standards than those with no librarian participation and six more than those with mentioned librarian participation. One-way ANOVA showed that differences in total search quality scores between all three groups were statistically significant (F2,267 = 10.1233; P < 0.0001). Problems remain with SR search quality and reporting. SRs with librarian or information specialist co-authors are correlated with significantly higher quality reported search strategies. To minimize bias in SRs, authors and editors could encourage librarian engagement in SRs including authorship as a potential way to help improve documentation of the search strategy. Copyright © 2015 Elsevier Inc. All rights reserved.

Automated extraction of ejection fraction for quality measurement using regular expressions in Unstructured Information Management Architecture (UIMA) for heart failure

PubMed Central

DuVall, Scott L; South, Brett R; Bray, Bruce E; Bolton, Daniel; Heavirland, Julia; Pickard, Steve; Heidenreich, Paul; Shen, Shuying; Weir, Charlene; Samore, Matthew; Goldstein, Mary K

2012-01-01

Objectives Left ventricular ejection fraction (EF) is a key component of heart failure quality measures used within the Department of Veteran Affairs (VA). Our goals were to build a natural language processing system to extract the EF from free-text echocardiogram reports to automate measurement reporting and to validate the accuracy of the system using a comparison reference standard developed through human review. This project was a Translational Use Case Project within the VA Consortium for Healthcare Informatics. Materials and methods We created a set of regular expressions and rules to capture the EF using a random sample of 765 echocardiograms from seven VA medical centers. The documents were randomly assigned to two sets: a set of 275 used for training and a second set of 490 used for testing and validation. To establish the reference standard, two independent reviewers annotated all documents in both sets; a third reviewer adjudicated disagreements. Results System test results for document-level classification of EF of <40% had a sensitivity (recall) of 98.41%, a specificity of 100%, a positive predictive value (precision) of 100%, and an F measure of 99.2%. System test results at the concept level had a sensitivity of 88.9% (95% CI 87.7% to 90.0%), a positive predictive value of 95% (95% CI 94.2% to 95.9%), and an F measure of 91.9% (95% CI 91.2% to 92.7%). Discussion An EF value of <40% can be accurately identified in VA echocardiogram reports. Conclusions An automated information extraction system can be used to accurately extract EF for quality measurement. PMID:22437073

Well installation and documentation, and ground-water sampling protocols for the pilot National Water-Quality Assessment Program

USGS Publications Warehouse

Hardy, M.A.; Leahy, P.P.; Alley, W.M.

1989-01-01

Several pilot projects are being conducted as part of the National Water Quality Assessment (NAWQA) Program. The purpose of the pilot program is to test and refine concepts for a proposed full-scale program. Three of the pilot projects are specifically designed to assess groundwater. The purpose of this report is to describe the criteria that are being used in the NAWQA pilot projects for selecting and documenting wells, installing new wells, and sampling wells for different water quality constituents. Guidelines are presented for the selection of wells for sampling. Information needed to accurately document each well includes site characteristics related to the location of the well, land use near the well, and important well construction features. These guidelines ensure the consistency of the information collected and will provide comparable data for interpretive purposes. Guidelines for the installation of wells are presented and include procedures that need to be followed for preparations prior to drilling, the selection of the drilling technique and casing type, the grouting procedure, and the well-development technique. A major component of the protocols is related to water quality sampling. Tasks are identified that need to be completed prior to visiting the site for sampling. Guidelines are presented for purging the well prior t sampling, both in terms of the volume of water pumped and the chemical stability of field parameters. Guidelines are presented concerning sampler selection as related to both inorganic and organic constituents. Documentation needed to describe the measurements and observations related to sampling each well and treating and preserving the samples are also presented. Procedures are presented for the storage and shipping of water samples, equipment cleaning, and quality assurance. Quality assurance guidelines include the description of the general distribution of the various quality assurance samples (blanks, spikes, duplicates, and reference samples) that will be used in the pilot program. (Lantz-PTT)

Lack of evidence and standardization in care pathway documents for patients with ST-elevated myocardial infarction.

PubMed

Aeyels, Daan; Van Vugt, Stijn; Sinnaeve, Peter R; Panella, Massimiliano; Van Zelm, Ruben; Sermeus, Walter; Vanhaecht, Kris

2016-04-01

Clinical practice variation and the subsequent burden on health care quality has been documented for patients with ST-elevated myocardial infarction (STEMI). Reduction of clinical practice variation is possible by increasing guideline adherence. Care pathway documents can increase guideline adherence by implementing evidence-based key interventions and quality indicators in daily practice. This study aims to examine guideline adherence of care pathway documents for patients with STEMI. Lay-out, size and timeframe of submitted care pathways documents were analysed. Two independent reviewers used a checklist to systematically assess the guideline adherence of care pathway documents. The checklist comprised a set of key interventions and quality indicators extracted from evidence and international guidelines. The checklist distinguished the evidence level for each item and was validated by expert consensus. Results were verified by inviting participating hospitals to provide feedback. Fifteen out of 25 invited hospitals submitted care pathway documents for STEMI. The care pathway documents differed in timeframe, lay-out and size. Analysis of the care pathway documents showed important variation in formalizing adherence to evidence: between hospitals, inclusion of 24 key interventions in care pathway documents varied from 13 to 97%. Inclusion of 11 essential quality indicators varied from 0 to 40%. Care pathway documents for patients with STEMI differ considerably in lay-out, timeframe and size. This study showed variation in, and suboptimal inclusion of, evidence-based key interventions and quality indicators in care pathway documents. The use of these care pathway documents might result in suboptimal quality of care for STEMI patients. © The European Society of Cardiology 2015.

International Metadata Standards and Enterprise Data Quality Metadata Systems

NASA Technical Reports Server (NTRS)

Habermann, Ted

2016-01-01

Well-documented data quality is critical in situations where scientists and decision-makers need to combine multiple datasets from different disciplines and collection systems to address scientific questions or difficult decisions. Standardized data quality metadata could be very helpful in these situations. Many efforts at developing data quality standards falter because of the diversity of approaches to measuring and reporting data quality. The one size fits all paradigm does not generally work well in this situation. I will describe these and other capabilities of ISO 19157 with examples of how they are being used to describe data quality across the NASA EOS Enterprise and also compare these approaches with other standards.

Air pollution and public health: a guidance document for risk managers.

PubMed

Craig, Lorraine; Brook, Jeffrey R; Chiotti, Quentin; Croes, Bart; Gower, Stephanie; Hedley, Anthony; Krewski, Daniel; Krupnick, Alan; Krzyzanowski, Michal; Moran, Michael D; Pennell, William; Samet, Jonathan M; Schneider, Jurgen; Shortreed, John; Williams, Martin

2008-01-01

This guidance document is a reference for air quality policymakers and managers providing state-of-the-art, evidence-based information on key determinants of air quality management decisions. The document reflects the findings of five annual meetings of the NERAM (Network for Environmental Risk Assessment and Management) International Colloquium Series on Air Quality Management (2001-2006), as well as the results of supporting international research. The topics covered in the guidance document reflect critical science and policy aspects of air quality risk management including i) health effects, ii) air quality emissions, measurement and modeling, iii) air quality management interventions, and iv) clean air policy challenges and opportunities.

Documenting quality improvement and patient safety efforts: the quality portfolio. A statement from the academic hospitalist taskforce.

PubMed

Taylor, Benjamin B; Parekh, Vikas; Estrada, Carlos A; Schleyer, Anneliese; Sharpe, Bradley

2014-01-01

Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined framework, detailed instructions for use and an example to guide users. The portfolio has eight categories including: (1) a faculty narrative, (2) leadership and administrative activities, (3) project activities, (4) education and curricula, (5) research and scholarship, (6) honors, awards, and recognition, (7) training and certification, and (8) an appendix. The authors offer this comprehensive, yet practical tool as a method to document quality and safety activities. It is relevant for physicians across disciplines and institutions and may be useful as a standalone document or as an adjunct to traditional promotion documents. As the Next Accreditation System is implemented, academic medical centers will require faculty who can teach and implement the systems-based practice requirements. The quality portfolio is a method to document quality improvement and safety activities.

Quality-Assurance/Quality-Control Manual for Collection and Analysis of Water-Quality Data in the Ohio District, US Geological Survey

USGS Publications Warehouse

Francy, D.S.; Jones, A.L.; Myers, Donna N.; Rowe, G.L.; Eberle, Michael; Sarver, K.M.

1998-01-01

The U.S. Geological Survey (USGS), Water Resources Division (WRD), requires that quality-assurance/quality-control (QA/QC) activities be included in any sampling and analysis program. Operational QA/QC procedures address local needs while incorporating national policies. Therefore, specific technical policies were established for all activities associated with water-quality project being done by the Ohio District. The policies described in this report provide Ohio District personnel, cooperating agencies, and others with a reference manual on QA/QC procedures that are followed in collecitng and analyzing water-quality samples and reporting water-quality information in the Ohio District. The project chief, project support staff, District Water-Quality Specialist, and District Laboratory Coordinator are all involved in planning and implementing QA/QC activities at the district level. The District Chief and other district-level managers provide oversight, and the Regional Water-Quality Specialist, Office of Water Quality (USGS headquarters), and the Branch of Quality Systems within the Office of Water Quality create national QA/QC polices and provide assistance to District personnel. In the literature, the quality of all measurement data is expressed in terms of precision, variability, bias, accuracy, completeness, representativeness, and comparability. In the Ohio District, bias and variability will be used to describe quality-control data generated from samples in the field and laboratory. Each project chief must plan for implementation and financing of QA/QC activities necessary to achieve data-quality objectives. At least 15 percent of the total project effort must be directed toward QA/QC activities. Of this total, 5-10 percent will be used for collection and analysis of quality-control samples. This is an absolute minimum, and more may be required based on project objectives. Proper techniques must be followed in the collection and processing of surface-water, ground-water, biological, precipitation, bed-sediment, bedload, suspended-sediment, and solid-phase samples. These techniques are briefly described in this report and are extensively documented. The reference documents listed in this report will be kept by the District librarian and District Water-Quality Specialist and updated regularly so that they are available to all District staff. Proper handling and documentation before, during, and after field activities are essential to ensure the integrity of the sample and to correct erroneous reporting of data results. Field sites are to be properly identified and entered into the data base before field data-collection activities begin. During field activities, field notes are to be completed and sample bottles appropriately labeled a nd stored. After field activities, all paperwork is to be completed promptly and samples transferred to the laboratory within allowable holding times. All equipment used by District personnel for the collection and processing of water-quality samples is to be properly operated, maintained, and calibrated by project personnel. This includes equipment for onsite measurement of water-quality characteristics (temperature, specific conductance, pH, dissolved oxygen, alkalinity, acidity, and turbidity) and equipment and instruments used for biological sampling. The District Water-Quality Specialist and District Laboratory Coordinator are responsible for preventive maintenance and calibration of equipment in the Ohio District laboratory. The USGS National Water Quality Laboratory in Arvada, Colo., is the primary source of analytical services for most project work done by the Ohio District. Analyses done at the Ohio District laboratory are usually those that must be completed within a few hours of sample collection. Contract laboratories or other USGS laboratories are sometimes used instead of the NWQL or the Ohio District laboratory. When a contract laboratory is used, the projec

Quality-assurance plan for water-resources activities of the U. S. Geological Survey in Montana--1991

USGS Publications Warehouse

Moreland, Joe A.

1991-01-01

As the Nation's principal earth-science information agency, the U.S. Geological Survey has developed a worldwide reputation for collecting accurate data and producing factual, impartial interpretive reports. To ensure continued confidence in the pro- ducts, the Water Resources Division of the U.S. Geological Survey has implemented a policy that all scientific work will be performed in accordance with a centrally managed quality-assurance program. The formal policy for quality assurance within the Montana District was established and documented in USGS Open-File Report 91-194. This report has been revised to reflect changes in personnel and organi- zational structure that have occurred since 1991. Quality assurance is formalized by describing organization and operational responsibilities, the quality-assurance policy, and the quality- assurance responsibilities for performing District functions. The District conducts its work through offices in Helena, Billings, Kalispell, and Fort Peck. Data-collection programs and interpretive studies are conducted by three operating sections and four support units. Discipline specialists provide technical advice and assistance. Management advisors provide guidance on various personnel issues and support functions.

Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Montana--1995

USGS Publications Warehouse

Moreland, Joe A.

1995-01-01

As the Nation's principal earth-science information agency, the U.S. Geological Survey has developed a worldwide reputation for collecting accurate data and producing factual, impartial interpretive reports. To ensure continued confidence in the pro- ducts, the Water Resources Division of the U.S. Geological Survey has implemented a policy that all scientific work will be performed in accordance with a centrally managed quality-assurance program. The formal policy for quality assurance within the Montana District was established and documented in USGS Open-File Report 91-194. This report has been revised to reflect changes in personnel and organi- zational structure that have occurred since 1991. Quality assurance is formalized by describing organization and operational responsibilities, the quality-assurance policy, and the quality- assurance responsibilities for performing District functions. The District conducts its work through offices in Helena, Billings, Kalispell, and Fort Peck. Data-collection programs and interpretive studies are conducted by three operating sections and four support units. Discipline specialists provide technical advice and assistance. Management advisors provide guidance on various personnel issues and support functions.

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

PubMed Central

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2007-01-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. PMID:17941715

Estimates of inorganic nitrogen wet deposition from precipitation for the conterminous United States, 1955-84

USGS Publications Warehouse

Gronberg, Jo Ann M.; Ludtke, Amy S.; Knifong, Donna L.

2014-01-01

The U.S. Geological Survey’s National Water-Quality Assessment program requires nutrient input information for analysis of national and regional assessment of water quality. Historical data are needed to lengthen the data record for assessment of trends in water quality. This report provides estimates of inorganic nitrogen deposition from precipitation for the conterminous United States for 1955–56, 1961–65, and 1981–84. The estimates were derived from ammonium, nitrate, and inorganic nitrogen concentrations in atmospheric wet deposition and precipitation-depth data. This report documents the sources of these data and the methods that were used to estimate the inorganic nitrogen deposition. Tabular datasets, including the analytical results, precipitation depth, and calculated site-specific precipitation-weighted concentrations, and raster datasets of nitrogen from wet deposition are provided as appendixes in this report.

First-Term Reenlistment Quality Study (FITREQUEST).

DTIC Science & Technology

1983-11-01

Nonsupport of Family Trainability Recycled During Initial Unit Inspections Entry Training*I Reports of Survey Resists Authority Retraining 8DE (GRAD...will constitute and chair a SAG to monitor study process. (3) ODCSPER will prepare ad submit DD Porn 1498 and final study documents to WIC. d

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1993)

EPA Science Inventory

This criteria document focuses on a review and assessment of the effects on human health and welfare of the nitrogen oxides, nitric oxide (NO) and nitrogen dioxide (NO2), and the related compounds, nitrites, nitrates, nitrogenous acids, and nitrosamines. Although the emphasis is ...

Everglades Ecosystem Assessment: Water Management and Quality, Eutrophication, Mercury Contamination, Soils and Habitat - EPA 904-R-07-001, August 2007

EPA Pesticide Factsheets

This report summarizes the results for the Program and 2005 Phase III biogeochemical sampling. This survey documented ecological condition for the 2,063-square-mile freshwater portion of the Everglades Protection Area.

[Quality of documentation of intraoperative and postoperative complications : improvement of documentation for a nationwide quality assurance program and comparison with routine data].

PubMed

Jakob, J; Marenda, D; Sold, M; Schlüter, M; Post, S; Kienle, P

2014-08-01

Complications after cholecystectomy are continuously documented in a nationwide database in Germany. Recent studies demonstrated a lack of reliability of these data. The aim of the study was to evaluate the impact of a control algorithm on documentation quality and the use of routine diagnosis coding as an additional validation instrument. Completeness and correctness of the documentation of complications after cholecystectomy was compared over a time interval of 12 months before and after implementation of an algorithm for faster and more accurate documentation. Furthermore, the coding of all diagnoses was screened to identify intraoperative and postoperative complications. The sensitivity of the documentation for complications improved from 46 % to 70 % (p = 0.05, specificity 98 % in both time intervals). A prolonged time interval of more than 6 weeks between patient discharge and documentation was associated with inferior data quality (incorrect documentation in 1.5 % versus 15 %, p < 0.05). The rate of case documentation within the 6 weeks after hospital discharge was clearly improved after implementation of the control algorithm. Sensitivity and specificity of screening for complications by evaluating routine diagnoses coding were 70 % and 85 %, respectively. The quality of documentation was improved by implementation of a simple memory algorithm.

State-local policy management project. Final report

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

Not Available

1981-08-01

The report describes case studies to explore new approaches for increasing state and local coordination in planning and managing programs in areas with significant scientific and technical components such as energy and environment. Specifically, the case studies reveal efforts of various states in the areas of energy conservation, weatherization, emergency preparedness, and air quality. Successes and failures of Maryland's decentralized approach to energy conservation are documented; success of the thermal and lighting efficiency standards program in Texas is discussed; state aid for local energy conservation programs in Clinton County, Michigan, is reviewed; and the success of the weatherization program inmore » Oregon is examined. Pilot programs in weatherization in Pennsylvania are shown to have led a statewide effort. Two Minnesota projects in emergency preparedness are documented and factors for success are listed. In addition, long-range planning for fuel shortages in New York is examined and the benefits of regional planning in Fairfax County, Virgina, are noted. Efforts are examined to improve air quality in Ohio, California, and New Jersey.« less

Designing Flight Deck Procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl

2005-01-01

Three reports address the design of flight-deck procedures and various aspects of human interaction with cockpit systems that have direct impact on flight safety. One report, On the Typography of Flight- Deck Documentation, discusses basic research about typography and the kind of information needed by designers of flight deck documentation. Flight crews reading poorly designed documentation may easily overlook a crucial item on the checklist. The report surveys and summarizes the available literature regarding the design and typographical aspects of printed material. It focuses on typographical factors such as proper typefaces, character height, use of lower- and upper-case characters, line length, and spacing. Graphical aspects such as layout, color coding, fonts, and character contrast are discussed; and several cockpit conditions such as lighting levels and glare are addressed, as well as usage factors such as angular alignment, paper quality, and colors. Most of the insights and recommendations discussed in this report are transferable to paperless cockpit systems of the future and computer-based procedure displays (e.g., "electronic flight bag") in aerospace systems and similar systems that are used in other industries such as medical, nuclear systems, maritime operations, and military systems.

The Nexus between Instructional Supervision, Supervisors' and Teachers': The Practical Paradox and Its Effect on Quality Education a Case of Woliat Zone Administration Elementary and Secondary Schools (1-8)

ERIC Educational Resources Information Center

Dea, Mulatu

2016-01-01

Even though the new instructional supervision practices materialized in the schools level, teachers were not properly supported well, so that the students achievements was decreasing in national exams than before as the regional grade report documents revealed and quality is deteriorating from time to times. Hence, the main objective of this study…

Application and Evaluation of Interactive 3D PDF for Presenting and Sharing Planning Results for Liver Surgery in Clinical Routine

PubMed Central

Newe, Axel; Becker, Linda; Schenk, Andrea

2014-01-01

Background & Objectives The Portable Document Format (PDF) is the de-facto standard for the exchange of electronic documents. It is platform-independent, suitable for the exchange of medical data, and allows for the embedding of three-dimensional (3D) surface mesh models. In this article, we present the first clinical routine application of interactive 3D surface mesh models which have been integrated into PDF files for the presentation and the exchange of Computer Assisted Surgery Planning (CASP) results in liver surgery. We aimed to prove the feasibility of applying 3D PDF in medical reporting and investigated the user experience with this new technology. Methods We developed an interactive 3D PDF report document format and implemented a software tool to create these reports automatically. After more than 1000 liver CASP cases that have been reported in clinical routine using our 3D PDF report, an international user survey was carried out online to evaluate the user experience. Results Our solution enables the user to interactively explore the anatomical configuration and to have different analyses and various resection proposals displayed within a 3D PDF document covering only a single page that acts more like a software application than like a typical PDF file (“PDF App”). The new 3D PDF report offers many advantages over the previous solutions. According to the results of the online survey, the users have assessed the pragmatic quality (functionality, usability, perspicuity, efficiency) as well as the hedonic quality (attractiveness, novelty) very positively. Conclusion The usage of 3D PDF for reporting and sharing CASP results is feasible and well accepted by the target audience. Using interactive PDF with embedded 3D models is an enabler for presenting and exchanging complex medical information in an easy and platform-independent way. Medical staff as well as patients can benefit from the possibilities provided by 3D PDF. Our results open the door for a wider use of this new technology, since the basic idea can and should be applied for many medical disciplines and use cases. PMID:25551375

Application and evaluation of interactive 3D PDF for presenting and sharing planning results for liver surgery in clinical routine.

PubMed

Newe, Axel; Becker, Linda; Schenk, Andrea

2014-01-01

The Portable Document Format (PDF) is the de-facto standard for the exchange of electronic documents. It is platform-independent, suitable for the exchange of medical data, and allows for the embedding of three-dimensional (3D) surface mesh models. In this article, we present the first clinical routine application of interactive 3D surface mesh models which have been integrated into PDF files for the presentation and the exchange of Computer Assisted Surgery Planning (CASP) results in liver surgery. We aimed to prove the feasibility of applying 3D PDF in medical reporting and investigated the user experience with this new technology. We developed an interactive 3D PDF report document format and implemented a software tool to create these reports automatically. After more than 1000 liver CASP cases that have been reported in clinical routine using our 3D PDF report, an international user survey was carried out online to evaluate the user experience. Our solution enables the user to interactively explore the anatomical configuration and to have different analyses and various resection proposals displayed within a 3D PDF document covering only a single page that acts more like a software application than like a typical PDF file ("PDF App"). The new 3D PDF report offers many advantages over the previous solutions. According to the results of the online survey, the users have assessed the pragmatic quality (functionality, usability, perspicuity, efficiency) as well as the hedonic quality (attractiveness, novelty) very positively. The usage of 3D PDF for reporting and sharing CASP results is feasible and well accepted by the target audience. Using interactive PDF with embedded 3D models is an enabler for presenting and exchanging complex medical information in an easy and platform-independent way. Medical staff as well as patients can benefit from the possibilities provided by 3D PDF. Our results open the door for a wider use of this new technology, since the basic idea can and should be applied for many medical disciplines and use cases.

Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

PubMed Central

Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

2014-01-01

Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

Voluntary peer review as innovative tool for quality improvement in the intensive care unit--a retrospective descriptive cohort study in German intensive care units.

PubMed

Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

2014-01-01

Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs - representing over 300 patient beds - had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

Underground Test Area Fiscal Year 2013 Annual Quality Assurance Report Nevada National Security Site, Nevada, Revision 0

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

Krenzien, Susan; Marutzky, Sam

This report is required by the Underground Test Area (UGTA) Quality Assurance Plan (QAP) and identifies the UGTA quality assurance (QA) activities for fiscal year (FY) 2013. All UGTA organizations—U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO); Desert Research Institute (DRI); Lawrence Livermore National Laboratory (LLNL); Los Alamos National Laboratory (LANL); Navarro-Intera, LLC (N-I); National Security Technologies, LLC (NSTec); and the U.S. Geological Survey (USGS)—conducted QA activities in FY 2013. The activities included conducting assessments, identifying findings and completing corrective actions, evaluating laboratory performance, and publishing documents. In addition, integrated UGTA required reading and correctivemore » action tracking was instituted.« less

TECHNICAL GUIDANCE DOCUMENT: CONSTRUCTION QUALITY MANAGEMENT FOR REMEDIAL ACTION AND REMEDIAL DESIGN WASTE CONTAINMENT SYSTEMS

EPA Science Inventory

This Technical Guidance Document is intended to augment the numerous construction quality control and construction quality assurance (CQC and CQA) documents that are available far materials associated with waste containment systems developed for Superfund site remediation. In ge...

Terahertz (THz) Optical Parameters of Three-Dimensional (3-D) Printing Materials

DTIC Science & Technology

2017-03-01

prototyping and low production rate manufacturing technology, the internal composition and structural quality of prints need to be known and...DISCLAIMER THE FINDINGS IN THIS REPORT ARE NOT TO BE CONSTRUED AS AN OFFICIAL DEPARTMENT OF THE ARMY POSITION UNLESS SO DESIGNATED BY...OTHER AUTHORIZED DOCUMENTS. TRADE NAMES USE OF TRADE NAMES OR MANUFACTURERS IN THIS REPORT DOES NOT CONSTITUTE AN OFFICIAL ENDORSEMENT OR

GATEWAY Report Brief: Tunable-White Lighting at the ACC Care Center

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

None, None

Summary of a GATEWAY program report that documented the performance of tunable-white LED lighting systems installed in several spaces within the ACC Care Center, a senior-care facility in Sacramento, CA. The project results included energy savings and improved lighting quality, as well as other possible health-related benefits that may have been attributable, at least in part, to the lighting changes.

Implementing personal digital assistant documentation of pharmacist interventions in a military treatment facility.

PubMed

Ford, Stephen; Illich, Stan; Smith, Lisa; Franklin, Arthur

2006-01-01

To describe the use of personal digital assistants (PDAs) in documenting pharmacists' clinical interventions. Evans Army Community Hospital (EACH), a 78-bed military treatment facility, in Colorado Springs. Pharmacists on staff at EACH. All pharmacists at EACH used PDAs with the pilot software to record interventions for 1 month. The program underwent final design changes and then became the sole source for recording pharmacist interventions. The results of this project are being evaluated every 3 months for the first year and yearly thereafter. Visual CE (Syware Inc. Cambridge, Mass.) software was selected to develop fields for the documentation tool. This software is simple and easy to use, and users can retrieve reports of interventions from both inpatient and outpatient sections. The software needed to be designed so that data entry would only take a few minutes and ad hoc reports could be produced easily. Number of pharmacist interventions reported, time spent in clinical interventions, and outcome of clinical intervention. Implementing a PDA-based system for documenting pharmacist interventions across ambulatory, inpatient, and clinical services dramatically increased reporting during the first 6 months after implementation (August 2004-February 2005). After initial fielding, clinical pharmacists in advanced practice settings (such as disease management clinic, anticoagulation clinic) recognized a need to tailor the program to their specific activities, which resulted in a spin-off program unique to their practice roles. A PDA-based system for documenting clinical interventions at a military treatment facility increased reporting of interventions across all pharmacy points of service. Pharmacy leadership used these data to document the impact of pharmacist interventions on safety and quality of pharmaceutical care provided.

Health-related quality of life in pediatric patients with long-standing pancreatitis.

PubMed

Pohl, John F; Limbers, Christine A; Kay, Marie; Harman, Annette; Rollins, Michael; Varni, James W

2012-05-01

There are limited data on health-related quality of life (HRQOL) in pediatric patients with long-standing pancreatitis (including acute relapsing and chronic pancreatitis) using age-appropriate measurement instruments. We evaluated HRQOL in children with long-standing pancreatitis using the PedsQL 4.0 Generic Core Scales by patient self-report as well as parent proxy report. Additionally, patient self-reports and parent proxy reports were completed for the PedsQL Multidimensional Fatigue Scale. Across all of the dimensions, significantly impaired HRQOL and higher fatigue were noted for both pediatric patient self-report and parent proxy report in comparison with the matched healthy children samples. Higher fatigue was associated with lower HRQOL. There was moderate to good agreement between patient self-reports and parent proxy reports. Given the impaired HRQOL and fatigue documented in the present study, future studies are needed to determine whether specific factors can modify HRQOL and fatigue in this patient population.

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.

PubMed

2016-11-14

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 2017 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 and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.

Loch Vale Watershed Project quality assurance report, 1995-1998

USGS Publications Warehouse

Allstott, E.J.; Bashkin, Michael A.; Baron, Jill S.

1999-01-01

The Loch Vale Watershed (LVWS) project was initiated in 1980 by the National Park Service with funding from the Aquatic Effects Research Program of the National Acid Precipitation Assessment Program. Initial research objectives were to understand the processes that would either mitigate or accelerate the effects of pollution on soil and surface water chemistry, and to build a record in which long-term trends could be identified and examined.It is important for all data collected in Loch Vale to meet the high standards of quality set forth in previous LVWS QA/QC reports and LVWS Methods Manuals. Given the ever-widening usage of data collected in Loch Vale, it is equally important to provide users of that data with a report assuring that all data are sound. Parameters covered in this report are the quality of meteorological measurements, hydrological measurements, surface water chemistry, and similarities in catch efficiency of two raingage types in Loch Vale for the period of 1995-1998.Routine sampling of weather conditions, precipitation chemistry, and stream/lake water chemistry began in 1982. Since then, all samples and data have been analyzed according to widely accepted and published methods. Weather data have been collected, analyzed, and stored by LVWS project personnel. Methods for the handling of meteorological data are well documented (Denning 1988, Edwards 1991, Newkirk 1995,and Allstott 1995). Precipitation chemistry has always been collected according to National Atmospheric Deposition Program protocol (Bigelow 1988), and analyzed at the Central Analytical Laboratory of the Illinois State Water Survey in Champaign, IL. QA/QC procedures of the National Atmospheric Deposition Program are well documented (Aubertin 1990). Protocols for sampling surface waters are also well documented (Newkirk 1995). Analysis of surface water chemistry has been performed using standard EPA protocol at the US Forest Service's Rocky Mt. Station Biogeochemistry Laboratory since 1993.

Preparing PNNL Reports with LaTeX

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

Waichler, Scott R.

2005-06-01

LaTeX is a mature document preparation system that is the standard in many scientific and academic workplaces. It has been used extensively by scattered individuals and research groups within PNNL for years, but until now there have been no centralized or lab-focused resources to help authors and editors. PNNL authors and editors can produce correctly formatted PNNL or PNWD reports using the LaTeX document preparation system and the available template files. Please visit the PNNL-LaTeX Project (http://stidev.pnl.gov/resources/latex/, inside the PNNL firewall) for additional information and files. In LaTeX, document content is maintained separately from document structure for the most part.more » This means that the author can easily produce the same content in different formats and, more importantly, can focus on the content and write it in a plain text file that doesn't go awry, is easily transferable, and won't become obsolete due to software changes. LaTeX produces the finest print quality output; its typesetting is noticeably better than that of MS Word. This is particularly true for mathematics, tables, and other types of special text. Other benefits of LaTeX: easy handling of large numbers of figures and tables; automatic and error-free captioning, citation, cross-referencing, hyperlinking, and indexing; excellent published and online documentation; free or low-cost distributions for Windows/Linux/Unix/Mac OS X. This document serves two purposes: (1) it provides instructions to produce reports formatted to PNNL requirements using LaTeX, and (2) the document itself is in the form of a PNNL report, providing examples of many solved formatting challenges. Authors can use this document or its skeleton version (with formatting examples removed) as the starting point for their own reports. The pnnreport.cls class file and pnnl.bst bibliography style file contain the required formatting specifications for reports to the Department of Energy. Options are also provided for formatting PNWD (non-1830) reports. This documentation and the referenced files are meant to provide a complete package of PNNL particulars for authors and editors who wish to prepare technical reports using LaTeX. The example material in this document was borrowed from real reports and edited for demonstration purposes. The subject matter content of the example material is not relevant here and generally does not make literal sense in the context of this document. Brackets ''[]'' are used to denote large blocks of example text. The PDF file for this report contains hyperlinks to facilitate navigation. Hyperlinks are provided for all cross-referenced material, including section headings, figures, tables, and references. Not all hyperlinks are colored but will be obvious when you move your mouse over them.« less

[Biologically active food supplements: legislative and regulator basis. Report 2].

PubMed

Sukhanov, B P; Kerimova, M G

2004-01-01

The article presents the history of food supplements' origin. The main requirements to them are given an account of the main legislative and normative documents, regulating the composition and considered as an important instrument for improving the structure and quality of nutrition of the population.

The forensic psychiatric report.

PubMed

Norko, Michael A; Buchanan, Mar Alec

2015-01-01

The construction of a written forensic report is a core component of forensic practice, demonstrating the evaluator's skill in conducting the evaluation and in communicating relevant information to the legal audience in an effective manner. Although communication skills and quality of written documentation are important in clinical psychiatry generally, they form the sine qua non of successful forensic work, which consists in telling complex stories in a coherent and compelling fashion. High quality forensic reports require careful preparation from the earliest stages of work on a case. They generally follow an expected structure, which permits the evaluator to provide all the data necessary to form a carefully reasoned opinion that addresses the legal questions posed. Formats and content of reports vary according to the type of case and the circumstances of the evaluation and so require flexibility within customary frameworks. The style and quality of writing are critical to the crafting of forensic reports. The effects on legal decision-makers of various approaches to the presentation of information in reports has not been studied empirically, but guidance from experienced forensic psychiatrists is available. There is a small body of research on quality improvement in forensic writing, and further empiric study is warranted.

Canadian Consensus-based and Evidence-based Guidelines for Benign Endometrial Pathology Reporting in Biopsy Material.

PubMed

Parra-Herran, Carlos; Cesari, Matthew; Djordjevic, Bojana; Grondin, Katherine; Kinloch, Mary; Köbel, Martin; Pirzada, Amrah; Plotkin, Anna; Gilks, C Blake

2018-04-19

Standardized terminology has proven benefits in cancer reporting; in contrast, reporting of benign diagnoses in endometrial biopsy currently lacks such standardization. Unification and update on the lexicon can provide the structure and consistency needed for optimal patient care and quality assurance purposes. The Special Interest Group in Gynecologic Pathology of the Canadian Association of Pathologists-Association Canadienne des Pathologistes (CAP-ACP) embarked in an initiative to address the current need for consensus terminology in benign endometrial biopsy pathology reporting. Nine members of the Special Interest Group developed a guideline for structured diagnosis of benign endometrial pathology through critical appraisal of the available peer-reviewed literature and joint discussions. The first version of the document was circulated for feedback to a group of professionals in akin fields, the CAP-ACP Executive Committee and the CAP-ACP general membership. The final 1-page document included 17 diagnostic terms comprising the most common benign endometrial entities, as well as explanatory notes for pathologists. The proposed terminology was implemented in the practice of 5 pathologists from the group, who applied the guideline to all benign endometrial biopsies over a 2-wk period. A total of 212 benign endometrial biopsies were evaluated in this implementation step; the recommended terminology adequately covered the diagnosis in 203 cases (95.8%). A list of terminology for benign endometrial biopsy reporting, based on expert consensus and critical appraisal of the available literature, is presented. On the basis of our results of implementation at multiple centers, the proposed guideline can successfully cover the large majority of diagnostic scenarios. The document has the potential to positively impact patient care, promote quality assurance, and facilitate research initiatives aimed at improving histopathologic assessment of benign endometrium.

Flight testing and frequency domain analysis for rotorcraft handling qualities characteristics

NASA Technical Reports Server (NTRS)

Ham, Johnnie A.; Gardner, Charles K.; Tischler, Mark B.

1993-01-01

A demonstration of frequency domain flight testing techniques and analyses was performed on a U.S. Army OH-58D helicopter in support of the OH-58D Airworthiness and Flight Characteristics Evaluation and the Army's development and ongoing review of Aeronautical Design Standard 33C, Handling Qualities Requirements for Military Rotorcraft. Hover and forward flight (60 knots) tests were conducted in 1 flight hour by Army experimental test pilots. Further processing of the hover data generated a complete database of velocity, angular rate, and acceleration frequency responses to control inputs. A joint effort was then undertaken by the Airworthiness Qualification Test Directorate (AQTD) and the U.S. Army Aeroflightdynamics Directorate (AFDD) to derive handling qualities information from the frequency response database. A significant amount of information could be extracted from the frequency domain database using a variety of approaches. This report documents numerous results that have been obtained from the simple frequency domain tests; in many areas, these results provide more insight into the aircraft dynamics that affect handling qualities than to traditional flight tests. The handling qualities results include ADS-33C bandwidth and phase delay calculations, vibration spectral determinations, transfer function models to examine single axis results, and a six degree of freedom fully coupled state space model. The ability of this model to accurately predict aircraft responses was verified using data from pulse inputs. This report also documents the frequency-sweep flight test technique and data analysis used to support the tests.

Conversion of Low Quality Waste Heat to Electric Power with Small-Scale Organic Rankine Cycle (ORC) Engine/Generator Technology

DTIC Science & Technology

2016-08-01

REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 The public reporting burden for this collection of information is estimated to average 1...urrendy valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) , 2. REPORT TYPE 3. DATES COVERED (From...NUMBER (Include area code) 919-282-1050 Standard Form 298 (Rev. 8198) Pntscnbed by ANSI Std. Z39.18 Cost & Performance Report 58XX i COST

Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

PubMed

Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

2017-10-27

Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

Data Model and Relational Database Design for Highway Runoff Water-Quality Metadata

USGS Publications Warehouse

Granato, Gregory E.; Tessler, Steven

2001-01-01

A National highway and urban runoff waterquality metadatabase was developed by the U.S. Geological Survey in cooperation with the Federal Highway Administration as part of the National Highway Runoff Water-Quality Data and Methodology Synthesis (NDAMS). The database was designed to catalog available literature and to document results of the synthesis in a format that would facilitate current and future research on highway and urban runoff. This report documents the design and implementation of the NDAMS relational database, which was designed to provide a catalog of available information and the results of an assessment of the available data. All the citations and the metadata collected during the review process are presented in a stratified metadatabase that contains citations for relevant publications, abstracts (or previa), and reportreview metadata for a sample of selected reports that document results of runoff quality investigations. The database is referred to as a metadatabase because it contains information about available data sets rather than a record of the original data. The database contains the metadata needed to evaluate and characterize how valid, current, complete, comparable, and technically defensible published and available information may be when evaluated for application to the different dataquality objectives as defined by decision makers. This database is a relational database, in that all information is ultimately linked to a given citation in the catalog of available reports. The main database file contains 86 tables consisting of 29 data tables, 11 association tables, and 46 domain tables. The data tables all link to a particular citation, and each data table is focused on one aspect of the information collected in the literature search and the evaluation of available information. This database is implemented in the Microsoft (MS) Access database software because it is widely used within and outside of government and is familiar to many existing and potential customers. The stratified metadatabase design for the NDAMS program is presented in the MS Access file DBDESIGN.mdb and documented with a data dictionary in the NDAMS_DD.mdb file recorded on the CD-ROM. The data dictionary file includes complete documentation of the table names, table descriptions, and information about each of the 419 fields in the database.

Announcement—guidance document for acquiring reliable data in ecological restoration projects

USGS Publications Warehouse

Stapanian, Martin A.; Rodriguez, Karen; Lewis, Timothy E.; Blume, Louis; Palmer, Craig J.; Walters, Lynn; Schofield, Judith; Amos, Molly M.; Bucher, Adam

2016-01-01

The Laurentian Great Lakes are undergoing intensive ecological restoration in Canada and the United States. In the United States, an interagency committee was formed to facilitate implementation of quality practices for federally funded restoration projects in the Great Lakes basin. The Committee's responsibilities include developing a guidance document that will provide a common approach to the application of quality assurance and quality control (QA/QC) practices for restoration projects. The document will serve as a “how-to” guide for ensuring data quality during each aspect of ecological restoration projects. In addition, the document will provide suggestions on linking QA/QC data with the routine project data and hints on creating detailed supporting documentation. Finally, the document will advocate integrating all components of the project, including QA/QC applications, into an overarching decision-support framework. The guidance document is expected to be released by the U.S. EPA Great Lakes National Program Office in 2017.

E-nursing documentation as a tool for quality assurance.

PubMed

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

The article presents the results of a project with which we describe the reengineering of nursing documentation. Documentation in nursing is an efficient tool for ensuring quality health care and consequently quality patient treatment along the whole clinical path. We have taken into account the nursing process and patient treatment based on Henderson theoretical model of nursing that consists of 14 basic living activities. The model of new documentation enables tracing, transparency, selectivity, monitoring and analyses. All these factors lead to improvements of a health system as well as to improved safety of patients and members of nursing teams. Thus the documentation was developed for three health care segments: secondary and tertiary level, dispensaries and community health care. The new quality introduced to the documentation process by information and communication technology is presented by a database model and a software prototype for managing documentation.

The NASA role in major areas of human concern: Environmental quality

NASA Technical Reports Server (NTRS)

1973-01-01

After introducing some of the general factors that have affected progress in the area of environmental quality, NASA program elements are examined to illustrate relevant points of contact. Interpretive steps are taken throughout the report to show a few of the more important ways people's lives have been affected as a result of the work of NASA and other organizations functioning in this area. The principal documents used and interviews conducted are identified.

Rocky Mountain Arsenal, Sanitary Sewer Interim Response Action, Construction Documents for New Sanitary Sewer Construction. Volume 2

DTIC Science & Technology

1990-05-01

curves ; test reports; test cylinders: samples, O&M manuals including parts lists; certifications; warranties and other such required submittals...purpose. 14.4.3. Authority and responsibilities of all quality control personnel. 14.4.4. Schedule of Use of inspection personnel by types and phase of...quality control program shall include four phases of inspection and tests. The Contracting Officer’s representative shall be notified at least 24

STAR-CCM+ Verification and Validation Plan

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

Pointer, William David

2016-09-30

The commercial Computational Fluid Dynamics (CFD) code STAR-CCM+ provides general purpose finite volume method solutions for fluid dynamics and energy transport. This document defines plans for verification and validation (V&V) of the base code and models implemented within the code by the Consortium for Advanced Simulation of Light water reactors (CASL). The software quality assurance activities described herein are port of the overall software life cycle defined in the CASL Software Quality Assurance (SQA) Plan [Sieger, 2015]. STAR-CCM+ serves as the principal foundation for development of an advanced predictive multi-phase boiling simulation capability within CASL. The CASL Thermal Hydraulics Methodsmore » (THM) team develops advanced closure models required to describe the subgrid-resolution behavior of secondary fluids or fluid phases in multiphase boiling flows within the Eulerian-Eulerian framework of the code. These include wall heat partitioning models that describe the formation of vapor on the surface and the forces the define bubble/droplet dynamic motion. The CASL models are implemented as user coding or field functions within the general framework of the code. This report defines procedures and requirements for V&V of the multi-phase CFD capability developed by CASL THM. Results of V&V evaluations will be documented in a separate STAR-CCM+ V&V assessment report. This report is expected to be a living document and will be updated as additional validation cases are identified and adopted as part of the CASL THM V&V suite.« less

Improving public health evaluation: a qualitative investigation of practitioners' needs.

PubMed

Denford, Sarah; Lakshman, Rajalakshmi; Callaghan, Margaret; Abraham, Charles

2018-01-30

In 2011, the House of Lords published a report on Behaviour Change, in which they report that "a lot more could, and should, be done to improve the evaluation of interventions." This study aimed to undertake a needs assessment of what kind of evaluation training and materials would be of most use to UK public health practitioners by conducting interviews with practitioners about everyday evaluation practice and needed guidance and materials. Semi-structured interviews were conducted with 32 public health practitioners in two UK regions, Cambridgeshire and the South West. Participants included directors of public health, consultants in public health, health improvement advisors, public health intelligence, and public health research officers. A topic guide included questions designed to explore participants existing evaluation practice and their needs for further training and guidance. Data were analysed using thematic analyses. Practitioners highlighted the need for evaluation to defend the effectiveness of existing programs and protect funding provisions. However, practitioners often lacked training in evaluation, and felt unqualified to perform such a task. The majority of practitioners did not use, or were not aware of many existing evaluation guidance documents. They wanted quality-assured, practical guidance that relate to the real world settings in which they operate. Practitioners also mentioned the need for better links and support from academics in public health. Whilst numerous guidance documents supporting public health evaluation exist, these documents are currently underused by practitioners - either because they are not considered useful, or because practitioners are not aware of them. Integrating existing guides into a catalogue of guidance documents, and developing a new-quality assured, practical and useful document may support the evaluation of public health programs. This in turn has the potential to identify those programs that are effective; thus improving public health and reducing financial waste.

How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

PubMed

Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

2016-09-01

Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China

PubMed Central

Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping

2016-01-01

Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria–tetanus–pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency. PMID:27869729

Auditing the Immunization Data Quality from Routine Reports in Shangyu District, East China.

PubMed

Hu, Yu; Zhang, Xinpei; Li, Qian; Chen, Yaping

2016-11-18

Objective: To evaluate the immunization data quality in Shangyu District, East China. Methods: An audit for immunization data for the year 2014 was conducted in 20 vaccination clinics of Shangyu District. The consistency of immunization data was estimated by verification factors (VFs), which was the proportion of vaccine doses reported as being administered that could be verified by written documentation at vaccination clinics. The quality of monitoring systems was evaluated using the quality index (QI). Results: The VFs of 20 vaccine doses ranged from 0.94 to 1.04 at the district level. The VFs for the 20 vaccination clinics ranged from 0.57 to 1.07. The VFs for Shangyu District was 0.98. The mean of total QI score of the 20 vaccination clinics was 80.32%. A significant correlation between the VFs of the 3rd dose of the diphtheria-tetanus-pertussis combined vaccine (DTP) and QI scores was observed at the vaccination clinic level. Conclusions: Deficiencies in data consistency and immunization reporting practice in Shangyu District were observed. Targeted measures are suggested to improve the quality of the immunization reporting system in vaccination clinics with poor data consistency.

Experiences That Matter: Enhancing Student Learning and Success. Annual Report 2007

ERIC Educational Resources Information Center

National Survey of Student Engagement, 2007

2007-01-01

The National Survey of Student Engagement (NSSE) documents dimensions of quality in undergraduate education and provides information and assistance to colleges, universities, and other organizations to improve student learning. Its primary activity is annually surveying college students to assess the extent to which they engage in educational…

Cooperation for Quality Services in a Period of Declining Resources. Institute Report.

ERIC Educational Resources Information Center

Scholl, Geraldine T., Ed.

The document contains edited versions of sessions from the 1981 Special Study Institute, the fourth in a series designed initially for state education consultants for the visually handicapped. Objectives of the 1981 Institute are listed--to establish coordination, communication, and cooperation among teacher trainers; to develop interagency…

Lead Sampling Technician Training Course. Trainer Manual.

ERIC Educational Resources Information Center

ICF, Inc., Washington, DC.

This document presents a model curriculum for use by trainers presenting training course in assessing and reporting dust and debris from deteriorated lead-based paint. The course, which was developed by the U.S. Environmental Protection Agency, is intended for use with housing quality standard inspectors, rehabilitation specialists, home…

A CASE STUDY OF THE LOS ANGELES COUNTY PALOS VERDES LANDFILL GAS DEVELOPMENT PROJECT

EPA Science Inventory

This report documents the first-ever-attempt to capture sanitary landfill gases and beneficiate them to natural gas pipeline quality--or very nearly so. For this reason the authors must credit the entrepreneurs for a successful first full-scale demonstration of a technology that ...

76 FR 58266 - Agency Information Collection Activities; Proposed Collection; Comment Request; Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... contents of the docket, and access those documents in the public docket that are available electronically... monitor recreational water quality; assess, manage, and communicate health risks from waterborne microbial... public exposure to microbial pathogens. To qualify for a BEACH Act Grant, a state must submit information...

Sedimentation Solutions for Military Ocean Terminal Sunny Point (MOTSU), North Carolina

DTIC Science & Technology

2012-07-01

quality at MOTSU at the request of US Army Engineer District–Wilmington (USAED-SAW). The objective was achieved through numerical modeling ...literature review, and sediment forecasting. This report documents the results of the numerical modeling study only. Two advantageous approaches for...data .............................................................................................................. 25  4  Model Development

Down and In: Assessment Practices at the Program Level

ERIC Educational Resources Information Center

Ewell, Peter; Paulson, Karen; Kinzie, Jillian

2011-01-01

Assessing the quality of undergraduate student learning continues to be a priority in U.S. postsecondary education. Although variations in outcome assessment practices have long been suspected, they have not been systematically documented. To follow up the 2009 National Institute for Learning Outcomes Assessment (NILOA) report on institutional…

Pre-Apprenticeships in Three Key Trades. Support Document

ERIC Educational Resources Information Center

Dumbrell, Tom; Smith, Erica

2007-01-01

This report looks at whether pre-apprenticeships increase the potential supply of tradespeople, with a special focus on electrotechnology, automotive and engineering students. It found that pre-apprenticeships have been used in Australia for many years and are widely regarded as a valuable strategy for increasing the supply and quality of…

[5th Report of the German Association of Cardiologists in Private Practice (BNK) on Quality Assurance in Cardiac Catheterization and Coronary Intervention 2003-2005].

PubMed

Levenson, B; Albrecht, A; Göhring, St; Haerer, W; Herholz, H; Reifart, N; Sauer, G; Troger, B

2007-02-01

On behalf of the German Association of Cardiologists in Private Practice (BNK) the Steering Committee of the QuIK Registry reports on the results of the voluntary quality assurance in invasive cardiology in 2003-2005 and compares it to other data collections. In 2005 more than 70% of diagnostic (LHK) and 78% of therapeutic (PCI) cardiac catheterization procedures in private practice were entered into the registry. Altogether 229,462 LHK and 64,818 PCI were documented over the 3 years. In the reported period age of patients, percentage of acute coronary syndromes and three-vessel coronary artery disease increased in LHK as well as in PCI while consumption of contrast media and fluoroscopy time decreased. By implemented possibility of follow-up, a high rate of external auditing (monitoring) and certification QuIK remains a worldwide unique quality assurance project in cardiology. On a stable data basis over 10 years the QuIK Registry enables the implementation of quality indicators for future quality assurance purposes.

TU-AB-201-02: An Automated Treatment Plan Quality Assurance Program for Tandem and Ovoid High Dose-Rate Brachytherapy

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

Tan, J; Shi, F; Hrycushko, B

2015-06-15

Purpose: For tandem and ovoid (T&O) HDR brachytherapy in our clinic, it is required that the planning physicist manually capture ∼10 images during planning, perform a secondary dose calculation and generate a report, combine them into a single PDF document, and upload it to a record- and-verify system to prove to an independent plan checker that the case was planned correctly. Not only does this slow down the already time-consuming clinical workflow, the PDF document also limits the number of parameters that can be checked. To solve these problems, we have developed a web-based automatic quality assurance (QA) program. Methods:more » We set up a QA server accessible through a web- interface. A T&O plan and CT images are exported as DICOMRT files and uploaded to the server. The software checks 13 geometric features, e.g. if the dwell positions are reasonable, and 10 dosimetric features, e.g. secondary dose calculations via TG43 formalism and D2cc to critical structures. A PDF report is automatically generated with errors and potential issues highlighted. It also contains images showing important geometric and dosimetric aspects to prove the plan was created following standard guidelines. Results: The program has been clinically implemented in our clinic. In each of the 58 T&O plans we tested, a 14- page QA report was automatically generated. It took ∼45 sec to export the plan and CT images and ∼30 sec to perform the QA tests and generate the report. In contrast, our manual QA document preparation tooks on average ∼7 minutes under optimal conditions and up to 20 minutes when mistakes were made during the document assembly. Conclusion: We have tested the efficiency and effectiveness of an automated process for treatment plan QA of HDR T&O cases. This software was shown to improve the workflow compared to our conventional manual approach.« less

Florida Initiative for Quality Cancer Care: improvements on colorectal cancer quality of care indicators during a 3-year interval.

PubMed

Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

2014-01-01

The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥ 12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. Copyright © 2014. Published by Elsevier Inc.

ANMCO/AIIC/SIT Consensus Information Document: definition, precision, and suitability of electrocardiographic signals of electrocardiographs, ergometry, Holter electrocardiogram, telemetry, and bedside monitoring systems.

PubMed

Gulizia, Michele Massimo; Casolo, Giancarlo; Zuin, Guerrino; Morichelli, Loredana; Calcagnini, Giovanni; Ventimiglia, Vincenzo; Censi, Federica; Caldarola, Pasquale; Russo, Giancarmine; Leogrande, Lorenzo; Franco Gensini, Gian

2017-05-01

The electrocardiogram (ECG) signal can be derived from different sources. These include systems for surface ECG, Holter monitoring, ergometric stress tests, and telemetry systems and bedside monitoring of vital parameters, which are useful for rhythm and ST-segment analysis and ECG screening of electrical sudden cardiac death predictors. A precise ECG diagnosis is based upon correct recording, elaboration, and presentation of the signal. Several sources of artefacts and potential external causes may influence the quality of the original ECG waveforms. Other factors that may affect the quality of the information presented depend upon the technical solutions employed to improve the signal. The choice of the instrumentations and solutions used to offer a high-quality ECG signal are, therefore, of paramount importance. Some requirements are reported in detail in scientific statements and recommendations. The aim of this consensus document is to give scientific reference for the choice of systems able to offer high quality ECG signal acquisition, processing, and presentation suitable for clinical use.

ANMCO/AIIC/SIT Consensus Information Document: definition, precision, and suitability of electrocardiographic signals of electrocardiographs, ergometry, Holter electrocardiogram, telemetry, and bedside monitoring systems

PubMed Central

Casolo, Giancarlo; Zuin, Guerrino; Morichelli, Loredana; Calcagnini, Giovanni; Ventimiglia, Vincenzo; Censi, Federica; Caldarola, Pasquale; Russo, Giancarmine; Leogrande, Lorenzo; Franco Gensini, Gian

2017-01-01

Abstract The electrocardiogram (ECG) signal can be derived from different sources. These include systems for surface ECG, Holter monitoring, ergometric stress tests, and telemetry systems and bedside monitoring of vital parameters, which are useful for rhythm and ST-segment analysis and ECG screening of electrical sudden cardiac death predictors. A precise ECG diagnosis is based upon correct recording, elaboration, and presentation of the signal. Several sources of artefacts and potential external causes may influence the quality of the original ECG waveforms. Other factors that may affect the quality of the information presented depend upon the technical solutions employed to improve the signal. The choice of the instrumentations and solutions used to offer a high-quality ECG signal are, therefore, of paramount importance. Some requirements are reported in detail in scientific statements and recommendations. The aim of this consensus document is to give scientific reference for the choice of systems able to offer high quality ECG signal acquisition, processing, and presentation suitable for clinical use. PMID:28751842

Quality-assurance procedures: Method 5G determination of particulate emissions from wood heaters from a dilution tunnel sampling location

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

Ward, T.E.; Hartman, M.W.; Olin, R.C.

1989-06-01

Quality-assurance procedures are contained in this comprehensive document intended to be used as an aid for wood-heater manufacturers and testing laboratories in performing particulate matter sampling of wood heaters according to EPA protocol, Method 5G. These procedures may be used in research and development, and as an aid in auditing and certification testing. A detailed, step-by-step quality assurance guide is provided to aid in the procurement and assembly of testing apparatus, to clearly describe the procedures, and to facilitate data collection and reporting. Suggested data sheets are supplied that can be used as an aid for both recordkeeping and certificationmore » applications. Throughout the document, activity matrices are provided to serve as a summary reference. Checklists are also supplied that can be used by testing personnel. Finally, for the purposes of ensuring data quality, procedures are outlined for apparatus operation, maintenance, and traceability. These procedures combined with the detailed description of the sampling and analysis protocol will help ensure the accuracy and reliability of Method 5G emission-testing results.« less

Coronary Artery Disease - Reporting and Data System (CAD-RADS): An Expert Consensus Document of SCCT, ACR and NASCI: Endorsed by the ACC.

PubMed

Cury, Ricardo C; Abbara, Suhny; Achenbach, Stephan; Agatston, Arthur; Berman, Daniel S; Budoff, Matthew J; Dill, Karin E; Jacobs, Jill E; Maroules, Christopher D; Rubin, Geoffrey D; Rybicki, Frank J; Schoepf, U Joseph; Shaw, Leslee J; Stillman, Arthur E; White, Charles S; Woodard, Pamela K; Leipsic, Jonathon A

2016-09-01

The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

PubMed

Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

2015-01-01

The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

[Recommendations for the control of documents and the establishment of a documentary system].

PubMed

Vinner, E

2013-06-01

The quality management system that must be implemented in a MBL to meet the requirements of the standard NF EN ISO 15189 is based, among other things, on the creation and use by staff of a documentary system approved and updated. This documentary system is constituted by external documents (standards, suppliers' documents...) and internal documents (quality manual, procedures, instructions, technical and quality recordings...). A procedure of the documentary system control must be formalized. The documentary system should be modeled in order to identify the various procedures to be drafted and the incurred risks in the case a document would be missing in this system. Each document must be indexed in a unique way and document management must be carried out rigorously. The use of document management software is a great help to manage the life cycle of documents.

Protocol for a national prevalence study of advance care planning documentation and self-reported uptake in Australia

PubMed Central

Ruseckaite, Rasa; Detering, Karen M; Perera, Veronica; Walker, Lynne; Sinclair, Craig; Clayton, Josephine M; Nolte, Linda

2017-01-01

Introduction Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake. This makes it difficult to evaluate the impact of ACP initiatives. This study aims to determine the Australian national prevalence of ACP and completion of Advance Care Directives (ACDs) in hospitals, aged care facilities and general practices. It will also explore people’s self-reported use of ACP and views about the process. Methods and analysis Researchers will conduct a national multicentre cross-sectional prevalence study, consisting of a record audit and surveys of people aged 65 years or more in three sectors. From 49 participating Australian organisations, 50 records will be audited (total of 2450 records). People whose records were audited, who speak English and have a decision-making capacity will also be invited to complete a survey. The primary outcome measure will be the number of people who have formal or informal ACP documentation that can be located in records within 15 min. Other outcomes will include demographics, measure of illness and functional capacity, details of ACP documentation (including type of document), location of documentation in the person’s records and whether current clinical care plans are consistent with ACP documentation. People will be surveyed, to measure self-reported interest, uptake and use of ACP/ACDs, and self-reported quality of life. Ethics and dissemination This protocol has been approved by the Austin Health Human Research Ethics Committee (reference HREC/17/Austin/83). Results will be submitted to international peer-reviewed journals and presented at international conferences. Trial registration number ACTRN12617000743369 PMID:29101142

Use of quality measures for Medicaid behavioral health services by state agencies: implications for health care reform.

PubMed

Seibert, Julie; Fields, Suzanne; Fullerton, Catherine Anne; Mark, Tami L; Malkani, Sabrina; Walsh, Christine; Ehrlich, Emily; Imshaug, Melina; Tabrizi, Maryam

2015-06-01

The structure-process-outcome quality framework espoused by Donabedian provides a conceptual way to examine and prioritize behavioral health quality measures used by states. This report presents an environmental scan of the quality measures and satisfaction surveys that state Medicaid managed care and behavioral health agencies used prior to Medicaid expansion in 2014. Data were collected by reviewing online documents related to Medicaid managed care contracts for behavioral health, quality strategies, quality improvement plans, quality and performance indicators data, annual outcomes reports, performance measure specification manuals, legislative reports, and Medicaid waiver requests for proposals. Information was publicly available for 29 states. Most states relied on process measures, along with some structure and outcome measures. Although all states reported on at least one process measure of behavioral health quality, 52% of states did not use any outcomes measures and 48% of states had no structure measures. A majority of the states (69%) used behavioral health measures from the National Committee for Quality Assurance's Healthcare Effectiveness Data and Information Set, and all but one state in the sample (97%) used consumer experience-of-care surveys. Many states supplemented these data with locally developed behavioral health indicators that rely on administrative and nonadministrative data. State Medicaid agencies are using nationally recognized as well as local measures to assess quality of behavioral health care. Findings indicate a need for additional nationally endorsed measures in the area of substance use disorders and treatment outcomes.

Quality-assurance plan for the analysis of suspended sediment by the U.S. Geological Survey in Montana

USGS Publications Warehouse

Dodge, Kent A.; Lambing, John H.

2006-01-01

A quality-assurance plan has been developed for use by the sediment laboratory of the U.S. Geological Survey Montana Water Science Center in conducting activities related to the analysis of suspended sediment. The plan documents quality-assurance policies for sediment-laboratory certification, personnel responsibilities and training, documentation requirements, and laboratory safety. The plan also documents quality-assurance procedures related to laboratory equipment and supplies, sample management, sample analysis, analytical quality control, and data management.

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: quantitative examination of variation between practices in recruitment, implementation and effectiveness.

PubMed

Dreischulte, Tobias; Grant, Aileen; Hapca, Adrian; Guthrie, Bruce

2018-01-05

The cluster randomised trial of the Data-driven Quality Improvement in Primary Care (DQIP) intervention showed that education, informatics and financial incentives for general medical practices to review patients with ongoing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets reduced the primary end point of high-risk prescribing by 37%, where both ongoing and new high-risk prescribing were significantly reduced. This quantitative process evaluation examined practice factors associated with (1) participation in the DQIP trial, (2) review activity (extent and nature of documented reviews) and (3) practice level effectiveness (relative reductions in the primary end point). Invited practices recruited (n=33) and not recruited (n=32) to the DQIP trial in Scotland, UK. (1) Characteristics of recruited versus non-recruited practices. Associations of (2) practice characteristics and 'adoption' (self-reported implementation work done by practices) with documented review activity and (3) of practice characteristics, DQIP adoption and review activity with effectiveness. (1) Recruited practices had lower performance in the quality and outcomes framework than those declining participation. (2) Not being an approved general practitioner training practice and higher self-reported adoption were significantly associated with higher review activity. (3) Effectiveness ranged from a relative increase in high-risk prescribing of 24.1% to a relative reduction of 77.2%. High-risk prescribing and DQIP adoption (but not documented review activity) were significantly associated with greater effectiveness in the final multivariate model, explaining 64.0% of variation in effectiveness. Intervention implementation and effectiveness of the DQIP intervention varied substantially between practices. Although the DQIP intervention primarily targeted review of ongoing high-risk prescribing, the finding that self-reported DQIP adoption was a stronger predictor of effectiveness than documented review activity supports that reducing initiation and/or re-initiation of high-risk prescribing is key to its effectiveness. NCT01425502; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

JPL Test Effectiveness Analysis

NASA Technical Reports Server (NTRS)

Shreck, Stephanie; Sharratt, Stephen; Smith, Joseph F.; Strong, Edward

2008-01-01

1) The pilot study provided meaningful conclusions that are generally consistent with the earlier Test Effectiveness work done between 1992 and 1994: a) Analysis of pre-launch problem/failure reports is consistent with earlier work. b) Analysis of post-launch early mission anomaly reports indicates that there are more software issues in newer missions, and the no-test category for identification of post-launch failures is more significant than in the earlier analysis. 2) Future work includes understanding how differences in Missions effect these analyses: a) There are large variations in the number of problem reports and issues that are documented by the different Projects/Missions. b) Some missions do not have any reported environmental test anomalies, even though environmental tests were performed. 3) Each project/mission has different standards and conventions for filling out the PFR forms, the industry may wish to address this issue: a) Existing problem reporting forms are to document and track problems, failures, and issues (etc.) for the projects, to ensure high quality. b) Existing problem reporting forms are not intended for data mining.

The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

PubMed

Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

2016-09-01

Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme.

PubMed

Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R

2009-01-01

5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

Devices and Aids for Training M1 Tank Gunnery in the Army National Guard: A Review of Military Documents and the Research Literature.

DTIC Science & Technology

1991-04-01

U.S. DEPARTMENT OF COMMERCE NATIONAL TECHNICAL INFORMATION SERVICE SPRINGFIELD, VA 22161 D ISC, 1A13 NO TICK THIS DOCUMENT IS BEST QUALITY AVAILABLE...training strategy for use at the company level by the Army National Guard (ARNG). Six devices and aids relevant to gunnery training in an armory...M1 tank gunnery training strategy for use at home station. This report describes the results of the first phase of the project, wherein candidate

Quality of clinical trials: A moving target

PubMed Central

Bhatt, Arun

2011-01-01

Quality of clinical trials depends on data integrity and subject protection. Globalization, outsourcing and increasing complexicity of clinical trials have made the target of achieving global quality challenging. The quality, as judged by regulatory inspections of the investigator sites, sponsors/contract research organizations and Institutional Review Board, has been of concern to the US Food and Drug Administration, as there has been hardly any change in frequency and nature of common deficiencies. To meet the regulatory expectations, the sponsors need to improve quality by developing systems with specific standards for each clinical trial process. The quality systems include: personnel roles and responsibilities, training, policies and procedures, quality assurance and auditing, document management, record retention, and reporting and corrective and preventive action. With an objective to improve quality, the FDA has planned new inspection approaches such as risk-based inspections, surveillance inspections, real-time oversight, and audit of sponsor quality systems. The FDA has partnered with Duke University for Clinical Trials Transformation Initiative, which will conduct research projects on design principles, data quality and quantity including monitoring, study start-up, and adverse event reporting. These recent initiatives will go a long way in improving quality of clinical trials. PMID:22145122

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

Will hospital report cards make the grade?

PubMed

1997-07-01

Hospital report cards that document patients' medical outcomes are attracting increasing attention for their role in guiding health care decisions by employers, consumers and providers. Significant questions remain, however, regarding the validity and utility of this information. This Issue Brief is based on a seminar held by the Center for Studying Health System Change at which two expert panels discussed whether report cards make the grade. The first panel approached this subject through a Socratic dialogue that focused on the release of a hypothetical community hospital report card. The second panel weighed in on two research presentations related to report cards. The panelists agreed that efforts to collect and report clinical outcomes data are flawed. Even so, release of the data can help improve clinical quality and foster an environment in which health care quality information ultimately has an impact on health care decision making.

Environmental Quality Index - Overview Report | Science ...

EPA Pesticide Factsheets

A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and humanhealth. Described in this report is the effort to construct an environmental quality index representing multiple domains of the ambient environment, includingair, water, land, built and sociodemographic for all counties in the U.S. for the time period including the years 2000-2005. The EQI was created for two mainpurposes: a.) as an indicator of ambient conditions/exposure in environmental health modeling and b.) as a covariate to adjust for ambient conditions inenvironmental models. However, as detailed in the discussion of this report, the EQI can be adapted and used for other objectives. The EQI was developedin four parts: domain identification; data source identification and review; variable construction; and data reduction. Each of these four areas represents achapter in the report where detailed information is provided on the development of the EQI. The methods applied provide a reproducible approach thatcapitalizes almost exclusively on publically-available data sources.This report is written as an overview to the companion technical document. A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) was developed for all counties in the U.S. using indicators from the

Petroleum Quality Information System 2013 Annual Report

DTIC Science & Technology

2013-01-01

Content: (ppm) 10 0.10 Metals : (ppm) 0.5 total 0.10 Alkali Metals and Metalloids: (ppm) 1 total 0.99 Table 3-12 displays Direct Sugar to ...183 146 189 185 111 143 0 50 100 150 200 250 300 350 400 450 2005 2006 2007 2008 2009 2010 2011 2012 2013 To ta l S am pl es Calendar Year In-Line...Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour

[Quality Management in Medicine: What the Surgeon Needs to Know].

PubMed

Holtel, M; Roßmüller, T; Frommhold, K

2016-10-01

Quality management (QM) is a method used in the field of economics that was adopted late by the medical sector. The coincidence of quality management and what is referred to as economisation in medicine frequently leads to QM being - incorrectly - perceived as part of the economisation problem rather than as part of its solution. Quality assurance defines and observes key performance indicators for the achievement of quality objectives. QM is a form of active management that intends to systematically exclude the effects of chance. It is supposed to enable those in charge of an institution to deal with complex processes, to influence them and achieve quality even under unfavourable circumstances. Clearly defined written standards are an important aspect of QM and allow for 80 % of patients to be treated faster and less labour-intensively and thus to create more capacity for the individual treatment of the 20 % of patients requiring other than routine care. Standards provide a framework to rely on for department heads and other staff alike. They reduce complexity, support processes in stress situations and prevent inconsistent decisions in the course of treatment. Document management ensures transparent and up-to-date in-house standards and creates continuity. Good documents are short, easy to use, and, at the same time, comply with requirements. Specifications describe in-house standards; validation documents provide a forensically sound documentation. Quality management has a broad impact on an institution. It helps staff reflect on their daily work, and it initiates a reporting and auditing system as well as the systematic management of responses to surveys and complaints. Risk management is another aspect of QM; it provides structures to identify, analyse, assess and modify risks and subject them to risk controlling. Quality management is not necessarily associated with certification. However, if certification is intended, it serves to define requirements, increase motivation for the implementation of measures to be taken, and provide long-term continuity in newly adopted processes. Specialist certificates issued by medical associations frequently emphasise an interdisciplinary treatment approach; however, their certification processes are often of poor quality. The effectiveness and efficiency is evident for individual QM instruments in medicine. It is very likely that quality management improves effectiveness in the whole field of medicine, but this has yet to be proved. Georg Thieme Verlag KG Stuttgart · New York.

Quality Measures for the Care of Patients with Narcolepsy

PubMed Central

Krahn, Lois E.; Hershner, Shelley; Loeding, Lauren D.; Maski, Kiran P.; Rifkin, Daniel I.; Selim, Bernardo; Watson, Nathaniel F.

2015-01-01

The American Academy of Sleep Medicine (AASM) commissioned a Workgroup to develop quality measures for the care of patients with narcolepsy. Following a comprehensive literature search, 306 publications were found addressing quality care or measures. Strength of association was graded between proposed process measures and desired outcomes. Following the AASM process for quality measure development, we identified three outcomes (including one outcome measure) and seven process measures. The first desired outcome was to reduce excessive daytime sleepiness by employing two process measures: quantifying sleepiness and initiating treatment. The second outcome was to improve the accuracy of diagnosis by employing the two process measures: completing both a comprehensive sleep history and an objective sleep assessment. The third outcome was to reduce adverse events through three steps: ensuring treatment follow-up, documenting medical comorbidities, and documenting safety measures counseling. All narcolepsy measures described in this report were developed by the Narcolepsy Quality Measures Work-group and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with narcolepsy. Citation: Krahn LE, Hershner S, Loeding LD, Maski KP, Rifkin DI, Selim B, Watson NF. Quality measures for the care of patients with narcolepsy. J Clin Sleep Med 2015;11(3):335–355. PMID:25700880

Chicago Residents’ Perceptions of Air Quality: Objective Pollution, the Built Environment, and Neighborhood Stigma Theory

PubMed Central

King, Katherine E.

2014-01-01

Substantial research documents higher pollution levels in minority neighborhoods, but little research evaluates how residents perceive their own communities’ pollution risks. According to “Neighborhood stigma” theory, survey respondents share a cultural bias that minorities cause social dysfunction, leading to over-reports of dysfunction in minority communities. This study investigates perceptions of residential outdoor air quality by linking objective data on built and social environments with multiple measures of pollution and a representative survey of Chicago residents. Consistent with the scholarly narrative, results show air quality is rated worse where minorities and poverty are concentrated, even after extensive adjustment for objective pollution and built environment measures. Perceptions of air pollution may thus be driven by neighborhood socioeconomic position far more than by respondents’ ability to perceive pollution. The finding that 63.5% of the sample reported excellent or good air quality helps to explain current challenging in promoting environmental action. PMID:26527847

QUALITY CONTROLS FOR PCR

EPA Science Inventory

The purpose of this presentation is to present an overview of the quality control (QC) sections of a draft EPA document entitled, "Quality Assurance/Quality Control Guidance for Laboratories Performing PCR Analyses on Environmental Samples." This document has been prepared by th...

Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

PubMed

Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

2014-12-01

Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Conjunctive programming: An interactive approach to software system synthesis

NASA Technical Reports Server (NTRS)

Tausworthe, Robert C.

1992-01-01

This report introduces a technique of software documentation called conjunctive programming and discusses its role in the development and maintenance of software systems. The report also describes the conjoin tool, an adjunct to assist practitioners. Aimed at supporting software reuse while conforming with conventional development practices, conjunctive programming is defined as the extraction, integration, and embellishment of pertinent information obtained directly from an existing database of software artifacts, such as specifications, source code, configuration data, link-edit scripts, utility files, and other relevant information, into a product that achieves desired levels of detail, content, and production quality. Conjunctive programs typically include automatically generated tables of contents, indexes, cross references, bibliographic citations, tables, and figures (including graphics and illustrations). This report presents an example of conjunctive programming by documenting the use and implementation of the conjoin program.

Quality Assurance Program Plan for SFR Metallic Fuel Data Qualification

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

Benoit, Timothy; Hlotke, John Daniel; Yacout, Abdellatif

2017-07-05

This document contains an evaluation of the applicability of the current Quality Assurance Standards from the American Society of Mechanical Engineers Standard NQA-1 (NQA-1) criteria and identifies and describes the quality assurance process(es) by which attributes of historical, analytical, and other data associated with sodium-cooled fast reactor [SFR] metallic fuel and/or related reactor fuel designs and constituency will be evaluated. This process is being instituted to facilitate validation of data to the extent that such data may be used to support future licensing efforts associated with advanced reactor designs. The initial data to be evaluated under this program were generatedmore » during the US Integral Fast Reactor program between 1984-1994, where the data includes, but is not limited to, research and development data and associated documents, test plans and associated protocols, operations and test data, technical reports, and information associated with past United States Nuclear Regulatory Commission reviews of SFR designs.« less

Representations of a High-Quality System of Undergraduate Education in English Higher Education Policy Documents

ERIC Educational Resources Information Center

Ashwin, Paul; Abbas, Andrea; McLean, Monica

2015-01-01

This article examines the ways in which a high-quality system of undergraduate education is represented in recent policy documents from a range of actors interested in higher education. Drawing on Basil Bernstein's ideas, the authors conceptualise the policy documents as reflecting a struggle over competing views of quality that are expressed…

Effects of Quality Composts and Other Organic Amendments and Their Humic and Fulvic Acid Fractions on the Germination and Early Growth of Slickspot Peppergrass (Lepidium Papilliferum) and Switchgrass in Various Experimental Conditions

DTIC Science & Technology

2008-09-01

U.S. ARMY. THIS REPORT IS INTENDED ONLY FOR THE INTERNAL MANAGEMENT USE OF THE CONTRACTOR AND U.S. GOVERNEMENT” Approved for public release...distribution is unlimited. END OF FRONT COVER/TITLE PAGE Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for...ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public

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

Tang, Q.; Xie, S.

This report describes the Atmospheric Radiation Measurement (ARM) Best Estimate (ARMBE) station-based surface data (ARMBESTNS) value-added product. It is a twin data product of the ARMBE 2-Dimensional gridded (ARMBE2DGRID) data set. Unlike the ARMBE2DGRID data set, ARMBESTNS data are reported at the original site locations and show the original information (except for the interpolation over time). Therefore, the users have the flexibility to process the data with the approach more suitable for their applications. This document provides information about the input data, quality control (QC) method, and output format of this data set. As much of the information is identicalmore » to that of the ARMBE2DGRID data, this document will emphasize more on the different aspects of these two data sets.« less

Topographic and hydrographic survey data for the São Francisco River near Torrinha, Bahia, Brazil, 2014

USGS Publications Warehouse

Fosness, Ryan L.; Dietsch, Benjamin J.

2015-10-21

This report presents the surveying techniques and data-processing methods used to collect, process, and disseminate topographic and hydrographic data. All standard and non‑standard data-collection methods, techniques, and data process methods were documented. Additional discussion describes the quality-assurance and quality-control elements used in this study, along with the limitations for the Torrinha-Itacoatiara study reach data. The topographic and hydrographic geospatial data are published along with associated metadata.

Effectiveness of UK provider financial incentives on quality of care: a systematic review.

PubMed

Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

2017-11-01

Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

PubMed

2015-11-13

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 2016 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 and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

Drug interactions among commonly used medications. Chart simplifies data from critical literature review.

PubMed Central

Crowther, N. R.; Holbrook, A. M.; Kenwright, R.; Kenwright, M.

1997-01-01

OBJECTIVE: To simplify risk assessment, we have developed a way to present critically appraised drug interaction information through a chart. DATA SOURCES: Fifty drugs most frequently prescribed by Canadian family physicians and 16 drugs and substances that frequently interact with these drugs were the basis for a literature review. Drug interaction textbooks and MEDLINE (from 1966 to 1994) were searched for documented interactions. Reports of additive effects and animal or in vitro studies were excluded. STUDY SELECTION: All reports of interactions were evaluated for clinical effect, clinical significance, and quality of evidence. SYNTHESIS: Of the 464 drug-drug or drug-substance pairs evaluated, 387 (83.4%) demonstrated an interaction, 59 (12.7%) documented no effect, and 18 (3.9%) pairs had conflicting evidence. Five percent of interactions were of major clinical significance; only 1.3% were of major clinical significance and supported by good-quality evidence. By using symbols, colours, and legends in a "grid-map" format, a large amount of drug interaction information was reduced to a single-page chart suitable for a desk reference or wall mounting. CONCLUSIONS: Our chart organizes a large amount of drug interaction information in a format that allows for rapid appreciation of outcome, clinical significance, and quality of evidence. PMID:9386884

Journal of the College of Physicians and Surgeons of Pakistan: Five Years Bibliometric Analysis.

PubMed

Saeed Ullah, Saeed; Jan, Saeed Ullah; Jan, Tahir; Ahmad, Hafiz Nafees; Jan, Muhammad Yahya; Rauf, Muhammad Abdur

2016-11-01

To conduct the bibliometric analysis of the Journal of the College of Physicians and Surgeons Pakistan (JCPSP) from 2012 to 2014. The prime objectives of this report were to determine the number and percentage of articles by year, authorship pattern, gender and geographical affiliation, ranking by subject and citation analysis. A data collection instrument was developed as bibliometric form. The data was analysed using the Microsoft Excel spread sheet. Editorials and letters to editors were excluded. There were 1106 total research documents, including 721 original articles and 385 case reports. A rapid increase in number of articles per year was noticed, more original papers than case reports. Majority of the authors were male. The contribution of Balochistan and Khyber Pakhtunkhwa was less than the other provinces. JCPSP was the most cited document in the reference list of the research documents. The scholars of Khyber Pakhtunkhwa and Balochistan and female researchers should give more attention in writing quality articles eligible for consideration at this Journal. It is also suggested that writers should be compelled to address such fields of medical sciences as neurology, nephrology, anatomy and pharmacology, while writing original articles and case reports.

SU-F-P-05: Initial Experience with an Independent Certification Program for Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

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

Solberg, T; Robar, J; Gevaert, T

Purpose: The ASTRO document “Safety is no accident: A FRAMEWORK FOR QUALITY RADIATION ONCOLOGY AND CARE” recommends external reviews of specialized modalities. The purpose of this presentation is to describe the implementation of such a program for Stereotactic Radiosurgery (SRS) and Stereotactic Body radiation Therapy (SBRT). Methods: The margin of error for SRS and SBRT delivery is significantly smaller than that of conventional radiotherapy and therefore requires special attention and diligence. The Novalis Certified program was created to fill an unmet need for specialized SRS / SBRT credentialing. A standards document was drafted by a panel of experts from severalmore » disciplines, including medical physics, radiation oncology and neurosurgery. The document, based on national and international standards, covers requirements in program structure, personnel, training, clinical application, technology, quality management, and patient and equipment QA. The credentialing process was modeled after existing certification programs and includes an institution-generated self-study, extensive document review and an onsite audit. Reviewers generate a descriptive report, which is reviewed by a multidisciplinary expert panel. Outcomes of the review may include mandatory requirements and optional recommendations. Results: 15 institutions have received Novalis Certification, including 3 in the US, 7 in Europe, 4 in Australia and 1 in Asia. 87 other centers are at various stages of the process. Nine reviews have resulted in mandatory requirements, however all of these were addressed within three months of the audit report. All reviews have produced specific recommendations ranging from programmatic to technical in nature. Institutions felt that the credentialing process addressed a critical need and was highly valuable to the institution. Conclusion: Novalis Certification is a unique peer review program assessing safety and quality in SRS and SBRT, while recognizing international practice standards. The approach is capable of highlighting outstanding requirements and providing recommendations to enhance both new and established programs. Timothy Solberg is co-owner of Global Radiosurgery services, LLC.« less

TU-B-19A-01: Image Registration II: TG132-Quality Assurance for Image Registration

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

Brock, K; Mutic, S

2014-06-15

AAPM Task Group 132 was charged with a review of the current approaches and solutions for image registration in radiotherapy and to provide recommendations for quality assurance and quality control of these clinical processes. As the results of image registration are always used as the input of another process for planning or delivery, it is important for the user to understand and document the uncertainty associate with the algorithm in general and the Result of a specific registration. The recommendations of this task group, which at the time of abstract submission are currently being reviewed by the AAPM, include themore » following components. The user should understand the basic image registration techniques and methods of visualizing image fusion. The disclosure of basic components of the image registration by commercial vendors is critical in this respect. The physicists should perform end-to-end tests of imaging, registration, and planning/treatment systems if image registration is performed on a stand-alone system. A comprehensive commissioning process should be performed and documented by the physicist prior to clinical use of the system. As documentation is important to the safe implementation of this process, a request and report system should be integrated into the clinical workflow. Finally, a patient specific QA practice should be established for efficient evaluation of image registration results. The implementation of these recommendations will be described and illustrated during this educational session. Learning Objectives: Highlight the importance of understanding the image registration techniques used in their clinic. Describe the end-to-end tests needed for stand-alone registration systems. Illustrate a comprehensive commissioning program using both phantom data and clinical images. Describe a request and report system to ensure communication and documentation. Demonstrate an clinically-efficient patient QA practice for efficient evaluation of image registration.« less

Guidance and Control Software Project Data - Volume 1: Planning Documents

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the planning documents from the GCS project. Volume 1 contains five appendices: A. Plan for Software Aspects of Certification for the Guidance and Control Software Project; B. Software Development Standards for the Guidance and Control Software Project; C. Software Verification Plan for the Guidance and Control Software Project; D. Software Configuration Management Plan for the Guidance and Control Software Project; and E. Software Quality Assurance Activities.

Reporting of harms outcomes: a comparison of journal publications with unpublished clinical study reports of orlistat trials.

PubMed

Hodkinson, Alex; Gamble, Carrol; Smith, Catrin Tudur

2016-04-22

The quality of harms reporting in journal publications is often poor, which can impede the risk-benefit interpretation of a clinical trial. Clinical study reports can provide more reliable, complete, and informative data on harms compared to the corresponding journal publication. This case study compares the quality and quantity of harms data reported in journal publications and clinical study reports of orlistat trials. Publications related to clinical trials of orlistat were identified through comprehensive literature searches. A request was made to Roche (Genentech; South San Francisco, CA, USA) for clinical study reports related to the orlistat trials identified in our search. We compared adverse events, serious adverse events, and the reporting of 15 harms criteria in both document types and compared meta-analytic results using data from the clinical study reports against the journal publications. Five journal publications with matching clinical study reports were available for five independent clinical trials. Journal publications did not always report the complete list of identified adverse events and serious adverse events. We found some differences in the magnitude of the pooled risk difference between both document types with a statistically significant risk difference for three adverse events and two serious adverse events using data reported in the clinical study reports; these events were of mild intensity and unrelated to the orlistat. The CONSORT harms reporting criteria were often satisfied in the methods section of the clinical study reports (70-90 % of the methods section criteria satisfied in the clinical study reports compared to 10-50 % in the journal publications), but both document types satisfied 80-100 % of the results section criteria, albeit with greater detail being provided in the clinical study reports. In this case study, journal publications provided insufficient information on harms outcomes of clinical trials and did not specify that a subset of harms data were being presented. Clinical study reports often present data on harms, including serious adverse events, which are not reported or mentioned in the journal publications. Therefore, clinical study reports could support a more complete, accurate, and reliable investigation, and researchers undertaking evidence synthesis of harm outcomes should not rely only on incomplete published data that are presented in the journal publications.

Using Inspections to Improve the Quality of Product Documentation and Code.

ERIC Educational Resources Information Center

Zuchero, John

1995-01-01

Describes how, by adapting software inspections to assess documentation and code, technical writers can collaborate with development personnel, editors, and customers to dramatically improve both the quality of documentation and the very process of inspecting that documentation. Notes that the five steps involved in the inspection process are:…

Total nutrient and sediment loads, trends, yields, and nontidal water-quality indicators for selected nontidal stations, Chesapeake Bay Watershed, 1985–2011

USGS Publications Warehouse

Langland, Michael J.; Blomquist, Joel D.; Moyer, Douglas; Hyer, Kenneth; Chanat, Jeffrey G.

2013-01-01

The U.S. Geological Survey, in cooperation with Chesapeake Bay Program (CBP) partners, routinely reports long-term concentration trends and monthly and annual constituent loads for stream water-quality monitoring stations across the Chesapeake Bay watershed. This report documents flow-adjusted trends in sediment and total nitrogen and phosphorus concentrations for 31 stations in the years 1985–2011 and for 32 stations in the years 2002–2011. Sediment and total nitrogen and phosphorus yields for 65 stations are presented for the years 2006–2011. A combined nontidal water-quality indicator (based on both trends and yields) indicates there are more stations classified as “improving water-quality trend and a low yield” than “degrading water-quality trend and a high yield” for total nitrogen. The same type of 2-way classification for total phosphorus and sediment results in equal numbers of stations in each indicator class.

Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

PubMed

Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

2016-09-01

Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

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

The quality of assessments for childhood psychopathology within a regional medical center.

PubMed

Sattler, Adam F; Leffler, Jarrod M; Harrison, Nicole L; Bieber, Ewa D; Kosmach, Joseph J; Sim, Leslie A; Whiteside, Stephen P H

2018-05-17

Accurate assessment is essential to implementing effective mental health treatment; however, little research has explored child clinicians' assessment practices in applied settings. The current study thus examines practitioners' use of evidence-based assessment (EBA) instruments (i.e., self-report measures and structured interviews), specificity of identified diagnoses (i.e., use of specific diagnostic labels vs. nonstandardized labels, not otherwise specified [NOS] diagnoses, and adjustment disorder diagnoses), and documentation of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, American Psychiatric Association, 2000) criteria. Use of these practices was evaluated via analysis of documentation contained within a regional medical center's medical records. This analysis was limited to 2,499 session notes from patient appointments associated with psychiatric disorders newly diagnosed during 2013. In total, session notes were linked to 694 children aged 7 to 17. Results indicated that EBA use was low overall, although self-report measures were utilized relatively frequently versus structured interviews. Diagnostic specificity was also low overall and clinicians rarely documented full diagnostic criteria; however, EBA use was associated with increased diagnostic specificity. Further, clinicians practicing in psychological, psychiatric, and primary care settings were more likely to use self-report measures as compared to those practicing in an integrated behavioral health social work setting. In addition, structured interviews were most likely to be utilized by clinicians practicing in a psychological services setting. Finally, clinicians were more likely to use self-report measures when the identified primary concern was a mood disorder or attention-deficit/hyperactivity disorder (ADHD). Based on these results, we provide suggestions and references to resources for clinicians seeking to improve the quality of their assessments via implementation of EBA. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Feasibility Study of Shoreline Protection and Lake Level Regulation for Lake Ontario. Reconnaissance Report. Volume I. Main Report.

DTIC Science & Technology

1981-11-01

EVALUATION Impact Assessment 62 Evaluation 65 STUDY MANAGEMENT Interdisciplinary Study Approach 67 Public Involvement 69 Environmental Impact ...agencies to assess and document the effect of proposed actions on the envi- ronment in an Environmental Impact Statement (EIS). In compliance with this 9...these being National Economic Development (NED) and Environmental Quality (EQ). It also specifies the range of impacts that must be assessed, and

ArchE - An Architecture Design Assistant

DTIC Science & Technology

2007-08-02

Architecture Design Assistant Len Bass August 2, 2007 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the...ArchE - An Architecture Design Assistant 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK...X, Module X 3 Author / Presenter, Date if Needed What is ArchE? ArchE is a software architecture design assistant, which: • Takes quality and

An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014).

PubMed

Brooks, Ingrid A; Sayre, Michael R; Spencer, Caroline; Archer, Frank L

2016-02-01

The Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US. As US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach. Seventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession. Documents produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.

International Social Indicators: An Overview of On-Going Activities.

ERIC Educational Resources Information Center

Van Dusen, Roxann A.

International social indicators, focusing on assessment of the quality of life, measurement of social changes, and program evaluation, are the subject of this paper. Beginning with a look at various national reports which are currently being produced, it is felt that these documents and the data gathering activities upon which they are based form…

Accreditation and Power: A Discourse Analysis of a New Regime of Governance in Higher Education

ERIC Educational Resources Information Center

Engebretsen, Eivind; Heggen, Kristin; Eilertsen, Heidi Annett

2012-01-01

This article studies discourses within the accreditation of Norwegian higher education conducted by the Norwegian Agency for Quality Assurance in Education (NOKUT), using one concrete case (the accreditation of bachelor programs in nursing). Analysis of policy documents and accreditation reports are influenced by two of Foucault's concepts of…

Investing in Education: Analysis of the 1999 World Education Indicators. Education and Skills.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This Organisation for Economic Cooperation and Development report documents the growing demand for learning around the world. A quantitative description of the functioning of education systems allows for international comparisons and the identification of the strengths and weaknesses of various approaches to providing quality education. Chapter 1,…

New Teachers with Life Experiences: How Different Are They?

ERIC Educational Resources Information Center

Haipt, Mildred

Little empirical research has documented the impressionistic reports that mature-age students bring a unique and highly desirable set of personal qualities to the teaching profession. To help fill the gap, this study gathered empirical data from both mature-age and college-age students (N=74) on the following: (1) personality characteristics; (2)…

HEFCE Strategic Plan, 2001-06. Report.

ERIC Educational Resources Information Center

Higher Education Funding Council for England, Bristol.

This document outlines the strategic plan of the Higher Education Funding Council for England (HEFCE) for the years 2001 through 2006. The mission of the HEFCE is to promote and fund high quality, cost-effective teaching and research, meeting the diverse needs of students, the economy, and society. To achieve this mission, the HEFCE intends to…

Distant Education in 2001: Accreditation & Quality. The Accrediting Commission Looks at the Evolving Forms of Correspondence Instruction.

ERIC Educational Resources Information Center

National Home Study Council, Washington, DC. Accrediting Commission.

This collection of 10 essays is the outgrowth of a 1983 Accrediting Commission meeting which examined the implications for accreditation of the "Green Chair Group" report entitled "Predicting Distant Education in the Year 2001," an earlier document containing the predictions of 25 educators and executives concerning…

GEO-CAPE Aerosol Working Group Report

NASA Technical Reports Server (NTRS)

Chin, Mian; Jethva, Hiren; Joiner, Joanna; Lyapustin, Alexei; Mattoo, Shana; Torres, Omar; Vasilkov, Alexander; Kondragunta, Shobha; Ciren, Pubu; Remer, Lorraine;

Preliminary report for using X-rays as verification and authentication tool

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

Esch, Ernst Ingo; Desimone, David J.; Lakis, Rollin Evan

2016-04-06

We examined x-rays for the use as authentication and verification tool in treaty verification. Several x-ray pictures were taken to determine the quality and feasibility of x-rays for these tasks. This document describes the capability of the used x-ray system and outlines its parameters and possible use.

Integrated Science Assessment (ISA) for Particulate Matter ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Particulate Matter (PM). This report is EPA’s latest evaluation of the scientific literature on the potential human health and welfare effects associated with ambient exposures to particulate matter (PM). The development of this document is part of the Agency's periodic review of the national ambient air quality standards (NAAQS) for PM. The recently completed PM ISA and supplementary annexes, in conjunction with additional technical and policy assessments developed by EPA’s Office of Air and Radiation, will provide the scientific basis to inform EPA decisions related to the review of the current PM NAAQS. Key information and judgments formerly contained in an Air Quality Criteria Document (AQCD) for PM are incorporated in this assessment. Additional details of the pertinent literature published since the last review, as well as selected older studies of particular interest, are included in a series of annexes. This ISA thus serves to update and revise the evaluation of the scientific evidence available at the time of the previous review of the NAAQS for PM that was concluded in 2006.

Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.

PubMed

Newman, Eric D; Lerch, Virginia; Billet, Jon; Berger, Andrea; Kirchner, H Lester

2015-04-01

Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software. The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception. Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted. We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated. Copyright © 2015 by the American College of Rheumatology.

Computer-generated vs. physician-documented history of present illness (HPI): results of a blinded comparison.

PubMed

Almario, Christopher V; Chey, William; Kaung, Aung; Whitman, Cynthia; Fuller, Garth; Reid, Mark; Nguyen, Ken; Bolus, Roger; Dennis, Buddy; Encarnacion, Rey; Martinez, Bibiana; Talley, Jennifer; Modi, Rushaba; Agarwal, Nikhil; Lee, Aaron; Kubomoto, Scott; Sharma, Gobind; Bolus, Sally; Chang, Lin; Spiegel, Brennan M R

2015-01-01

Healthcare delivery now mandates shorter visits with higher documentation requirements, undermining the patient-provider interaction. To improve clinic visit efficiency, we developed a patient-provider portal that systematically collects patient symptoms using a computer algorithm called Automated Evaluation of Gastrointestinal Symptoms (AEGIS). AEGIS also automatically "translates" the patient report into a full narrative history of present illness (HPI). We aimed to compare the quality of computer-generated vs. physician-documented HPIs. We performed a cross-sectional study with a paired sample design among individuals visiting outpatient adult gastrointestinal (GI) clinics for evaluation of active GI symptoms. Participants first underwent usual care and then subsequently completed AEGIS. Each individual thereby had both a physician-documented and a computer-generated HPI. Forty-eight blinded physicians assessed HPI quality across six domains using 5-point scales: (i) overall impression, (ii) thoroughness, (iii) usefulness, (iv) organization, (v) succinctness, and (vi) comprehensibility. We compared HPI scores within patient using a repeated measures model. Seventy-five patients had both computer-generated and physician-documented HPIs. The mean overall impression score for computer-generated HPIs was higher than physician HPIs (3.68 vs. 2.80; P<0.001), even after adjusting for physician and visit type, location, mode of transcription, and demographics. Computer-generated HPIs were also judged more complete (3.70 vs. 2.73; P<0.001), more useful (3.82 vs. 3.04; P<0.001), better organized (3.66 vs. 2.80; P<0.001), more succinct (3.55 vs. 3.17; P<0.001), and more comprehensible (3.66 vs. 2.97; P<0.001). Computer-generated HPIs were of higher overall quality, better organized, and more succinct, comprehensible, complete, and useful compared with HPIs written by physicians during usual care in GI clinics.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A well-designed online transfusion reaction reporting system improves the estimation of transfusion reaction incidence and quality of care in transfusion practice.

PubMed

Yeh, Su-Peng; Chang, Ci-Wen; Chen, Ju-Chuan; Yeh, Wan-Chen; Chen, Pei-Chi; Chuang, Su-Jung; Lin, Chiou-Ping; Hsu, Ling-Nu; Chen, Han-Mih; Lu, Jang-Jih; Peng, Ching-Tien

2011-12-01

Recognizing and reporting a transfusion reaction is important in transfusion practice. However, the actual incidence of transfusion reactions is frequently underestimated. We designed an online transfusion reaction reporting system for nurses who take care of transfusion recipients. The common management before and after transfusion and the 18 most common transfusion reactions were itemized as tick boxes. We found the overall documented incidence of transfusion reaction increased dramatically, from 0.21% to 0.61% per unit of blood, after we started using an online reporting system. Overall, 94% (30/32) of nurses took only 1 week to become familiar with the new system, and 88% (28/32) considered the new system helpful in improving the quality of clinical transfusion care. By using an intranet connection, blood bank physicians can also identify patients who are having a reaction and provide appropriate recommendations immediately. A well-designed online reporting system may improve the ability to estimate the incidence of transfusion reactions and the quality of transfusion care.

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2014 CFR

2014-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2013 CFR

2013-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

40 CFR 136.7 - Quality assurance and quality control.

Code of Federal Regulations, 2012 CFR

2012-07-01

... quality control elements, where applicable, into the laboratory's documented standard operating procedure... quality control elements must be clearly documented in the written standard operating procedure for each... Methods contains QA/QC procedures in the Part 1000 section of the Standard Methods Compendium. The...

Evaluation of image quality of digital photo documentation of female genital injuries following sexual assault.

PubMed

Ernst, E J; Speck, Patricia M; Fitzpatrick, Joyce J

2011-12-01

With the patient's consent, physical injuries sustained in a sexual assault are evaluated and treated by the sexual assault nurse examiner (SANE) and documented on preprinted traumagrams and with photographs. Digital imaging is now available to the SANE for documentation of sexual assault injuries, but studies of the image quality of forensic digital imaging of female genital injuries after sexual assault were not found in the literature. The Photo Documentation Image Quality Scoring System (PDIQSS) was developed to rate the image quality of digital photo documentation of female genital injuries after sexual assault. Three expert observers performed evaluations on 30 separate images at two points in time. An image quality score, the sum of eight integral technical and anatomical attributes on the PDIQSS, was obtained for each image. Individual image quality ratings, defined by rating image quality for each of the data, were also determined. The results demonstrated a high level of image quality and agreement when measured in all dimensions. For the SANE in clinical practice, the results of this study indicate that a high degree of agreement exists between expert observers when using the PDIQSS to rate image quality of individual digital photographs of female genital injuries after sexual assault. © 2011 International Association of Forensic Nurses.

Crowdsourcing the Measurement of Interstate Conflict

PubMed Central

2016-01-01

Much of the data used to measure conflict is extracted from news reports. This is typically accomplished using either expert coders to quantify the relevant information or machine coders to automatically extract data from documents. Although expert coding is costly, it produces quality data. Machine coding is fast and inexpensive, but the data are noisy. To diminish the severity of this tradeoff, we introduce a method for analyzing news documents that uses crowdsourcing, supplemented with computational approaches. The new method is tested on documents about Militarized Interstate Disputes, and its accuracy ranges between about 68 and 76 percent. This is shown to be a considerable improvement over automated coding, and to cost less and be much faster than expert coding. PMID:27310427

Quality of reporting in infertility journals.

PubMed

Glujovsky, Demian; Boggino, Carolina; Riestra, Barbara; Coscia, Andrea; Sueldo, Carlos E; Ciapponi, Agustín

2015-01-01

To evaluate whether fertility and top gynecology journals indexed in PubMed require the use of reporting guidelines and to identify the percentage of randomized controlled trials (RCTs) published in 2013 that were written following CONSORT guidelines in the top four fertility journals (by their highest impact factor). Cross-sectional study evaluating instructions for authors and RCTs published in fertility journals. Academic institution. None. None. Proportion of instruction-for-authors documents that suggested or required the use of reporting guidelines, and proportion of RCTs published in 2013 that accomplished the CONSORT checklist. In 47% (16/34) of the journals one or more reporting guidelines were mentioned in the instructions for authors' documents. PRISMA and CONSORT were the most commonly mentioned reporting guidelines. None of the analyzed RCTs completed the 25 items of CONSORT guideline. Sequence generation or allocation concealment was not described in 69% of the studies. One-third of the journals did not publish a flowchart, 72% did not show relative and absolute size-effect measures, and 42% did not use measures of imprecision. In the summaries, 42% did not discuss the limitations of the study and 78% did not mention the generalizability of the results. Less than half of the analyzed peer-reviewed journals request the authors to use reporting guidelines. Nevertheless, among the top fertility and gynecology journals, reporting guidelines are widely mentioned. Overall, accomplishment of CONSORT items was suboptimal. Editorial boards, reviewers, and authors should join efforts to improve the quality of reporting. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

EPA Guidance for Geospatially Related Quality Assurance Project Plans

EPA Pesticide Factsheets

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

AIR QUALITY CRITERIA DOCUMENT(S) FOR LEAD

EPA Science Inventory

This collection of documents intend to assess the latest scientific information on the health and environmental fate and effects of lead to provide scientific bases for periodic review and possible revision of the National Ambient Air Quality Standards (NAAQS) for lead.

Construction quality assurance report for the Y-12 Construction/Demolition Landfill VII (CDL VII), Oak Ridge, Tennessee

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

Burton, P.M.

This Construction Quality Assurance (CQA) Report provides documentation that Bid Option 2 of the Y-12 Plant Construction Demolition Landfill 7 (CDL-7) was constructed in substantial compliance with the Tennessee Department of Environment and Conservation (TDEC) approved design, as indicated and specified in the permit drawings, approved changes, and specifications. CDL-7 is located in Anderson County on the south side of Chestnut Ridge, approximately 0.5 miles south of the Y-12 Plant in Oak Ridge, Tennessee. This report applies specifically to the limits of excavation for Area No. 1 portions of the perimeter maintenance road and drainage channel and Sedimentation Pond No.more » 3. A partial ``As-Built`` survey was performed and is included.« less

Online Error Reporting for Managing Quality Control Within Radiology.

PubMed

Golnari, Pedram; Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

2016-06-01

Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.

K-12 education sector desk reference. Final report

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

NONE

1998-01-01

K-12 schools are a major energy customer. To help utility managers better analyze their business relationships with this important market segment, this reference provides background information, statistics, and other useful information. This is a reference. It is a compilation of figures, charts, and tables taken from many existing sources representing some of the best information available about K-12 schools. Analysts reviews over 2,500 pages of government and private sector documents (listed in Appendix A) to select the 100 pages included here. They made every effort to select documents likely to be useful to utility planning staff and program managers. Wherevermore » possible, specific state data have been included to help utility staff compute impacts within a service territory. Both a phone number and e-mail address have been included wherever available for each document listed in Appendix A. The report includes data on the following: energy use; federal mandates; deferred maintenance; indoor air quality; and technology in education. 21 figs., 49 tabs.« less

Video documentation of experiments at the USGS debris-flow flume 1992–2017

USGS Publications Warehouse

Logan, Matthew; Iverson, Richard M.

2007-11-23

This set of videos presents about 18 hours of footage documenting the 163 experiments conducted at the USGS debris-flow flume from 1992 to 2017. Owing to improvements in video technology over the years, the quality of footage from recent experiments generally exceeds that from earlier experiments.Use the list below to access the individual videos, which are mostly grouped by date and subject matter. When a video is selected from the list, multiple video sequences are generally shown in succession, beginning with a far-field overview and proceeding to close-up views and post-experiment documentation.Interpretations and data from experiments at the USGS debris-flow flume are not provided here but can be found in published reports, many of which are available online at: https://profile.usgs.gov/riverson/A brief introduction to the flume facility is also available online in USGS Open-File Report 92–483 [http://pubs.er.usgs.gov/usgspubs/ofr/ofr92483].

Clean Watersheds Needs Survey (CWNS) 2008 Report to Congress

EPA Pesticide Factsheets

The Environmental Protection Agency's CWNS is required by Sections 205(a) and 516(b)(1) of the CWA. The CWNS is a summary of the estimated capital costs for water quality projects and other activities eligible for SRF support as authorized by the 1987 CWA Amendments. The Clean Watersheds Needs Survey (CWNS) 2008 Report to Congress summarizes the results of EPA's 15th national survey of capital costs to address water quality or water quality related public health problems. The total wastewater and stormwater management needs for the nation are $298.1 billion as of January 1, 2008. This amount includes $192.2 billion for wastewater treatment plants, pipe repairs, and buying and installing new pipes; $63.6 billion for combined sewer overflow correction; and $42.3 billion for stormwater management. Small communities have documented needs of $22.7 billion.

Section 3. The SPARROW Surface Water-Quality Model: Theory, Application and User Documentation

USGS Publications Warehouse

Schwarz, G.E.; Hoos, A.B.; Alexander, R.B.; Smith, R.A.

2006-01-01

SPARROW (SPAtially Referenced Regressions On Watershed attributes) is a watershed modeling technique for relating water-quality measurements made at a network of monitoring stations to attributes of the watersheds containing the stations. The core of the model consists of a nonlinear regression equation describing the non-conservative transport of contaminants from point and diffuse sources on land to rivers and through the stream and river network. The model predicts contaminant flux, concentration, and yield in streams and has been used to evaluate alternative hypotheses about the important contaminant sources and watershed properties that control transport over large spatial scales. This report provides documentation for the SPARROW modeling technique and computer software to guide users in constructing and applying basic SPARROW models. The documentation gives details of the SPARROW software, including the input data and installation requirements, and guidance in the specification, calibration, and application of basic SPARROW models, as well as descriptions of the model output and its interpretation. The documentation is intended for both researchers and water-resource managers with interest in using the results of existing models and developing and applying new SPARROW models. The documentation of the model is presented in two parts. Part 1 provides a theoretical and practical introduction to SPARROW modeling techniques, which includes a discussion of the objectives, conceptual attributes, and model infrastructure of SPARROW. Part 1 also includes background on the commonly used model specifications and the methods for estimating and evaluating parameters, evaluating model fit, and generating water-quality predictions and measures of uncertainty. Part 2 provides a user's guide to SPARROW, which includes a discussion of the software architecture and details of the model input requirements and output files, graphs, and maps. The text documentation and computer software are available on the Web at http://usgs.er.gov/sparrow/sparrow-mod/.

Trends in liability affecting technical writers

NASA Technical Reports Server (NTRS)

Driskill, L. P.

1981-01-01

Liability of technical writers for defective products is explored. Documents generated during a product's life cycle (including design memos, design tests, clinical trials, trial use reports, letters, and proposals) become relevant because they are likely to become the only available means of showing that the product was not defectively designed. These documents become the evidence that the product underwent balanced and well considered planning, development, testing, quality control, and field testing. The predicted increased involvement of technical writers in the prevention and defense of product liability claims is cited in view of a greater number of cases turning on "failure to warn".

Hidden costs in the physician-insurer relationship.

PubMed

Cote, Jane; Latham, Claire

2003-01-01

Numerous reports document the frictions in health care funding systems, particularly related to the physician-insurer dyad. Efforts to improve efficient patient care by improving interactions between the physician and insurer are ongoing. This article examines one dimension--relationship quality--and demonstrates how attention to building commitment and trust within the relationship has financial benefits. Using a survey of physician practice personnel, commitment and trust are shown to have a positive influence on financial performance metrics. Commitment and trust antecedents are empirically documented. These antecedents provide a starting point for physician practices seeking to enhance their insurer relationships as a mechanism for improved operations.

Technical Guidance for Assessing Environmental Justice in ...

EPA Pesticide Factsheets

The Technical Guidance for Assessing Environmental Justice in Regulatory Analysis (also referred to as the Environmental Justice Technical Guidance or EJTG) is intended for use by Agency analysts, including risk assessors, economists, and other analytic staff that conduct analyses to evaluate EJ concerns in the context of regulatory actions. Senior EPA managers and decision makers also may find this document useful to understand analytic expectations and to ensure that EJ concerns are appropriately considered in the development of analyses to support regulatory actions under EPA’s action development process. Specifically, the document outlines approaches and methods to help Agency analysts evaluate EJ concerns. The document provides overarching direction to analysts by outlining a series of questions that will ensure the decision maker has appropriate information about baseline risks across population groups, and how those risks are distributed under the options being considered. In addition, the document provides a set of recommendations and requirements as well as best practices for use in analyzing and reporting results from consideration of EJ concerns. These principles will help ensure consistency, quality, and transparency across regulatory actions, while allowing for flexibility needed across different regulatory actions. The purpose of the EJTG is ensure consistency, quality, and transparency in considering environmental justice, while allowing f

The content and meaning of administrative work: a qualitative study of nursing practices.

PubMed

Michel, Lucie; Waelli, Mathias; Allen, Davina; Minvielle, Etienne

2017-09-01

To investigate the content and meaning of nurses' administrative work. Nurses often report that administrative work keeps them away from bedside care. The content and meaning of this work remains insufficiently explored. Comparative case studies. The investigation took place in 2014. It was based on 254 hours of observations and 27 interviews with nurses and staff in two contrasting units: intensive care and long-term care. A time and motion study was also performed over a period of 96 hours. Documentation and Organizational Activities is composed of six categories; documenting the patient record, coordination, management of patient flow, transmission of information, reporting quality indicators, ordering supplies- stock management Equal amounts of time were spent on these activities in each case. Nurses did not express complaints about documentation in intensive care, whereas they reported feeling frustrated by it in long-term care. These differences reflected the extent to which these activities could be integrated into nurses' clinical work and this is in turn was related to several factors: staff ratios, informatics, and relevance to nursing work. Documentation and Organizational Activities are a main component of care. The meaning nurses attribute to them is dependent on organizational context. These activities are often perceived as competing with bedside care, but this does not have to be the case. The challenge for managers is to fully integrate them into nursing practice. Results also suggest that nurses' Documentation and Organizational Activities should be incorporated into informatics strategies. © 2017 John Wiley & Sons Ltd.

Documentation of clinical care in hospital patients' medical records: A qualitative study of medical students' perspectives on clinical documentation education.

PubMed

Rowlands, Stella; Coverdale, Steven; Callen, Joanne

2016-12-01

Clinical documentation is essential for communication between health professionals and the provision of quality care to patients. To examine medical students' perspectives of their education in documentation of clinical care in hospital patients' medical records. A qualitative design using semi-structured interviews with fourth-year medical students was undertaken at a hospital-based clinical school in an Australian university. Several themes reflecting medical students' clinical documentation education emerged from the data: formal clinical documentation education using lectures and tutorials was minimal; most education occurred on the job by junior doctors and student's expressed concerns regarding variation in education between teams and receiving limited feedback on performance. Respondents reported on the importance of feedback for their learning of disease processes and treatments. They suggested that improvements could be made in the timing of clinical documentation education and they stressed the importance of training on the job. On-the-job education with feedback in clinical documentation provides a learning opportunity for medical students and is essential in order to ensure accurate, safe, succinct and timely clinical notes. © The Author(s) 2016.

Development of the Quality of Australian Nursing Documentation in Aged Care (QANDAC) instrument to assess paper-based and electronic resident records.

PubMed

Wang, Ning; Björvell, Catrin; Hailey, David; Yu, Ping

2014-12-01

To develop an Australian nursing documentation in aged care (Quality of Australian Nursing Documentation in Aged Care (QANDAC)) instrument to measure the quality of paper-based and electronic resident records. The instrument was based on the nursing process model and on three attributes of documentation quality identified in a systematic review. The development process involved five phases following approaches to designing criterion-referenced measures. The face and content validities and the inter-rater reliability of the instrument were estimated using a focus group approach and consensus model. The instrument contains 34 questions in three sections: completion of nursing history and assessment, description of care process and meeting the requirements of data entry. Estimates of the validity and inter-rater reliability of the instrument gave satisfactory results. The QANDAC instrument may be a useful audit tool for quality improvement and research in aged care documentation. © 2013 ACOTA.

Advanced 3D Printers for Cellular Solids

DTIC Science & Technology

2016-06-30

2211 3d printing , cellular solids REPORT DOCUMENTATION PAGE 11. SPONSOR/MONITOR’S REPORT NUMBER(S) 10. SPONSOR/MONITOR’S ACRONYM(S) ARO 8...quality 3D printing and rapid prototyping in a fraction of the time taken by traditional 3D printers, using eco-friendly, inexpensive office paper and...STL file, which then can be used in printing the 3D model. Mechanical performance using compressive crushing of the 3D printed part will be studied

The Pursuit of Excellence: Improving the Quality of Our Urban Schools through Desegregation, Equity and Choice. A Final Report from the Program Committee of The Worcester Conference on Equity and Choice (Worcester, Massachusetts, April 9-10, 1984).

ERIC Educational Resources Information Center

Clinchy, Evans

In April 1984, more than 350 parents, teachers, principals and administrators from major urban school systems in Massachusetts met to define what an "excellent" desegregated urban public school system should be. This conference report, following excerpts from a keynote address by John E. Durkin, documents seven workshops which focused on…

Michigan Water Year 2005

USGS Publications Warehouse

Blumer, S.P.; Whited, C.R.; Ellis, J.M.; Minnerick, R.J.; LeuVoy, R.L.

2006-01-01

This volume of the annual hydrologic data report of Michigan is one of a series of annual reports that document hydrologic data gathered from the U.S. Geological Survey's surface- and ground-water data-collection networks in each state, Puerto Rico, and the Trust Territories. These records of streamflow, ground-water levels, and quality of water provide the hydrologic information needed by State, local, and Federal agencies, and the private sector for developing and managing our Nation's land and water resources.

Water resources data-Maine, water year 2003

USGS Publications Warehouse

Stewart, G.J.; Caldwell, J.M.; Cloutier, A.R.

2004-01-01

This volume of the annual hydrologic data report of Maine is one of a series of annual reports that document data gathered from the U.S. Geological Survey's surface- and ground-water data-collection networks in each State, Puerto Rico, and the Trust Territories. These records of streamflow, ground-water levels, and quality of water provide the hydrologic information needed by State, local, and Federal agencies, and the private sector for developing and managing our Nation's land and water resources.

Health Literacy Demands of Patient-Reported Evaluation Tools in Orthopedics: A Mixed-Methods Case Study.

PubMed

Hadden, Kristie; Prince, Latrina Y; Barnes, C Lowry

In response to an assessment of organizational health literacy practices at a major academic health center, this case study evaluated the health literacy demands of patient-reported outcome measures commonly used in orthopedic surgery practices to identify areas for improvement. A mixed-methods approach was used to analyze the readability and patient feedback of orthopedic patient-reported outcome materials. Qualitative results were derived from focus group notes, observations, recordings, and consensus documents. Results were combined to formulate recommendations for quality improvement. Readability results indicated that narrative portions of sample patient outcome tools were written within or below the recommended eighth-grade reading level (= 5.9). However, document literacy results were higher than the recommended reading level (= 9.8). Focus group results revealed that participants had consensus on 8 of 12 plain language best practices, including use of bullet lists and jargon or technical words in both instruments. Although the typical readability of both instruments was not exceedingly high, appropriate readability formula and assessment methods gave a more comprehensive assessment of true readability. In addition, participant feedback revealed the need to reduce jargon and improve formatting to lessen the health literacy demands on patients. As clinicians turn more toward patient-reported measures to assess health care quality, it is important to consider the health literacy demands that are inherent in the instruments they are given in our health systems.

CAD-RADS(TM) Coronary Artery Disease - Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology.

PubMed

Cury, Ricardo C; Abbara, Suhny; Achenbach, Stephan; Agatston, Arthur; Berman, Daniel S; Budoff, Matthew J; Dill, Karin E; Jacobs, Jill E; Maroules, Christopher D; Rubin, Geoffrey D; Rybicki, Frank J; Schoepf, U Joseph; Shaw, Leslee J; Stillman, Arthur E; White, Charles S; Woodard, Pamela K; Leipsic, Jonathon A

2016-01-01

The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report. Specific recommendations are provided for further management of patients with stable or acute chest pain based on the CAD-RADS classification. The main goal of CAD-RADS is to standardize reporting of coronary CTA results and to facilitate communication of test results to referring physicians along with suggestions for subsequent patient management. In addition, CAD-RADS will provide a framework of standardization that may benefit education, research, peer-review and quality assurance with the potential to ultimately result in improved quality of care. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Increased capture of pediatric surgical complications utilizing a novel case-log web application to enhance quality improvement.

PubMed

Fisher, Jason C; Kuenzler, Keith A; Tomita, Sandra S; Sinha, Prashant; Shah, Paresh; Ginsburg, Howard B

2017-01-01

Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications. We deployed a custom web application that allows pediatric surgeons to maintain case logs. The program includes a module for entering complication data in real time. Reminders to enter outcome data occur at key postoperative intervals to optimize recall of events. Between October 1, 2014, and March 31, 2015, frequencies of surgical complications captured by the existing hospital reporting system were compared with data aggregated by our application. 780 cases were captured by the web application, compared with 276 cases registered by the hospital system. We observed an increase in the capture of major complications when compared to the hospital dataset (14 events vs. 4 events). This web application improved real-time reporting of surgical complications, exceeding the accuracy of administrative datasets. Custom informatics solutions may help reduce barriers to self-reporting of adverse events and improve the data that presently inform pediatric surgical QI. Diagnostic study/Retrospective study. Level III - case control study. Copyright © 2017 Elsevier Inc. All rights reserved.

High-Quality 3d Models and Their Use in a Cultural Heritage Conservation Project

NASA Astrophysics Data System (ADS)

Tucci, G.; Bonora, V.; Conti, A.; Fiorini, L.

2017-08-01

Cultural heritage digitization and 3D modelling processes are mainly based on laser scanning and digital photogrammetry techniques to produce complete, detailed and photorealistic three-dimensional surveys: geometric as well as chromatic aspects, in turn testimony of materials, work techniques, state of preservation, etc., are documented using digitization processes. The paper explores the topic of 3D documentation for conservation purposes; it analyses how geomatics contributes in different steps of a restoration process and it presents an overview of different uses of 3D models for the conservation and enhancement of the cultural heritage. The paper reports on the project to digitize the earthenware frieze of the Ospedale del Ceppo in Pistoia (Italy) for 3D documentation, restoration work support, and digital and physical reconstruction and integration purposes. The intent to design an exhibition area suggests new ways to take advantage of 3D data originally acquired for documentation and scientific purposes.

Fuzzy Document Clustering Approach using WordNet Lexical Categories

NASA Astrophysics Data System (ADS)

Gharib, Tarek F.; Fouad, Mohammed M.; Aref, Mostafa M.

Text mining refers generally to the process of extracting interesting information and knowledge from unstructured text. This area is growing rapidly mainly because of the strong need for analysing the huge and large amount of textual data that reside on internal file systems and the Web. Text document clustering provides an effective navigation mechanism to organize this large amount of data by grouping their documents into a small number of meaningful classes. In this paper we proposed a fuzzy text document clustering approach using WordNet lexical categories and Fuzzy c-Means algorithm. Some experiments are performed to compare efficiency of the proposed approach with the recently reported approaches. Experimental results show that Fuzzy clustering leads to great performance results. Fuzzy c-means algorithm overcomes other classical clustering algorithms like k-means and bisecting k-means in both clustering quality and running time efficiency.

Air Quality Modeling Technical Support Document for the Final Cross State Air Pollution Rule Update

EPA Pesticide Factsheets

In this technical support document (TSD) we describe the air quality modeling performed to support the final Cross State Air Pollution Rule for the 2008 ozone National Ambient Air Quality Standards (NAAQS).

Quality standards in a rheumatology Day-Care Hospital Unit. The proposal of the Spanish Society of Rheumatology Day Hospitals' Working Group.

PubMed

García-Vicuña, Rosario; Montoro, María; Egües Dubuc, César Antonio; Bustabad Reyes, Sagrario; Gómez-Centeno, Antonio; Muñoz-Fernández, Santiago; Pérez Pampín, Eva; Román Ivorra, Jose Andrés; Balsa, Alejandro; Loza, Estíbaliz

2014-01-01

In recent years, the Rheumatology Day-Care Hospital Units (DHU have undergone extensive development. However, the quality standards are poorly documented and mainly limited to structure items rather than including broad and specific areas of this specialty. To develop specific quality standards for Rheumatology DHU. After a systematic review of the literature and related documents, a working group (WG) involving 8 DHU-experienced rheumatologists developed an initial proposal of the quality standards, under the supervision of an expert methodologist. A second round was held by the WG group to review the initial proposal and to consider further suggestions. Once the content was agreed upon by consensus, a final report was prepared. 17 structure standards, 25 process standards and 10 results standards were defined, with special emphasis on specific aspects of the Rheumatology DHU. The proposal includes: 1) essential standards to 2) excellent standards, 3) a Rheumatology DHU services portfolio and 4) performance criteria. The proposed quality standards are the basis for developing the indicators and other management tools for Rheumatology DHU, thereby ensuring a patient-oriented practice based on both the evidence and the experience. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Statistical corruption in Beijing's air quality data has likely ended in 2012

NASA Astrophysics Data System (ADS)

Stoerk, Thomas

2016-02-01

This research documents changes in likely misreporting in official air quality data from Beijing for the years 2008-2013. It is shown that, consistent with prior research, the official Chinese data report suspiciously few observations that exceed the politically important Blue Sky Day threshold, a particular air pollution level used to evaluate local officials, and an excess of observations just below that threshold. Similar data, measured by the US Embassy in Beijing, do not show this irregularity. To document likely misreporting, this analysis proposes a new way of comparing air quality data via Benford's Law, a statistical regularity known to fit air pollution data. Using this method to compare the official data to the US Embassy data for the first time, I find that the Chinese data fit Benford's Law poorly until a change in air quality measurements at the end of 2012. From 2013 onwards, the Chinese data fit Benford's Law closely. The US Embassy data, by contrast, exhibit no variation over time in the fit with Benford's Law, implying that the underlying pollution processes remain unchanged. These findings suggest that misreporting of air quality data for Beijing has likely ended in 2012. Additionally, I use aerosol optical density data to show the general applicability of this method of detecting likely misreporting in air pollution data.

DEMONSTRATION AND QUALITY ASSURANCE PROJECT ...

EPA Pesticide Factsheets

The demonstration of technologies for determining the presence of dioxin in soil and sediment is being conducted under the U.S. Environmental Protection Agency Superfund Innovative Technology Evaluation Program in Saginaw, Michigan, at Green Point Environmental Learning Center from approximately April 26 to May 6, 2004. The primary purpose of the demonstration is to evaluate innovative monitoring technologies. The technologies listed below will be demonstrated. .AhRC PCRTM Kit, Hybrizyme Corporation .Ah-IMMUNOASSY@ Kit, Paralsian, Inc. .Coplanar PCB Immunoassay Kit, Abraxis LLC .DF-l Dioxin/Furan Immunoassay Kit, CAPE Technologies L.L.C. .CALUX@ by Xenobiotic Detection Systems, Inc- .Dioxin ELISA Kit, Wako Pure Chemical Industries LTD. This demonstration plan describes the procedures that will be used to verify the performance and cost of these technologies. The plan incorporates the quality assurance and quality control elements needed to generate data of sufficient quality to document each technology's performance and cost. A separate innovative technology verification report (ITVR) will.be prepared for each technology. The ITVRs will present the demonstration findings associated with the demonstration objectives. The objective of this program is to promote the acceptance and use of innovative field technologies by providing well-documented performance and cost data obtained from field demonstrations.

Institutional and economic influences on quality of nursing documentation.

PubMed

Parker, L E; Wells, K B; Buchanan, J L; Benjamin, B

1994-01-01

This study evaluates the quality of nursing documentation within the hospital record for a particularly vulnerable group of patients, the depressed aged. Specifically, the effects of prospective payment, unit type, hospital type, and nurse staffing levels on nursing documentation within hospital charts were assessed.

Goal-oriented evaluation of binarization algorithms for historical document images

NASA Astrophysics Data System (ADS)

Obafemi-Ajayi, Tayo; Agam, Gady

2013-01-01

Binarization is of significant importance in document analysis systems. It is an essential first step, prior to further stages such as Optical Character Recognition (OCR), document segmentation, or enhancement of readability of the document after some restoration stages. Hence, proper evaluation of binarization methods to verify their effectiveness is of great value to the document analysis community. In this work, we perform a detailed goal-oriented evaluation of image quality assessment of the 18 binarization methods that participated in the DIBCO 2011 competition using the 16 historical document test images used in the contest. We are interested in the image quality assessment of the outputs generated by the different binarization algorithms as well as the OCR performance, where possible. We compare our evaluation of the algorithms based on human perception of quality to the DIBCO evaluation metrics. The results obtained provide an insight into the effectiveness of these methods with respect to human perception of image quality as well as OCR performance.

Clinical benchmarking enabled by the digital health record.

PubMed

Ricciardi, T N; Masarie, F E; Middleton, B

2001-01-01

Office-based physicians are often ill equipped to report aggregate information about their patients and practice of medicine, since their practices have relied upon paper records for the management of clinical information. Physicians who do not have access to large-scale information technology support can now benefit from low-cost clinical documentation and reporting tools. We developed a hosted clinical data mart for users of a web-enabled charting tool, targeting the solo or small group practice. The system uses secure Java Server Pages with a dashboard-like menu to provide point-and-click access to simple reports such as case mix, medications, utilization, productivity, and patient demographics in its first release. The system automatically normalizes user-entered clinical terms to enhance the quality of structured data. Individual providers benefit from rapid patient identification for disease management, quality of care self-assessments, drug recalls, and compliance with clinical guidelines. The system provides knowledge integration by linking to trusted sources of online medical information in context. Information derived from the clinical record is clinically more accurate than billing data. Provider self-assessment and benchmarking empowers physicians, who may resent "being profiled" by external entities. In contrast to large-scale data warehouse projects, the current system delivers immediate value to individual physicians who choose an electronic clinical documentation tool.

Biological Water Quality Criteria

EPA Pesticide Factsheets

Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

Application of LANDSAT to the Surveillance of Lake Eutrophication in the Great Lakes Basin. Final Report.

ERIC Educational Resources Information Center

Rogers, Robert H.

This document reviews the process by which the cost benefits of using LANDSAT on an operational basis in the surveillance of lake eutrophication was established. The program identified the information needs of users conducting on-going water quality programs, transformed these needs into remote sensing requirements, produced LANDSAT maps and data…

A More Literate Georgia: An Agenda for Action. A Report by the Dean's Literacy Task Force.

ERIC Educational Resources Information Center

Georgia Univ., Athens. Coll. of Education.

The essays contained in this document, which launches the University of Georgia Education Initiative, attempt to address Georgia's need for increased literacy in realistic and constructive terms. Taken together, these essays constitute an agenda for action--a challenge to all those who wish to provide Georgians with the quality education they…

STATUS OF SEMI-CONTINUOUS MONITORING INSTRUMENTATION FOR GAS AND WATER SOLUBLE PARTICLE COMPONENTS NEEDED FOR DIAGNOSTIC TESTING OF AMBIENT AIR QUALITY SIMULATION MODELS

EPA Science Inventory

This status report documents the effort by the National Exposure Research Laboratory (NERL), Office of Research and Development (ORD) of the U.S. Environmental Protection Agency (U.S. EPA) to provide methods of measurement, including calibration procedures, that meet the requir...

"Now I Know My ABCDs": Asset-Based Community Development with School Children in Ethiopia

ERIC Educational Resources Information Center

Johnson Butterfield, Alice K.; Yeneabat, Mulu; Moxley, David P.

2016-01-01

Asset-based community development (ABCD) is a promising practice for communities to engage in self-determination through the efforts residents invest in identifying community assets, framing and documenting the issues communities face, and taking action to advance quality of life. The ABCD literature does not report on the application of ABCD…

Assessment of Quality Vocational Education in State Prisons. Executive Summary. Final Report.

ERIC Educational Resources Information Center

Rice, Eric; And Others

A study explored the relationship of program components and variables within successful correctional vocational education programs in adult state prisons, and the outcomes of those programs, leading to in-depth descriptions of exemplary programs in the full document on this project (see note). Program success was determined by the following data:…

Development and Exchange of Instructional Resources in Water Quality Control Programs, III: Selecting Audio-Visual Equipment.

ERIC Educational Resources Information Center

Moon, Donald K.

This document is one in a series of reports which reviews instructional materials and equipment and offers suggestions about how to select equipment. Topics discussed include: (1) the general criteria for audio-visual equipment selection such as performance, safety, comparability, sturdiness and repairability; and (2) specific equipment criteria…

Results of the 2002 QUEST Survey. Annual Staff Survey. Research Report.

ERIC Educational Resources Information Center

Howard Community Coll., Columbia, MD. Office of Planning and Evaluation.

This document is the results of the 2002 employee survey (Quality Evaluation of Service Trends) for all Howard Community College Employees. The response rate was 64%. Ratings for various topics and services were made on a five-point scale ranging from poor to excellent. Employees were also given an "unfamiliar with" category, which did…

Delivering a First Quality Education for the Twenty First Century.

ERIC Educational Resources Information Center

Salzman, Harold; Moss, Philip; Tilly, Chris

This document is the strategic plan for the Foothill-De Anza Community College District, which consists of two community colleges: Foothill College and De Anza College. The report begins with a summary of the district's past successes and a statement of the desire to evolve according to social demands. Major issues are identified as follows: the…

U.S. Naval War College Global 2014 Game Report

DTIC Science & Technology

2015-02-01

Gaming Department faculty and documents the findings of these efforts. The War Gaming Department conducts high quality research , analysis, gaming, and...Navy. It strives to provide interested parties with intellectually honest analysis of complex problems using a wide range of research tools and...3   II. Research Methodology and Game Design .............................................................. 5   Research Questions

Alternative Fuels for Washington's School Buses: A Report to the Washington State Legislature.

ERIC Educational Resources Information Center

Lyons, John Kim; McCoy, Gilbert A.

This document presents findings of a study that evaluated the use of both propane and compressed natural gas as alternative fuels for Washington State school buses. It discusses air quality improvement actions by state- and federal-level regulators and summarizes vehicle design, development, and commercialization activities by all major engine,…

The Effect of a Monitoring Scheme on Tutorial Attendance and Assignment Submission

ERIC Educational Resources Information Center

Burke, Grainne; Mac an Bhaird, Ciaran; O'Shea, Ann

2013-01-01

We report on the implementation of a monitoring scheme by the Department of Mathematics and Statistics at the National University of Ireland Maynooth. The scheme was introduced in an attempt to increase the level and quality of students' engagement with certain aspects of their undergraduate course. It is well documented that students with higher…

Making Materials Based on TeX and CAS/DGS--Reports on CADGME 2012 Conference Working Group

ERIC Educational Resources Information Center

Kaneko, Masataka; Yamashita, Satoshi; Kitahara, Kiyoshi; Maeda, Yoshifumi; Usui, Hisashi; Takato, Setsuo

2014-01-01

TeX has become one of the most popular tools for editing teaching materials or textbooks in collegiate mathematics education, since it enables usual mathematics teachers to easily produce high-quality mathematical documents. Its capabilities for visualization and computation are fairly limited, so that many teachers simultaneously use various…

Simulating Apprenticeship Using Multimedia in Higher Education: A Case from the Information Systems Field

ERIC Educational Resources Information Center

Bider, Ilia; Henkel, Martin; Kowalski, Stewart; Perjons, Erik

2015-01-01

Purpose: This paper aims to report on a project aimed at using simulation for improving the quality of teaching and learning modeling skills. More specifically, the project goal was to facilitate the students to acquire skills of building models of organizational structure and behavior through analysis of internal and external documents, and…

The 2001 QUEST Survey Results. Annual Staff Survey. Research Report.

ERIC Educational Resources Information Center

Howard Community Coll., Columbia, MD. Office of Planning and Evaluation.

This document is the results of the 2001 employee survey (Quality Evaluation of Service Trends) for all Howard Community College Employees. The response rate was 63%. Ratings for various topics and services were made on a five-point scale ranging from poor to excellent. Employees were also given an "unfamiliar with" category, which did…

The Millennium QUEST: Results of the Survey. Annual Staff Survey. Research Report.

ERIC Educational Resources Information Center

Howard Community Coll., Columbia, MD. Office of Planning and Evaluation.

This document is the results of the 2000 employee survey (Quality Evaluation of Service Trends) for all Howard Community College Employees. The response rate was 57% and respondents replied both by paper and electronically. Ratings for various topics and services were made on a five-point scale ranging from poor to excellent. Employees were also…

Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

PubMed

Feuerstein, Joseph D; Castillo, Natalia E; Siddique, Sana S; Lewandowski, Jeffrey J; Geissler, Kathy; Martinez-Vazquez, Manuel; Thukral, Chandrashekhar; Leffler, Daniel A; Cheifetz, Adam S

2016-03-01

Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P < .001), year of graduation from medical school (OR, 0.500; 95% CI, 0.352-0.709; P < .001), and total number of comorbidities (OR, 1.089; 95% CI, 1.016-1.168; P = .016) were associated with compliance with all core measures. We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

PubMed

Li, Dan

2016-08-01

To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete picture of patients' care needs that require nursing interventions. The implication of this study involves pressure ulcer prevention and litigable risk of nursing documentation. © 2016 John Wiley & Sons Ltd.

Development and Evaluation of a Diagnostic Documentation Support System using Knowledge Processing

NASA Astrophysics Data System (ADS)

Makino, Kyoko; Hayakawa, Rumi; Terai, Koichi; Fukatsu, Hiroshi

In this paper, we will introduce a system which supports creating diagnostic reports. Diagnostic reports are documents by doctors of radiology describing the existence and nonexistence of abnormalities from the inspection images, such as CT and MRI, and summarize a patient's state and disease. Our system indicates insufficiencies in these reports created by younger doctors, by using knowledge processing based on a medical knowledge dictionary. These indications are not only clerical errors, but the system also analyzes the purpose of the inspection and determines whether a comparison with a former inspection is required, or whether there is any shortage in description. We verified our system by using actual data of 2,233 report pairs, a pair comprised of a report written by a younger doctor and a check result of the report by an experienced doctor. The results of the verification showed that the rules of string analysis for detecting clerical errors and sentence wordiness obtained a recall of over 90% and a precision of over 75%. Moreover, the rules based on a medical knowledge dictionary for detecting the lack of required comparison with a former inspection and the shortage in description for the inspection purpose obtained a recall of over 70%. From these results, we confirmed that our system contributes to the quality improvement of diagnostic reports. We expect that our system can comprehensively support diagnostic documentations by cooperating with the interface which refers to inspection images or past reports.

Self-reported skin symptoms and skin-related quality of life among Latino immigrant poultry processing and other manual workers.

PubMed

Quandt, Sara A; Newman, Jill C; Pichardo-Geisinger, Rita; Mora, Dana C; Chen, Haiying; Feldman, Steven R; Arcury, Thomas A

2014-05-01

Manual labor employment occurs in environments with exposures likely to impact skin-related quality of life (SRQOL). The objectives of this paper are to (1) document the dimensions of SRQOL, (2) examine its association with skin symptoms, and (3) identify the predictors of SRQOL in Latino manual workers. A population-based survey of 733 Latino manual workers obtained Dermatology Life Quality Index (DLQI) and skin symptoms in the prior year. Two-thirds of workers were employed in production. Skin symptoms in prior year were reported by 23%. Impaired SRQOL was reported by 23%. In multivariate analyses, reduced SRQOL was associated with age, occupation, childhood indigenous language use, and experience of skin symptoms in the prior year. Despite overall high SRQOL exposures in some immigrant occupational groups produce reduce SRQOL. This rural, immigrant population faces significant obstacles to obtaining dermatological care; efforts are needed to improve their SRQOL. © 2013 Wiley Periodicals, Inc.

Assessing research productivity in an oncology research institute: the role of the documentation center.

PubMed Central

Ugolini, D; Bogliolo, A; Parodi, S; Casilli, C; Santi, L

1997-01-01

An evaluation method used to assess the quality of research productivity and to provide priorities for budget allocation purposes is presented. This method, developed by a working group of the National Institute for Research on Cancer (IST), Genoa, Italy, is based on the partitioning of categories of the Science Citation Index and Journal Citation Reports (SCI-JCR) into deciles, which normalizes journal impact factors in order to gauge the quality of the productivity. A second parameter related to the number of staff of each institute department co-authoring a given paper has been introduced in order to guide departmental budget allocations. The information scientists of the IST Documentation Center who participated in the working group played a pivotal role in developing the computerized database of publications, providing and analyzing data, supplying and evaluating literature on the topic, and placing international bibliographic databases at the working group's disposal. PMID:9028569

The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

PubMed

Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

2012-09-01

Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

Connecticut Highlands Technical Report - Documentation of the Regional Rainfall-Runoff Model

USGS Publications Warehouse

Ahearn, Elizabeth A.; Bjerklie, David M.

2010-01-01

This report provides the supporting data and describes the data sources, methodologies, and assumptions used in the assessment of existing and potential water resources of the Highlands of Connecticut and Pennsylvania (referred to herein as the “Highlands”). Included in this report are Highlands groundwater and surface-water use data and the methods of data compilation. Annual mean streamflow and annual mean base-flow estimates from selected U.S. Geological Survey (USGS) gaging stations were computed using data for the period of record through water year 2005. The methods of watershed modeling are discussed and regional and sub-regional water budgets are provided. Information on Highlands surface-water-quality trends is presented. USGS web sites are provided as sources for additional information on groundwater levels, streamflow records, and ground- and surface-water-quality data. Interpretation of these data and the findings are summarized in the Highlands study report.

NASA Lewis Wind Tunnel Model Systems Criteria

NASA Technical Reports Server (NTRS)

Soeder, Ronald H.; Haller, Henry C.

1994-01-01

This report describes criteria for the design, analysis, quality assurance, and documentation of models or test articles that are to be tested in the aeropropulsion facilities at the NASA Lewis Research Center. The report presents three methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it gives quality assurance criteria for models tested in Lewis' aeropropulsion facilities. Both customer-furnished model systems and in-house model systems are discussed. The functions of the facility manager, project engineer, operations engineer, research engineer, and facility electrical engineer are defined. The format for pretest meetings, prerun safety meetings, and the model criteria review are outlined Then, the format for the model systems report (a requirement for each model that is to be tested at NASA Lewis) is described, the engineers that are responsible for developing the model systems report are listed, and the time table for its delivery to the facility manager is given.

Air Quality Modeling Technical Support Document for the 2008 Ozone NAAQS Cross-State Air Pollution Rule Proposal

EPA Pesticide Factsheets

In this technical support document (TSD) we describe the air quality modeling performed to support the proposed Cross-State Air Pollution Rule for the 2008 ozone National Ambient Air Quality Standards (NAAQS)

Air Quality Modeling Technical Support Document for the 2015 Ozone NAAQS Preliminary Interstate Transport Assessment

EPA Pesticide Factsheets

In this technical support document (TSD) EPA describes the air quality modeling performed to support the 2015 ozone National Ambient Air Quality Standards (NAAQS) preliminary interstate transport assessment Notice of Data Availability (NODA).

TQM: A bibliography with abstracts. [total quality management

NASA Technical Reports Server (NTRS)

Gottlich, Gretchen L. (Editor)

1992-01-01

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

Protocol for a national prevalence study of advance care planning documentation and self-reported uptake in Australia.

PubMed

Ruseckaite, Rasa; Detering, Karen M; Evans, Sue M; Perera, Veronica; Walker, Lynne; Sinclair, Craig; Clayton, Josephine M; Nolte, Linda

2017-11-03

Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake. This makes it difficult to evaluate the impact of ACP initiatives. This study aims to determine the Australian national prevalence of ACP and completion of Advance Care Directives (ACDs) in hospitals, aged care facilities and general practices. It will also explore people's self-reported use of ACP and views about the process. Researchers will conduct a national multicentre cross-sectional prevalence study, consisting of a record audit and surveys of people aged 65 years or more in three sectors. From 49 participating Australian organisations, 50 records will be audited (total of 2450 records). People whose records were audited, who speak English and have a decision-making capacity will also be invited to complete a survey. The primary outcome measure will be the number of people who have formal or informal ACP documentation that can be located in records within 15 min. Other outcomes will include demographics, measure of illness and functional capacity, details of ACP documentation (including type of document), location of documentation in the person's records and whether current clinical care plans are consistent with ACP documentation. People will be surveyed, to measure self-reported interest, uptake and use of ACP/ACDs, and self-reported quality of life. This protocol has been approved by the Austin Health Human Research Ethics Committee (reference HREC/17/Austin/83). Results will be submitted to international peer-reviewed journals and presented at international conferences. ACTRN12617000743369. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Basic Requirements for Collecting, Documenting, and Reporting Precipitation and Stormwater-Flow Measurements

USGS Publications Warehouse

Church, Peter E.; Granato, Gregory E.; Owens, David W.

1999-01-01

Accurate and representative precipitation and stormwater-flow data are crucial for use of highway- or urban-runoff study results, either individually or in a regional or national synthesis of stormwater-runoff data. Equally important is information on the level of accuracy and representativeness of this precipitation and stormwaterflow data. Accurate and representative measurements of precipitation and stormwater flow, however, are difficult to obtain because of the rapidly changing spatial and temporal distribution of precipitation and flows during a storm. Many hydrologic and hydraulic factors must be considered in performing the following: selecting sites for measuring precipitation and stormwater flow that will provide data that adequately meet the objectives and goals of the study, determining frequencies and durations of data collection to fully characterize the storm and the rapidly changing stormwater flows, and selecting methods that will yield accurate data over the full range of both rainfall intensities and stormwater flows. To ensure that the accuracy and representativeness of precipitation and stormwater-flow data can be evaluated, decisions as to (1) where in the drainage system precipitation and stormwater flows are measured, (2) how frequently precipitation and stormwater flows are measured, (3) what methods are used to measure precipitation and stormwater flows, and (4) on what basis are these decisions made, must all be documented and communicated in an accessible format, such as a project description report, a data report or an appendix to a technical report, and (or) archived in a State or national records center. A quality assurance/quality control program must be established to ensure that this information is documented and reported, and that decisions made in the design phase of a study are continually reviewed, internally and externally, throughout the study. Without the supporting data needed to evaluate the accuracy and representativeness of the precipitation and stormwater-flow measurements, the data collected and interpretations made may have little meaning.

Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

PubMed

Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

2008-11-01

Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.

Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors.

PubMed

Nair, Bala G; Peterson, Gene N; Newman, Shu-Fang; Wu, Wei-Ying; Kolios-Morris, Vickie; Schwid, Howard A

2012-06-01

Continuation of perioperative beta-blockers for surgical patients who are receiving beta-blockers prior to arrival for surgery is an important quality measure (SCIP-Card-2). For this measure to be considered successful, name, date, and time of the perioperative beta-blocker must be documented. Alternately, if the beta-blocker is not given, the medical reason for not administering must be documented. Before the study was conducted, the institution lacked a highly reliable process to document the date and time of self-administration of beta-blockers prior to hospital admission. Because of this, compliance with the beta-blocker quality measure was poor (-65%). To improve this measure, the anesthesia care team was made responsible for documenting perioperative beta-blockade. Clear documentation guidelines were outlined, and an electronic Anesthesia Information Management System (AIMS) was configured to facilitate complete documentation of the beta-blocker quality measure. In addition, real-time electronic alerts were generated using Smart Anesthesia Messenger (SAM), an internally developed decision-support system, to notify users concerning incomplete beta-blocker documentation. Weekly compliance for perioperative beta-blocker documentation before the study was 65.8 +/- 16.6%, which served as the baseline value. When the anesthesia care team started documenting perioperative beta-blocker in AIMS, compliance was 60.5 +/- 8.6% (p = .677 as compared with baseline). Electronic alerts with SAM improved documentation compliance to 94.6 +/- 3.5% (p < .001 as compared with baseline). To achieve high compliance for the beta-blocker measure, it is essential to (1) clearly assign a medical team to perform beta-blocker documentation and (2) enhance features in the electronic medical systems to alert the user concerning incomplete documentation.

AIR QUALITY CRITERIA CARBON MONOXIDE, EXTERNAL REVIEW DRAFT

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) promulgates the National Ambient Air Quality Standards (NAAQS) on the basis of scientific information contained in criteria documents. The last air quality criteria document for carbon monoxide (CO) was completed by EPA in 1991. This...

Quality Veneer and Lumber Company - Restart or New?

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Air Quality Analysis for PSD

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Factors in Software Quality. Volume I. Concepts and Definitions of Software Quality

DTIC Science & Technology

1977-11-01

FLEXIBILITY COMPLEXITY EXPANDABILITY PRECISION DOCUMENTATION TOLERANCE REPAIRABILITY COMPATABIL ITY SERVICEABILITY 2-4 AiI1I~3~I!-T A1 11 NI󈧥 AIiB 9l 0...applications. Several standard documents are required by DOD/AF’ regulations . The following references were used to compile the rFpnge of documents...documents are specified by the AF regulations or SPO-local regulations listed above. Each ot the document types for a long life/high cost software

Improving Air Quality with Economic Incentive Programs

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

EPA Quality Assurance Policy Statement

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Systematic review of studies of staffing and quality in nursing homes.

PubMed

Bostick, Jane E; Rantz, Marilyn J; Flesner, Marcia K; Riggs, C Jo

2006-07-01

To evaluate a range of staffing measures and data sources for long-term use in public reporting of staffing as a quality measure in nursing homes. Eighty-seven research articles and government documents published from 1975 to 2003 were reviewed and summarized. Relevant content was extracted and organized around 3 themes: staffing measures, quality measures, and risk adjustment variables. Data sources for staffing information were also identified. There is a proven association between higher total staffing levels (especially licensed staff) and improved quality of care. Studies also indicate a significant relationship between high turnover and poor resident outcomes. Functional ability, pressure ulcers, and weight loss are the most sensitive quality indicators linked to staffing. The best national data sources for staffing and quality include the Minimum Data Set (MDS) and On-line Survey and Certification Automated Records (OSCAR). However, the accuracy of this self-reported information requires further reliability and validity testing. A nationwide instrument needs to be developed to accurately measure staff turnover. Large-scale studies using payroll data to measure staff retention and its impact on resident outcomes are recommended. Future research should use the most nurse-sensitive quality indicators such as pressure ulcers, functional status, and weight loss.

SU-F-T-231: Improving the Efficiency of a Radiotherapy Peer-Review System for Quality Assurance

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

Hsu, S; Basavatia, A; Garg, M

Purpose: To improve the efficiency of a radiotherapy peer-review system using a commercially available software application for plan quality evaluation and documentation. Methods: A commercial application, FullAccess (Radialogica LLC, Version 1.4.4), was implemented in a Citrix platform for peer-review process and patient documentation. This application can display images, isodose lines, and dose-volume histograms and create plan reports for peer-review process. Dose metrics in the report can also be benchmarked for plan quality evaluation. Site-specific templates were generated based on departmental treatment planning policies and procedures for each disease site, which generally follow RTOG protocols as well as published prospective clinicalmore » trial data, including both conventional fractionation and hypo-fractionation schema. Once a plan is ready for review, the planner exports the plan to FullAccess, applies the site-specific template, and presents the report for plan review. The plan is still reviewed in the treatment planning system, as that is the legal record. Upon physician’s approval of a plan, the plan is packaged for peer review with the plan report and dose metrics are saved to the database. Results: The reports show dose metrics of PTVs and critical organs for the plans and also indicate whether or not the metrics are within tolerance. Graphical results with green, yellow, and red lights are displayed of whether planning objectives have been met. In addition, benchmarking statistics are collected to see where the current plan falls compared to all historical plans on each metric. All physicians in peer review can easily verify constraints by these reports. Conclusion: We have demonstrated the improvement in a radiotherapy peer-review system, which allows physicians to easily verify planning constraints for different disease sites and fractionation schema, allows for standardization in the clinic to ensure that departmental policies are maintained, and builds a comprehensive database for potential clinical outcome evaluation.« less

Surgical quality assessment. A simplified approach.

PubMed

DeLong, D L

1991-10-01

The current approach to QA primarily involves taking action when problems are discovered and designing a documentation system that records the deliverance of quality care. Involving the entire staff helps eliminate problems before they occur. By keeping abreast of current problems and soliciting input from staff members, the QA at our hospital has improved dramatically. The cross-referencing of JCAHO and AORN standards on the assessment form and the single-sheet reporting form expedite the evaluation process and simplify record keeping. The bulletin board increases staff members' understanding of QA and boosts morale and participation. A sound and effective QA program does not require reorganizing an entire department, nor should it invoke negative connotations. Developing an effective QA program merely requires rethinking current processes. The program must meet the department's specific needs, and although many departments concentrate on documentation, auditing charts does not give a complete picture of the quality of care delivered. The QA committee must employ a variety of data collection methods on multiple indicators to ensure an accurate representation of the care delivered, and they must not overlook any issues that directly affect patient outcomes.

Quality in Colonoscopy: Beyond the Adenoma Detection Rate Fever

PubMed Central

Taveira, Filipe; Areia, Miguel; Elvas, Luís; Alves, Susana; Brito, Daniel; Saraiva, Sandra; Cadime, Ana Teresa

2017-01-01

Background Colonoscopy quality is a hot topic in gastroenterological communities, with several actual guidelines focusing on this aspect. Although the adenoma detection rate (ADR) is the single most important indicator, several other metrics are described and need reporting. Electronic medical reports are essential for the audit of quality indicators; nevertheless, they have proved not to be faultless. Aim The aim of this study was to analyse and audit quality indicators (apart from ADR) using only our internal electronic endoscopy records as a starting point for improvement. Methods An analysis of electronically recorded information of 8,851 total colonoscopies from a single tertiary centre from 2010 to 2015 was performed. Results The mean patient age was 63.4 ± 8.5 years; 45.5% of them were female, and in 14.6% sedation was used. Photographic documentation was done in 98.4% with 10.7 photographs on average, and 37.4% reports had <8 pictures per exam. Bowel preparation was rated as adequate in 67%, fair in 27% and inadequate in 4.9% of cases. The adjusted caecal intubation rate (CIR) was 92%, while negative predictors were inadequate preparation (OR 119, 95% CI 84–170), no sedation (OR 2.39, 95% CI 1.81–3.15), female gender (OR 1.61, 95% CI 1.38–1.88) and age ≥65 years (OR 1.56, 95% CI 1.34–1.82). In 28% of patients, a snare polypectomy was performed, correlating with adequate preparation (OR 5.75, 95% CI 3.90–8.48), male gender (OR 1.82, 95% CI 1.64–2.01) and age ≥65 years (OR 1.25, 95% CI 1.13–1.37; p < 0.01) as positive predictors. An annual evolution was observed with improvements in photographic documentation (10.7 vs. 12.9; p < 0.001), CIR (91 vs. 94%; p = 0.002) and “adequate” bowel preparation (p = 0.004). Conclusions: There is much more to report than the ADR to ensure quality in colonoscopy practice. Better registry systematization and integrated software should be goals to achieve in the short term. PMID:29255755

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

Matthews, Patrick K.

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 550: Smoky Contamination Area, Nevada National Security Site, Nevada. CAU 550 includes 19 corrective action sites (CASs), which consist of one weapons-related atmospheric test (Smoky), three safety experiments (Ceres, Oberon, Titania), and 15 debris sites (Table ES-1). The CASs were sorted into the following study groups based on release potential and technical similarities: • Study Group 1, Atmospheric Test • Study Group 2, Safety Experiments • Study Group 3, Washes • Study Group 4, Debris The purpose of this document is to provide justificationmore » and documentation supporting the conclusion that no further corrective action is needed for CAU 550 based on implementation of the corrective actions listed in Table ES-1. Corrective action investigation (CAI) activities were performed between August 2012 and October 2013 as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 550: Smoky Contamination Area; and in accordance with the Soils Activity Quality Assurance Plan. The approach for the CAI was to investigate and make data quality objective (DQO) decisions based on the types of releases present. The purpose of the CAI was to fulfill data needs as defined during the DQO process. The CAU 550 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated the dataset is complete and acceptable for use in fulfilling the DQO data needs.« less

Quality improvement in breast cancer project: compliance with antiresorptive agents and changing patterns of drug use.

PubMed

Borden, Charles P; Shapiro, Charles L; Ramirez, Maria Teresa; Kotur, Linda; Farrar, William

2014-02-01

The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute participated in NCCN's Quality Improvement in Breast Cancer initiative. The Opportunities for Improvement (OFI) team elected to improve concordance with the NCCN Clinical Practice Guidelines in Oncology for Breast Cancer recommendation that all patients diagnosed with skeletal metastases receive bisphosphonates. Assembling a multidisciplinary team of clinicians, researchers, and administrative stakeholders, the OFI team followed Six Sigma's approach to problem-solving known as DMAIC (define, measure, analyze, improve, and control). Baseline concordance was 79%, which was below the recommended target range. Initial analysis quickly revealed that 5 cases were concordant, resulting in a new baseline of 89%. The key root cause identified for the remaining gap was lack of documentation. The solution included education regarding documentation for existing staff, in addition to hard-wiring the material into new physician orientation, discussion of all patients with bone disease at tumor board meetings, and improved consistency with use of the new electronic medical record system. After implementation, the reported concordance was 92%, and the lack of documentation problem decreased from 11% in the baseline study to 6%. The team concluded that use of the NCCN Oncology Outcomes Database as an opportunity for clinical quality improvement initiatives not only is possible but also should be an essential element of any clinical program looking to continuously improve.

Water Resources Data, North Dakota, Water Year 1998. Volume 2. Ground Water

USGS Publications Warehouse

Harkness, R.E.; Wald, J.D.

2000-01-01

This edition of the annual hydrologic data report of North Dakota is one of a series of annual reports that document hydrologic data collected from the U.S. Geological Survey's collection networks in each State, Puerto Rico, and the Trust Territories. These records of streamflow, ground-water levels, and quality of water provide the hydrologic information needed by Federal, State, local agencies, and the private sector for developing and managing land and water resources in North Dakota. 

Water Resources Data: New Jersey, Water Year 1998, Volume 1, Surface-Water Data

USGS Publications Warehouse

Reed, T.J.; Centinaro, G.L.; Dudek, J.F.; Corcino, V.; Stekroadt, G.C.; McTigure, R.C.

1999-01-01

This volume of the annual hydrologic data report of New Jersey is one of a series of annual reports that document hydrologic data gathered from the U.S. Geological Survey's surface- and ground-water data-collection networks in each State, Puerto Rico, and the Trust Territories. These records of streamflow, ground-water levels, and water quality provide the hydrologic information needed by state, local and federal agencies, and the private sector for developing and managing our Nation's land and water resources.

Management: A bibliography for NASA managers

NASA Technical Reports Server (NTRS)

1985-01-01

This bibliography lists 706 reports, articles, and other documents introduced into the NASA scientific and technical information system in 1984. Entries, which include abstracts, are arranged in the following categories: human factors and personnel issues; management theory and techniques; industrial management and manufacturing; robotics and expert systems; computers and information management; research and development; economics, costs, and markets; logistics and operations management; reliability and quality control; and legality, legislation, and policy. Subject, personal author, corporate source, contract number, report number, and accession number indexes are included.

Water Resources Data, North Dakota, Water Year 2000. Volume 2. Ground Water

USGS Publications Warehouse

Harkness, R.E.; Wald, J.D.

2001-01-01

This edition of the annual hydrologic data report of North Dakota is one of a series of annual reports that document hydrologic data collected from the U.S. Geological Survey's collection networks in each State, Puerto Rico, and the Trust Territories. These records of streamflow, ground-water levels, and quality of water provide the hydrologic information needed by Federal, State, local agencies, and the private sector for developing and managing land and water resources in North Dakota. 

Telephone Flat Geothermal Development Project Environmental Impact Statement Environmental Impact Report. Final: Comments and Responses to Comments

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

None

This document is the Comments and Responses to Comments volume of the Final Environmental Impact Statement and Environmental Impact Report prepared for the proposed Telephone Flat Geothermal Development Project (Final EIS/EIR). This volume of the Final EIS/EIR provides copies of the written comments received on the Draft EIS/EIR and the leady agency responses to those comments in conformance with the requirements of the National Environmental Policy Act (NEPA) and the California Environmental Quality Act (CEQA).

The Baldrige Award for Education: How To Measure and Document Quality Improvement.

ERIC Educational Resources Information Center

Arcaro, Jerome S.

This volume describes in practical terms how schools and colleges can use the Malcolm Baldrige National Quality Award assessment as a tool to document and measure areas of existing quality and to identify areas for improvement. This Award is currently given annually to recognize quality in business companies with plans to expand it to include…

Examining Changes to Michigan's Early Childhood Quality Rating and Improvement System (QRIS). REL 2015-029

ERIC Educational Resources Information Center

Faria, Ann-Marie; Hawkinson, Laura E.; Greenberg, Ariela C.; Howard, Eboni C.; Brown, Leah

2015-01-01

Documenting and improving early childhood program quality is a national priority, leading to a rapid expansion of Quality Rating and Improvement Systems (QRISs). QRISs document and improve the quality of early childhood education programs and provide clear information to families about their child care choices. The current study described how…

Effects of hospital care environment on patient mortality and nurse outcomes.

PubMed

Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy

2009-01-01

The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

Effects of hospital care environment on patient mortality and nurse outcomes.

PubMed

Aiken, Linda H; Clarke, Sean P; Sloane, Douglas M; Lake, Eileen T; Cheney, Timothy

2008-05-01

The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

GenePRIMP: A Gene Prediction Improvement Pipeline For Prokaryotic Genomes

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

Kyrpides, Nikos C.; Ivanova, Natalia N.; Pati, Amrita

2010-07-08

GenePRIMP (Gene Prediction Improvement Pipeline, Http://geneprimp.jgi-psf.org), a computational process that performs evidence-based evaluation of gene models in prokaryotic genomes and reports anomalies including inconsistent start sites, missing genes, and split genes. We show that manual curation of gene models using the anomaly reports generated by GenePRIMP improves their quality and demonstrate the applicability of GenePRIMP in improving finishing quality and comparing different genome sequencing and annotation technologies. Keywords in context: Gene model, Quality Control, Translation start sites, Automatic correction. Hardware requirements; PC, MAC; Operating System: UNIX/LINUX; Compiler/Version: Perl 5.8.5 or higher; Special requirements: NCBI Blast and nr installation; File Types:more » Source Code, Executable module(s), Sample problem input data; installation instructions other; programmer documentation. Location/transmission: http://geneprimp.jgi-psf.org/gp.tar.gz« less

Publication Guidelines for Quality Improvement Studies in Health Care: Evolution of the SQUIRE Project

PubMed Central

Batalden, Paul; Stevens, David; Ogrinc, Greg; Mooney, Susan

2008-01-01

In 2005 we published draft guidelines for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. The current article contains the revised version, which we refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). We describe the consensus process, which included informal feedback, formal written commentaries, input from publication guideline developers, review of the literature on the epistemology of improvement and on methods for evaluating complex social programs, and a meeting of stakeholders for critical review of the guidelines’ content and wording, followed by commentary on sequential versions from an expert consultant group. Finally, we examine major differences between SQUIRE and the initial draft, and consider limitations of and unresolved questions about SQUIRE; we also describe ancillary supporting documents and alternative versions under development, and plans for dissemination, testing, and further development of SQUIRE. PMID:18830766

Underground Test Area Activity Quality Assurance Plan Nevada National Security Site, Nevada. Revision 2

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

Krenzien, Susan; Farnham, Irene

This Quality Assurance Plan (QAP) provides the overall quality assurance (QA) requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Underground Test Area (UGTA) activities. The requirements in this QAP are consistent with DOE Order 414.1D, Change 1, Quality Assurance (DOE, 2013a); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). If a participant’s requirement document differs from this QAP, the stricter requirement will take precedence.more » NNSA/NFO, or designee, must review this QAP every two years. Changes that do not affect the overall scope or requirements will not require an immediate QAP revision but will be incorporated into the next revision cycle after identification. Section 1.0 describes UGTA objectives, participant responsibilities, and administrative and management quality requirements (i.e., training, records, procurement). Section 1.0 also details data management and computer software requirements. Section 2.0 establishes the requirements to ensure newly collected data are valid, existing data uses are appropriate, and environmental-modeling methods are reliable. Section 3.0 provides feedback loops through assessments and reports to management. Section 4.0 provides the framework for corrective actions. Section 5.0 provides references for this document.« less

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

Air Quality Operating Permits Programs Which Apply to Tribal Lands

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Food Composition Tables in Southeast Asia: The Contribution of the SMILING Project.

PubMed

Hulshof, Paul; Doets, Esmee; Seyha, Sok; Bunthang, Touch; Vonglokham, Manithong; Kounnavong, Sengchanh; Famida, Umi; Muslimatun, Siti; Santika, Otte; Prihatini, Sri; Nazarudin, Nazarina; Jahari, Abas; Rojroongwasinkul, Nipa; Chittchang, Uraiporn; Mai, Le Bach; Dung, Le Hong; Lua, Tran Thi; Nowak, Verena; Elburg, Lucy; Melse-Boonstra, Alida; Brouwer, Inge

2018-06-08

Objectives Food composition data are key for many nutrition related activities in research, planning and policy. Combatting micronutrient malnutrition among women and young children using sustainable food based approaches, as aimed at in the SMILING project, requires high quality food composition data. Methods In order to develop capacity and to align procedures for establishing, updating and assessing the quality of key nutrient data in the food composition tables in Southeast Asia, a detailed roadmap was developed to identify and propose steps for this. This included a training workshop to build capacity in the field of food composition data, and alignment of procedures for selecting foods and nutrients to be included for quality assessment, and update of country specific food composition tables. The SEA partners in the SMILING project finalised a country specific food composition table (FCT) with updated compositional data on selected foods and nutrients considered key for designing nutrient dense and optimal diets for the target groups. Results Between 140 and 175 foods were selected for inclusion in the country specific FCTs. Key-nutrients were: energy, protein, total fat, carbohydrates, iron, zinc, (pro-)-vitamin A, folate, calcium, vitamin D, vitamin B1, vitamin B2, vitamin B3, vitamin B6, vitamin B12 and vitamin C. A detailed quality assessment on 13 key-foods per nutrient was performed using international guidelines. Nutrient data for specific local food items were often unavailable and data on folate, vitamin B12 and vitamin B6 contents were mostly missing. For many foods, documentation was not available, thereby complicating an in-depth quality assessment. Despite these limitations, the SMILING project offered a unique opportunity to increase awareness of the importance of high quality well documented food composition data. Conclusion for Practise The self-reported data quality demonstrated that there is considerable room for improvement of the nutrient data quality in some countries. In addition, investment in sustainable capacity development and an urgent need to produce and document high quality data on the micronutrient composition of especially local foods is required.

Psychosocial health and quality of life among children with cardiac diagnoses: agreement and discrepancies between parent and child reports.

PubMed

Patel, Bhavika J; Lai, Lillian; Goldfield, Gary; Sananes, Renee; Longmuir, Patricia E

2017-05-01

Psychosocial health issues are common among children with cardiac diagnoses. Understanding parent and child perceptions is important because parents are the primary health information source. Significant discrepancies have been documented between parent/child quality-of-life data but have not been examined among psychosocial diagnostic instruments. This study examined agreement and discrepancies between parent and child reports of psychosocial health and quality of life in the paediatric cardiology population. Children (n=50, 6-14 years) with diagnoses of CHDs (n=38), arrhythmia (n=5), cardiomyopathy (n=4), or infectious disease affecting the heart (n=3) were enrolled, completing one or more outcome measures. Children and their parents completed self-reports and parent proxy reports of quality of life - Pediatric Quality of Life Inventory - and psychosocial health - Behavioral Assessment Scale for Children (Version 2). Patients also completed the Multidimensional Anxiety Scale for Children. Associations (Pearson's correlations, Intraclass Correlation Coefficients) and differences (Student's t-tests) between parent proxy reports and child self-reports were evaluated. Moderate parent-child correlations were found for physical (R=0.33, p=0.03), school (R=0.43, p<0.01), social (R=0.36, p=0.02), and overall psychosocial (R=0.43, p<0.01) quality of life. Parent-child reports of externalising behaviour problems, for example aggression, were strongly correlated (R=0.70, p<0.01). No significant parent-child associations were found for emotional quality of life (R=0.25, p=0.10), internalising problems (R=0.17, p=0.56), personal adjustment/adaptation skills (R=0.23, p=0.42), or anxiety (R=0.07, p=0.72). Our data suggest that clinicians caring for paediatric cardiac patients should assess both parent and child perspectives, particularly in relation to domains such as anxiety and emotional quality of life, which are more difficult to observe.

Quality assurance and quality control in mammography: a review of available guidance worldwide.

PubMed

Reis, Cláudia; Pascoal, Ana; Sakellaris, Taxiarchis; Koutalonis, Manthos

2013-10-01

Review available guidance for quality assurance (QA) in mammography and discuss its contribution to harmonise practices worldwide. Literature search was performed on different sources to identify guidance documents for QA in mammography available worldwide in international bodies, healthcare providers, professional/scientific associations. The guidance documents identified were reviewed and a selection was compared for type of guidance (clinical/technical), technology and proposed QA methodologies focusing on dose and image quality (IQ) performance assessment. Fourteen protocols (targeted at conventional and digital mammography) were reviewed. All included recommendations for testing acquisition, processing and display systems associated with mammographic equipment. All guidance reviewed highlighted the importance of dose assessment and testing the Automatic Exposure Control (AEC) system. Recommended tests for assessment of IQ showed variations in the proposed methodologies. Recommended testing focused on assessment of low-contrast detection, spatial resolution and noise. QC of image display is recommended following the American Association of Physicists in Medicine guidelines. The existing QA guidance for mammography is derived from key documents (American College of Radiology and European Union guidelines) and proposes similar tests despite the variations in detail and methodologies. Studies reported on QA data should provide detail on experimental technique to allow robust data comparison. Countries aiming to implement a mammography/QA program may select/prioritise the tests depending on available technology and resources. •An effective QA program should be practical to implement in a clinical setting. •QA should address the various stages of the imaging chain: acquisition, processing and display. •AEC system QC testing is simple to implement and provides information on equipment performance.

Microbial (Pathogen)/Recreational Water Quality Criteria

EPA Pesticide Factsheets

Documents pertaining to Recreational Human Health Ambient Water Quality Criteria for Microbial Organisms (Pathogens). These documents include safe levels for cyanotoxins microcystin and cylindrospermopsin, and Coliphage to protect human health.

Swespine: the Swedish spine register : the 2012 report.

PubMed

Strömqvist, Björn; Fritzell, Peter; Hägg, Olle; Jönsson, Bo; Sandén, Bengt

2013-04-01

Swespine, the Swedish National Spine Register, has existed for 20 years and is in general use within the country since over 10 years regarding degenerative lumbar spine disorders. Today there are protocols for registering all disorders of the entire spinal column. Patient-based pre- and postoperative questionnaires, completed before surgery and at 1, 2, 5 and 10 years postoperatively. Among patient-based data are VAS pain, ODI, SF-36 and EQ-5D. Postoperatively evaluation of leg and back pain as compared to preoperatively ("global assessment"), overall satisfaction with outcome and working conditions are registered in addition to the same parameters as preoperatively evaluation. A yearly report is produced including an analytic part of a certain topic, in this issue disc prosthesis surgery. More than 75,000 surgically treated patients are registered to date with an increasing number yearly. The present report includes 7,285 patients; 1-, 2- and 5-year follow-up data of previously operated patients are also included for lumbar disorders as well as for disc prosthesis surgery. For the degenerative lumbar spine disorders (disc herniation, spinal stenosis, spondylolisthesis and DDD) significant improvements are seen in all aspects as exemplified by pronounced improvement regarding EQ-5D and ODI. Results seem to be stable over time. Spinal stenosis is the most common indication for spine surgery. Disc prosthesis surgery yields results on a par with fusion surgery in disc degenerative pain. The utility of spine surgery is well documented by the results. Results of spine surgery as documented on a national basis can be utilized for quality assurance and quality improvement as well as for research purposes, documenting changes over time and bench marking when introducing new surgical techniques. A basis for international comparisons is also laid.

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...

Three Quality Professional Documents to Guide Teachers for Puberty, Relationships and Sexuality Education

ERIC Educational Resources Information Center

Goldman, Juliette D. G.; Collier-Harris, Christine A.

2017-01-01

Quality school-based sexuality education is important for all children and adolescents. The global trend towards students' earlier, longer, and technologically connected pubertal experience makes the timely provision of such education particularly significant. Quality international sexuality education documents are available for teachers…

Worldwide Report, Nuclear Development and Proliferation

DTIC Science & Technology

1984-05-14

PROLIFERATION IMC QUALITY: 19980729 081 FBIS FOREIGN BROADCAST INFORMATION SERVICE REPRODUCED BY NATIONAL TECHNICAL INFORMATION SERVICE U.S...Information Service , Springfield, Virginia 22161. In order- ing, it is recommended that the JPRS number, title, date and author, if applicable, of...Information Service , and are listed in the Monthly Catalog of U.S. Government Publications issued by the Superintendent of Documents, U.S. Government

Our Families, Our Children: The Lesbian and Gay Child Care Task Force Report on Quality Child Care.

ERIC Educational Resources Information Center

Dispenza, Mary

The Lesbian and Gay Child Care Task Force documented anecdotal evidence of homophobia in child care and school age communities, including: (1) refusal to accept children from lesbian, gay, bisexual, and transgender (LGBT) families into child care; (2) biased attitudes expressed to children when they speak about their families; and (3) demonstrated…

Multilevel Grouping, Grades Preschool-5 Small and Rural Schools. Outstanding Teaching Practices Series, Volume 4.

ERIC Educational Resources Information Center

Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

This document reports on the 1991-92 Teacher Recognition Program honoring exceptional teachers from rural and small schools in the New England states, New York, Puerto Rico, and the Virgin Islands. The program was intended to enrich the quality of education in the Northeast United States and its Caribbean jurisdictions by sharing information about…

User's Guide for ERB 7 SEFDT. Volume 1: User's Guide. Volume 2: Quality Control Report, Year 1

NASA Technical Reports Server (NTRS)

Ray, S. N.; Tighe, R. J.; Scherrer, S. A.

1984-01-01

The Nimbus-7 ERB SEFDT Data User's Guide is presented. The guide consists of four subsections which describe: (1) the scope of the data User's Guide; (2) the background on Nimbus-7 Spacecraft and the ERB experiment; (3) the SEFDT data product and processing scenario; and (4) other related products and documents.

A deposit model for magmatic iron-titanium-oxide deposits related to Proterozoic massif anorthosite plutonic suites: Chapter K in Mineral Deposit Models for Resource Assessment

USGS Publications Warehouse

Woodruff, Laurel G.; Nicholson, Suzanne W.; Fey, David L.

2013-01-01

Active mines have developed large open pits with extensive waste-rock piles, but because of the nature of the ore and waste rock, the major environmental impacts documented at the mine sites are reported to be waste disposal issues and somewhat degraded water quality.

The Millennium QUEST: Results of the Survey. Annual Staff Survey. Complete Set of Tables & Charts. Research Report Number 108.

ERIC Educational Resources Information Center

Livieratos, Barbara B.

This document provides a quick overview and set of detailed tables of the findings of the annual employee survey at Howard Community College (Maryland). The Quality Evaluation of Service Trends (QUEST) Survey affords all college employees the opportunity to give their assessment of college services, campus climate, job satisfaction, and college…