45 CFR 60.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of a patient(s) or quality of health care services; (2) Any recommendation by a peer review... with the primary purpose of evaluating the quality of patient care practices or services ordered or... through a formal peer review process for the purpose of furthering quality health care, or a committee of...

Lean interventions in healthcare: do they actually work? A systematic literature review.

PubMed

Moraros, John; Lemstra, Mark; Nwankwo, Chijioke

2016-04-01

Lean is a widely used quality improvement methodology initially developed and used in the automotive and manufacturing industries but recently expanded to the healthcare sector. This systematic literature review seeks to independently assess the effect of Lean or Lean interventions on worker and patient satisfaction, health and process outcomes, and financial costs. We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS. Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately. Data on design, methods, interventions and key outcomes were extracted and collated. Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety. While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Comparison of case note review methods for evaluating quality and safety in health care.

PubMed

Hutchinson, A; Coster, J E; Cooper, K L; McIntosh, A; Walters, S J; Bath, P A; Pearson, M; Young, T A; Rantell, K; Campbell, M J; Ratcliffe, J

2010-02-01

To determine which of two methods of case note review--holistic (implicit) and criterion-based (explicit)--provides the most useful and reliable information for quality and safety of care, and the level of agreement within and between groups of health-care professionals when they use the two methods to review the same record. To explore the process-outcome relationship between holistic and criterion-based quality-of-care measures and hospital-level outcome indicators. Case notes of patients at randomly selected hospitals in England. In the first part of the study, retrospective multiple reviews of 684 case notes were undertaken at nine acute hospitals using both holistic and criterion-based review methods. Quality-of-care measures included evidence-based review criteria and a quality-of-care rating scale. Textual commentary on the quality of care was provided as a component of holistic review. Review teams comprised combinations of: doctors (n = 16), specialist nurses (n = 10) and clinically trained audit staff (n = 3) and non-clinical audit staff (n = 9). In the second part of the study, process (quality and safety) of care data were collected from the case notes of 1565 people with either chronic obstructive pulmonary disease (COPD) or heart failure in 20 hospitals. Doctors collected criterion-based data from case notes and used implicit review methods to derive textual comments on the quality of care provided and score the care overall. Data were analysed for intrarater consistency, inter-rater reliability between pairs of staff using intraclass correlation coefficients (ICCs) and completeness of criterion data capture, and comparisons were made within and between staff groups and between review methods. To explore the process-outcome relationship, a range of publicly available health-care indicator data were used as proxy outcomes in a multilevel analysis. Overall, 1473 holistic and 1389 criterion-based reviews were undertaken in the first part of the study. When same staff-type reviewer pairs/groups reviewed the same record, holistic scale score inter-rater reliability was moderate within each of the three staff groups [intraclass correlation coefficient (ICC) 0.46-0.52], and inter-rater reliability for criterion-based scores was moderate to good (ICC 0.61-0.88). When different staff-type pairs/groups reviewed the same record, agreement between the reviewer pairs/groups was weak to moderate for overall care (ICC 0.24-0.43). Comparison of holistic review score and criterion-based score of case notes reviewed by doctors and by non-clinical audit staff showed a reasonable level of agreement (p-values for difference 0.406 and 0.223, respectively), although results from all three staff types showed no overall level of agreement (p-value for difference 0.057). Detailed qualitative analysis of the textual data indicated that the three staff types tended to provide different forms of commentary on quality of care, although there was some overlap between some groups. In the process-outcome study there generally were high criterion-based scores for all hospitals, whereas there was more interhospital variation between the holistic review overall scale scores. Textual commentary on the quality of care verified the holistic scale scores. Differences among hospitals with regard to the relationship between mortality and quality of care were not statistically significant. Using the holistic approach, the three groups of staff appeared to interpret the recorded care differently when they each reviewed the same record. When the same clinical record was reviewed by doctors and non-clinical audit staff, there was no significant difference between the assessments of quality of care generated by the two groups. All three staff groups performed reasonably well when using criterion-based review, although the quality and type of information provided by doctors was of greater value. Therefore, when measuring quality of care from case notes, consideration needs to be given to the method of review, the type of staff undertaking the review, and the methods of analysis available to the review team. Review can be enhanced using a combination of both criterion-based and structured holistic methods with textual commentary, and variation in quality of care can best be identified from a combination of holistic scale scores and textual data review.

Clinical peer review in the United States: history, legal development and subsequent abuse.

PubMed

Vyas, Dinesh; Hozain, Ahmed E

2014-06-07

The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews.

Clinical peer review in the United States: History, legal development and subsequent abuse

PubMed Central

Vyas, Dinesh; Hozain, Ahmed E

2014-01-01

The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews. PMID:24914357

The "peer" in "peer review"

USGS Publications Warehouse

Perry, Gad; Bertoluci, Jaime; Bury, R. Bruce; Hansen, Robert W.; Jehle, Robert; Measey, John; Moon, Brad R.; Muths, Erin L.; Zuffi, Marco A.L.

2011-01-01

Peer review is the best available mechanism for assessing and improving the quality of scientific work. As herpetology broadens its disciplinary and geographic boundaries, high-quality external review is ever more essential. We are writing this editorial jointly because the review process has become increasingly difficult. The resulting delays slow publication times, negatively affect performance reviews, tenure, promotions, and grant proposal success. It harms authors, agencies, and institutions (Ware 2011).

Development of an evidence-based review with recommendations using an online iterative process.

PubMed

Rudmik, Luke; Smith, Timothy L

2011-01-01

The practice of modern medicine is governed by evidence-based principles. Due to the plethora of medical literature, clinicians often rely on systematic reviews and clinical guidelines to summarize the evidence and provide best practices. Implementation of an evidence-based clinical approach can minimize variation in health care delivery and optimize the quality of patient care. This article reports a method for developing an "Evidence-based Review with Recommendations" using an online iterative process. The manuscript describes the following steps involved in this process: Clinical topic selection, Evidence-hased review assignment, Literature review and initial manuscript preparation, Iterative review process with author selection, and Manuscript finalization. The goal of this article is to improve efficiency and increase the production of evidence-based reviews while maintaining the high quality and transparency associated with the rigorous methodology utilized for clinical guideline development. With the rise of evidence-based medicine, most medical and surgical specialties have an abundance of clinical topics which would benefit from a formal evidence-based review. Although clinical guideline development is an important methodology, the associated challenges limit development to only the absolute highest priority clinical topics. As outlined in this article, the online iterative approach to the development of an Evidence-based Review with Recommendations may improve productivity without compromising the quality associated with formal guideline development methodology. Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

Flight Dynamics Mission Support and Quality Assurance Process

NASA Technical Reports Server (NTRS)

Oh, InHwan

1996-01-01

This paper summarizes the method of the Computer Sciences Corporation Flight Dynamics Operation (FDO) quality assurance approach to support the National Aeronautics and Space Administration Goddard Space Flight Center Flight Dynamics Support Branch. Historically, a strong need has existed for developing systematic quality assurance using methods that account for the unique nature and environment of satellite Flight Dynamics mission support. Over the past few years FDO has developed and implemented proactive quality assurance processes applied to each of the six phases of the Flight Dynamics mission support life cycle: systems and operations concept, system requirements and specifications, software development support, operations planing and training, launch support, and on-orbit mission operations. Rather than performing quality assurance as a final step after work is completed, quality assurance has been built in as work progresses in the form of process assurance. Process assurance activities occur throughout the Flight Dynamics mission support life cycle. The FDO Product Assurance Office developed process checklists for prephase process reviews, mission team orientations, in-progress reviews, and end-of-phase audits. This paper will outline the evolving history of FDO quality assurance approaches, discuss the tailoring of Computer Science Corporations's process assurance cycle procedures, describe some of the quality assurance approaches that have been or are being developed, and present some of the successful results.

Changing Our Selves, Our Schools, and Our School System: Students Take on the New York City Quality Review Process

ERIC Educational Resources Information Center

Parkham, Shamika; McBroom, Aravis

2015-01-01

In this chapter, two student members of the Student Voice Collaborative (SVC) describe their experiences as "Student Shadows" during the annual Quality Review process, used throughout the New York Department of Education to evaluate how well schools are organized to support student achievement. They chronicle how this experience enhanced…

Thin Blue Lines and Red Crosses: Signposts to Quality in Family Day Care?

ERIC Educational Resources Information Center

White, Jayne

2005-01-01

This paper explores some of the findings of a study focussing on constructions of family day care from the perspectives of caregivers/educators and coordinators as they engaged in a quality review process using a recently developed resource--The Quality Journey/He haerenga whai hua (2000). The paper positions quality review as a part of a…

Clinical perspective: creating an effective practice peer review process-a primer.

PubMed

Gandhi, Manisha; Louis, Frances S; Wilson, Shae H; Clark, Steven L

2017-03-01

Peer review serves as an important adjunct to other hospital quality and safety programs. Despite its importance, the available literature contains virtually no guidance regarding the structure and function of effective peer review committees. This Clinical Perspective provides a summary of the purposes, structure, and functioning of effective peer review committees. We also discuss important legal considerations that are a necessary component of such processes. This discussion includes useful templates for case selection and review. Proper committee structure, membership, work flow, and leadership as well as close cooperation with the hospital medical executive committee and legal representatives are essential to any effective peer review process. A thoughtful, fair, systematic, and organized approach to creating a peer review process will lead to confidence in the committee by providers, hospital leadership, and patients. If properly constructed, such committees may also assist in monitoring and enforcing compliance with departmental protocols, thus reducing harm and promoting high-quality practice. Copyright © 2016 Elsevier Inc. All rights reserved.

The Four-Part Literature Review Process: Breaking It Down for Students

ERIC Educational Resources Information Center

Price, Rebecca H.

2017-01-01

Both undergraduate and graduate students face similar challenges when tasked with writing literature reviews. Breaking down the literature review into a four-part process helps students decrease frustration and increase quality. This article provides usable advice for anyone teaching or writing literature reviews. Tips and illustrations illuminate…

Quality Measures for Hospice and Palliative Care: Piloting the PEACE Measures

PubMed Central

Rokoske, Franziska S.; Durham, Danielle; Cagle, John G.; Hanson, Laura C.

2014-01-01

Abstract Background: The Carolinas Center for Medical Excellence launched the PEACE project in 2006, under contract with the Centers for Medicare & Medicaid Services (CMS), to identify, develop, and pilot test quality measures for hospice and palliative care programs. Objectives: The project collected pilot data to test the usability and feasibility of potential quality measures and data collection processes for hospice and palliative care programs. Settings/subjects: Twenty-two hospices participating in a national Quality Improvement Collaborative (QIC) submitted data from 367 chart reviews for pain care and 45 chart reviews for nausea care. Fourteen additional hospices completed a one-time data submission of 126 chart reviews on 60 potential patient-level quality measures across eight domains of care and an organizational assessment evaluating structure and processes of care. Design: Usability was assessed by examining the range, variability and size of the populations targeted by each quality measure. Feasibility was assessed during the second pilot study by surveying data abstractors about the abstraction process and examining the rates of missing data. The impact of data collection processes was assessed by comparing results obtained using different processes. Results: Measures shown to be both usable and feasible included: screening for physical symptoms on admission and documentation of treatment preferences. Methods of data collection and measure construction appear to influence observed rates of quality of care. Conclusions: We successfully identified quality measures with potential for use in hospices and palliative care programs. Future research is needed to understand whether these measures are sensitive to quality improvement interventions. PMID:24921162

Quality Measurements in Radiology: A Systematic Review of the Literature and Survey of Radiology Benefit Management Groups.

PubMed

Narayan, Anand; Cinelli, Christina; Carrino, John A; Nagy, Paul; Coresh, Josef; Riese, Victoria G; Durand, Daniel J

2015-11-01

As the US health care system transitions toward value-based reimbursement, there is an increasing need for metrics to quantify health care quality. Within radiology, many quality metrics are in use, and still more have been proposed, but there have been limited attempts to systematically inventory these measures and classify them using a standard framework. The purpose of this study was to develop an exhaustive inventory of public and private sector imaging quality metrics classified according to the classic Donabedian framework (structure, process, and outcome). A systematic review was performed in which eligibility criteria included published articles (from 2000 onward) from multiple databases. Studies were double-read, with discrepancies resolved by consensus. For the radiology benefit management group (RBM) survey, the six known companies nationally were surveyed. Outcome measures were organized on the basis of standard categories (structure, process, and outcome) and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy yielded 1,816 citations; review yielded 110 reports (29 included for final analysis). Three of six RBMs (50%) responded to the survey; the websites of the other RBMs were searched for additional metrics. Seventy-five unique metrics were reported: 35 structure (46%), 20 outcome (27%), and 20 process (27%) metrics. For RBMs, 35 metrics were reported: 27 structure (77%), 4 process (11%), and 4 outcome (11%) metrics. The most commonly cited structure, process, and outcome metrics included ACR accreditation (37%), ACR Appropriateness Criteria (85%), and peer review (95%), respectively. Imaging quality metrics are more likely to be structural (46%) than process (27%) or outcome (27%) based (P < .05). As national value-based reimbursement programs increasingly emphasize outcome-based metrics, radiologists must keep pace by developing the data infrastructure required to collect outcome-based quality metrics. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A literature review of quantitative indicators to measure the quality of labor and delivery care.

PubMed

Tripathi, Vandana

2016-02-01

Strengthening measurement of the quality of labor and delivery (L&D) care in low-resource countries requires an understanding of existing approaches. To identify quantitative indicators of L&D care quality and assess gaps in indicators. PubMed, CINAHL Plus, and Embase databases were searched for research published in English between January 1, 1990, and October 31, 2013, using structured terms. Studies describing indicators for L&D care quality assessment were included. Those whose abstracts contained inclusion criteria underwent full-text review. Study characteristics, including indicator selection and data sources, were extracted via a standard spreadsheet. The structured search identified 1224 studies. After abstract and full-text review, 477 were included in the analysis. Most studies selected indicators by using literature review, clinical guidelines, or expert panels. Few indicators were empirically validated; most studies relied on medical record review to measure indicators. Many quantitative indicators have been used to measure L&D care quality, but few have been validated beyond expert opinion. There has been limited use of clinical observation in quality assessment of care processes. The findings suggest the need for validated, efficient consensus indicators of the quality of L&D care processes, particularly in low-resource countries. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

42 CFR 431.834 - Access to records: Claims processing assessment systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.834 Access to records: Claims processing assessment systems. The agency, upon written request, must provide HHS staff with access to all records pertaining to its MQC claims processing assessment system reviews...

Random Versus Nonrandom Peer Review: A Case for More Meaningful Peer Review.

PubMed

Itri, Jason N; Donithan, Adam; Patel, Sohil H

2018-05-10

Random peer review programs are not optimized to discover cases with diagnostic error and thus have inherent limitations with respect to educational and quality improvement value. Nonrandom peer review offers an alternative approach in which diagnostic error cases are targeted for collection during routine clinical practice. The objective of this study was to compare error cases identified through random and nonrandom peer review approaches at an academic center. During the 1-year study period, the number of discrepancy cases and score of discrepancy were determined from each approach. The nonrandom peer review process collected 190 cases, of which 60 were scored as 2 (minor discrepancy), 94 as 3 (significant discrepancy), and 36 as 4 (major discrepancy). In the random peer review process, 1,690 cases were reviewed, of which 1,646 were scored as 1 (no discrepancy), 44 were scored as 2 (minor discrepancy), and none were scored as 3 or 4. Several teaching lessons and quality improvement measures were developed as a result of analysis of error cases collected through the nonrandom peer review process. Our experience supports the implementation of nonrandom peer review as a replacement to random peer review, with nonrandom peer review serving as a more effective method for collecting diagnostic error cases with educational and quality improvement value. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Nutrition Program Quality Assurance through a Formalized Process of On-Site Program Review

ERIC Educational Resources Information Center

Paddock, Joan Doyle; Dollahite, Jamie

2012-01-01

A protocol for a systematic onsite review of the Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education was developed to support quality programming and ensure compliance with state guidelines and federal regulations. Onsite review of local nutrition program operations is one strategy to meet this…

Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models

PubMed Central

Kowalczuk, Maria K; Dudbridge, Frank; Nanda, Shreeya; Harriman, Stephanie L; Patel, Jigisha; Moylan, Elizabeth C

2015-01-01

Objectives To assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ with regard to report quality and reviewer recommendations. Design Retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. Setting BioMed Central biology and medical journals. BMC Infectious Diseases and BMC Microbiology are similar in size, rejection rates, impact factors and editorial processes, but the former uses open peer review while the latter uses single-blind peer review. The Journal of Inflammation has operated under both peer review models. Sample Two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. Results For each journal, author-suggested reviewers provided reports of comparable quality to non-author-suggested reviewers, but were significantly more likely to recommend acceptance, irrespective of the peer review model (p<0.0001 for BMC Infectious Diseases, BMC Microbiology and the Journal of Inflammation). For BMC Infectious Diseases, the overall quality of reviewer reports measured by the Review Quality Instrument was 5% higher than for BMC Microbiology (p=0.042). For the Journal of Inflammation, the quality of reports was the same irrespective of the peer review model used. Conclusions Reviewers suggested by authors provide reports of comparable quality to non-author-suggested reviewers, but are significantly more likely to recommend acceptance. Open peer review reports for BMC Infectious Diseases were of higher quality than single-blind reports for BMC Microbiology. There was no difference in quality of peer review in the Journal of Inflammation under open peer review compared with single blind. PMID:26423855

Peer Review as a Strategy for Improving Students' Writing Process

ERIC Educational Resources Information Center

Baker, Kimberly M.

2016-01-01

Peer review is an established strategy for improving the quality of students' writing. This study moves beyond the focus on outcomes to assess the peer-review process. In particular, this study focuses on the timing of the peer review, a highly structured feedback form, and student writers' revisions after engaging in peer review. This study draws…

Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature

PubMed Central

Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R.; Salek, Sam

2017-01-01

Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general paucity of research in this area, particularly regarding the development and systematic application of techniques for evaluating quality decision making, with no consensus around a gold standard. This review has identified QoDoS as the most promising available technique for assessing decision making in the lifecycle of medicines and the next steps would be to further test its validity, sensitivity, and reliability. PMID:28443022

Lean interventions in healthcare: do they actually work? A systematic literature review

PubMed Central

Moraros, John; Lemstra, Mark; Nwankwo, Chijioke

2016-01-01

Purpose Lean is a widely used quality improvement methodology initially developed and used in the automotive and manufacturing industries but recently expanded to the healthcare sector. This systematic literature review seeks to independently assess the effect of Lean or Lean interventions on worker and patient satisfaction, health and process outcomes, and financial costs. Data sources We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS. Study selection Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately. Data extraction Data on design, methods, interventions and key outcomes were extracted and collated. Results of data synthesis Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety. Conclusion While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings. PMID:26811118

Guidelines for performing systematic reviews in the development of toxicity factors.

PubMed

Schaefer, Heather R; Myers, Jessica L

2017-12-01

The Texas Commission on Environmental Quality (TCEQ) developed guidance on conducting systematic reviews during the development of chemical-specific toxicity factors. Using elements from publicly available frameworks, the TCEQ systematic review process was developed in order to supplement the existing TCEQ Guidelines for developing toxicity factors (TCEQ Regulatory Guidance 442). The TCEQ systematic review process includes six steps: 1) Problem Formulation; 2) Systematic Literature Review and Study Selection; 3) Data Extraction; 4) Study Quality and Risk of Bias Assessment; 5) Evidence Integration and Endpoint Determination; and 6) Confidence Rating. This document provides guidance on conducting a systematic literature review and integrating evidence from different data streams when developing chemical-specific reference values (ReVs) and unit risk factors (URFs). However, this process can also be modified or expanded to address other questions that would benefit from systematic review practices. The systematic review and evidence integration framework can improve regulatory decision-making processes, increase transparency, minimize bias, improve consistency between different risk assessments, and further improve confidence in toxicity factor development. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Peer Review and Surgical Innovation: Robotic Surgery and Its Hurdles.

PubMed

Vyas, Dinesh; Cronin, Sean

2015-12-01

The peer review processes as outlined in the Health Care Quality Improvement Act (HCQIA) is meant ensure quality standard of care through a self-policing mechanism by the medical community. This process grants immunity for people filing a peer review, which is meant to protect whistleblowers. However, it also creates a loophole that can be used maliciously to hinder competition. This is accentuated when surgeons are integrating new technologies, such as robotic surgery, into their practice. With more than 2000 da Vinci robots in use and more than 300 new units being shipped each year, robotic surgery has become a mainstay in the surgical field. The applications for robots continue to expand as surgeons discover their expanding capability. We need a better peer review process. That ensures the peer review is void of competitive bias. Peer reviewers need to be familiar with the procedure and the technology. The current process could stymie innovation in the name of competition.

Special Report on Review of "The Department of Energy's Quality Assurance Process for Prime Recipients' Reporting for the American Recovery and Reinvestment Act"

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

None

2009-10-01

The American Recovery and Reinvestment Act of 2009 (Recovery Act) was established to jumpstart the U.S. economy, create or save millions of jobs, spur technological advances in health and science, and invest in the Nation's energy future. The Department of Energy (Department) will receive an unprecedented $37 billion in Recovery Act funding to support a variety of science, energy, and environmental initiatives. The majority of the funding received by the Department will be allocated to various recipients through grants, cooperative agreements, contracts, and other financial instruments. To ensure transparency and accountability, the Office of Management and Budget (OMB) requires thatmore » recipients report on their receipt and use of Recovery Act funds on a quarterly basis to FederalReporting.gov. OMB also specifies that Federal agencies should develop and implement formal procedures to help ensure the quality of recipient reported information. Data that must be reported by recipients includes total funding received; funds expended or obligated; projects or activities for which funds were obligated or expended; and the number of jobs created and/or retained. OMB requires that Federal agencies perform limited data quality reviews of recipient data to identify material omissions and/or significant reporting errors and notify the recipients of the need to make appropriate and timely changes to erroneous reports. As part of a larger audit of recipient Recovery Act reporting and performance measurement and in support of a Government-wide review sponsored by the Recovery Accountability and Transparency Board, we completed an interim review to determine whether the Department had established a process to ensure the quality and accuracy of recipient reports. Our review revealed that the Department had developed a quality assurance process to facilitate the quarterly reviews of recipient data. The process included procedures to compare existing information from the Department's financial information systems with that reported to FederalReporting.gov by recipients. In addition, plans were in place to notify recipients of anomalies and/or errors exposed by the quality assurance process. While the Department has made a good deal of progress in this area, we did, however, identify several issues which could, if not addressed, impact the effectiveness of the quality assurance process.« less

Clinical peer review program self-evaluation for US hospitals.

PubMed

Edwards, Marc T

2010-01-01

Prior research has shown wide variation in clinical peer review program structure, process, governance, and perceived effectiveness. This study sought to validate the utility of a Peer Review Program Self-Evaluation Tool as a potential guide to physician and hospital leaders seeking greater program value. Data from 330 hospitals show that the total score from the self-evaluation tool is strongly associated with perceived quality impact. Organizational culture also plays a significant role. When controlling for these factors, there was no evidence of benefit from a multispecialty review process. Physicians do not generally use reliable methods to measure clinical performance. A high rate of change since 2007 has not produced much improvement. The Peer Review Program Self-Evaluation Tool reliably differentiates hospitals along a continuum of perceived program performance. The full potential of peer review as a process to improve the quality and safety of care has yet to be realized.

The evolution of a doctor of nursing practice capstone process: programmatic revisions to improve the quality of student projects.

PubMed

Nelson, Joan M; Cook, Paul F; Raterink, Ginger

2013-01-01

The past several years have seen explosive growth in the number of doctor of nursing practice (DNP) degree programs offered by colleges of nursing in the United States. Through a process of trial and error since 2005, the faculty at the University of Colorado, College of Nursing, have revised the course structure and procedures related to the DNP capstone project to improve the quality and usefulness of these student projects. Efforts have focused on educating and involving all nursing faculty in the DNP capstone process, distinguishing between competencies for our PhD and DNP projects, clearly aligning the DNP capstone project with quality improvement methods rather than with research, working with our campus institutional review board to clarify regulatory review requirements for quality improvement studies, developing a review committee to oversee DNP students' projects, and structuring our sequential course requirements to encourage students' professional presentations and publications. Our current capstone process reflects 7 years of iterative work, which we summarize in this article in hopes that it will help institutions currently in the process of developing a DNP program. Copyright © 2013 Elsevier Inc. All rights reserved.

The Role of Riparian Vegetation in Protecting and Improving Chemical Water Quality in Streams

Treesearch

Michael G. Dosskey; Philippe Vidon; Noel P. Gurwick; Craig J. Allan; Tim P. Duval; Richard Lowrance

2010-01-01

We review the research literature and summarize the major processes by which riparian vegetation influences chemical water quality in streams, as well as how these processes vary among vegetation types, and discuss how these processes respond to removal and restoration of riparian vegetation and thereby determine the timing and level of response in stream water quality...

75 FR 18788 - Malcolm Baldrige National Quality Award Panel of Judges

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-13

... prominent in the fields of quality, innovation, and performance management and appointed by the Secretary of... Award. The agenda will include: Review of the 2009 Judging Process, Baldrige Program and Judging Process...

The objective impact of clinical peer review on hospital quality and safety.

PubMed

Edwards, Marc T

2011-01-01

Despite its importance, the objective impact of clinical peer review on the quality and safety of care has not been studied. Data from 296 acute care hospitals show that peer review program and related organizational factors can explain up to 18% of the variation in standardized measures of quality and patient safety. The majority of programs rely on an outmoded and dysfunctional process model. Adoption of best practices informed by the continuing study of peer review program effectiveness has the potential to significantly improve patient outcomes.

Does Value Stream Mapping affect the structure, process, and outcome quality in care facilities? A systematic review.

PubMed

Nowak, Marina; Pfaff, Holger; Karbach, Ute

2017-08-24

Quality improvement within health and social care facilities is needed and has to be evidence-based and patient-centered. Value Stream Mapping, a method of Lean management, aims to increase the patients' value and quality of care by a visualization and quantification of the care process. The aim of this research is to examine the effectiveness of Value Stream Mapping on structure, process, and outcome quality in care facilities. A systematic review is conducted. PubMed, EBSCOhost, including Business Source Complete, Academic Search Complete, PSYCInfo, PSYNDX, SocINDEX with Full Text, Web of Knowledge, and EMBASE ScienceDirect are searched in February 2016. All peer-reviewed papers evaluating Value Stream Mapping and published in English or German from January 2000 are included. For data synthesis, all study results are categorized into Donabedian's model of structure, process, and outcome quality. To assess and interpret the effectiveness of Value Stream Mapping, the frequencies of the results statistically examined are considered. Of the 903 articles retrieved, 22 studies fulfill the inclusion criteria. Of these, 11 studies are used to answer the research question. Value Stream Mapping has positive effects on the time dimension of process and outcome quality. It seems to reduce non-value-added time (e.g., waiting time) and length of stay. All study designs are before and after studies without control, and methodologically sophisticated studies are missing. For a final conclusion about Value Stream Mapping's effectiveness, more research with improved methodology is needed. Despite this lack of evidence, Value Stream Mapping has the potential to improve quality of care on the time dimension. The contextual influence has to be investigated to make conclusions about the relationship between different quality domains when applying Value Stream Mapping. However, for using this review's conclusion, the limitation of including heterogeneous and potentially biased results has to be considered.

[Fast Detection of Camellia Sinensis Growth Process and Tea Quality Informations with Spectral Technology: A Review].

PubMed

Peng, Ji-yu; Song, Xing-lin; Liu, Fei; Bao, Yi-dan; He, Yong

2016-03-01

The research achievements and trends of spectral technology in fast detection of Camellia sinensis growth process information and tea quality information were being reviewed. Spectral technology is a kind of fast, nondestructive, efficient detection technology, which mainly contains infrared spectroscopy, fluorescence spectroscopy, Raman spectroscopy and mass spectroscopy. The rapid detection of Camellia sinensis growth process information and tea quality is helpful to realize the informatization and automation of tea production and ensure the tea quality and safety. This paper provides a review on its applications containing the detection of tea (Camellia sinensis) growing status(nitrogen, chlorophyll, diseases and insect pest), the discrimination of tea varieties, the grade discrimination of tea, the detection of tea internal quality (catechins, total polyphenols, caffeine, amino acid, pesticide residual and so on), the quality evaluation of tea beverage and tea by-product, the machinery of tea quality determination and discrimination. This paper briefly introduces the trends of the technology of the determination of tea growth process information, sensor and industrial application. In conclusion, spectral technology showed high potential to detect Camellia sinensis growth process information, to predict tea internal quality and to classify tea varieties and grades. Suitable chemometrics and preprocessing methods is helpful to improve the performance of the model and get rid of redundancy, which provides the possibility to develop the portable machinery. Future work is to develop the portable machinery and on-line detection system is recommended to improve the further application. The application and research achievement of spectral technology concerning about tea were outlined in this paper for the first time, which contained Camellia sinensis growth, tea production, the quality and safety of tea and by-produce and so on, as well as some problems to be solved and its future applicability in modern tea industrial.

Solid Wastes and Water Quality.

ERIC Educational Resources Information Center

DeWalle, F. B.; Chian, E. S. K.

1978-01-01

Presents a literature review of solid wastes and water quality, covering publications of 1976-77. This review covers areas such as: (1) environmental impacts and health aspects for waste disposal, and (2) processed and hazardous wastes. A list of 80 references is also presented. (HM)

A prospective study on an innovative online forum for peer reviewing of surgical science.

PubMed

Almquist, Martin; von Allmen, Regula S; Carradice, Dan; Oosterling, Steven J; McFarlane, Kirsty; Wijnhoven, Bas

2017-01-01

Peer review is important to the scientific process. However, the present system has been criticised and accused of bias, lack of transparency, failure to detect significant breakthrough and error. At the British Journal of Surgery (BJS), after surveying authors' and reviewers' opinions on peer review, we piloted an open online forum with the aim of improving the peer review process. In December 2014, a web-based survey assessing attitudes towards open online review was sent to reviewers with a BJS account in Scholar One. From April to June 2015, authors were invited to allow their manuscripts to undergo online peer review in addition to the standard peer review process. The quality of each review was evaluated by editors and editorial assistants using a validated instrument based on a Likert scale. The survey was sent to 6635 reviewers. In all, 1454 (21.9%) responded. Support for online peer review was strong, with only 10% stating that they would not subject their manuscripts to online peer review. The most prevalent concern was about intellectual property, being highlighted in 118 of 284 comments (41.5%). Out of 265 eligible manuscripts, 110 were included in the online peer review trial. Around 7000 potential reviewers were invited to review each manuscript. In all, 44 of 110 manuscripts (40%) received 100 reviews from 59 reviewers, alongside 115 conventional reviews. The quality of the open forum reviews was lower than for conventional reviews (2.13 (± 0.75) versus 2.84 (± 0.71), P<0.001). Open online peer review is feasible in this setting, but it attracts few reviews, of lower quality than conventional peer reviews.

A prospective study on an innovative online forum for peer reviewing of surgical science

PubMed Central

von Allmen, Regula S.; Carradice, Dan; Oosterling, Steven J.; McFarlane, Kirsty; Wijnhoven, Bas

2017-01-01

Background Peer review is important to the scientific process. However, the present system has been criticised and accused of bias, lack of transparency, failure to detect significant breakthrough and error. At the British Journal of Surgery (BJS), after surveying authors’ and reviewers’ opinions on peer review, we piloted an open online forum with the aim of improving the peer review process. Methods In December 2014, a web-based survey assessing attitudes towards open online review was sent to reviewers with a BJS account in Scholar One. From April to June 2015, authors were invited to allow their manuscripts to undergo online peer review in addition to the standard peer review process. The quality of each review was evaluated by editors and editorial assistants using a validated instrument based on a Likert scale. Results The survey was sent to 6635 reviewers. In all, 1454 (21.9%) responded. Support for online peer review was strong, with only 10% stating that they would not subject their manuscripts to online peer review. The most prevalent concern was about intellectual property, being highlighted in 118 of 284 comments (41.5%). Out of 265 eligible manuscripts, 110 were included in the online peer review trial. Around 7000 potential reviewers were invited to review each manuscript. In all, 44 of 110 manuscripts (40%) received 100 reviews from 59 reviewers, alongside 115 conventional reviews. The quality of the open forum reviews was lower than for conventional reviews (2.13 (± 0.75) versus 2.84 (± 0.71), P<0.001). Conclusion Open online peer review is feasible in this setting, but it attracts few reviews, of lower quality than conventional peer reviews. PMID:28662046

Exploration and practice of methods and processes of evidence-based rapid review on peer review of WHO EML application.

PubMed

Li, Youping; Yu, Jiajie; Du, Liang; Sun, Xin; Kwong, Joey S W; Wu, Bin; Hu, Zhiqiang; Lu, Jing; Xu, Ting; Zhang, Lingli

2015-11-01

After 38 years of development, the procedure of selection and evaluation of the World Health Organization Essential Medicine List (WHO EML) is increasingly scientific and formal. However, peer review for the applications of World Health Organization Essential Medicine List is always required in a short period. It is necessary to build up a set of methods and processes for rapid review. We identified the process of evidenced-based rapid review on WHO EML application for peer reviews according to 11 items which were required during reporting of the peer review results of the proposals. The most important items for the rapid review of World Health Organization Essential Medicine List peer reviewers are (1) to confirm the requirements and identify the purposes; (2) to establish the research questions and translate the questions into the 'Participants, Interventions, Comparators, Outcomes, Study design' (PICOS) format; (3) to search and screen available evidence, for which high-level evidence is preferred, such as systematic reviews or meta-analyses, health technology assessment, clinical guidelines; (4) to extract data, where we extract primary information based on the purposes; (5) to synthesize data by qualitative methods, assess the quality of evidence, and compare the results; (6) to provide the answers to the applications, quality of evidences and strength of recommendations. Our study established a set of methods and processes for the rapid review of World Health Organization Essential Medicine List peer review, and our findings were used to guide the reviewers to fulfill the 19(th) World Health Organization Essential Medicine List peer review. The methods and processes were feasible and met the necessary requirements in terms of time and quality. Continuous improvement and evaluation in practice are warranted. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

Hydrodynamic pressure processing: Impact on the quality attributes of fresh and further-processed meat products

USDA-ARS?s Scientific Manuscript database

This book chapter reviews hydrodynamic pressure processing (HDP) as an innovative, postharvest technology for enhancing the quality attributes of fresh and further-processed meat products. A variety of meat products have been tested for their response to the high pressure shockwaves of HDP. The st...

The use of data for process and quality improvement in long term care and home care: a systematic review of the literature.

PubMed

Sales, Anne E; Bostrom, Anne-Marie; Bucknall, Tracey; Draper, Kellie; Fraser, Kimberly; Schalm, Corinne; Warren, Sharon

2012-02-01

Standardized resident or client assessments, including the Resident Assessment Instrument (RAI), have been available in long term care and home care settings (continuing care sector) in many jurisdictions for a number of years. Although using these data can make quality improvement activities more efficient and less costly, there has not been a review of the literature reporting quality improvement interventions using standardized data. To address 2 questions: (1) How have RAI and other standardized data been used in process or quality improvement activities in the continuing care sector? and (2) Has the use of RAI and similar data resulted in improvements to resident or other outcomes? Searches using a combination of keyword and controlled vocabulary term searches were conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, the Cochrane Library, and PsychINFO. ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: English language publications from database inception to October 2008 were included. Eligibility criteria included the following: (1) set in continuing care (long-term care facility or home care), (2) involved some form of intervention designed to improve quality or process of care, and (3) used standardized data in the quality or process improvement intervention. After reviewing the articles, we grouped the studies according to the type of intervention used to initiate process improvement. Four different intervention types were identified. We organized the results and discussion by these 4 intervention types. Key word searches identified 713 articles, of which we excluded 639 on abstract review because they did not meet inclusion criteria. A further 50 articles were excluded on full-text review, leaving a total of 24 articles. Of the 24 studies, 10 used a defined process improvement model, 8 used a combination of interventions (multimodal), 5 implemented new guidelines or protocols, and 1 used an education intervention. The most frequently cited issues contributing to unsuccessful quality improvement interventions were lack of staff, high staff turnover, and limited time available to train staff in ways that would improve client care. Innovative strategies and supporting research are required to determine how to intervene successfully to improve quality in these settings characterized by low staffing levels and predominantly nonprofessional staff. Research on how to effectively enable practitioners to use data to improve quality of care, and ultimately quality of life, needs to be a priority. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Quality assurance in Australian hospitals: who does it and how?

PubMed

Renwick, M; Harvey, R

1990-01-01

To seek information on the type, method and extent of quality assurance being undertaken in all public and private hospitals within Australia. Mailed questionnaire. There was a predominance of two types of review being undertaken. Some important deficiencies in the quality assurance process were identified. Far more private than public hospitals reviewed medical records and surveyed patient satisfaction.

Retrospective analysis of the quality of reports by author-suggested and non-author-suggested reviewers in journals operating on open or single-blind peer review models.

PubMed

Kowalczuk, Maria K; Dudbridge, Frank; Nanda, Shreeya; Harriman, Stephanie L; Patel, Jigisha; Moylan, Elizabeth C

2015-09-29

To assess whether reports from reviewers recommended by authors show a bias in quality and recommendation for editorial decision, compared with reviewers suggested by other parties, and whether reviewer reports for journals operating on open or single-blind peer review models differ with regard to report quality and reviewer recommendations. Retrospective analysis of the quality of reviewer reports using an established Review Quality Instrument, and analysis of reviewer recommendations and author satisfaction surveys. BioMed Central biology and medical journals. BMC Infectious Diseases and BMC Microbiology are similar in size, rejection rates, impact factors and editorial processes, but the former uses open peer review while the latter uses single-blind peer review. The Journal of Inflammation has operated under both peer review models. Two hundred reviewer reports submitted to BMC Infectious Diseases, 200 reviewer reports submitted to BMC Microbiology and 400 reviewer reports submitted to the Journal of Inflammation. For each journal, author-suggested reviewers provided reports of comparable quality to non-author-suggested reviewers, but were significantly more likely to recommend acceptance, irrespective of the peer review model (p<0.0001 for BMC Infectious Diseases, BMC Microbiology and the Journal of Inflammation). For BMC Infectious Diseases, the overall quality of reviewer reports measured by the Review Quality Instrument was 5% higher than for BMC Microbiology (p=0.042). For the Journal of Inflammation, the quality of reports was the same irrespective of the peer review model used. Reviewers suggested by authors provide reports of comparable quality to non-author-suggested reviewers, but are significantly more likely to recommend acceptance. Open peer review reports for BMC Infectious Diseases were of higher quality than single-blind reports for BMC Microbiology. There was no difference in quality of peer review in the Journal of Inflammation under open peer review compared with single blind. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review

PubMed Central

Dewa, Carolyn S; Loong, Desmond; Bonato, Sarah; Trojanowski, Lucy

2017-01-01

Objectives This study reviews the current state of the published peer-reviewed literature related to physician burnout and two quality of care dimensions. The purpose of this systematic literature review is to address the question, ‘How does physician burnout affect the quality of healthcare related to the dimensions of acceptability and safety?’ Design Using a multiphase screening process, this systematic literature review is based on publically available peer-reviewed studies published between 2002 and 2017. Six electronic databases were searched: (1) MEDLINE Current, (2) MEDLINE In-process, (3) MEDLINE Epub Ahead of Print, (4) PsycINFO, (5) Embase and (6) Web of Science. Setting Physicians practicing in civilian settings. Participants Practicing physicians who have completed training. Primary and secondary outcome measures Quality of healthcare related to acceptability (ie, patient satisfaction, physician communication and physician attitudes) and safety (ie, minimising risks or harm to patients). Results 4114 unique citations were identified. Of these, 12 articles were included in the review. Two studies were rated as having high risk of bias and 10 as having moderate risk. Four studies were conducted in North America, four in Europe, one in the Middle East and three in East Asia. Results of this systematic literature review suggest there is moderate evidence that burnout is associated with safety-related quality of care. Because of the variability in the way patient acceptability-related quality of care was measured and the inconsistency in study findings, the evidence supporting the relationship between burnout and patient acceptability-related quality of care is less strong. Conclusions The focus on direct care-related quality highlights additional ways that physician burnout affects the healthcare system. These studies can help to inform decisions about how to improve patient care by addressing physician burnout. Continued work looking at the relationship between dimensions of acceptability-related quality of care measures and burnout is needed to advance the field. PMID:28637730

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

PubMed Central

2013-01-01

Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words) PMID:23331384

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

PubMed

Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

2013-01-19

Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.

Overview on the mechanisms of coffee germination and fermentation and their significance for coffee and coffee beverage quality.

PubMed

Waters, Deborah M; Arendt, Elke K; Moroni, Alice V

2017-01-22

Quality of coffee is a complex trait and is influenced by physical and sensory parameters. A complex succession of transformations during the processing of seeds to roasted coffee will inevitably influence the in-cup attributes of coffee. Germination and fermentation of the beans are two bioprocesses that take place during post-harvest treatment, and may lead to significant modifications of coffee attributes. The aim of this review is to address the current knowledge of dynamics of these two processes and their significance for bean modifications and coffee quality. The first part of this review gives an overview of coffee germination and its influence on coffee chemistry and quality. The germination process initiates while these non-orthodox seeds are still inside the cherry. This process is asynchronous and the evolution of germination depends on how the beans are processed. A range of metabolic reactions takes place during germination and can influence the carbohydrate, protein, and lipid composition of the beans. The second part of this review focuses on the microbiota associated with the beans during post-harvesting, exploring its effects on coffee quality and safety. The microbiota associated with the coffee cherries and beans comprise several bacterial, yeast, and fungal species and affects the processing from cherries to coffee beans. Indigenous bacteria and yeasts play a role in the degradation of pulp/mucilage, and their metabolism can affect the sensory attributes of coffee. On the other hand, the fungal population occurring during post-harvest and storage negatively affects coffee quality, especially regarding spoilage, off-tastes, and mycotoxin production.

Evolution of Internal Quality Assurance at One University--A Case Study

ERIC Educational Resources Information Center

O'Sullivan, David

2017-01-01

Purpose: Quality assurance (QA) at one University has evolved over the past 15 years through emerging National and European standards, various leadership initiatives and through the engagement of key stakeholders in co-designing and implementing internal QA processes. In 2000, the QA process was focussed mainly on quality review (QR) that involved…

Program Quality Review Training Materials for Elementary and Middle School Levels. Overhead Transparencies, Readings, Handouts, Samples of Student Work.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Office of School Improvement.

This guidebook contains training materials to be used by California elementary and middle-level schools in conducting the Program Quality Review (PQR). The PQR process of curriculum self-review enables the school community to focus, through extensive discussion, on how the school's curriculum and instruction can be improved so that all students…

What Is Nursing Home Quality and How Is It Measured?

PubMed Central

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Results: Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. Implications: We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed. PMID:20631035

Effects of a proposed quality improvement process in the proportion of the reported ultrasound findings unsupported by stored images.

PubMed

Schenone, Mauro; Ziebarth, Sarah; Duncan, Jose; Stokes, Lea; Hernandez, Angela

2018-02-05

To investigate the proportion of documented ultrasound findings that were unsupported by stored ultrasound images in the obstetric ultrasound unit, before and after the implementation of a quality improvement process consisting of a checklist and feedback. A quality improvement process was created involving utilization of a checklist and feedback from physician to sonographer. The feedback was based on findings of the physician's review of the report and images using a check list. To assess the impact of this process, two groups were compared. Group 1 consisted of 58 ultrasound reports created prior to initiation of the process. Group 2 included 65 ultrasound reports created after process implementation. Each chart was reviewed by a physician and a sonographer. Findings considered unsupported by stored images by both reviewers were used for analysis, and the proportion of unsupported findings was compared between the two groups. Results are expressed as mean ± standard error. A p value of < .05 was used to determine statistical significance. Univariate analysis of baseline characteristics and potential confounders showed no statistically significant difference between the groups. The mean proportion of unsupported findings in Group 1 was 5.1 ± 0.87, with Group 2 having a significantly lower proportion (2.6 ± 0.62) (p value = .018). Results suggest a significant decrease in the proportion of unsupported findings in ultrasound reports after quality improvement process implementation. Thus, we present a simple yet effective quality improvement process to reduce unsupported ultrasound findings.

Preanalytical errors in medical laboratories: a review of the available methodologies of data collection and analysis.

PubMed

West, Jamie; Atherton, Jennifer; Costelloe, Seán J; Pourmahram, Ghazaleh; Stretton, Adam; Cornes, Michael

2017-01-01

Preanalytical errors have previously been shown to contribute a significant proportion of errors in laboratory processes and contribute to a number of patient safety risks. Accreditation against ISO 15189:2012 requires that laboratory Quality Management Systems consider the impact of preanalytical processes in areas such as the identification and control of non-conformances, continual improvement, internal audit and quality indicators. Previous studies have shown that there is a wide variation in the definition, repertoire and collection methods for preanalytical quality indicators. The International Federation of Clinical Chemistry Working Group on Laboratory Errors and Patient Safety has defined a number of quality indicators for the preanalytical stage, and the adoption of harmonized definitions will support interlaboratory comparisons and continual improvement. There are a variety of data collection methods, including audit, manual recording processes, incident reporting mechanisms and laboratory information systems. Quality management processes such as benchmarking, statistical process control, Pareto analysis and failure mode and effect analysis can be used to review data and should be incorporated into clinical governance mechanisms. In this paper, The Association for Clinical Biochemistry and Laboratory Medicine PreAnalytical Specialist Interest Group review the various data collection methods available. Our recommendation is the use of the laboratory information management systems as a recording mechanism for preanalytical errors as this provides the easiest and most standardized mechanism of data capture.

Methodological quality of systematic reviews addressing femoroacetabular impingement.

PubMed

Kowalczuk, Marcin; Adamich, John; Simunovic, Nicole; Farrokhyar, Forough; Ayeni, Olufemi R

2015-09-01

As the body of literature on femoroacetabular impingement (FAI) continues to grow, clinicians turn to systematic reviews to remain current with the best available evidence. The quality of systematic reviews in the FAI literature is currently unknown. The goal of this study was to assess the quality of the reporting of systematic reviews addressing FAI over the last 11 years (2003-2014) and to identify the specific methodological shortcomings and strengths. A search of the electronic databases, MEDLINE, EMBASE and PubMed, was performed to identify relevant systematic reviews. Methodological quality was assessed by two reviewers using the revised assessment of multiple systematic reviews (R-AMSTAR) scoring tool. An intraclass correlation coefficient (ICC) with 95 % confidence intervals (CI) was used to determine agreement between reviewers on R-AMSTAR quality scores. A total of 22 systematic reviews were assessed for methodological quality. The mean consensus R-AMSTAR score across all studies was 26.7 out of 40.0, indicating fair methodological quality. An ICC of 0.931, 95 % CI 0.843-0.971 indicated excellent agreement between reviewers during the scoring process. The systematic reviews addressing FAI are generally of fair methodological quality. Use of tools such as the R-AMSTAR score or PRISMA guidelines while designing future systematic reviews can assist in eliminating methodological shortcomings identified in this review. These shortcomings need to be kept in mind by clinicians when applying the current literature to their patient populations and making treatment decisions. Systematic reviews of highest methodological quality should be used by clinicians when possible to answer clinical questions.

Do team processes really have an effect on clinical performance? A systematic literature review.

PubMed

Schmutz, J; Manser, T

2013-04-01

There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine the impact of team process behaviours on clinical performance. We conducted a literature search in five major databases. Inclusion criteria were: English peer-reviewed papers published between January 2001 and May 2012, which showed or tried to show (i) a statistical relationship of a team process variable and clinical performance or (ii) an improvement of a performance variable through a team process intervention. Study quality was assessed using predefined quality indicators. For every study, we calculated the relevant effect sizes. We included 28 studies in the review, seven of which were intervention studies. Every study reported at least one significant relationship between team processes or an intervention and performance. Also, some non-significant effects were reported. Most of the reported effect sizes were large or medium. The study quality ranged from medium to high. The studies are highly diverse regarding the specific team process behaviours investigated and also regarding the methods used. However, they suggest that team process behaviours do influence clinical performance and that training results in increased performance. Future research should rely on existing theoretical frameworks, valid, and reliable methods to assess processes such as teamwork or coordination and focus on the development of adequate tools to assess process performance, linking them with outcomes in the clinical setting.

Notification: Evaluation of EPA’s Approval Process for Air Quality Dispersion Models

EPA Pesticide Factsheets

Project #OPE-FY17-0016, June 5, 2017. The EPA OIG plans to begin preliminary research to assess the effectiveness of EPA's process for reviewing and approving air quality dispersion models it recommends for use.

The Validity of Peer Review in a General Medicine Journal

PubMed Central

Jackson, Jeffrey L.; Srinivasan, Malathi; Rea, Joanna; Fletcher, Kathlyn E.; Kravitz, Richard L.

2011-01-01

All the opinions in this article are those of the authors and should not be construed to reflect, in any way, those of the Department of Veterans Affairs. Background Our study purpose was to assess the predictive validity of reviewer quality ratings and editorial decisions in a general medicine journal. Methods Submissions to the Journal of General Internal Medicine (JGIM) between July 2004 and June 2005 were included. We abstracted JGIM peer review quality ratings, verified the publication status of all articles and calculated an impact factor for published articles (Rw) by dividing the 3-year citation rate by the average for this group of papers; an Rw>1 indicates a greater than average impact. Results Of 507 submissions, 128 (25%) were published in JGIM, 331 rejected (128 with review) and 48 were either not resubmitted after revision was requested or were withdrawn by the author. Of 331 rejections, 243 were published elsewhere. Articles published in JGIM had a higher citation rate than those published elsewhere (Rw: 1.6 vs. 1.1, p = 0.002). Reviewer quality ratings of article quality had good internal consistency and reviewer recommendations markedly influenced publication decisions. There was no quality rating cutpoint that accurately distinguished high from low impact articles. There was a stepwise increase in Rw for articles rejected without review, rejected after review or accepted by JGIM (Rw 0.60 vs. 0.87 vs. 1.56, p<0.0005). However, there was low agreement between reviewers for quality ratings and publication recommendations. The editorial publication decision accurately discriminated high and low impact articles in 68% of submissions. We found evidence of better accuracy with a greater number of reviewers. Conclusions The peer review process largely succeeds in selecting high impact articles and dispatching lower impact ones, but the process is far from perfect. While the inter-rater reliability between individual reviewers is low, the accuracy of sorting is improved with a greater number of reviewers. PMID:21799867

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

Description and Yield of Current Quality and Safety Review in Selected US Academic Emergency Departments.

PubMed

Griffey, Richard Thomas; Schneider, Ryan M; Sharp, Brian R; Pothof, Jeffrey J; Hodkins, Sheridan; Capp, Roberta; Wiler, Jennifer L; Sreshta, Neil; Sather, John E; Sampson, Christopher S; Powell, Jonathan T; Groner, Kathryn Y; Adler, Lee M

2017-06-29

Quality and safety review for performance improvement is important for systems of care and is required for US academic emergency departments (EDs). Assessment of the impact of patient safety initiatives in the context of increasing burdens of quality measurement compels standardized, meaningful, high-yield approaches for performance review. Limited data describe how quality and safety reviews are currently conducted and how well they perform in detecting patient harm and areas for improvement. We hypothesized that decades-old approaches used in many academic EDs are inefficient and low yield for identifying patient harm. We conducted a prospective observational study to evaluate the efficiency and yield of current quality review processes at five academic EDs for a 12-month period. Sites provided descriptions of their current practice and collected summary data on the number and severity of events identified in their reviews and the referral sources that led to their capture. Categories of common referral sources were established at the beginning of the study. Sites used the Institute for Healthcare Improvement's definition in defining an adverse event and a modified National Coordinating Council for Medication Error Reporting and Prevention (MERP) Index for grading severity of events. Participating sites had similar processes for quality review, including a two-level review process, monthly reviews and conferences, similar screening criteria, and a grading system for evaluating cases. In 60 months of data collection, we reviewed a total of 4735 cases and identified 381 events. This included 287 near-misses, errors/events (MERP A-I) and 94 adverse events (AEs) (MERP E-I). The overall AE rate (event rate with harm) was 1.99 (95% confidence interval = 1.62%-2.43%), ranging from 1.24% to 3.47% across sites. The overall rate of quality concerns (events without harm) was 6.06% (5.42%-6.78%), ranging from 2.96% to 10.95% across sites. Seventy-two-hour returns were the most frequent referral source used, accounting for 47% of the cases reviewed but with a yield of only 0.81% in identifying harm. Other referral sources similarly had very low yields. External referrals were the highest yield referral source, with 14.34% (10.64%-19.03%) identifying AEs. As a percentage of the 94 AEs identified, external referrals also accounted for 41.49% of cases. With an overall adverse event rate of 1.99%, commonly used referral sources seem to be low yield and inefficient for detecting patient harm. Approximately 6% of the cases identified by these criteria yielded a near miss or quality concern. New approaches to quality and safety review in the ED are needed to optimize their yield and efficiency for identifying harm and areas for improvement.

Quality assurance of qualitative research: a review of the discourse

PubMed Central

2011-01-01

Background Increasing demand for qualitative research within global health has emerged alongside increasing demand for demonstration of quality of research, in line with the evidence-based model of medicine. In quantitative health sciences research, in particular clinical trials, there exist clear and widely-recognised guidelines for conducting quality assurance of research. However, no comparable guidelines exist for qualitative research and although there are long-standing debates on what constitutes 'quality' in qualitative research, the concept of 'quality assurance' has not been explored widely. In acknowledgement of this gap, we sought to review discourses around quality assurance of qualitative research, as a first step towards developing guidance. Methods A range of databases, journals and grey literature sources were searched, and papers were included if they explicitly addressed quality assurance within a qualitative paradigm. A meta-narrative approach was used to review and synthesise the literature. Results Among the 37 papers included in the review, two dominant narratives were interpreted from the literature, reflecting contrasting approaches to quality assurance. The first focuses on demonstrating quality within research outputs; the second focuses on principles for quality practice throughout the research process. The second narrative appears to offer an approach to quality assurance that befits the values of qualitative research, emphasising the need to consider quality throughout the research process. Conclusions The paper identifies the strengths of the approaches represented in each narrative and recommend these are brought together in the development of a flexible framework to help qualitative researchers to define, apply and demonstrate principles of quality in their research. PMID:22182674

Peer review and the publication process.

PubMed

Ali, Parveen Azam; Watson, Roger

2016-10-01

To provide an overview of the peer review process, its various types, selection of peer reviewers, the purpose and significance of the peer review with regard to the assessment and management of quality of publications in academic journals. Discussion paper. This paper draws on information gained from literature on the peer review process and the authors' knowledge and experience of contributing as peer reviewers and editors in the field of health care, including nursing. There are various types of peer review: single blind; double blind; open; and post-publication review. The role of the reviewers in reviewing manuscripts and their contribution to the scientific and academic community remains important.

Recent Developments in Superheated Steam Processing of Foods-A Review.

PubMed

Alfy, Anto; Kiran, B V; Jeevitha, G C; Hebbar, H Umesh

2016-10-02

Although the use of superheated steam has been known for quite a long time, only in the recent past has it emerged as a viable technology for food processing. Superheated steam, having higher enthalpy, can quickly transfer heat to the material being processed, resulting in its rapid heating. The major advantages of using superheated steam for food processing are better product quality (color, shrinkage, and rehydration characteristics), reduced oxidation losses, and higher energy efficiency. This review provides a comprehensive overview of recent studies on the application of superheated steam for food-processing operations such as drying, decontamination and microbial load reduction, parboiling, and enzyme inactivation. The review encompasses aspects such as the effect of superheated steam processing on product quality, mathematical models reported for superheated steam drying, and the future scope of application in food processing. Recent studies on process improvisation, wherein superheated steam is used at low pressure, in fluidized bed mode, sequential processing with hot air/infrared, and in combination with micro droplets of water have also been discussed.

Nanosystem trends in drug delivery using quality-by-design concept.

PubMed

Li, Jing; Qiao, Yanjiang; Wu, Zhisheng

2017-06-28

Quality by design (QbD) has become an inevitable trend because of its benefits for product quality and process understanding. Trials have been conducted using QbD in nanosystems' optimization. This paper reviews the application of QbD for processing nanosystems and summarizes the application procedure. It provides prospective guidelines for future investigations that apply QbD to nanosystem manufacturing processes. Employing the QbD concept in this way is a novel area in nanosystem quality. Copyright © 2017 Elsevier B.V. All rights reserved.

A Model to Build Capacity through a Multi-Program Curriculum Review Process

ERIC Educational Resources Information Center

Dyjur, Patti; Lock, Jennifer

2016-01-01

Curriculum reviews are becoming more prevalent in higher educational institutions as a means to address quality assurance and improve program offerings. However, the review process can be structured so that instructors experience professional learning benefits as they work with program-level learning outcomes, map their courses, and analyze…

User's manual for computer program BASEPLOT

USGS Publications Warehouse

Sanders, Curtis L.

2002-01-01

The checking and reviewing of daily records of streamflow within the U.S. Geological Survey is traditionally accomplished by hand-plotting and mentally collating tables of data. The process is time consuming, difficult to standardize, and subject to errors in computation, data entry, and logic. In addition, the presentation of flow data on the internet requires more timely and accurate computation of daily flow records. BASEPLOT was developed for checking and review of primary streamflow records within the U.S. Geological Survey. Use of BASEPLOT enables users to (1) provide efficiencies during the record checking and review process, (2) improve quality control, (3) achieve uniformity of checking and review techniques of simple stage-discharge relations, and (4) provide a tool for teaching streamflow computation techniques. The BASEPLOT program produces tables of quality control checks and produces plots of rating curves and discharge measurements; variable shift (V-shift) diagrams; and V-shifts converted to stage-discharge plots, using data stored in the U.S. Geological Survey Automatic Data Processing System database. In addition, the program plots unit-value hydrographs that show unit-value stages, shifts, and datum corrections; input shifts, datum corrections, and effective dates; discharge measurements; effective dates for rating tables; and numeric quality control checks. Checklist/tutorial forms are provided for reviewers to ensure completeness of review and standardize the review process. The program was written for the U.S. Geological Survey SUN computer using the Statistical Analysis System (SAS) software produced by SAS Institute, Incorporated.

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

Bell, L.; Castaldi, A.; Jones, C.

The ultimate goal of the project is to develop procedures, techniques, data and other information that will aid in the design of cost effective and energy efficient drying processes that produce high quality foods. This objective has been sought by performing studies to determine the pertinent properties of food products, by developing models to describe the fundamental phenomena of food drying and by testing the models at laboratory scale. Finally, this information is used to develop recommendations and strategies for improved dryer design and control. This volume emphasizes a detailed literature review and several extensive experimental studies. Since the basicmore » principle of food dehydration is the removal of water from food, the process of removing water causes quality changes which can be categorized as physical, chemical, and nutritional. These changes often have adverse effects on the quality of the resulting dehydrated food. In this work, the types of physical and chemical changes common in food drying and the important factors for them were reviewed. Pertinent kinetic models and kinetic data reported in literature were also collected and compiled as the results of review study. The overall objectives of this study were to identify major quality change in foods caused by drying process and to get the knowledge of the relationship between the quality change and factors known to affect them. The quality parameters reviewed included: browning, lipid oxidation, color loss, shrinkage, solubility, texture, aroma and flavor, vitamin and protein loss and microbiological concerns. 54 refs., 74 figs., 49 tabs.« less

Structured implicit review: a new method for monitoring nursing care quality.

PubMed

Pearson, M L; Lee, J L; Chang, B L; Elliott, M; Kahn, K L; Rubenstein, L V

2000-11-01

Nurses' independent decisions about assessment, treatment, and nursing interventions for hospitalized patients are important determinants of quality of care. Physician peer implicit review of medical records has been central to Medicare quality management and is considered the gold standard for reviewing physician care, but peer implicit review of nursing processes of care has not received similar attention. The objective of this study was to develop and evaluate nurse structured implicit review (SIR) methods. We developed SIR instruments for rating the quality of inpatient nursing care for congestive heart failure (CHF) and cerebrovascular accident (CVA). Nurse reviewers used the SIR form to rate a nationally representative sample of randomly selected medical records for each disease from 297 acute care hospitals in 5 states (collected by the RAND-HCFA Prospective Payment System study). The study subjects were elderly Medicare inpatients with CHF (n = 291) or CVA (n = 283). We developed and tested scales reflecting domains of nursing process, evaluated interrater and interitem reliability, and assessed the extent to which items and scales predicted overall ratings of the quality of nursing care. Interrater reliability for 14 of 16 scales (CHF) or 10 of 16 scales (CVA) was > or = 0.40. Interitem reliability was > 0.80 for all but 1 scale (both diseases). Functional Assessment, Physical Assessment, and Medication Tracking ratings were the strongest predictors of overall nursing quality ratings (P < 0.001 for each). Nurse peer review with SIR has adequate interrater and excellent scale reliabilities and can be a valuable tool for assessing nurse performance.

Internal Quality Assurance Reviews: Challenges and Processes--Walter Sisulu University's Business, Management Sciences and Law Faculty

ERIC Educational Resources Information Center

Moodly, A.; Saunderson, I.

2008-01-01

The Council for Higher Educations' (CHE) Higher Education Quality Committee (HEQC) requires internal quality evaluations to be performed on the various programmes offered by the Faculty before visitation by the HEQC. This article examines some of the challenges and processes followed by six of the departments of Walter Sisulu University's Faculty…

42 CFR 480.107 - Limitations on redisclosure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... the Act or for CMS to process sanctions under section 1156 of the Act; (d) If the health care services...

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments

PubMed Central

2013-01-01

Background Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. Methods This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration’s review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. Results The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Conclusions Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness. PMID:24625035

Establishing the effectiveness of patient decision aids: key constructs and measurement instruments.

PubMed

Sepucha, Karen R; Borkhoff, Cornelia M; Lally, Joanne; Levin, Carrie A; Matlock, Daniel D; Ng, Chirk Jenn; Ropka, Mary E; Stacey, Dawn; Joseph-Williams, Natalie; Wills, Celia E; Thomson, Richard

2013-01-01

Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration's review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study reported on all key decision-making process and decision quality constructs. Evidence of PtDA effectiveness in improving the quality of the decision-making process and decision quality is strong and growing. There is not, however, consensus or standardization of measurement for either the decision-making process or decision quality. Additional work is needed to develop and evaluate measurement instruments and further explore theoretical issues to advance future research on PtDA effectiveness.

Quality in the pharmaceutical industry - A literature review.

PubMed

Haleem, Reham M; Salem, Maissa Y; Fatahallah, Faten A; Abdelfattah, Laila E

2015-10-01

The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices.

Power ultrasound in meat processing.

PubMed

Alarcon-Rojo, A D; Janacua, H; Rodriguez, J C; Paniwnyk, L; Mason, T J

2015-09-01

Ultrasound has a wide range of applications in various agricultural sectors. In food processing, it is considered to be an emerging technology with the potential to speed up processes without damaging the quality of foodstuffs. Here we review the reports on the applications of ultrasound specifically with a view to its use in meat processing. Emphasis is placed on the effects on quality and technological properties such as texture, water retention, colour, curing, marinating, cooking yield, freezing, thawing and microbial inhibition. After the literature review it is concluded that ultrasound is a useful tool for the meat industry as it helps in tenderisation, accelerates maturation and mass transfer, reduces cooking energy, increases shelf life of meat without affecting other quality properties, improves functional properties of emulsified products, eases mould cleaning and improves the sterilisation of equipment surfaces. Copyright © 2015 Elsevier Ltd. All rights reserved.

Peer Review of Best Practices

NASA Astrophysics Data System (ADS)

Pearlman, J.; Buttigieg, P. L.; Simpson, P.; Munoz, C.; Dufois, F.; Heslop, E. E.

2017-12-01

To ensure the quality of oceanographic data, there is a clear need to employ best practices (BPs) for ocean observation and information management. However, effectively discovering these BPs is a challenge, hindering harmonized quality assurance across projects and programmes. To remedy this, we are prototyping a resource for the stable archiving and efficient discovery of BPs through a granular, semantically indexed, and consistently formatted web resource. While these technical advances have value, they cannot ensure improved oceanographic data quality without effective and inclusive peer review processes. Peer review of digitized best practices can take a number of forms from traditional (blind) peer review as practiced by journal publishers through to the evolving "open" approach where community reviews have both the authors and reviewers identified. This presentation will discuss the options for peer review mechanisms for best practices, including a hybrid approach where both expert panels and open community review are used to improve methodologies and thus downstream data quality. It is not yet clear if the ocean community prefers open versus blind reviews for best practices. It is also unclear the extent to which innovation versus solid technical base should have a higher priority in the reviews. Further, it is not clear whether the reviews should use an internal expert panel of the IODE OceanBestPractices Repository (http://www.oceanbestpractices.net/) or should be done as part of a journal publications process or both, as mentioned above. Thus, we will also describe our future approach to `field test' these review models on a multi-stakeholder compendium of digitized best practice documents.

[Evaluating the rehabilitation process by means of peer review: examination of the methods used and findings of the 2000/2001 data collection in the somatic indications].

PubMed

Farin, E; Carl, C; Lichtenberg, S; Jäckel, W H; Maier-Riehle, B; Rütten-Köppel, E

2003-12-01

This paper reports the results of a peer review system that was implemented in the context of the quality assurance programme of the statutory German Pension Insurance scheme. The data reported refer to the 2000/2001 data collection period for medical rehabilitation in the somatic indications. Examination of inter-rater reliability for judgements of individual raters shows satisfactory results only in orthopaedics. In the quality assurance programme, rehabilitation centres are usually evaluated by the mean of 20 rater judgements. The reliability of this aggregated measure is satisfactory in all indications. The results of 561 rehabilitation centres show that those quality criteria are in particular need of improvement that refer to subjective concepts of patients (e. g., subjective theories of illness). Between peer review procedures in 1998 and 1999, the quality scores of rehabilitation centres had improved whereas between 1999 and 2000/2001, no further improvement can be shown. However, those rehabilitation centres with a low quality score in 1999 (lowest quartile of the distribution) underwent a positive development between 1999 and 2000/2001. Reasons for this trend and possibilities for improving interrater reliability of the peer review process as an element of the quality assurance programme of the German Pension Insurance scheme are discussed.

Monitoring Quality Across Home Visiting Models: A Field Test of Michigan's Home Visiting Quality Assurance System.

PubMed

Heany, Julia; Torres, Jennifer; Zagar, Cynthia; Kostelec, Tiffany

2018-06-05

Introduction In order to achieve the positive outcomes with parents and children demonstrated by many home visiting models, home visiting services must be well implemented. The Michigan Home Visiting Initiative developed a tool and procedure for monitoring implementation quality across models referred to as Michigan's Home Visiting Quality Assurance System (MHVQAS). This study field tested the MHVQAS. This article focuses on one of the study's evaluation questions: Can the MHVQAS be applied across models? Methods Eight local implementing agencies (LIAs) from four home visiting models (Healthy Families America, Early Head Start-Home Based, Parents as Teachers, Maternal Infant Health Program) and five reviewers participated in the study by completing site visits, tracking their time and costs, and completing surveys about the process. LIAs also submitted their most recent review by their model developer. The researchers conducted participant observation of the review process. Results Ratings on the MHVQAS were not significantly different between models. There were some differences in interrater reliability and perceived reliability between models. There were no significant differences between models in perceived validity, satisfaction with the review process, or cost to participate. Observational data suggested that cross-model applicability could be improved by assisting sites in relating the requirements of the tool to the specifics of their model. Discussion The MHVQAS shows promise as a tool and process to monitor implementation quality of home visiting services across models. The results of the study will be used to make improvements before the MHVQAS is used in practice.

Academic Excellence: A Commentary and Reflections on the Inherent Value of Peer Review

ERIC Educational Resources Information Center

Roberts, Thomas J.; Shambrook, Jennifer

2012-01-01

Academic peer review is widely viewed as fair, equitable, and essential to academic quality. Successfully completing the process through publication or award is widely deemed as one of the most rigorous and prestigious forms of scholarly accomplishment. Despite this sentiment the academic peer review process is not without fault. It is criticized…

Management of Hospital Formularies in Ontario: Challenges within a Local Health Integration Network.

PubMed

Burke, Natasha; Bowen, James M; Troyan, Sue; Jegathisawaran, Jathishinie; Gosse, Carolyn; Tonkin, Marita; Kagoma, Sandra; Goeree, Ron; Holbrook, Anne

2016-01-01

Expenditures on drugs dispensed and administered to patients in Canadian hospitals have been estimated at $2.4 billion per year. Pharmacy and therapeutics (P&T) committees play a key role in the evaluation and management of drug therapies in this setting. Hospitals differ with respect to the composition of these committees, their members' expertise, and the processes used for making formulary decisions. To examine the current processes for formulary drug review from the perspective of P&T committees and their individual members, and to examine the needs and preferences of these stakeholders related to evidence review and potential collaborative drug review processes within a large Local Health Integration Network (LHIN) in Ontario. Twenty-three sites within 10 hospital corporations in LHIN 4 (Hamilton Niagara Haldimand Brant) were recruited. A 2-part questionnaire was developed and pretested for clarity and comprehensiveness. The institution profile section of the questionnaire was to be completed by pharmacy directors and the P&T section by committee members. Ten pharmacy directors and 28 committee members representing 10 P&T committees responded. A mean of 6.4 new drug requests were reviewed annually by each P&T committee. Across the LHIN, the workload associated with reviewing submissions for new drugs to be added to the formulary represented 0.84 full-time equivalent. The quality of clinical evidence in the drug submissions was rated more favourably than the quality of economic evidence; furthermore, the use of economic evidence was limited by a lack of health economics expertise within the committees. A centralized review process for the LHIN was perceived as beneficial to improve efficiency, the quality of review, and standardization, and also to reduce costs. Across the Hamilton Niagara Haldimand Brant LHIN, considerable time and resources are spent on the review of potential new drugs for addition to the hospitals' formularies. A standardized formulary review process, with greater use of provincial and national drug reviews, would likely benefit all LHINs.

Contact and non-contact ultrasonic measurement in the food industry: a review

NASA Astrophysics Data System (ADS)

Taufiq Mohd Khairi, Mohd; Ibrahim, Sallehuddin; Yunus, Mohd Amri Md; Faramarzi, Mahdi

2016-01-01

The monitoring of the food manufacturing process is vital since it determines the safety and quality level of foods which directly affect the consumers’ health. Companies which produce high quality products will gain trust from consumers. This factor helps the companies to make profits. The use of efficient and appropriate sensors for the monitoring process can also reduce cost. The food assessing process based on an ultrasonic sensor has attracted the attention of the food industry due to its excellent capabilities in several applications. The utilization of low or high frequencies for the ultrasonic transducer has provided an enormous benefit for analysing, modifying and guaranteeing the quality of food. The contact and non-contact ultrasonic modes for measurement also contributed significantly to the food processing. This paper presents a review of the application of the contact and non-contact mode of ultrasonic measurement focusing on safety and quality control areas. The results from previous researches are shown and elaborated.

Professional Learning: A Collaborative Model for Online Teaching and Development

ERIC Educational Resources Information Center

Bowser, Audrey; Davis, Kimberley; Singleton, Jacques; Small, Topeka

2017-01-01

This article examined a unique collaborative initiative between a team of graduate level faculty to improve the quality of course development and delivery using a collaborative review process. The collaborative review of teaching has become a widely accepted means for assuring quality distance learning coursework and for the purpose of evaluating…

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Is compensation "bad for health"? A systematic meta-review.

PubMed

Spearing, Natalie M; Connelly, Luke B

2011-01-01

There is a common perception that injury compensation has a negative impact on health status, and systematic reviews supporting this thesis have been used to influence policy and practice decisions. This study evaluates the quality of the empirical evidence of a negative correlation between injury compensation and health outcomes, based on systematic reviews involving both verifiable and non-verifiable injuries. Systematic meta-review (a "review of reviews"). PubMED, CINAHL, EMBASE, PEDro, PsycInfo, EconLit, Lexis, ABI/INFORM, The Cochrane Library, and the AHRQ EPC were searched from the date of their inception to August 2008, and hand searches were conducted. Selection criteria were established a priori. Included systematic reviews examined the impact of compensation on health, involved adults, were published in English and used a range of outcome measures. Two investigators independently applied standard instruments to evaluate the methodological quality of the included reviews. Data on compensation scheme design (i.e., the intervention) and outcome measures were also extracted. Eleven systematic reviews involving verifiable and non-verifiable injuries met the inclusion criteria. Nine reviews reported an association between compensation and poor health outcomes. All of them were affected by the generally low quality of the primary (observational) research in this field, the heterogeneous nature of compensation laws (schemes) and legal processes for seeking compensation, and the difficulties in measuring compensation in relation to health. Notwithstanding the limitations of the research in this field, one higher quality review examining a single compensation process and relying on primary studies using health outcome (rather than proxy) measures found strong evidence of no association between litigation and poor health following whiplash, challenging the general belief that legal processes have a negative impact on health status. Moves to alter scheme design and limit access to compensation on the basis that it is "bad for health" are therefore premature, as evidence of such an association is unclear. 2009 Elsevier Ltd. All rights reserved.

A tiered quality assurance review process for clinical data management standard operating procedures in an academic health center.

PubMed

Ittenbach, Richard F; Baker, Cynthia L; Corsmo, Jeremy J

2014-05-01

Standard operating procedures (SOPs) were once considered the province of the pharmaceutical industry but are now viewed as a key component of quality assurance programs. To address variability and increase the rigor of clinical data management (CDM) operations, the Cincinnati Children's Hospital Medical Center (CCHMC) decided to create CDM SOPs. In response to this challenge, and as part of a broader institutional initiative, the CCHMC leadership established an executive steering committee to oversee the development and implementation of CDM SOPs. This resulted in the creation of a quality assurance review process with three review panels: an SOP development team (16 clinical data managers and technical staff members), a faculty review panel (8 senior faculty and administrators), and an expert advisory panel (3 national CDM experts). This innovative, tiered review process helped ensure that the new SOPs would be created and implemented in accord with good CDM practices and standards. Twelve fully vetted, institutionally endorsed SOPs and one CDM template resulted from the intensive, iterative 10-month process (December 2011 to early October 2012). Phased implementation, which incoporated the CDM SOPs into the existing audit process for certain types of clinical research studies, was on schedule at the time of this writing. Once CCHMC researchers have had the opportunity to use the SOPs over time and across a broad range of research settings and conditions, the SOPs will be revisited and revalidated.

The evolution of peer review as a basis for scientific publication: directional selection towards a robust discipline?

PubMed

Ferreira, Catarina; Bastille-Rousseau, Guillaume; Bennett, Amanda M; Ellington, E Hance; Terwissen, Christine; Austin, Cayla; Borlestean, Adrian; Boudreau, Melanie R; Chan, Kevin; Forsythe, Adrian; Hossie, Thomas J; Landolt, Kristen; Longhi, Jessica; Otis, Josée-Anne; Peers, Michael J L; Rae, Jason; Seguin, Jacob; Watt, Cristen; Wehtje, Morgan; Murray, Dennis L

2016-08-01

Peer review is pivotal to science and academia, as it represents a widely accepted strategy for ensuring quality control in scientific research. Yet, the peer-review system is poorly adapted to recent changes in the discipline and current societal needs. We provide historical context for the cultural lag that governs peer review that has eventually led to the system's current structural weaknesses (voluntary review, unstandardized review criteria, decentralized process). We argue that some current attempts to upgrade or otherwise modify the peer-review system are merely sticking-plaster solutions to these fundamental flaws, and therefore are unlikely to resolve them in the long term. We claim that for peer review to be relevant, effective, and contemporary with today's publishing demands across scientific disciplines, its main components need to be redesigned. We propose directional changes that are likely to improve the quality, rigour, and timeliness of peer review, and thereby ensure that this critical process serves the community it was created for. © 2015 Cambridge Philosophical Society.

The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: a systematic literature review.

PubMed

Dewa, Carolyn S; Loong, Desmond; Bonato, Sarah; Trojanowski, Lucy; Rea, Margaret

2017-11-09

There has been increasing interest in examining the relationship between physician wellbeing and quality of patient care. However, few reviews have specifically focused on resident burnout and quality of patient care. The purpose of this systematic literature review of the current scientific literature is to address the question, "How does resident burnout affect the quality of healthcare related to the dimensions of acceptability and safety?" This systematic literature review uses a multi-step screening process of publicly available peer-reviewed studies from five electronic databases: (1) Medline Current, (2) Medline In-process, (3) PsycINFO, (4) Embase, and (5) Web of Science. The electronic literature search resulted in the identification of 4638 unique citations. Of these, 10 articles were included in the review. Studies were assessed for risk of bias. Of the 10 studies that met the inclusion criteria, eight were conducted in the US, one in The Netherlands, and one in Mexico. Eight of the 10 studies focused on patient safety. The results of these included studies suggest there is moderate evidence that burnout is associated with patient safety (i.e., resident self-perceived medical errors and sub-optimal care). There is less evidence that specific dimensions of burnout are related to acceptability (i.e., quality of care, communication with patients). The results of this systematic literature review suggest a relationship between patient safety and burnout. These results potentially have important implications for the medical training milieu because residents are still in training and at the same time are asked to teach students. The results also indicate a need for more evidence-based interventions that support continued research examining quality of care measures, especially as they relate to acceptability.

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

21 CFR 211.100 - Written procedures; deviations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Process Controls § 211.100 Written procedures; deviations. (a) There shall be written procedures for production and process control designed to assure that the drug products have the identity, strength, quality... approved by the appropriate organizational units and reviewed and approved by the quality control unit. (b...

Lessons learned from a rigorous peer-review process for building the Climate Literacy and Energy Awareness (CLEAN) collection of high-quality digital teaching materials

NASA Astrophysics Data System (ADS)

Gold, A. U.; Ledley, T. S.; McCaffrey, M. S.; Buhr, S. M.; Manduca, C. A.; Niepold, F.; Fox, S.; Howell, C. D.; Lynds, S. E.

2010-12-01

The topic of climate change permeates all aspects of our society: the news, household debates, scientific conferences, etc. To provide students with accurate information about climate science and energy awareness, educators require scientifically and pedagogically robust teaching materials. To address this need, the NSF-funded Climate Literacy & Energy Awareness Network (CLEAN) Pathway has assembled a new peer-reviewed digital collection as part of the National Science Digital Library (NSDL) featuring teaching materials centered on climate and energy science for grades 6 through 16. The scope and framework of the collection is defined by the Essential Principles of Climate Science (CCSP 2009) and a set of energy awareness principles developed in the project. The collection provides trustworthy teaching materials on these socially relevant topics and prepares students to become responsible decision-makers. While a peer-review process is desirable for curriculum developer as well as collection builder to ensure quality, its implementation is non-trivial. We have designed a rigorous and transparent peer-review process for the CLEAN collection, and our experiences provide general guidelines that can be used to judge the quality of digital teaching materials across disciplines. Our multi-stage review process ensures that only resources with teaching goals relevant to developing climate literacy and energy awareness are considered. Each relevant resource is reviewed by two individuals to assess the i) scientific accuracy, ii) pedagogic effectiveness, and iii) usability/technical quality. A science review by an expert ensures the scientific quality and accuracy. Resources that pass all review steps are forwarded to a review panel of educators and scientists who make a final decision regarding inclusion of the materials in the CLEAN collection. Results from the first panel review show that about 20% (~100) of the resources that were initially considered for inclusion passed final review. Reviewer comments are recorded as annotations to enhance the resources in the collection and help educators with the implementation in their curriculum. CLEAN launched the first collection of digital educational resources about climate science and energy awareness in November 2010. The final CLEAN collection will include ≥500 resources and will also provide the alignment with the Benchmarks for Science Literacy and the NAAEE Excellence in Environmental Education Guidelines for Learning through the interactive NSDL strandmaps. We will present the first user feedback to this new collection.

Is non-linear frequency compression amplification beneficial to adults and children with hearing loss? A systematic review.

PubMed

Akinseye, Gladys Atinuke; Dickinson, Ann-Marie; Munro, Kevin J

2018-04-01

To conduct a systematic review of the benefits of non-linear frequency compression (NLFC) in adults and children. Ten databases were searched for studies comparing the effects of NLFC and conventional processing (CP) for the period January 2008 to September 2017. Twelve articles were included in this review: four adults and school-aged only, one pre-school only and three with both adults and school-aged children. A two-stage process was implemented to grade the evidence. The individual studies were graded based on their study type (from 1 = highest quality of evidence to 5 = the lowest quality) and then sub-graded based on their quality ("a" for "good quality" or "b" for "lesser quality"). All studies were awarded 4a, except the single pre-school study, which was awarded 2a. The overall evidence for each population was graded based on the quality, quantity and consistency of the studies. The body of evidence was rated as very low for both adults and school-aged children, but high for pre-school children. The low number (and quality) of studies means that evidence supporting the benefit from NLFC is inconclusive. Further high-quality RCTs are required to provide a conclusive answer to this question.

Lean and Six Sigma in acute care: a systematic review of reviews.

PubMed

Deblois, Simon; Lepanto, Luigi

2016-01-01

The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research. A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al. (2006). Data were reported according to PRISMA. The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events. There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge. Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the factors of success and the barriers to their implementation, as well as their long-term impact. This is the first broad systematic review of reviews, synthesizing data pertaining to implementation issues and results in acute care settings, to be published. It will benefit health care managers assessing the potential of these approaches and the potential drawbacks associated with their implementation. Moreover, it identifies directions for future research.

Pharmaceutical quality by design: product and process development, understanding, and control.

PubMed

Yu, Lawrence X

2008-04-01

The purpose of this paper is to discuss the pharmaceutical Quality by Design (QbD) and describe how it can be used to ensure pharmaceutical quality. The QbD was described and some of its elements identified. Process parameters and quality attributes were identified for each unit operation during manufacture of solid oral dosage forms. The use of QbD was contrasted with the evaluation of product quality by testing alone. The QbD is a systemic approach to pharmaceutical development. It means designing and developing formulations and manufacturing processes to ensure predefined product quality. Some of the QbD elements include: Defining target product quality profile; Designing product and manufacturing processes; Identifying critical quality attributes, process parameters, and sources of variability; Controlling manufacturing processes to produce consistent quality over time. Using QbD, pharmaceutical quality is assured by understanding and controlling formulation and manufacturing variables. Product testing confirms the product quality. Implementation of QbD will enable transformation of the chemistry, manufacturing, and controls (CMC) review of abbreviated new drug applications (ANDAs) into a science-based pharmaceutical quality assessment.

Assessing Postgraduate Student Perceptions and Measures of Learning in a Peer Review Feedback Process

ERIC Educational Resources Information Center

Simpson, Genevieve; Clifton, Julian

2016-01-01

Peer review feedback, developed to assist students with increasing the quality of group reports and developing peer review skills, was added to a master's level Climate Change Policy and Planning unit. A pre- and post-survey was conducted to determine whether students found the process a valuable learning opportunity: 87% of students responding to…

Peer Review and the Dilemmas of Quality Control in Programme Accreditation in South African Higher Education: Challenges and Possibilities

ERIC Educational Resources Information Center

Cross, Michael; Naidoo, Devika

2011-01-01

The paper scrutinises the dynamics and the nature of peer review in the programme evaluation and accreditation process within the context of diverse individual and institutional legacies in South Africa. It analyses the peer review process and highlights the contestation at political, policy and epistemological levels. The paper argues that,…

What Is Nursing Home Quality and How Is It Measured?

ERIC Educational Resources Information Center

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

Innovative Ingredients and Emerging Technologies for Controlling Ice Recrystallization, Texture, and Structure Stability in Frozen Dairy Desserts: A Review.

PubMed

Soukoulis, Christos; Fisk, Ian

2016-11-17

Over the past decade, ice cream manufacturers have developed a strong understanding of the functionality of key ingredients and processing, developing effective explanations for the link between structure forming agents, stability mechanisms, and perceived quality. Increasing demand for products perceived as healthier/more natural with minimal processing has identified a number of new tools to improve quality and storage stability of frozen dairy desserts. Ingredients such as dietary fiber, polysaccharides, prebiotics, alternate sweeteners, fat sources rich in unsaturated fatty acids and ice strucsturing proteins (ISP) have been successfully applied as cryoprotective, texturizing, and structuring agents. Emerging minimal processing technologies including hydrostatic pressure processing, ultrasonic or high pressure assisted freezing, low temperature extrusion and enzymatically induced biopolymers crosslinking have been evaluated for their ability to improve colloidal stability, texture and sensory quality. It is therefore timely for a comprehensive review.

EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event Case Study

EPA Pesticide Factsheets

In June, 2007, participants from EPA headquarters, EPA Region 7, and the four States in EPA Region 7 (IA, KS, MO, and NE) conducted a Lean business kaizen event on the EPA–State process for developing and revising water quality standards (WQS).

Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Chapter 9, August 2004

EPA Science Inventory

EPA is in 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 review and re...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER (FOURTH EXTERNAL REVIEW DRAFT) [REVISED CHAPTERS 7, 8, AND 9, JUNE 2004

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter 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 review and revisio...

Quality in the pharmaceutical industry – A literature review

PubMed Central

Haleem, Reham M.; Salem, Maissa Y.; Fatahallah, Faten A.; Abdelfattah, Laila E.

2013-01-01

Objectives The aim of this study is to:a.Highlight the most important guidelines and practices of quality in the pharmaceutical industry.b.Organize such guidelines and practices to create a guide to pave the way for other researchers who would like to dig deeper into these guidelines and practices. Design A review was conducted of 102 publications; 56 publications were concerned with the pharmaceutical quality directly while 46 publications were concerned with the general quality practices. The content of those sources was analyzed and the following themes were identified:a.Research theme 1: Guidelines of the pharmaceutical quality.b.Research theme 2: General practices recently applied in the pharmaceutical industry. Main outcome measures The following guidelines were identified and reviewed: WHO guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I. In research theme II; the following topics were identified and reviewed: quality risk management, quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma, process analytical technology, lean manufacturing, total quality management, ISO series and HACCP. Results Upon reviewing the previously highlighted guidelines and the practices that are widely applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers and articles that explain the general guidelines and practices but the literature lack those describing application; case studies of the pharmaceutical factories applying those guidelines and significance of those guidelines and practices. Conclusions It is recommended that the literature would invest more in the area of application and significance of guidelines and practices. New case studies should be done to prove the feasibility of such practices. PMID:26594110

Effect of pay for performance to improve quality of maternal and child care in low- and middle-income countries: a systematic review.

PubMed

Das, Ashis; Gopalan, Saji S; Chandramohan, Daniel

2016-04-14

Pay for Performance (P4P) mechanisms to health facilities and providers are currently being tested in several low- and middle-income countries (LMIC) to improve maternal and child health (MCH). This paper reviews the existing evidence on the effect of P4P program on quality of MCH care in LMICs. A systematic review of literature was conducted according to a registered protocol. MEDLINE, Web of Science, and Embase were searched using the key words maternal care, quality of care, ante natal care, emergency obstetric and neonatal care (EmONC) and child care. Of 4535 records retrieved, only eight papers met the inclusion criteria. Primary outcome of interest was quality of MCH disaggregated into structural quality, process quality and outcomes. Risk of bias across studies was assessed through a customized quality checklist. There were four controlled before after intervention studies, three cluster randomized controlled trials and one case control with post-intervention comparison of P4P programs for MCH care in Burundi, Democratic Republic of Congo, Egypt, the Philippines, and Rwanda. There is some evidence of positive effect of P4P only on process quality of MCH. The effect of P4P on delivery, EmONC, post natal care and under-five child care were not evaluated in these studies. There is weak evidence for P4P's positive effect on maternal and neonatal health outcomes and out-of-pocket expenses. P4P program had a few negative effects on structural quality. P4P is effective to improve process quality of ante natal care. However, further research is needed to understand P4P's impact on MCH and their causal pathways in LMICs. PROSPERO registration number CRD42014013077 .

A Review of Paradigms for Evaluating the Quality of Online Education Programs

ERIC Educational Resources Information Center

Shelton, Kaye

2011-01-01

As the demands for public accountability increase for higher education, institutions must demonstrate quality within programs and processes, including those provided through online education. While quality may be elusive to specifically quantify, there have been several recommendations for identifying and defining quality online education that…

Assuring Quality in Online Offerings: Insights from a University's Faculty

ERIC Educational Resources Information Center

Budden, Connie B.; Budden, Heather L.; Hall, Michelle; Longman, Debbie G.

2015-01-01

As the growth of online education offered by universities accelerates and spreads, universities are increasingly grappling with concerns related to widespread availability and the maintenance of academic quality. The "Quality Matters at Southeastern" Program fosters quality through a peer review process and offers a certification process…

Peer feedback for examiner quality assurance on MRCGP International South Asia: a mixed methods study.

PubMed

Perera, D P; Andrades, Marie; Wass, Val

2017-12-08

The International Membership Examination (MRCGP[INT]) of the Royal College of General Practitioners UK is a unique collaboration between four South Asian countries with diverse cultures, epidemiology, clinical facilities and resources. In this setting good quality assurance is imperative to achieve acceptable standards of inter rater reliability. This study aims to explore the process of peer feedback for examiner quality assurance with regard to factors affecting the implementation and acceptance of the method. A sequential mixed methods approach was used based on focus group discussions with examiners (n = 12) and clinical examination convenors who acted as peer reviewers (n = 4). A questionnaire based on emerging themes and literature review was then completed by 20 examiners at the subsequent OSCE exam. Qualitative data were analysed using an iterative reflexive process. Quantitative data were integrated by interpretive analysis looking for convergence, complementarity or dissonance. The qualitative data helped understand the issues and informed the process of developing the questionnaire. The quantitative data allowed for further refining of issues, wider sampling of examiners and giving voice to different perspectives. Examiners stated specifically that peer feedback gave an opportunity for discussion, standardisation of judgments and improved discriminatory abilities. Interpersonal dynamics, hierarchy and perception of validity of feedback were major factors influencing acceptance of feedback. Examiners desired increased transparency, accountability and the opportunity for equal partnership within the process. The process was stressful for examiners and reviewers; however acceptance increased with increasing exposure to receiving feedback. The process could be refined to improve acceptability through scrupulous attention to training and selection of those giving feedback to improve the perceived validity of feedback and improved reviewer feedback skills to enable better interpersonal dynamics and a more equitable feedback process. It is important to highlight the role of quality assurance and peer feedback as a tool for continuous improvement and maintenance of standards to examiners during training. Examiner quality assurance using peer feedback was generally a successful and accepted process. The findings highlight areas for improvement and guide the path towards a model of feedback that is responsive to examiner views and cultural sensibilities.

SU-F-P-06: Moving From Computed Radiography to Digital Radiography: A Collaborative Approach to Improve Image Quality

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

Sandoval, D; Mlady, G; Selwyn, R

Purpose: To bring together radiologists, technologists, and physicists to utilize post-processing techniques in digital radiography (DR) in order to optimize image acquisition and improve image quality. Methods: Sub-optimal images acquired on a new General Electric (GE) DR system were flagged for follow-up by radiologists and reviewed by technologists and medical physicists. Various exam types from adult musculoskeletal (n=35), adult chest (n=4), and pediatric (n=7) were chosen for review. 673 total images were reviewed. These images were processed using five customized algorithms provided by GE. An image score sheet was created allowing the radiologist to assign a numeric score to eachmore » of the processed images, this allowed for objective comparison to the original images. Each image was scored based on seven properties: 1) overall image look, 2) soft tissue contrast, 3) high contrast, 4) latitude, 5) tissue equalization, 6) edge enhancement, 7) visualization of structures. Additional space allowed for additional comments not captured in scoring categories. Radiologists scored the images from 1 – 10 with 1 being non-diagnostic quality and 10 being superior diagnostic quality. Scores for each custom algorithm for each image set were summed. The algorithm with the highest score for each image set was then set as the default processing. Results: Images placed into the PACS “QC folder” for image processing reasons decreased. Feedback from radiologists was, overall, that image quality for these studies had improved. All default processing for these image types was changed to the new algorithm. Conclusion: This work is an example of the collaboration between radiologists, technologists, and physicists at the University of New Mexico to add value to the radiology department. The significant amount of work required to prepare the processing algorithms, reprocessing and scoring of the images was eagerly taken on by all team members in order to produce better quality images and improve patient care.« less

Ethical dilemmas of recording and reviewing neonatal resuscitation.

PubMed

den Boer, Maria C; Houtlosser, Mirjam; van Zanten, Henriëtte Anje; Foglia, Elizabeth E; Engberts, Dirk P; Te Pas, Arjan B

2018-05-01

Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved. Recording and reviewing vital physiological parameters and video imaging of neonatal resuscitation in the delivery room is a valuable tool for quality assurance, education and research. Furthermore, it can improve the quality of neonatal resuscitation provided. We observed that ethical dilemmas arise as the review process is operating in several domains of healthcare that all have their specific moral framework with requirements and conditions on issues such as consent, privacy and data storage. These moral requirements and conditions vary due to local circumstances. Further research on the ethical aspects of recording and reviewing is desirable before wider implementation of this technique can be recommended. © 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.

Using lean methodology to improve efficiency of electronic order set maintenance in the hospital.

PubMed

Idemoto, Lori; Williams, Barbara; Blackmore, Craig

2016-01-01

Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets. In March of 2014, we implemented a systematic, cyclical order set review process, with a set schedule, defined responsibilities for various stakeholders, formal meetings and communication between stakeholders, and transparency of the process. We first identified and deactivated 89 order sets which were infrequently used. Between March and August 2014, 142 order sets went through the new review process. Processing time for the build duration of order sets decreased from a mean of 79.6 to 43.2 days (p<.001, CI=22.1, 50.7). Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical.

Improving program documentation quality through the application of continuous improvement processes.

PubMed

Lovlien, Cheryl A; Johansen, Martha; Timm, Sandra; Eversman, Shari; Gusa, Dorothy; Twedell, Diane

2007-01-01

Maintaining the integrity of record keeping and retrievable information related to the provision of continuing education credit creates challenges for a large organization. Accurate educational program documentation is vital to support the knowledge and professional development of nursing staff. Quality review and accurate documentation of programs for nursing staff development occurred at one institution through the use of continuous improvement principles. Integration of the new process into the current system maintains the process of providing quality record keeping.

Using quality indicators in anaesthesia: feeding back data to improve care.

PubMed

Benn, J; Arnold, G; Wei, I; Riley, C; Aleva, F

2012-07-01

After recent UK policy developments, considerable attention has been focused upon how clinical specialties measure and report on the quality of care delivered to patients. Defining the right indicators alone is insufficient to close the feedback loop. This narrative review aims to describe and synthesize a diverse body of research relevant to the question of how information from quality indicators can be fed back and used effectively to improve care. Anaesthesia poses certain challenges in the identification of valid outcome indicators sensitive to variations in anaesthetic care. Metrics collected during the immediate post-anaesthetic recovery period, such as patient temperature, patient-reported quality of recovery, and pain and nausea, provide potentially useful information for the anaesthetist, yet this information is not routinely fed back. Reviews of the effects of feeding back performance data to healthcare providers suggest that this may result in small to moderate positive effects upon outcomes and professional practice, with stronger effects where feedback is integrated within a broader quality improvement strategy. The dominant model for use of data within quality improvement is based upon the industrial process control approach, in which care processes are monitored continuously for process changes which are rapidly detectable for corrective action. From this review and experience of implementing these principles in practice, effective feedback from quality indicators is timely, credible, confidential, tailored to the recipient, and continuous. Considerable further work is needed to understand how information from quality indicators can be fed back in an effective way to clinicians and clinical units, in order to support revalidation and continuous improvement.

76 FR 77492 - Draft Guidance on Improving the Process for Preparing Efficient and Timely Environmental Reviews...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

..., is a fundamental tool used to harmonize our environmental, economic, and social aspirations and is a... COUNCIL ON ENVIRONMENTAL QUALITY Draft Guidance on Improving the Process for Preparing Efficient and Timely Environmental Reviews under the National Environmental Policy Act AGENCY: Council on...

Medical journal peer review: process and bias.

PubMed

Manchikanti, Laxmaiah; Kaye, Alan D; Boswell, Mark V; Hirsch, Joshua A

2015-01-01

Scientific peer review is pivotal in health care research in that it facilitates the evaluation of findings for competence, significance, and originality by qualified experts. While the origins of peer review can be traced to the societies of the eighteenth century, it became an institutionalized part of the scholarly process in the latter half of the twentieth century. This was a response to the growth of research and greater subject specialization. With the current increase in the number of specialty journals, the peer review process continues to evolve to meet the needs of patients, clinicians, and policy makers. The peer review process itself faces challenges. Unblinded peer review might suffer from positive or negative bias towards certain authors, specialties, and institutions. Peer review can also suffer when editors and/or reviewers might be unable to understand the contents of the submitted manuscript. This can result in an inability to detect major flaws, or revelations of major flaws after acceptance of publication by the editors. Other concerns include potentially long delays in publication and challenges uncovering plagiarism, duplication, corruption and scientific misconduct. Conversely, a multitude of these challenges have led to claims of scientific misconduct and an erosion of faith. These challenges have invited criticism of the peer review process itself. However, despite its imperfections, the peer review process enjoys widespread support in the scientific community. Peer review bias is one of the major focuses of today's scientific assessment of the literature. Various types of peer review bias include content-based bias, confirmation bias, bias due to conservatism, bias against interdisciplinary research, publication bias, and the bias of conflicts of interest. Consequently, peer review would benefit from various changes and improvements with appropriate training of reviewers to provide quality reviews to maintain the quality and integrity of research without bias. Thus, an appropriate, transparent peer review is not only ideal, but necessary for the future to facilitate scientific progress.

Automated data mining of a proprietary database system for physician quality improvement.

PubMed

Johnstone, Peter A S; Crenshaw, Tim; Cassels, Diane G; Fox, Timothy H

2008-04-01

Physician practice quality improvement is a subject of intense national debate. This report describes using a software data acquisition program to mine an existing, commonly used proprietary radiation oncology database to assess physician performance. Between 2003 and 2004, a manual analysis was performed of electronic portal image (EPI) review records. Custom software was recently developed to mine the record-and-verify database and the review process of EPI at our institution. In late 2006, a report was developed that allowed for immediate review of physician completeness and speed of EPI review for any prescribed period. The software extracted >46,000 EPIs between 2003 and 2007, providing EPI review status and time to review by each physician. Between 2003 and 2007, the department EPI review improved from 77% to 97% (range, 85.4-100%), with a decrease in the mean time to review from 4.2 days to 2.4 days. The initial intervention in 2003 to 2004 was moderately successful in changing the EPI review patterns; it was not repeated because of the time required to perform it. However, the implementation in 2006 of the automated review tool yielded a profound change in practice. Using the software, the automated chart review required approximately 1.5 h for mining and extracting the data for the 4-year period. This study quantified the EPI review process as it evolved during a 4-year period at our institution and found that automation of data retrieval and review simplified and facilitated physician quality improvement.

Learning from open source software projects to improve scientific review.

PubMed

Ghosh, Satrajit S; Klein, Arno; Avants, Brian; Millman, K Jarrod

2012-01-01

Peer-reviewed publications are the primary mechanism for sharing scientific results. The current peer-review process is, however, fraught with many problems that undermine the pace, validity, and credibility of science. We highlight five salient problems: (1) reviewers are expected to have comprehensive expertise; (2) reviewers do not have sufficient access to methods and materials to evaluate a study; (3) reviewers are neither identified nor acknowledged; (4) there is no measure of the quality of a review; and (5) reviews take a lot of time, and once submitted cannot evolve. We propose that these problems can be resolved by making the following changes to the review process. Distributing reviews to many reviewers would allow each reviewer to focus on portions of the article that reflect the reviewer's specialty or area of interest and place less of a burden on any one reviewer. Providing reviewers materials and methods to perform comprehensive evaluation would facilitate transparency, greater scrutiny, and replication of results. Acknowledging reviewers makes it possible to quantitatively assess reviewer contributions, which could be used to establish the impact of the reviewer in the scientific community. Quantifying review quality could help establish the importance of individual reviews and reviewers as well as the submitted article. Finally, we recommend expediting post-publication reviews and allowing for the dialog to continue and flourish in a dynamic and interactive manner. We argue that these solutions can be implemented by adapting existing features from open-source software management and social networking technologies. We propose a model of an open, interactive review system that quantifies the significance of articles, the quality of reviews, and the reputation of reviewers.

Learning from open source software projects to improve scientific review

PubMed Central

Ghosh, Satrajit S.; Klein, Arno; Avants, Brian; Millman, K. Jarrod

2012-01-01

Peer-reviewed publications are the primary mechanism for sharing scientific results. The current peer-review process is, however, fraught with many problems that undermine the pace, validity, and credibility of science. We highlight five salient problems: (1) reviewers are expected to have comprehensive expertise; (2) reviewers do not have sufficient access to methods and materials to evaluate a study; (3) reviewers are neither identified nor acknowledged; (4) there is no measure of the quality of a review; and (5) reviews take a lot of time, and once submitted cannot evolve. We propose that these problems can be resolved by making the following changes to the review process. Distributing reviews to many reviewers would allow each reviewer to focus on portions of the article that reflect the reviewer's specialty or area of interest and place less of a burden on any one reviewer. Providing reviewers materials and methods to perform comprehensive evaluation would facilitate transparency, greater scrutiny, and replication of results. Acknowledging reviewers makes it possible to quantitatively assess reviewer contributions, which could be used to establish the impact of the reviewer in the scientific community. Quantifying review quality could help establish the importance of individual reviews and reviewers as well as the submitted article. Finally, we recommend expediting post-publication reviews and allowing for the dialog to continue and flourish in a dynamic and interactive manner. We argue that these solutions can be implemented by adapting existing features from open-source software management and social networking technologies. We propose a model of an open, interactive review system that quantifies the significance of articles, the quality of reviews, and the reputation of reviewers. PMID:22529798

Benchmarking performance: Environmental impact statements in Egypt

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

Badr, El-Sayed A., E-mail: ebadr@mans.edu.e; Zahran, Ashraf A., E-mail: ashraf_zahran@yahoo.co; Cashmore, Matthew, E-mail: m.cashmore@uea.ac.u

Environmental impact assessment (EIA) was formally introduced in Egypt in 1994. This short paper evaluates 'how well' the EIA process is working in practice in Egypt, by reviewing the quality of 45 environmental impact statements (EISs) produced between 2000 and 2007 for a variety of project types. The Lee and Colley review package was used to assess the quality of the selected EISs. About 69% of the EISs sampled were found to be of a satisfactory quality. An assessment of the performance of different elements of the EIA process indicates that descriptive tasks tend to be performed better than scientificmore » tasks. The quality of core elements of EIA (e.g., impact prediction, significance evaluation, scoping and consideration of alternatives) appears to be particularly problematic. Variables that influence the quality of EISs are identified and a number of broad recommendations are made for improving the effectiveness of the EIA system.« less

Quality Assurance of Quality Assurance Agencies from an Asian Perspective: Regulation, Autonomy and Accountability

ERIC Educational Resources Information Center

Hou, Angela Yung-Chi; Ince, Martin; Tsai, Sandy; Chiang, Chung Lin

2015-01-01

As quality guardians of higher education, quality assurance agencies are required to guarantee the credibility of the review process and to ensure the objectivity and transparency of their decisions and recommendations. These agencies are therefore expected to use a range of internal and external approaches to prove the quality of their review…

Protocol for a scoping review study to identify and classify patient-centred quality indicators.

PubMed

Jolley, Rachel J; Lorenzetti, Diane L; Manalili, Kimberly; Lu, Mingshan; Quan, Hude; Santana, Maria J

2017-01-05

The concept of patient-centred care (PCC) is changing the way healthcare is understood, accepted and delivered. The Institute of Medicine has defined PCC as 1 of its 6 aims to improve healthcare quality. However, in Canada, there are currently no nationwide standards in place for measuring and evaluating healthcare from a patient-centred approach. In this paper, we outline our scoping review protocol to systematically review published and unpublished literature specific to patient-centred quality indicators that have been implemented and evaluated across various care settings. Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. We will search electronic databases (MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Social Work Abstracts, Social Services Abstracts), grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. 2 reviewers will independently screen all abstracts and full-text studies for inclusion. We will include any study which focuses on quality indicators in the context of PCC. All bibliographic data, study characteristics and indicators will be collected and analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. The scoping review will synthesise patient-centred quality indicators and their characteristics as described in the literature. This review will be the first step to formally identify what quality indicators have been used to evaluate PCC across the healthcare continuum, and will be used to inform a stakeholder consensus process exploring the development of a generic set of patient-centred quality indicators applicable to multiple care settings. The results will be disseminated through a peer-reviewed publication, conference presentations and a one-day stakeholder meeting. 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/.

A review of randomized controlled trials of medical record powered clinical decision support system to improve quality of diabetes care.

PubMed

Ali, Syed Mustafa; Giordano, Richard; Lakhani, Saima; Walker, Dawn Marie

2016-03-01

A gap between current diabetes care practice and recommended diabetes care standards has consistently been reported in the literature. Many IT-based interventions have been developed to improve adherence to the quality of care standards for chronic illness like diabetes. The widespread implementation of electronic medical/health records has catalyzed clinical decision support systems (CDSS) which may improve the quality of diabetes care. Therefore, the objective of the review is to evaluate the effectiveness of CDSS in improving quality of type II diabetes care. Moreover, the review aims to highlight the key indicators of quality improvement to assist policy makers in development of future diabetes care policies through the integration of information technology and system. Setting inclusion criteria, a systematic literature search was conducted using Medline, Web of Science and Science Direct. Critical Appraisal Skills Programme (CASP) tools were used to evaluate the quality of studies. Eight randomized controlled trials (RCTs) were selected for the review. In the selected studies, seventeen clinical markers of diabetes care were discussed. Three quality of care indicators were given more importance in monitoring the progress of diabetes care, which is consistent with National Institute for Health and Care Excellence (NICE) guidelines. The presence of these indicators in the studies helped to determine which studies were selected for review. Clinical- and process-related improvements are compared between intervention group using CDSS and control group with usual care. Glycated hemoglobin (HbA1c), low density lipid cholesterol (LDL-C) and blood pressure (BP) were the quality of care indicators studied at the levels of process of care and clinical outcome. The review has found both inconsistent and variable results for quality of diabetes care measures. A significant improvement has been found in the process of care for all three measures of quality of diabetes care. However, weak to modest positive results are observed for the clinical measures of the diabetes care indicators. In addition to this, technology adoption of CDSS is found to be consistently low. The review suggests the need to conduct further empirical research using the critical diabetes care indicators (HbA1c, LDL-C and BP) to ascertain if CDSS improves the quality of diabetes care. Research designs should be improved, especially with regard to baseline characteristics, sample size and study period. With respect to implementation of CDSS, rather than a sudden change of clinical work practice, there should instead be an incremental, gradual adoption of technology that minimizes the disruption in clinical workflow. Copyright © 2016. Published by Elsevier Ireland Ltd.

A new full-field digital mammography system with and without the use of an advanced post-processing algorithm: comparison of image quality and diagnostic performance.

PubMed

Ahn, Hye Shin; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Kim, Bohyoung; Ko, Eun Sook; Han, Boo-Kyung; Chang, Jung Min; Yi, Ann; Cho, Nariya; Moon, Woo Kyung; Choi, Hye Young

2014-01-01

To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic performance, and priority rank. During a 22-month period, we prospectively enrolled 100 cases of specimen FFDM mammography (Brestige®), which was performed alone or in combination with a post-processing algorithm developed by the manufacturer: group A (SMA), specimen mammography without application of "Mammogram enhancement ver. 2.0"; group B (SMB), specimen mammography with application of "Mammogram enhancement ver. 2.0". Two sets of specimen mammographies were randomly reviewed by five experienced radiologists. Image quality, lesion detection, diagnostic performance, and priority rank with regard to image preference were evaluated. Three aspects of image quality (overall quality, contrast, and noise) of the SMB were significantly superior to those of SMA (p < 0.05). SMB was significantly superior to SMA for visualizing calcifications (p < 0.05). Diagnostic performance, as evaluated by cancer score, was similar between SMA and SMB. SMB was preferred to SMA by four of the five reviewers. The post-processing algorithm may improve image quality with better image preference in FFDM than without use of the software.

Evaluation of Research Ethics Committees: Criteria for the Ethical Quality of the Review Process.

PubMed

Scherzinger, Gregor; Bobbert, Monika

2017-01-01

Repeatedly, adequacy, performance and quality of Ethics Committees that oversee medical research trials are being discussed. Although they play a crucial role in reviewing medical research and protecting human subjects, it is far from clear to what degree they fulfill the task they have been assigned to. This eventuates in the call for an evaluation of their activity and, in some places, led to the establishment of accreditation schemes. At the same time, IRBs have become subject of detailed legislation in the process of the ongoing global juridification of medical research. Unsurprisingly, there is a tendency to understand the evaluation of RECs as a question of controlling their legal compliance. This paper discusses the need for a quality evaluation of IRBs from an ethical point of view and, by systematically reviewing the major ethical guidelines for IRBs, proposes a system of criteria that should orientate any evaluation of IRBs.

A review on the fermentation of foods and the residues of pesticides-biotransformation of pesticides and effects on fermentation and food quality.

PubMed

Regueiro, Jorge; López-Fernández, Olalla; Rial-Otero, Raquel; Cancho-Grande, Beatriz; Simal-Gándara, Jesús

2015-01-01

Residues of pesticides in food are influenced by processing such as fermentation. Reviewing the extensive literature showed that in most cases, this step leads to large reductions in original residue levels in the fermented food, with the formation of new pesticide by-products. The behavior of residues in fermentation can be rationalized in terms of the physical-chemical properties of the pesticide and the nature of the process. In addition, the presence of pesticides decrease the growth rate of fermentative microbiota (yeasts and bacterias), which provokes stuck and sluggish fermentations. These changes have in consequence repercussions on several aspects of food sensory quality (physical-chemical properties, polyphenolic content, and aromatic profile) of fermented food. The main aim of this review is to deal with all these topics to propose challenging needs in science-based quality management of pesticides residues in food.

Peer review of human studies run amok: a break in the fiduciary relation between scientists and the public.

PubMed

Feldstein Ewing, Sarah W; Saitz, Richard

2015-02-01

Peer review aims to ensure the quality and credibility of research reporting. Conducted by volunteer scientists who receive no guidance or direction, peer review widely varies from fast and facilitative, to unclear and obstructive. Poor quality is an issue because most science research is publicly funded, whereby scientists must make an effort to quickly disseminate their findings back to the public. An unfortunately not uncommon barrier in this process is ineffective peer review. Most scientists agree that when done well, editors and reviewers drive and maintain the high standards of science. At the same time, ineffective peer review can cause great delay with no introduced improvement in final product. These delays and requests interfere with the path of communication between scientist and public, at a great cost to editors, reviewers, authors and those who stand to benefit from application of the results of the studies. We offer a series of concrete recommendations to improve this process.

Challenges in Special Steel Making

NASA Astrophysics Data System (ADS)

Balachandran, G.

2018-02-01

Special bar quality [SBQ] is a long steel product where an assured quality is delivered by the steel mill to its customer. The bars have enhanced tolerance to higher stress application and it is demanded for specialised component making. The SBQ bars are sought for component making processing units such as closed die hot forging, hot extrusion, cold forging, machining, heat treatment, welding operations. The final component quality of the secondary processing units depends on the quality maintained at the steel maker end along with quality maintained at the fabricator end. Thus, quality control is ensured at every unit process stages. The various market segments catered to by SBQ steel segment is ever growing and is reviewed. Steel mills need adequate infrastructure and technological capability to make these higher quality steels. Some of the critical stages of processing SBQ and the critical quality maintenance parameters at the steel mill in the manufacture has been brought out.

Quality assessment of genetic counseling process in the context of presymptomatic testing for late-onset disorders: a thematic analysis of three review articles.

PubMed

Paneque, Milena; Sequeiros, Jorge; Skirton, Heather

2012-01-01

Presymptomatic testing (PST) is available for a range of late-onset disorders. Health practitioners generally follow guidelines regarding appropriate number of counseling sessions, involvement of multidisciplinary teams, topics for pretest discussion, and follow-up sessions; however, more understanding is needed about what helps consultands effectively and the impact of amount and quality of genetic counseling on the psychosocial sequelae of PST for late-onset disorders. We conducted a thematic analysis of three review articles on quality of the genetic counseling process, aiming at (1) exploring current evidence; (2) identifying quality assessment indicators; and (3) making recommendations for genetic counseling practice in late-onset disorders. We undertook a systematic search of 6 relevant databases: 38 articles were identified and 3 fitted our inclusion criteria; after quality appraisal, all were included in the review. The number of sessions, time spent, consultation environment, follow-up, and multidisciplinarity were identified as variables for quality assessment. Research on counseling in the context of genetic testing in familial cancer tends to be related to outcomes and indicators for quality assessment, while research concerning other late-onset diseases is mainly focused on the psychological impact of the test results. The quality and content of the overall process in noncancer late-onset diseases is insufficiently articulated. Despite the fact that PST for Huntington disease and other degenerative conditions has been offered for more than 20 years, good methodological approaches to assess quality of genetic counseling in that context remain elusive. This restricts improvement of the protocols for genetic services and, in general, healthcare for the at-risk population.

Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Drafts of Chapters 7 and 8, December 2003

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter 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 review an...

Quality Indicators for Safe Medication Preparation and Administration: A Systematic Review

PubMed Central

Maaskant, Jolanda M.; de Boer, Monica; Krediet, C. T. Paul; Nieveen van Dijkum, Els J. M.

2015-01-01

Background One-third of all medication errors causing harm to hospitalized patients occur in the medication preparation and administration phase, which is predominantly a nursing activity. To monitor, evaluate and improve the quality and safety of this process, evidence-based quality indicators can be used. Objectives The aim of study was to identify evidence-based quality indicators (structure, process and outcome) for safe in-hospital medication preparation and administration. Methods MEDLINE, EMBASE and CINAHL were searched for relevant studies published up to January 2015. Additionally, nine databases were searched to identify relevant grey literature. Two reviewers independently selected studies if (1) the method for quality indicator development combined a literature search with expert panel opinion, (2) the study contained quality indicators on medication safety, and (3) any of the quality indicators were applicable to hospital medication preparation and administration. A multidisciplinary team appraised the studies independently using the AIRE instrument, which contains four domains and 20 items. Quality indicators applicable to in-hospital medication preparation and administration were extracted using a structured form. Results The search identified 1683 studies, of which 64 were reviewed in detail and five met the inclusion criteria. Overall, according to the AIRE domains, all studies were clear on purpose; most of them applied stakeholder involvement and used evidence reasonably; usage of the indicator in practice was scarcely described. A total of 21 quality indicators were identified: 5 structure indicators (e.g. safety management and high alert medication), 11 process indicators (e.g. verification and protocols) and 5 outcome indicators (e.g. harm and death). These quality indicators partially cover the 7 rights. Conclusion Despite the relatively small number of included studies, the identified quality indicators can serve as an excellent starting point for further development of nursing specific quality indicators for medication safety. Especially on the right patient, right route, right time and right documentation there is room future development of quality indicators. PMID:25884623

Integrated care programmes for adults with chronic conditions: a meta-review.

PubMed

Martínez-González, Nahara Anani; Berchtold, Peter; Ullman, Klara; Busato, André; Egger, Matthias

2014-10-01

To review systematic reviews and meta-analyses of integrated care programmes in chronically ill patients, with a focus on methodological quality, elements of integration assessed and effects reported. Meta-review of systematic reviews and meta-analyses identified in Medline (1946-March 2012), Embase (1980-March 2012), CINHAL (1981-March 2012) and the Cochrane Library of Systematic Reviews (issue 1, 2012). Methodological quality assessed by the 11-item Assessment of Multiple Systematic Reviews (AMSTAR) checklist; elements of integration assessed using a published list of 10 key principles of integration; effects on patient-centred outcomes, process quality, use of healthcare and costs. Twenty-seven systematic reviews were identified; conditions included chronic heart failure (CHF; 12 reviews), diabetes mellitus (DM; seven reviews), chronic obstructive pulmonary disease (COPD; seven reviews) and asthma (five reviews). The median number of AMSTAR checklist items met was five: few reviewers searched for unpublished literature or described the primary studies and interventions in detail. Most reviews covered comprehensive services across the care continuum or standardization of care through inter-professional teams, but organizational culture, governance structure or financial management were rarely assessed. A majority of reviews found beneficial effects of integration, including reduced hospital admissions and re-admissions (in CHF and DM), improved adherence to treatment guidelines (DM, COPD and asthma) or quality of life (DM). Few reviews showed reductions in costs. Systematic reviews of integrated care programmes were of mixed quality, assessed only some components of integration of care, and showed consistent benefits for some outcomes but not others. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Taguchi's off line method and Multivariate loss function approach for quality management and optimization of process parameters -A review

NASA Astrophysics Data System (ADS)

Bharti, P. K.; Khan, M. I.; Singh, Harbinder

2010-10-01

Off-line quality control is considered to be an effective approach to improve product quality at a relatively low cost. The Taguchi method is one of the conventional approaches for this purpose. Through this approach, engineers can determine a feasible combination of design parameters such that the variability of a product's response can be reduced and the mean is close to the desired target. The traditional Taguchi method was focused on ensuring good performance at the parameter design stage with one quality characteristic, but most products and processes have multiple quality characteristics. The optimal parameter design minimizes the total quality loss for multiple quality characteristics. Several studies have presented approaches addressing multiple quality characteristics. Most of these papers were concerned with maximizing the parameter combination of signal to noise (SN) ratios. The results reveal the advantages of this approach are that the optimal parameter design is the same as the traditional Taguchi method for the single quality characteristic; the optimal design maximizes the amount of reduction of total quality loss for multiple quality characteristics. This paper presents a literature review on solving multi-response problems in the Taguchi method and its successful implementation in various industries.

A Scoping Review of Empirical Research Relating to Quality and Effectiveness of Research Ethics Review.

PubMed

Nicholls, Stuart G; Hayes, Tavis P; Brehaut, Jamie C; McDonald, Michael; Weijer, Charles; Saginur, Raphael; Fergusson, Dean

2015-01-01

To date there is no established consensus of assessment criteria for evaluating research ethics review. We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction. Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial--randomised or otherwise--of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review. Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review.

Transforming nanomedicine manufacturing toward Quality by Design and microfluidics.

PubMed

Colombo, Stefano; Beck-Broichsitter, Moritz; Bøtker, Johan Peter; Malmsten, Martin; Rantanen, Jukka; Bohr, Adam

2018-04-05

Nanopharmaceuticals aim at translating the unique features of nano-scale materials into therapeutic products and consequently their development relies critically on the progression in manufacturing technology to allow scalable processes complying with process economy and quality assurance. The relatively high failure rate in translational nanopharmaceutical research and development, with respect to new products on the market, is at least partly due to immature bottom-up manufacturing development and resulting sub-optimal control of quality attributes in nanopharmaceuticals. Recently, quality-oriented manufacturing of pharmaceuticals has undergone an unprecedented change toward process and product development interaction. In this context, Quality by Design (QbD) aims to integrate product and process development resulting in an increased number of product applications to regulatory agencies and stronger proprietary defense strategies of process-based products. Although QbD can be applied to essentially any production approach, microfluidic production offers particular opportunities for QbD-based manufacturing of nanopharmaceuticals. Microfluidics provides unique design flexibility, process control and parameter predictability, and also offers ample opportunities for modular production setups, allowing process feedback for continuously operating production and process control. The present review aims at outlining emerging opportunities in the synergistic implementation of QbD strategies and microfluidic production in contemporary development and manufacturing of nanopharmaceuticals. In doing so, aspects of design and development, but also technology management, are reviewed, as is the strategic role of these tools for aligning nanopharmaceutical innovation, development, and advanced industrialization in the broader pharmaceutical field. Copyright © 2018 Elsevier B.V. All rights reserved.

Sustaining quality in the community: trends in the performance of a structured diabetes care programme in primary care over 16 years.

PubMed

Riordan, F; McHugh, S M; Harkins, V; Marsden, P; Kearney, P M

2018-04-29

To examine the quality of care delivered by a structured primary care-led programme for people with Type 2 diabetes mellitus in 1999-2016. The Midland Diabetes Structured Care Programme provides structured primary care-led management. Trends over time in care processes were examined (using a chi-squared trend test and age- and gender-adjusted logistic regression). Screening and annual review attendance were reviewed. A composite of eight National Institute for Health and Care Excellence-recommended processes was used as a quality indicator. Participants who were referred to diabetes nurse specialists were compared with those not referred (Student's t-test, Pearson's chi-squared test, Wilcoxon-Mann-Whitney test). Proportions achieving outcome targets [HbA 1c ≤58 mmol/mol (7.5%), blood pressure ≤140/80 mmHg, cholesterol <5.0 mmol/l] were calculated. Data were available for people with diabetes aged ≥18 years: 1998/1999 (n=336); 2003 (n=843); 2008 (n=988); and 2016 (n=1029). Recording of some processes improved significantly over time (HbA 1c , cholesterol, blood pressure, creatinine), and in 2016 exceeded 97%. Foot assessment and annual review attendance declined. In 2016, only 29% of participants had all eight National Institute for Health and Care Excellence processes recorded. A higher proportion of people with diabetes who were referred to a diabetes nurse specialist had poor glycaemic control compared with those not referred. The proportions meeting blood pressure and lipid targets increased over time. Structured primary care led to improvements in the quality of care over time. Poorer recording of some processes, a decline in annual review attendance, and participants remaining at high risk suggest limits to what structured care alone can achieve. Engagement in continuous quality improvement to target other factors, including attendance and self-management, may deliver further improvements. © 2018 Diabetes UK.

[Quality assessment in anesthesia].

PubMed

Kupperwasser, B

1996-01-01

Quality assessment (assurance/improvement) is the set of methods used to measure and improve the delivered care and the department's performance against pre-established criteria or standards. The four stages of the self-maintained quality assessment cycle are: problem identification, problem analysis, problem correction and evaluation of corrective actions. Quality assessment is a measurable entity for which it is necessary to define and calibrate measurement parameters (indicators) from available data gathered from the hospital anaesthesia environment. Problem identification comes from the accumulation of indicators. There are four types of quality indicators: structure, process, outcome and sentinel indicators. The latter signal a quality defect, are independent of outcomes, are easier to analyse by statistical methods and closely related to processes and main targets of quality improvement. The three types of methods to analyse the problems (indicators) are: peer review, quantitative methods and risks management techniques. Peer review is performed by qualified anaesthesiologists. To improve its validity, the review process should be explicited and conclusions based on standards of practice and literature references. The quantitative methods are statistical analyses applied to the collected data and presented in a graphic format (histogram, Pareto diagram, control charts). The risks management techniques include: a) critical incident analysis establishing an objective relationship between a 'critical' event and the associated human behaviours; b) system accident analysis, based on the fact that accidents continue to occur despite safety systems and sophisticated technologies, checks of all the process components leading to the impredictable outcome and not just the human factors; c) cause-effect diagrams facilitate the problem analysis in reducing its causes to four fundamental components (persons, regulations, equipment, process). Definition and implementation of corrective measures, based on the findings of the two previous stages, are the third step of the evaluation cycle. The Hawthorne effect is an outcome improvement, before the implementation of any corrective actions. Verification of the implemented actions is the final and mandatory step closing the evaluation cycle.

A systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety.

PubMed

Xie, Anping; Carayon, Pascale

2015-01-01

Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.

Editors’ Perspectives on Enhancing Manuscript Quality and Editorial Decisions Through Peer Review and Reviewer Development

PubMed Central

Janke, Kristin K.; Traynor, Andrew P.

2017-01-01

Objectives. To identify peer reviewer and peer review characteristics that enhance manuscript quality and editorial decisions, and to identify valuable elements of peer reviewer training programs. Methods. A three-school, 15-year review of pharmacy practice and pharmacy administration faculty’s publications was conducted to identify high-publication volume journals for inclusion. Editors-in-chief identified all editors managing manuscripts for participation. A three-round modified Delphi process was used. Rounds advanced from open-ended questions regarding actions and attributes of good reviewers to consensus-seeking and clarifying questions related to quality, importance, value, and priority. Results. Nineteen editors representing eight pharmacy journals participated. Three characteristics of reviews were rated required or helpful in enhancing manuscript quality by all respondents: includes a critical analysis of the manuscript (88% required, 12% helpful), includes feedback that contains both strengths and areas of improvement (53% required, 47% helpful), and speaks to the manuscript’s utility in the literature (41% required, 59% helpful). Hands-on experience with review activities (88%) and exposure to good and bad reviews (88%) were identified as very valuable to peer reviewer development. Conclusion. Reviewers, individuals involved in faculty development, and journals should work to assist new reviewers in defining focused areas of expertise, building knowledge in these areas, and developing critical analysis skills. PMID:28630514

Improving patient safety through quality assurance.

PubMed

Raab, Stephen S

2006-05-01

Anatomic pathology laboratories use several quality assurance tools to detect errors and to improve patient safety. To review some of the anatomic pathology laboratory patient safety quality assurance practices. Different standards and measures in anatomic pathology quality assurance and patient safety were reviewed. Frequency of anatomic pathology laboratory error, variability in the use of specific quality assurance practices, and use of data for error reduction initiatives. Anatomic pathology error frequencies vary according to the detection method used. Based on secondary review, a College of American Pathologists Q-Probes study showed that the mean laboratory error frequency was 6.7%. A College of American Pathologists Q-Tracks study measuring frozen section discrepancy found that laboratories improved the longer they monitored and shared data. There is a lack of standardization across laboratories even for governmentally mandated quality assurance practices, such as cytologic-histologic correlation. The National Institutes of Health funded a consortium of laboratories to benchmark laboratory error frequencies, perform root cause analysis, and design error reduction initiatives, using quality assurance data. Based on the cytologic-histologic correlation process, these laboratories found an aggregate nongynecologic error frequency of 10.8%. Based on gynecologic error data, the laboratory at my institution used Toyota production system processes to lower gynecologic error frequencies and to improve Papanicolaou test metrics. Laboratory quality assurance practices have been used to track error rates, and laboratories are starting to use these data for error reduction initiatives.

Acknowledgements to referees.

PubMed

De Angelis, Valerio

2015-01-01

The quality of The Journal of Headache and Pain depends on the qualified and regular collaboration of renowned scientists, who devoted their time to constructively review the submitted articles.We are indebted to the following experts who reviewed papers that completed the peer-reviewing process within 2014.

Air quality management: evolution of policy and practice in the UK as exemplified by the experience of English local government

NASA Astrophysics Data System (ADS)

Beattie, C. I.; Longhurst, J. W. S.; Woodfield, N. K.

The air quality management (AQM) framework in the UK is designed to be an effects-based solution to air pollutants currently affecting human health. The AQM process has been legislated through The Environment Act 1995, which required the National Air Quality Strategy (NAQS) to be published. AQM practice and capability within local authorities has flourished since the publication of the NAQS in March 1997. This paper outlines the policy framework within which the UK operates, both at a domestic and European level, and reviews the air quality management process relating to current UK policy and EU policy. Data from questionnaire surveys are used to indicate the involvement of various sectors of local government in the air quality management process. These data indicate an increasing use of monitoring, and use of air dispersion modelling by English local authorities. Data relating to the management of air quality, for example, the existence and work of air quality groups, dissemination of information to the public and policy measures in place on a local scale to improve air quality, have also been reported. The UK NAQS has been reviewed in 1999 to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the socio-economic issues involved. The AQM process, as implemented by UK local authorities, provides an effective model for other European member states with regards to the implementation of the Air Quality Framework Directive. The future direction of air quality policy in the UK is also discussed.

Manuscript peer review at the AJR: facts, figures, and quality assessment.

PubMed

Friedman, D P

1995-04-01

Concern by the government, funding institutions, and the public for quality assurance in all aspects of medical endeavors mandates critical examination of various professional activities. Although peer review is generally regarded as the best system for selecting and improving scientific papers for publication, the efficacy of this process has never been proved. Moreover, the administrative functions of the editorial staff are often poorly understood. The purpose of this article is to make peer review a the AJR less esoteric and more understandable by quantifying some of its activities. This information is then assessed as it relates to the quality of this important step in scientific publication.

What we have learned: the impact of quality from a clinical trials perspective

PubMed Central

FitzGerald, T. J.

2011-01-01

In this review article we address the radiation oncology process improvements in clinical trials and review how these changes improve the quality for the next generation of trials. In recent years we have progressed from a time of limited data acquisition to the present in which we have real time influence of clinical trials quality. This enables immediate availability of the important elements including staging, eligibility, response and outcome for all trial investigators. Modern informatics platforms are well designed for future adaptive clinical trials. We review what will be needed in the informatics architecture of current and future clinical trials. PMID:22177875

Time required for institutional review board review at one Veterans Affairs medical center.

PubMed

Hall, Daniel E; Hanusa, Barbara H; Stone, Roslyn A; Ling, Bruce S; Arnold, Robert M

2015-02-01

Despite growing concern that institutional review boards (IRBs) impose burdensome delays on research, little is known about the time required for IRB review across different types of research. To measure the overall and incremental process times for IRB review as a process of quality improvement. After developing a detailed process flowchart of the IRB review process, 2 analysts abstracted temporal data from the records pertaining to all 103 protocols newly submitted to the IRB at a large urban Veterans Affairs medical center from June 1, 2009, through May 31, 2011. Disagreements were reviewed with the principal investigator to reach consensus. We then compared the review times across review types using analysis of variance and post hoc Scheffé tests after achieving normally distributed data through logarithmic transformation. Calendar days from initial submission to final approval of research protocols. Initial IRB review took 2 to 4 months, with expedited and exempt reviews requiring less time (median [range], 85 [23-631] and 82 [16-437] days, respectively) than full board reviews (median [range], 131 [64-296] days; P = .008). The median time required for credentialing of investigators was 1 day (range, 0-74 days), and review by the research and development committee took a median of 15 days (range, 0-184 days). There were no significant differences in credentialing or research and development times across review types (exempt, expedited, or full board). Of the extreme delays in IRB review, 80.0% were due to investigators' slow responses to requested changes. There were no systematic delays attributable to the information security officer, privacy officer, or IRB chair. Measuring and analyzing review times is a critical first step in establishing a culture and process of continuous quality improvement among IRBs that govern research programs. The review times observed at this IRB are substantially longer than the 60-day target recommended by expert panels. The method described here could be applied to other IRBs to begin identifying and improving inefficiencies.

[How to adapt to the requirements of "clinical value-oriented drug innovation" for pharmaceutical research in application process of new traditional Chinese medicine].

PubMed

Jin, Fang

2017-05-01

On August 9, 2015, the State Council promulgated the "Opinions of the State Council on the reform of drug and medical device review and approval system" (Guofa 2015 No. 44), and established the "clinical value-oriented drug innovation" model to encourage the research and development of new drugs. Following that, China Food and Drug Administration (CFDA) promulgated the "Notice on several policies for drug registration review and approval" (2015 No. 230 ) on November 11, 2015, clearly specifying that CFDA would "implement one-time approval for clinical trials application of the new drugs, and no longer take a phased declaration, review and approval system; for the new drugs that apply for clinical trials, mainly review the scientific natureof the clinical protocols and the risk control of the new drugs to guarantee the safety of subjects". Accordingly, the evaluation ideas and forms of new drug registration have also been adjusted greatly. For example, issues like the rationality of the drug manufacturing process, whether the scale can reflect the stability of the process, whether the preparation process is sufficient, and whether the choice of dosage form is reasonable are no longer the focus of evaluation before clinical trials. Issues regarding whether the preparation process design is reasonable, whether the effective components can be transferred to the preparation to a maximum extent, whether the process parameters determined in small and middle pilot trials can adapt to the requirements of mass production, no longer act as the reasons for refusing the clinical trials. The corresponding risks shall be borne by the applicant as the subject of liability. The focus in registration evaluation is mainly transferred to how to ensure the consistence of quality between clinical trial samples and the samples already available on market by guaranteeing stable sources of drug raw materials and stable quality of medicines as well as control of the whole preparation process. These issues run through the whole process of new drug development, but also have different focuses in different stages. According to the "Measures on communicating about drug research and development and technical review" (2016 No. 94) (On Trial) issued by CFDA on June 2, 2016, the applicants may communicate with the drug evaluation center in different phases in the process of new drugs registration in respects of medicine material problems, technological problems, and quality control of the preparations. In this paper, the transformation of Chinese medicine research model was described mainly in the following aspects: how to control the quality of medicines from origins, technology design of the preparation and technology process research, and how to establish whole-process quality system. The paper also reflects the concept that the quality of new Chinese drugs research and development comes from design. Copyright© by the Chinese Pharmaceutical Association.

Electron beam processing of fresh produce - A critical review

NASA Astrophysics Data System (ADS)

Pillai, Suresh D.; Shayanfar, Shima

2018-02-01

To meet the increasing global demand for fresh produce, robust processing methods that ensures both the safety and quality of fresh produce are needed. Since fresh produce cannot withstand thermal processing conditions, most of common safety interventions used in other foods are ineffective. Electron beam (eBeam) is a non-thermal technology that can be used to extend the shelf life and ensure the microbiological safety of fresh produce. There have been studies documenting the application of eBeam to ensure both safety and quality in fresh produce, however, there are still unexplored areas that still need further research. This is a critical review on the current literature on the application of eBeam technology for fresh produce.

Quality assessment of systematic reviews on alveolar socket preservation.

PubMed

Moraschini, V; Barboza, E Dos S P

2016-09-01

The aim of this overview was to evaluate and compare the quality of systematic reviews, with or without meta-analysis, that have evaluated studies on techniques or biomaterials used for the preservation of alveolar sockets post tooth extraction in humans. An electronic search was conducted without date restrictions using the Medline/PubMed, Cochrane Library, and Web of Science databases up to April 2015. Eligibility criteria included systematic reviews, with or without meta-analysis, focused on the preservation of post-extraction alveolar sockets in humans. Two independent authors assessed the quality of the included reviews using AMSTAR and the checklist proposed by Glenny et al. in 2003. After the selection process, 12 systematic reviews were included. None of these reviews obtained the maximum score using the quality assessment tools implemented, and the results of the analyses were highly variable. A significant statistical correlation was observed between the scores of the two checklists. A wide structural and methodological variability was observed between the systematic reviews published on the preservation of alveolar sockets post tooth extraction. None of the reviews evaluated obtained the maximum score using the two quality assessment tools implemented. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

PubMed Central

Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety. PMID:26246841

A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome.

PubMed

Lauche, Romy; Cramer, Holger; Häuser, Winfried; Dobos, Gustav; Langhorst, Jost

2015-01-01

Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

Quality by control: Towards model predictive control of mammalian cell culture bioprocesses.

PubMed

Sommeregger, Wolfgang; Sissolak, Bernhard; Kandra, Kulwant; von Stosch, Moritz; Mayer, Martin; Striedner, Gerald

2017-07-01

The industrial production of complex biopharmaceuticals using recombinant mammalian cell lines is still mainly built on a quality by testing approach, which is represented by fixed process conditions and extensive testing of the end-product. In 2004 the FDA launched the process analytical technology initiative, aiming to guide the industry towards advanced process monitoring and better understanding of how critical process parameters affect the critical quality attributes. Implementation of process analytical technology into the bio-production process enables moving from the quality by testing to a more flexible quality by design approach. The application of advanced sensor systems in combination with mathematical modelling techniques offers enhanced process understanding, allows on-line prediction of critical quality attributes and subsequently real-time product quality control. In this review opportunities and unsolved issues on the road to a successful quality by design and dynamic control implementation are discussed. A major focus is directed on the preconditions for the application of model predictive control for mammalian cell culture bioprocesses. Design of experiments providing information about the process dynamics upon parameter change, dynamic process models, on-line process state predictions and powerful software environments seem to be a prerequisite for quality by control realization. © 2017 The Authors. Biotechnology Journal published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Reference Model for Software and System Inspections. White Paper

NASA Technical Reports Server (NTRS)

He, Lulu; Shull, Forrest

2009-01-01

Software Quality Assurance (SQA) is an important component of the software development process. SQA processes provide assurance that the software products and processes in the project life cycle conform to their specified requirements by planning, enacting, and performing a set of activities to provide adequate confidence that quality is being built into the software. Typical techniques include: (1) Testing (2) Simulation (3) Model checking (4) Symbolic execution (5) Management reviews (6) Technical reviews (7) Inspections (8) Walk-throughs (9) Audits (10) Analysis (complexity analysis, control flow analysis, algorithmic analysis) (11) Formal method Our work over the last few years has resulted in substantial knowledge about SQA techniques, especially the areas of technical reviews and inspections. But can we apply the same QA techniques to the system development process? If yes, what kind of tailoring do we need before applying them in the system engineering context? If not, what types of QA techniques are actually used at system level? And, is there any room for improvement.) After a brief examination of the system engineering literature (especially focused on NASA and DoD guidance) we found that: (1) System and software development process interact with each other at different phases through development life cycle (2) Reviews are emphasized in both system and software development. (Figl.3). For some reviews (e.g. SRR, PDR, CDR), there are both system versions and software versions. (3) Analysis techniques are emphasized (e.g. Fault Tree Analysis, Preliminary Hazard Analysis) and some details are given about how to apply them. (4) Reviews are expected to use the outputs of the analysis techniques. In other words, these particular analyses are usually conducted in preparation for (before) reviews. The goal of our work is to explore the interaction between the Quality Assurance (QA) techniques at the system level and the software level.

42 CFR 424.58 - Accreditation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... crosswalk. (iii) A detailed description of the organization's operational processes, including procedures... survey forms, guidelines and instructions to surveyors, quality review processes for deficiencies identified with accreditation requirements, and dispute resolution processes and policies when there is a...

42 CFR 424.58 - Accreditation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... crosswalk. (iii) A detailed description of the organization's operational processes, including procedures... survey forms, guidelines and instructions to surveyors, quality review processes for deficiencies identified with accreditation requirements, and dispute resolution processes and policies when there is a...

42 CFR 424.58 - Accreditation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... crosswalk. (iii) A detailed description of the organization's operational processes, including procedures... survey forms, guidelines and instructions to surveyors, quality review processes for deficiencies identified with accreditation requirements, and dispute resolution processes and policies when there is a...

10 CFR 26.167 - Quality assurance and quality control.

Code of Federal Regulations, 2012 CFR

2012-01-01

... be designed, implemented, and reviewed to monitor the conduct of each step of the testing process. (b... sample and the error is determined to be technical or methodological, the licensee or other entity shall...

10 CFR 26.167 - Quality assurance and quality control.

Code of Federal Regulations, 2011 CFR

2011-01-01

... be designed, implemented, and reviewed to monitor the conduct of each step of the testing process. (b... sample and the error is determined to be technical or methodological, the licensee or other entity shall...

10 CFR 26.167 - Quality assurance and quality control.

Code of Federal Regulations, 2014 CFR

2014-01-01

... be designed, implemented, and reviewed to monitor the conduct of each step of the testing process. (b... sample and the error is determined to be technical or methodological, the licensee or other entity shall...

10 CFR 26.167 - Quality assurance and quality control.

Code of Federal Regulations, 2010 CFR

2010-01-01

... be designed, implemented, and reviewed to monitor the conduct of each step of the testing process. (b... sample and the error is determined to be technical or methodological, the licensee or other entity shall...

10 CFR 26.167 - Quality assurance and quality control.

Code of Federal Regulations, 2013 CFR

2013-01-01

... be designed, implemented, and reviewed to monitor the conduct of each step of the testing process. (b... sample and the error is determined to be technical or methodological, the licensee or other entity shall...

Report: Procedural Review of EPA’s Greenhouse Gases Endangerment Finding Data Quality Processes

EPA Pesticide Factsheets

Report #11-P-0702, September 26, 2011. EPA met statutory requirements for rulemaking and generally followed requirements and guidance related to ensuring the quality of the supporting technical information.

Analysis of Peer Review Comments: QM Recommendations and Feedback Intervention Theory

ERIC Educational Resources Information Center

Schwegler, Andria F.; Altman, Barbara W.

2015-01-01

Because feedback is a critical component of the continuous improvement cycle of the Quality Matters (QM) peer review process, the present research analyzed the feedback that peer reviewers provided to course developers after a voluntary, nonofficial QM peer review of online courses. Previous research reveals that the effects of feedback on…

Pre-University Chemistry Students in a Mimicked Scholarly Peer Review

ERIC Educational Resources Information Center

van Rens, Lisette; Hermarij, Philip; Pilot, Albert; Beishuizen, Jos; Hofman, Herman; Wal, Marjolein

2014-01-01

Peer review is a significant component in scientific research. Introducing peer review into inquiry processes may be regarded as an aim to develop student understanding regarding quality in inquiries. This study examines student understanding in inquiry peer reviews among pre-university chemistry students, aged 16-17, when they enact a design of a…

Community representation in hospital decision making: a literature review.

PubMed

Murray, Zoë

2015-06-01

Advancing quality in health services requires structures and processes that are informed by consumer input. Although this agenda is well recognised, few researchers have focussed on the establishment and maintenance of customer input throughout the structures and processes used to produce high-quality, safe care. We present an analysis of literature outlining the barriers and enablers involved in community representation in hospital governance. The review aimed to explore how community representation in hospital governance is achieved. Studies spanning 1997-2012 were analysed using Donabedian' s model of quality systems as a guide for categories of interest: structure, in relation to administration of quality; process, which is particularly concerned with cooperation and culture; and outcome, considered, in this case, to be the achievement of effective community representation on quality of care. There are limited published studies on community representation in hospital governance in Australia. What can be gleaned from the literature is: 1) quality subcommittees set up to assist Hospital Boards are a key structure for involving community representation in decision making around quality of care, and 2) there are a number of challenges to effectively developing the process of community representation in hospital governance: ambiguity and the potential for escalated indecision; inadequate value and consideration given to it by decision makers resulting in a lack of time and resources needed to support the community engagement strategy (time, facilitation, budgets); poor support and attitude amongst staff; and consumer issues, such as feeling isolated and intimidated by expert opinion. The analysis indicates that: quality subcommittees set up to assist boards are a key structure for involving community representation in decision making around quality of care. There are clearly a number of challenges to effectively developing the process of community representation in hospital governance, associated with ambiguity, organisational and consumer issues. For an inclusive agenda to real life, work must be done on understanding the representatives' role and the decision making process, adequately supporting the representational process, and developing organisational cooperation and culture regarding community representation.

First Processing Steps and the Quality of Wild and Farmed Fish

PubMed Central

Borderías, Antonio J; Sánchez-Alonso, Isabel

2011-01-01

First processing steps of fish are species-dependent and have common practices for wild and for farmed fish. Fish farming does, however, have certain advantages over traditional fisheries in that the processor can influence postmortem biochemistry and various quality parameters. This review summarizes information about the primary processing of fish based on the influence of catching, slaughtering, bleeding, gutting, washing, and filleting. Recommendations are given for the correct primary processing of fish. PMID:21535702

Public service quality improvements: a case for exemption from IRB review of public administration research.

PubMed

Jordan, Sara R

2014-01-01

Should the exemption from Institutional Review Board (IRB) evaluations currently in place for quality improvements research be extended to public administration research that addresses questions of improving the quality of public service delivery? As a means to both reduce the level of disdain held by a group of social science researchers for IRBs and to reduce the cost of review for minimal risk studies, I argue here that much of the current public administration research should also be exempted from normal processes of review by IRBs on the basis of their similarity to Quality Improvements (QI) research, a category of studies already granted exemption. This argument dovetails provisions currently in place for studies of public service and public benefit, but reframes these exemptions in the language of "quality improvements," which may be a more comfortable language for IRBs concerned to demonstrate compliance for review of all fields. To expedite this argument into the practices of IRBs, I included a checklist that researchers could use to self-identify their studies as QI, not research as such.

Continuous processing and the applications of online tools in pharmaceutical product manufacture: developments and examples.

PubMed

Ooi, Shing Ming; Sarkar, Srimanta; van Varenbergh, Griet; Schoeters, Kris; Heng, Paul Wan Sia

2013-04-01

Continuous processing and production in pharmaceutical manufacturing has received increased attention in recent years mainly due to the industries' pressing needs for more efficient, cost-effective processes and production, as well as regulatory facilitation. To achieve optimum product quality, the traditional trial-and-error method for the optimization of different process and formulation parameters is expensive and time consuming. Real-time evaluation and the control of product quality using an online process analyzer in continuous processing can provide high-quality production with very high-throughput at low unit cost. This review focuses on continuous processing and the application of different real-time monitoring tools used in the pharmaceutical industry for continuous processing from powder to tablets.

Silage review: Factors affecting dry matter and quality losses in silages.

PubMed

Borreani, G; Tabacco, E; Schmidt, R J; Holmes, B J; Muck, R E

2018-05-01

An overview was made of dry matter (DM) and quality losses that occur during the ensiling process from the field through the feeding phase. The aim was to review the relevant published literature of the last 15 yr focusing on developments achieved after the publication of the book Silage Science and Technology. This review discusses the factors affecting DM and quality losses in terms of field and pre-ensiling conditions, respiration and temperature at ensiling, fermentation patterns, methods of covering and weighting the silage cover, and management of aerobic deterioration. The possibility of reducing DM and quality losses during the ensiling process requires knowledge of how to measure losses on farm and establish the status of the silage during the feed-out phase, implementing the most effective management practices to avoid air exposure during conservation and reduce silage aerobic deterioration during feeding. The paper concludes with future perspectives and recommended management practices to reduce losses and increase efficiency over the whole ensiling process in view of increasing sustainability of the livestock production chain. The Authors. Published by FASS Inc. and Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Quality Matters[TM] Accessibility Survey: Institutional Practices and Policies for Online Courses

ERIC Educational Resources Information Center

Frey, Barbara A.; King, Denise K.

2011-01-01

Quality Matters (QM) is a professional organization that offers a faculty-centered, peer review process to certify the quality of online and blended courses. The purpose of this white paper is to share the results of a Quality Matters accessibility benchmarking study administered to 84 subscriber institutions. The primary goal of the survey was to…

Measuring e-Commerce service quality from online customer review using sentiment analysis

NASA Astrophysics Data System (ADS)

Kencana Sari, Puspita; Alamsyah, Andry; Wibowo, Sulistyo

2018-03-01

The biggest e-Commerce challenge to understand their market is to chart their level of service quality according to customer perception. The opportunities to collect user perception through online user review is considered faster methodology than conducting direct sampling methodology. To understand the service quality level, sentiment analysis methodology is used to classify the reviews into positive and negative sentiment for five dimensions of electronic service quality (e-Servqual). As case study in this research, we use Tokopedia, one of the biggest e-Commerce service in Indonesia. We obtain the online review comments about Tokopedia service quality during several month observations. The Naïve Bayes classification methodology is applied for the reason of its high-level accuracy and support large data processing. The result revealed that personalization and reliability dimension required more attention because have high negative sentiment. Meanwhile, trust and web design dimension have high positive sentiments that means it has very good services. The responsiveness dimension have balance sentiment positive and negative.

Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach

PubMed Central

Nair, Manisha; Baltag, Valentina; Bose, Krishna; Boschi-Pinto, Cynthia; Lambrechts, Thierry; Mathai, Matthews

2015-01-01

Purpose The World Health Organization (WHO) undertook an extensive and elaborate process to develop eight Global Standards to improve quality of health care services for adolescents. The objectives of this article are to present the Global Standards and their method of development. Methods The Global Standards were developed through a four-stage process: (1) conducting needs assessment; (2) developing the Global Standards and their criteria; (3) expert consultations; and (4) assessing their usability. Needs assessment involved conducting a meta-review of systematic reviews and two online global surveys in 2013, one with primary health care providers and another with adolescents. The Global Standards were developed based on the needs assessment in conjunction with analysis of 26 national standards from 25 countries. The final document was reviewed by experts from the World Health Organization regional and country offices, governments, academia, nongovernmental organizations, and development partners. The standards were subsequently tested in Benin and in a regional expert consultation of Latin America and Caribbean countries for their usability. Results The process resulted in the development of eight Global Standards and 79 criteria for measuring them: (1) adolescents' health literacy; (2) community support; (3) appropriate package of services; (4) providers' competencies; (5) facility characteristics; (6) equity and nondiscrimination; (7) data and quality improvement; and (8) adolescents' participation. Conclusions The eight standards are intended to act as benchmarks against which quality of health care provided to adolescents could be compared. Health care services can use the standards as part of their internal quality assurance mechanisms or as part of an external accreditation process. PMID:26299556

WE-E-204-02: Journal of Medical Physics and JACMP

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

Williamson, J.

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium ismore » to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.« less

WE-E-204-00: Where to Send My Manuscript

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

NONE

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium ismore » to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.« less

WE-E-204-01: ASTRO Based Journals

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

Klein, E.

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium ismore » to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.« less

WE-E-204-03: Radiology and Other Imaging Journals

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

Karellas, A.

Research papers authored by Medical Physicists address a large spectrum of oncologic, imaging, or basic research problems; exploit a wide range of physical and engineering methodologies; and often describe the efforts of a multidisciplinary research team. Given dozens of competing journals accepting medical physics articles, it may not be clear to an individual author which journal is the best venue for disseminating their work to the scientific community. Relevant factors usually include the Journal’s audience and scientific impact, but also such factors as perceived acceptance rate, interest in their topic, and quality of service. The purpose of this symposium ismore » to provide the medical physics community with an overview of scope, review processes, and article guidelines for the following journals: Radiology, Medical Physics, International Journal of Radiation Biology and Physics, Journal of Applied Clinical Medical Physics, and Practical Radiation Oncology. Senior members of the editorial board for each journal will provide details as to the journals review process, for example: single blind versus double blind reviews; open access policies, the hierarchy of the review process in terms of editorial board structure; the reality of acceptance, in terms of acceptance rate; and the types of research the journal prefers to publish. Other journals will be discussed as well. The goal is to provide for authors guidance before they begin to write their papers, not only for proper formatting, but also that the readership is appropriate for the particular paper, hopefully increasing the quality and impact of the paper and the likelihood of publication. Learning Objectives: To review each Journal’s submission and review process Guidance as to how to increase quality, impact and chances of acceptance To help decipher which journal is appropriate for a given work A. Karellas, Research collaboration with Koning, Corporation.« less

Workshop to Review Advances Made to the IRIS Process (Feb 2018)

EPA Pesticide Factsheets

NAS held a public workshop to review the progress made on the recommendations from the National Academies' National Research Council's May 2014 report on further improving the scientific quality of IRIS assessments.

[Quality Assurance in Sociomedical Evaluation by Peer Review: A Pilot Project of the German Statutory Pension Insurance].

PubMed

Strahl, A; Gerlich, C; Wolf, H-D; Gehrke, J; Müller-Garnn, A; Vogel, H

2016-03-01

The sociomedical evaluation by the German Pension Insurance serves the purpose of determining entitlement to disability pensions. A quality assurance concept for the sociomedical evaluation was developed, which is based on a peer Review process. Peer review is an established process of external quality assurance in health care. The review is based on a hierarchically constructed manual that was evaluated in this pilot project. The database consists of 260 medical reports for disability pension of 12 pension insurance agencies. 771 reviews from 19 peers were included in the evaluation of the inter-rater reliability. Kendall's coefficient of concordance W for more than 2 raters is used as primary measure of inter-rater reliability. Reliability appeared to be heterogeneous. Kendalls W varies for the particular criteria from 0.09 to 0.88 and reached for primary criterion reproducibility a value of 0.37. The reliability of the manual seemed acceptable in the context of existing research data and is in line with existing peer review research outcomes. Nevertheless, the concordance is limited and requires optimisation. Starting points for improvement can be seen in a systematic training and regular user meetings of the peers involved. © Georg Thieme Verlag KG Stuttgart · New York.

The Quality of Systematic Reviews in Head and Neck Microsurgery: A Perspective from Plastic Surgery and Otolaryngology.

PubMed

Sun, Beatrice J; Tijerina, Jonathan; Nazerali, Rahim S; Lee, Gordon K

2018-05-01

In recent years, there has been a push to publish higher level of evidence studies in medicine, particularly in plastic surgery. Well-conducted systematic reviews are considered the strongest level of evidence in medicine, recently becoming the key process indicators for quality delivery. A varying quality of systematic reviews, however, has led to concerns of their validity in clinical decision-making. We perform a quality analysis of systematic reviews published in head and neck microsurgery by the surgical specialties of plastic surgery and otolaryngology. An evaluation of systematic reviews published on microsurgery in 13 high-impact surgical journals was conducted by searching PubMed and Scopus. Two authors independently performed searches, screened for eligibility, and extracted data from included articles. Discrepancies were resolved by discussion and consensus. Assessment of Multiple Systematic Reviews (AMSTAR) criteria were used to assess methodological quality. The initial database search retrieved 166 articles. After removing duplicates, screening titles and abstracts, 26 articles remained for full text review. Seven did not focus on head and neck microsurgery and were further excluded, leaving 19 systematic reviews for final analysis. Of those, 10 systematic reviews were published by otolaryngology, and 9 were published by plastic surgery. Median AMSTAR score was 8 for otolaryngology, 7 for plastic surgery, and 8 overall, reflecting "fair to good" quality. The number of systematic reviews on head and neck microsurgery markedly increased over time. Of note, both the AMSTAR score and the number of systematic reviews published by plastic surgery have steadily increased from 2014 to 2016, whereas those published by otolaryngology have remained relatively stable since 2010. Our review shows a trend toward publishing more systematic reviews. The increasing quantity and quality of systematic reviews published by plastic surgeons indicates recognition in the need for higher levels of evidence in plastic surgery, as well as growing interest and advances in microsurgery. Given these trends, familiarity with quality assessment guidelines, such as AMSTAR, will remain important in providing a basis for building relevant value-based quality measures.

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4347 - Lender Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... subsequent office case review requirements, routine reviews of LAPP cases will be made by VA staff based upon..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

ACHP | Unified Federal Review

Science.gov Websites

UFR Process was established on July 29, 2014, by the execution of the Memorandum of Understanding Process is being led by a Steering Group consisting of the Council on Environmental Quality, the Review was established on July 29, 2014, through an interagency Memorandum of Understanding by eleven

Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

PubMed

Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

2013-12-01

Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

Process Product Integrity Audits: A Hardware Auditing Technique for the '90s'

NASA Technical Reports Server (NTRS)

Taylor, Mike

1994-01-01

The Space Shuttle program has experienced hardware problems that have delayed several shuttle launches. A NASA review determined that the problems could have been prevented. NASA further concluded that a new kind of Quality emphasis at all Space Shuttle prime contractors and subcontractors was necessary to ensure mission success. To meet this challenge, NASA initiated an innovative review process called Process/Product Integrity (PPIA).

[Report quality evaluation of systematic review or Meta-analysis published in China Journal of Chinese Materia Medica].

PubMed

Zhang, Yan; Yu, Dan-Dan; Cui, De-Hua; Liao, Xing; Guo, Hua

2018-03-01

To evaluate the report quality of intervention-related systematic reviews or Meta-analysis published in China Journal of Chinese Materia Medica, we searched CNKI and China Journal of Chinese Materia Medica webpages to collect intervention-related systematic reviews or Meta-analysis since the first issue of the magazine. A total of 40 systematic reviews or Meta-analysis reports were included, including one network Meta-analysis. According to the PRISMA statement published in 2009, the report quality of the systematic reviews or Meta-analysis was evaluated. According to the results, 3 had the low quality, 30 had the medium quality, and 7 had the high quality. The average score for all of items was 30 points (21-30.5 points for the medium quality). The 17 high-quality (31-40 points) report items were title, rationale, objectives, information sources, study selection, data collection process, data items, risk of bias in individual studies, summary measures, risk of bias across studies, study selection, study characteristics, risk of bias within studies, results of individual studies, synthesis of results, risk of bias across studies and funding; the 4 medium-quality (21-30.5 points) reporting items were eligibility criteria, search, limitations and conclusions; and the 6 low-quality (<=20.5 points) reporting items were structured summary, protocol and registration, synthesis of results, additional analysis (No.16), additional analysis (No.23) and summary of evidence. Through the analysis, it is found that the report quality of intervention-related systematic reviews or Meta-analysis published in China Journal of Chinese Materia Medica is medium, and it is necessary to improve the quality standard of the report. Copyright© by the Chinese Pharmaceutical Association.

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2014-02-01

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

[Quality management in intensive care medicine].

PubMed

Martin, J; Braun, J-P

2013-09-01

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

Effect of processing on nutritive values of milk protein.

PubMed

Borad, Sanket G; Kumar, Anuj; Singh, Ashish K

2017-11-22

Milk is an essential source of nutritionally excellent quality protein in human, particularly in vegan diet. Before consumption, milk is invariably processed depending upon final product requirement. This processing may alter the nutritive value of protein in a significant manner. The processing operations like thermal treatment, chemical treatment, biochemical processing, physical treatments, nonconventional treatments, etc. may exert positive or negative influence on nutritional quality of milk proteins. On one side, processing enhances the nutritive and therapeutic values of protein while on other side intermediate or end products generated during protein reactions may cause toxicity and/or antigenicity upon consumption at elevated level. The review discusses the changes occurring in nutritive quality of milk proteins under the influence of various processing operations.

Gynecomastia in Patients with Prostate Cancer: A Systematic Review.

PubMed

Fagerlund, Anders; Cormio, Luigi; Palangi, Lina; Lewin, Richard; Santanelli di Pompeo, Fabio; Elander, Anna; Selvaggi, Gennaro

2015-01-01

Gynecomastia and/or mastodynia is a common medical problem in patients receiving antiandrogen (bicalutamide or flutamide) treatment for prostate cancer; up to 70% of these patients result to be affected; furthermore, this can jeopardise patients' quality of life. To systematically review the quality of evidence of the current literature regarding treatment options for bicalutamide-induced gynecomastia, including efficacy, safety and patients' quality of life. The PubMed, Medline, Scopus, The Cochrane Library and SveMed+ databases were systematically searched between January 1, 2000 and December 31, 2014. All searches were undertaken between January and February 2015. The search phrase used was:"gynecomastia AND treatment AND prostate cancer". Two reviewers assessed 762 titles and abstracts identified. The search and review process was done in accordance with the PRISMA statement. The PICOS (patients, intervention, comparator, outcomes and study design) process was used to specify inclusion criteria. Quality of evidence was rated according to GRADE. Primary outcomes were: treatment effects, number of complications and side effects. Secondary outcome was: Quality of Life. Eleven studies met the inclusion criteria and are analysed in this review. Five studies reported pharmacological intervention with tamoxifen and/or anastrozole, either as prophylactic or therapeutic treatment. Four studies reported radiotherapy as prophylactic and/or therapeutic treatment. Two studies compared pharmacological treatment to radiotherapy. Most of the studies were randomized with varying risk of bias. According to GRADE, quality of evidence was moderate to high. Bicalutamide-induced gynecomastia and/or mastodynia can effectively be managed by oral tamoxifen (10-20 mg daily) or radiotherapy without relevant side effects. Prophylaxis or therapeutic treatment with tamoxifen results to be more effective than radiotherapy.

Gynecomastia in Patients with Prostate Cancer: A Systematic Review

PubMed Central

Cormio, Luigi; Palangi, Lina; Lewin, Richard; Santanelli di Pompeo, Fabio; Elander, Anna

2015-01-01

Introduction Gynecomastia and/or mastodynia is a common medical problem in patients receiving antiandrogen (bicalutamide or flutamide) treatment for prostate cancer; up to 70% of these patients result to be affected; furthermore, this can jeopardise patients’ quality of life. Aims To systematically review the quality of evidence of the current literature regarding treatment options for bicalutamide-induced gynecomastia, including efficacy, safety and patients’ quality of life. Methods The PubMed, Medline, Scopus, The Cochrane Library and SveMed+ databases were systematically searched between January 1, 2000 and December 31, 2014. All searches were undertaken between January and February 2015. The search phrase used was:”gynecomastia AND treatment AND prostate cancer”. Two reviewers assessed 762 titles and abstracts identified. The search and review process was done in accordance with the PRISMA statement. The PICOS (patients, intervention, comparator, outcomes and study design) process was used to specify inclusion criteria. Quality of evidence was rated according to GRADE. Main Outcome Measures Primary outcomes were: treatment effects, number of complications and side effects. Secondary outcome was: Quality of Life. Results Eleven studies met the inclusion criteria and are analysed in this review. Five studies reported pharmacological intervention with tamoxifen and/or anastrozole, either as prophylactic or therapeutic treatment. Four studies reported radiotherapy as prophylactic and/or therapeutic treatment. Two studies compared pharmacological treatment to radiotherapy. Most of the studies were randomized with varying risk of bias. According to GRADE, quality of evidence was moderate to high. Conclusions Bicalutamide-induced gynecomastia and/or mastodynia can effectively be managed by oral tamoxifen (10–20 mg daily) or radiotherapy without relevant side effects. Prophylaxis or therapeutic treatment with tamoxifen results to be more effective than radiotherapy. PMID:26308532

Food structure: Its formation and relationships with other properties.

PubMed

Joardder, Mohammad U H; Kumar, Chandan; Karim, M A

2017-04-13

Food materials are complex in nature as it has heterogeneous, amorphous, hygroscopic and porous properties. During processing, microstructure of food materials changes which significantly affects other properties of food. An appropriate understanding of the microstructure of the raw food material and its evolution during processing is critical in order to understand and accurately describe dehydration processes and quality anticipation. This review critically assesses the factors that influence the modification of microstructure in the course of drying of fruits and vegetables. The effect of simultaneous heat and mass transfer on microstructure in various drying methods is investigated. Effects of changes in microstructure on other functional properties of dried foods are discussed. After an extensive review of the literature, it is found that development of food structure significantly depends on fresh food properties and process parameters. Also, modification of microstructure influences the other properties of final product. An enhanced understanding of the relationships between food microstructure, drying process parameters and final product quality will facilitate the energy efficient optimum design of the food processor in order to achieve high-quality food.

A Scoping Review of Empirical Research Relating to Quality and Effectiveness of Research Ethics Review

PubMed Central

Nicholls, Stuart G.; Hayes, Tavis P.; Brehaut, Jamie C.; McDonald, Michael; Weijer, Charles; Saginur, Raphael; Fergusson, Dean

2015-01-01

Background To date there is no established consensus of assessment criteria for evaluating research ethics review. Methods We conducted a scoping review of empirical research assessing ethics review processes in order to identify common elements assessed, research foci, and research gaps to aid in the development of assessment criteria. Electronic searches of Ovid Medline, PsychInfo, and the Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED, were conducted. After de-duplication, 4234 titles and abstracts were reviewed. Altogether 4036 articles were excluded following screening of titles, abstracts and full text. A total of 198 articles included for final data extraction. Results Few studies originated from outside North America and Europe. No study reported using an underlying theory or framework of quality/effectiveness to guide study design or analyses. We did not identify any studies that had involved a controlled trial - randomised or otherwise – of ethics review procedures or processes. Studies varied substantially with respect to outcomes assessed, although tended to focus on structure and timeliness of ethics review. Discussion Our findings indicate a lack of consensus on appropriate assessment criteria, exemplified by the varied study outcomes identified, but also a fragmented body of research. To date research has been largely quantitative, with little attention given to stakeholder experiences, and is largely cross sectional. A lack of longitudinal research to date precludes analyses of change or assessment of quality improvement in ethics review. PMID:26225553

A Review and Analysis of Remote Sensing Capability for Air Quality Measurements as a Potential Decision Support Tool Conducted by the NASA DEVELOP Program

NASA Technical Reports Server (NTRS)

Ross, A.; Richards, A.; Keith, K.; Frew, C.; Boseck, J.; Sutton, S.; Watts, C.; Rickman, D.

2007-01-01

This project focused on a comprehensive utilization of air quality model products as decision support tools (DST) needed for public health applications. A review of past and future air quality measurement methods and their uncertainty, along with the relationship of air quality to national and global public health, is vital. This project described current and future NASA satellite remote sensing and ground sensing capabilities and the potential for using these sensors to enhance the prediction, prevention, and control of public health effects that result from poor air quality. The qualitative uncertainty of current satellite remotely sensed air quality, the ground-based remotely sensed air quality, the air quality/public health model, and the decision making process is evaluated in this study. Current peer-reviewed literature suggests that remotely sensed air quality parameters correlate well with ground-based sensor data. A satellite remote-sensed and ground-sensed data complement is needed to enhance the models/tools used by policy makers for the protection of national and global public health communities

Review and Process Effects of Spontaneous Note-Taking on Text Comprehension.

PubMed

Slotte; Lonka

1999-01-01

This study examines how quantitative and qualitative differences in spontaneously taken notes are related to text comprehension in combination with reviewing or not reviewing previously made notes. High school graduates (N = 226) were allowed to take notes in any way they desired while reading a philosophical text. Approximately half the participants were told that they could review their notes during writing tasks designed to measure the ability to define, compare, and evaluate text content. The other half of the participants answered the subsequent questions without their notes. The process of taking notes was rated on the basis of note quality and quantity. The results revealed significant review and process effects in spontaneous note-taking. Reviewing the notes during essay-writing generally resulted in good performance in an exam calling for deep-level text comprehension. However, this review effect was mainly limited to detailed learning instead of making one's own inferences. Results pertaining to note quality indicated that the participants who summarized the content of the text resulted in better performance in all tasks in comparison with those who produced notes following the text order or verbatim notes. The amount of note-taking was also positively related to text comprehension. The discussion focuses upon the situational appropriateness of note-taking effects that pose challenges to educators. Copyright 1999 Academic Press.

Advanced Manufacturing Systems in Food Processing and Packaging Industry

NASA Astrophysics Data System (ADS)

Shafie Sani, Mohd; Aziz, Faieza Abdul

2013-06-01

In this paper, several advanced manufacturing systems in food processing and packaging industry are reviewed, including: biodegradable smart packaging and Nano composites, advanced automation control system consists of fieldbus technology, distributed control system and food safety inspection features. The main purpose of current technology in food processing and packaging industry is discussed due to major concern on efficiency of the plant process, productivity, quality, as well as safety. These application were chosen because they are robust, flexible, reconfigurable, preserve the quality of the food, and efficient.

The quality of instruments to assess the process of shared decision making: A systematic review.

PubMed

Gärtner, Fania R; Bomhof-Roordink, Hanna; Smith, Ian P; Scholl, Isabelle; Stiggelbout, Anne M; Pieterse, Arwen H

2018-01-01

To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.

NIH Peer Review: Scored Review Criteria and Overall Impact

ERIC Educational Resources Information Center

Lindner, Mark D.; Vancea, Adrian; Chen, Mei-Ching; Chacko, George

2016-01-01

The National Institutes of Health (NIH) is the largest source of funding for biomedical research in the world. Funding decisions are made largely based on the outcome of a peer review process that is intended to provide a fair, equitable, timely, and unbiased review of the quality, scientific merit, and potential impact of the research. There have…

Reviewing for "Beyond Behavior": An Editor's Guide for Submitting a Comprehensive and Meaningful Review

ERIC Educational Resources Information Center

Mooney, Paul; Ryan, Joseph B.

2018-01-01

Reviewing manuscripts is an integral part of the publication process. Unfortunately, few scholars receive training in this skill. This article provides an overview of what it takes to conduct a quality review of a manuscript submission for a practitioner journal. The editors describe the manuscript types published by "Beyond Behavior"…

Quality Management and Control of Low Pressure Cast Aluminum Alloy

NASA Astrophysics Data System (ADS)

Zhang, Dianxi; Zhang, Yanbo; Yang, Xiufan; Chen, Zhaosong; Jiang, Zelan

2018-01-01

This paper briefly reviews the history of low pressure casting and summarizes the major production processes of low pressure casting. It briefly introduces the quality management and control of low pressure cast aluminum alloy. The main processes include are: preparation of raw materials, Melting, refining, physical and chemical analysis, K-mode inspection, sand core, mold, heat treatment and so on.

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

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.

Standardized languages and notations for graphical modelling of patient care processes: a systematic review.

PubMed

Mincarone, Pierpaolo; Leo, Carlo Giacomo; Trujillo-Martín, Maria Del Mar; Manson, Jan; Guarino, Roberto; Ponzini, Giuseppe; Sabina, Saverio

2018-04-01

The importance of working toward quality improvement in healthcare implies an increasing interest in analysing, understanding and optimizing process logic and sequences of activities embedded in healthcare processes. Their graphical representation promotes faster learning, higher retention and better compliance. The study identifies standardized graphical languages and notations applied to patient care processes and investigates their usefulness in the healthcare setting. Peer-reviewed literature up to 19 May 2016. Information complemented by a questionnaire sent to the authors of selected studies. Systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Five authors extracted results of selected studies. Ten articles met the inclusion criteria. One notation and language for healthcare process modelling were identified with an application to patient care processes: Business Process Model and Notation and Unified Modeling Language™. One of the authors of every selected study completed the questionnaire. Users' comprehensibility and facilitation of inter-professional analysis of processes have been recognized, in the filled in questionnaires, as major strengths for process modelling in healthcare. Both the notation and the language could increase the clarity of presentation thanks to their visual properties, the capacity of easily managing macro and micro scenarios, the possibility of clearly and precisely representing the process logic. Both could increase guidelines/pathways applicability by representing complex scenarios through charts and algorithms hence contributing to reduce unjustified practice variations which negatively impact on quality of care and patient safety.

Improving health care quality and safety: the role of collective learning.

PubMed

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes.

Improving health care quality and safety: the role of collective learning

PubMed Central

Singer, Sara J; Benzer, Justin K; Hamdan, Sami U

2015-01-01

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes. PMID:29355197

[Quality appraisal of systematic reviews or meta-analysis on traditional Chinese medicine published in Chinese journals].

PubMed

Liu, Jian-ping; Xia, Yun

2007-04-01

To critically assess the quality of literature about systematic review or meta-analysis on traditional Chinese medicine (TCM) published in Chinese journals. Electronic searches in CNKI, VIP and Wanfang data-base were conducted to retrieve the systematic reviews or meta-analysis reports on TCM, including herbal medicine, needling, acupuncture and moxibustion, as well as integrative medicine, they were identified and extracted according to the 18 items of QUOROM (quality of reporting of meta-analyses) Statement and relative information. The appraisal was made taking the indexes mainly including objectives, source of data, methods of data extraction, quality assessment of the included studies, measurement data synthesis, etc. Eighty-two systematic reviews were identified, except 6 reviews were excluded for repeatedly published or didn't comply with the enrolled criterion, 76 reviews concerning 51 kinds of diseases were enrolled for appraisal. Among them, 70 reviews evaluated the efficacy of TCM, mainly on Chinese herbs and 9 on acupuncture and moxibustion. In majority of the reviews, randomised controlled trials were included and the data resources were described, but in 26 reviews only the Chinese databases were searched and the description about data extraction and analysis method were too simple; and 70% of reviews assessed the quality of the included studies; none used flow chart to express the process of selection, inclusion and exclusion of studies. Few reviews or Meta-analysis reports reached the international standard and there is insufficient description of methodology for conducting systematic reviews, so it is hardly to be repeated. The authors suggested that advanced methodological training is necessary for reviewers.

The Dutch Review Process for Evaluating the Quality of Psychological Tests: History, Procedure, and Results

ERIC Educational Resources Information Center

Evers, Arne; Sijtsma, Klaas; Lucassen, Wouter; Meijer, Rob R.

2010-01-01

This article describes the 2009 revision of the Dutch Rating System for Test Quality and presents the results of test ratings from almost 30 years. The rating system evaluates the quality of a test on seven criteria: theoretical basis, quality of the testing materials, comprehensiveness of the manual, norms, reliability, construct validity, and…

Academic Staff Views of Quality Systems for Teaching and Learning: A Hong Kong Case Study

ERIC Educational Resources Information Center

Jones, John; Saram, Don Darshi De

2005-01-01

The "Teaching and Learning Quality Process Review" (TLQPR) recently completed in Hong Kong had an emphasis on education quality work. This paper analyses how, from the perspective of academic staff in one university in Hong Kong, the good intentions embedded in that idea are enhanced or subverted by the broader ?quality system setting in…

Machine Learning: A Crucial Tool for Sensor Design

PubMed Central

Zhao, Weixiang; Bhushan, Abhinav; Santamaria, Anthony D.; Simon, Melinda G.; Davis, Cristina E.

2009-01-01

Sensors have been widely used for disease diagnosis, environmental quality monitoring, food quality control, industrial process analysis and control, and other related fields. As a key tool for sensor data analysis, machine learning is becoming a core part of novel sensor design. Dividing a complete machine learning process into three steps: data pre-treatment, feature extraction and dimension reduction, and system modeling, this paper provides a review of the methods that are widely used for each step. For each method, the principles and the key issues that affect modeling results are discussed. After reviewing the potential problems in machine learning processes, this paper gives a summary of current algorithms in this field and provides some feasible directions for future studies. PMID:20191110

QA procedures needed for advanced RT techniques and its impact on treatment outcome

NASA Astrophysics Data System (ADS)

Knöös, T.

2015-01-01

The radiotherapy process is reviewed briefly and potential risks or pitfalls are identified. The focus is on modern advanced modalities in radiation therapy such as IMRT, VMAT, gating and tracking and also for the unknown to come. Existing methods, or quality controls (QC), or with better word barriers, are introduced at important steps of process with the purpose of prohibiting errors to continue through the process and thus avoiding an unwanted erroneous irradiation of the patient. The soft branch of quality assurance (QA) such as peer-review is also a major component of today's process and its safety. The importance of knowing your QCs is pointed out. The role of dosimetry method i.e. 3D-dosimetry is reviewed. Staff have to be working with awareness and alertness that can reduce most of the risks. Having comprehensive protocols known by all involved together with well-trained staff at the department with dedicated functions and responsibilities will further reduce the risk for unintended irradiations of patient. Having a well-designed QA system with the appropriate barriers have the possibility of producing high quality radiotherapy, which will also result in better outcome for the patients. The international head and neck trial illustrates very well the importance of accurate radiotherapy.

Innovations in coating technology.

PubMed

Behzadi, Sharareh S; Toegel, Stefan; Viernstein, Helmut

2008-01-01

Despite representing one of the oldest pharmaceutical techniques, coating of dosage forms is still frequently used in pharmaceutical manufacturing. The aims of coating range from simply masking the taste or odour of drugs to the sophisticated controlling of site and rate of drug release. The high expectations for different coating technologies have required great efforts regarding the development of reproducible and controllable production processes. Basically, improvements in coating methods have focused on particle movement, spraying systems, and air and energy transport. Thereby, homogeneous distribution of coating material and increased drying efficiency should be accomplished in order to achieve high end product quality. Moreover, given the claim of the FDA to design the end product quality already during the manufacturing process (Quality by Design), the development of analytical methods for the analysis, management and control of coating processes has attracted special attention during recent years. The present review focuses on recent patents claiming improvements in pharmaceutical coating technology and intends to first familiarize the reader with the available procedures and to subsequently explain the application of different analytical tools. Aiming to structure this comprehensive field, coating technologies are primarily divided into pan and fluidized bed coating methods. Regarding pan coating procedures, pans rotating around inclined, horizontal and vertical axes are reviewed separately. On the other hand, fluidized bed technologies are subdivided into those involving fluidized and spouted beds. Then, continuous processing techniques and improvements in spraying systems are discussed in dedicated chapters. Finally, currently used analytical methods for the understanding and management of coating processes are reviewed in detail in the last section of the review.

Process and implementation of participatory ergonomic interventions: a systematic review.

PubMed

van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

2010-10-01

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

The inclusion of reports of randomised trials published in languages other than English in systematic reviews.

PubMed

Moher, D; Pham, B; Lawson, M L; Klassen, T P

2003-01-01

To assemble a large dataset of language restricted and language inclusive systematic reviews, including both conventional medicinal (CM) and complementary and alternative medicine (CAM) interventions. To then assess the quality of these reports by considering and comparing different types of systematic reviews and their associated RCTs; CM and CAM interventions; the effect of language restrictions compared with language inclusions, and whether these results are influenced by other issues, including statistical heterogeneity and publication bias, in the systematic review process. MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and the Centralised Information Service for Complementary Medicine. Three types of systematic reviews were included: language restricted; language inclusive/English language (EL) reviews that searched RCTs in languages other than English (LOE) but did not find any and, hence, could not include any, in the quantitative data synthesis; and systematic reviews that searched for RCTs in LOE and included them in the quantitative data synthesis. Fisher's exact test was applied to compare the three different types of systematic reviews with respect to their reporting characteristics and the systematic review quality assessment tool. The odds ratio of LOE trials versus EL trials was computed for each review and this information was pooled across the reviews to examine the influence that language of publication and type of intervention (CM, CAM) have on the estimates of intervention effect. Several sensitivity analyses were performed. The LOE RCTs were predominantly in French and German. Language inclusive/LOE systematic reviews were of the highest quality compared with the other types of reviews. The CAM reviews were of higher quality compared with the CM reviews. There were only minor differences in the quality of reports of EL RCTs compared with the eight other languages considered. However, there are inconsistent differences in the quality of LOE reports depending on the intervention type. The results, and those reported previously, suggest that excluding reports of RCTs in LOE from the analytical part of a systematic review is reasonable. Because the present research and previous efforts have not included every type of CM RCT and the resulting possibility of the uncertainty as to when bias will be present by excluding LOE, it is always prudent to perform a comprehensive search for all evidence. This result only applies to reviews investigating the benefits of CM interventions. This does not imply that systematic reviewers should neglect reports in LOE. We recommend that systematic reviewers search for reports regardless of the language. There may be merit in including them in some aspects of the review process although this decision is likely to depend on several factors, including fiscal and other resources being available. Language restrictions significantly shift the estimates of an intervention's effectiveness when the intervention is CAM. Here, excluding trials reported in LOE, compared with their inclusion, resulted in a reduced intervention effect. The present results do not appear to be influenced by statistical heterogeneity and publication bias. With the exception of CAM systematic reviews, the quality of recently published systematic reviews is less than optimal. Language inclusive/LOE systematic reviews appear to be a marker for a better quality systematic review. Language restrictions do not appear to bias the estimates of a conventional intervention's effectiveness. However, there is substantial bias in the results of a CAM systematic review if LOE reports are excluded from it.

Team dynamics within quality improvement teams: a scoping review.

PubMed

Rowland, Paula; Lising, Dean; Sinclair, Lynne; Baker, G Ross

2018-03-31

This scoping review examines what is known about the processes of quality improvement (QI) teams, particularly related to how teams impact outcomes. The aim is to provide research-informed guidance for QI leaders and to inform future research questions. Databases searched included: MedLINE, EMBASE, CINAHL, Web of Science and SCOPUS. Eligible publications were written in English, published between 1999 and 2016. Articles were included in the review if they examined processes of the QI team, were related to healthcare QI and were primary research studies. Studies were excluded if they had insufficient detail regarding QI team processes. Descriptive detail extracted included: authors, geographical region and health sector. The Integrated (Health Care) Team Effectiveness Model was used to synthesize findings of studies along domains of team effectiveness: task design, team process, psychosocial traits and organizational context. Over two stages of searching, 4813 citations were reviewed. Of those, 48 full-text articles are included in the synthesis. This review demonstrates that QI teams are not immune from dysfunction. Further, a dysfunctional QI team is not likely to influence practice. However, a functional QI team alone is unlikely to create change. A positive QI team dynamic may be a necessary but insufficient condition for implementing QI strategies. Areas for further research include: interactions between QI teams and clinical microsystems, understanding the role of interprofessional representation on QI teams and exploring interactions between QI team task, composition and process.

A survey of quality assurance practices in biomedical open source software projects.

PubMed

Koru, Günes; El Emam, Khaled; Neisa, Angelica; Umarji, Medha

2007-05-07

Open source (OS) software is continuously gaining recognition and use in the biomedical domain, for example, in health informatics and bioinformatics. Given the mission critical nature of applications in this domain and their potential impact on patient safety, it is important to understand to what degree and how effectively biomedical OS developers perform standard quality assurance (QA) activities such as peer reviews and testing. This would allow the users of biomedical OS software to better understand the quality risks, if any, and the developers to identify process improvement opportunities to produce higher quality software. A survey of developers working on biomedical OS projects was conducted to examine the QA activities that are performed. We took a descriptive approach to summarize the implementation of QA activities and then examined some of the factors that may be related to the implementation of such practices. Our descriptive results show that 63% (95% CI, 54-72) of projects did not include peer reviews in their development process, while 82% (95% CI, 75-89) did include testing. Approximately 74% (95% CI, 67-81) of developers did not have a background in computing, 80% (95% CI, 74-87) were paid for their contributions to the project, and 52% (95% CI, 43-60) had PhDs. A multivariate logistic regression model to predict the implementation of peer reviews was not significant (likelihood ratio test = 16.86, 9 df, P = .051) and neither was a model to predict the implementation of testing (likelihood ratio test = 3.34, 9 df, P = .95). Less attention is paid to peer review than testing. However, the former is a complementary, and necessary, QA practice rather than an alternative. Therefore, one can argue that there are quality risks, at least at this point in time, in transitioning biomedical OS software into any critical settings that may have operational, financial, or safety implications. Developers of biomedical OS applications should invest more effort in implementing systemic peer review practices throughout the development and maintenance processes.

Assessing Quality and Evaluating Performance in Higher Education: Worlds Apart or Complementary Views?

ERIC Educational Resources Information Center

Sarrico, Claudia S.; Rosa, Maria J.; Teixeira, Pedro N.; Cardoso, Margarida F.

2010-01-01

This paper reflects on quality assessment and performance evaluation in higher education, namely by analysing the insufficient link between those two aspects. We start by reviewing the current state of the art regarding different processes and mechanisms of quality assessment and performance evaluation and discuss some of the major issues…

Making Story Time a Literacy Event for the Young Child.

ERIC Educational Resources Information Center

Weir, Beth

1989-01-01

Reviews research and anecdotal accounts which present instructional techniques and which suggest that the quality of instruction, quality of time, and quality of books are significant factors in ensuring that story reading is a true literacy event. Argues that consistent story readings facilitate the acquisition of the reading process. (RS)

77 FR 11484 - Agency Information Collection Activities: Proposed Collection; Comment Request-Negative QC Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... Quality Control process for the Supplemental Nutrition Assistance Program and the FNS-248 will be removed... other forms of information technology. Comments may be sent to: Francis B. Heil, Chief, Quality Control... directed to Francis B. Heil, (703) 305-2442. SUPPLEMENTARY INFORMATION: Title: Negative Quality Control...

Patients' involvement in improvement initiatives: a qualitative systematic review.

PubMed

van, Claire; McInerney, Patricia; Cooke, Richard

2015-10-01

Over the last 20 years, quality improvement in health has become an important strategy in health services in many countries. With the emphasis on quality health care, there has been a shift in social paradigms towards including service users in their own health on different levels. There is growing evidence in literature on the positive impact on health outcomes where patients are active participants in their personal care. There is however less information available on the broader influence of users on improvement in systems. The objective of this review was to identify the barriers and enablers to patients being involved in quality improvement efforts directed towards their own health care. This review considered studies that included adults and children of any age experiencing any health problem.The review considered studies that explored patient or user participation in quality improvement and the factors enabling and hindering this processThe qualitative component of this review considered studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Other texts such as opinion papers and reports were also considered. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. The searches using all identified keywords and index terms included the databases PubMed, PsycINFO, Medline, Scopus, EBSCOhost and CINAHL.Qualitative, text and opinion papers were considered for inclusion in this review.Closely related concepts like community involvement, family involvement, patients' involvement in their own care (for example, in the case of shared decision making), and patient centeredness in the context of a consultation were excluded. Qualitative and textual papers selected for retrieval were assessed by two independent reviewers for authenticity prior to inclusion in the review using the standardized critical appraisal instruments from the Joanna Briggs Institute. Qualitative and textual data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute. The above findings were pooled and through the identification of categories, a final meta-synthesis was formulated. Two synthesized findings were created from the included papers. Firstly, there are barriers to patients' participation in quality improvement in health and in spite of policy support for user involvement in quality improvement, it is a difficult strategy to implement. The second synthesized finding was that there are enablers to patients' involvement in quality improvement: when patients are involved in quality improvement efforts in health care, there are innovative, often unexpected, outcomes at different levels of the process, and sustaining these efforts is possible with ongoing individual or group support.Five categories which supported the synthesized findings were created through the meta-aggregative process. There are enablers and barriers to involving patients in quality improvement in health care that need to be considered when planning such interventions.Relationships and roles will need to be very clear from the outset. A developmental approach needs to be considered where support and training is part of the project. Where patients are truly engaged in service improvement, unexpected innovation occurs.There are many more reports and opinion papers published regarding this topic than there are rigorous research studies. This leaves the field open to the development of good methodological studies related to quality improvement and in particular to the participation of patients.

Building quality into medical product software design.

PubMed

Mallory, S R

1993-01-01

The software engineering and quality assurance disciplines are a requisite to the design of safe and effective software-based medical devices. It is in the areas of software methodology and process that the most beneficial application of these disciplines to software development can be made. Software is a product of complex operations and methodologies and is not amenable to the traditional electromechanical quality assurance processes. Software quality must be built in by the developers, with the software verification and validation engineers acting as the independent instruments for ensuring compliance with performance objectives and with development and maintenance standards. The implementation of a software quality assurance program is a complex process involving management support, organizational changes, and new skill sets, but the benefits are profound. Its rewards provide safe, reliable, cost-effective, maintainable, and manageable software, which may significantly speed the regulatory review process and therefore potentially shorten the overall time to market. The use of a trial project can greatly facilitate the learning process associated with the first-time application of a software quality assurance program.

A quality by design approach to scale-up of high-shear wet granulation process.

PubMed

Pandey, Preetanshu; Badawy, Sherif

2016-01-01

High-shear wet granulation is a complex process that in turn makes scale-up a challenging task. Scale-up of high-shear wet granulation process has been studied extensively in the past with various different methodologies being proposed in the literature. This review article discusses existing scale-up principles and categorizes the various approaches into two main scale-up strategies - parameter-based and attribute-based. With the advent of quality by design (QbD) principle in drug product development process, an increased emphasis toward the latter approach may be needed to ensure product robustness. In practice, a combination of both scale-up strategies is often utilized. In a QbD paradigm, there is also a need for an increased fundamental and mechanistic understanding of the process. This can be achieved either by increased experimentation that comes at higher costs, or by using modeling techniques, that are also discussed as part of this review.

Natural antioxidants as food and feed additives to promote health benefits and quality of meat products: A review.

PubMed

Jiang, Jiang; Xiong, Youling L

2016-10-01

Fresh and processed meats offer numerous nutritional and health benefits and provide unique eating satisfaction in the lifestyle of the modern society. However, consumption of red meat including processed products is subjected to increasing scrutiny due to the health risks associated with cytotoxins that potentially could be generated during meat preparation. Evidence from recent studies suggests free radical pathways as a plausible mechanism for toxin formation, and antioxidants have shown promise to mitigate process-generated chemical hazards. The present review discusses the involvements of lipid and protein oxidation in meat quality, nutrition, safety, and organoleptic properties; animal production and meat processing strategies which incorporate natural antioxidants to enhance the nutritional and health benefits of meat; and the application of mixed or purified natural antioxidants to eliminate or minimize the formation of carcinogens for chemical safety of cooked and processed meats. Copyright © 2016. Published by Elsevier Ltd.

[Current situations and problem analysis of influencing factors of traditional Chinese medicine tablets on forming quality].

PubMed

Li, Yan-Nian; Wu, Zhen-Feng; Wan, Na; Li, Yuan-Hui; Li, Hui-Ting; Yang, Ming

2018-04-01

The compressibility of tablets is the essential operating unit during the preparation of traditional Chinese medicine tablets, as well as a complicated process. Therefore, it is of great significance to comprehensively study the influencing factors on the formation process. This paper aimed to review the evaluation methods for the tablet forming quality and highlight the effects of material powder properties, excipients and preparation technology on the quality of traditional Chinese medicine tablets on the basis of relevant literatures. Furthermore, the common problems in tablet forming process are also analyzed to provide useful references for the development of tablet forming quality of traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

Qualification Procedures for VHSIC/VLSI

DTIC Science & Technology

1990-12-01

alternative approach for qualification of complex microcircuits. To address the technical issues related to a process oriented qualification approach, the...methodology of microcircuit process control to promote the United States to a position of supplying the nighest quality and most reliable...available resources . o Coordinate document reviews with weekly and monthly status reviews on progress. o Summarize results and collate into four basic

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

The value of 100% retrospective peer review in a forensic pathology practice.

PubMed

Obenson, Ken; Wright, Claire M

2013-11-01

Peer review in forensic pathology practice has become an important cornerstone of continuous quality improvement. Although there are several components to an effective and transparent peer review process, one of the most essential is the review of completed reports. The autopsy report may be reviewed prospectively (report reviewed before sign out) or retrospectively (report reviewed after sign out). Prospective reviews are more likely to be performed on criminal or criminally suspicious cases, pediatric and SIDS deaths and high profile cases. Retrospective reviews on the other hand are performed on a proportion of all other signed-out routine medico-legal cases. The actual percentage varies by jurisdiction since there are no agreed minimum standards. Manpower and workload factors appear to be critical to determining what percentage of cases are reviewed retrospectively. The objective of this report is to present a mechanism by which a 100% retrospective review policy has been implemented, how it integrates with quality management protocols, the outcomes of the reviews and what challenges remain to improve compliance with key quality indicators especially turn around time (TAT) statistics. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A Review on Advanced Treatment of Pharmaceutical Wastewater

NASA Astrophysics Data System (ADS)

Guo, Y.; Qi, P. S.; Liu, Y. Z.

2017-05-01

The composition of pharmaceutical wastewater is complex, which is high concentration of organic matter, microbial toxicity, high salt, and difficult to biodegrade. After secondary treatment, there are still trace amounts of suspended solids and dissolved organic matter. To improve the quality of pharmaceutical wastewater effluent, advanced treatment is essential. In this paper, the classification of the pharmaceutical technology was introduced, and the characteristics of pharmaceutical wastewater effluent quality were summarized. The methods of advanced treatment of pharmaceutical wastewater were reviewed afterwards, which included coagulation and sedimentation, flotation, activated carbon adsorption, membrane separation, advanced oxidation processes, membrane separation and biological treatment. Meanwhile, the characteristics of each process were described.

An efficient visualization method for analyzing biometric data

NASA Astrophysics Data System (ADS)

Rahmes, Mark; McGonagle, Mike; Yates, J. Harlan; Henning, Ronda; Hackett, Jay

2013-05-01

We introduce a novel application for biometric data analysis. This technology can be used as part of a unique and systematic approach designed to augment existing processing chains. Our system provides image quality control and analysis capabilities. We show how analysis and efficient visualization are used as part of an automated process. The goal of this system is to provide a unified platform for the analysis of biometric images that reduce manual effort and increase the likelihood of a match being brought to an examiner's attention from either a manual or lights-out application. We discuss the functionality of FeatureSCOPE™ which provides an efficient tool for feature analysis and quality control of biometric extracted features. Biometric databases must be checked for accuracy for a large volume of data attributes. Our solution accelerates review of features by a factor of up to 100 times. Review of qualitative results and cost reduction is shown by using efficient parallel visual review for quality control. Our process automatically sorts and filters features for examination, and packs these into a condensed view. An analyst can then rapidly page through screens of features and flag and annotate outliers as necessary.

Process monitoring and visualization solutions for hot-melt extrusion: a review.

PubMed

Saerens, Lien; Vervaet, Chris; Remon, Jean Paul; De Beer, Thomas

2014-02-01

Hot-melt extrusion (HME) is applied as a continuous pharmaceutical manufacturing process for the production of a variety of dosage forms and formulations. To ensure the continuity of this process, the quality of the extrudates must be assessed continuously during manufacturing. The objective of this review is to provide an overview and evaluation of the available process analytical techniques which can be applied in hot-melt extrusion. Pharmaceutical extruders are equipped with traditional (univariate) process monitoring tools, observing barrel and die temperatures, throughput, screw speed, torque, drive amperage, melt pressure and melt temperature. The relevance of several spectroscopic process analytical techniques for monitoring and control of pharmaceutical HME has been explored recently. Nevertheless, many other sensors visualizing HME and measuring diverse critical product and process parameters with potential use in pharmaceutical extrusion are available, and were thoroughly studied in polymer extrusion. The implementation of process analytical tools in HME serves two purposes: (1) improving process understanding by monitoring and visualizing the material behaviour and (2) monitoring and analysing critical product and process parameters for process control, allowing to maintain a desired process state and guaranteeing the quality of the end product. This review is the first to provide an evaluation of the process analytical tools applied for pharmaceutical HME monitoring and control, and discusses techniques that have been used in polymer extrusion having potential for monitoring and control of pharmaceutical HME. © 2013 Royal Pharmaceutical Society.

Working toward quality in obstetric anesthesia: a business approach.

PubMed

Lynde, Grant C

2017-06-01

Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's. Applying these lessons to the healthcare setting has been slow. Hospitals are only now introducing tools such as failure mode and effect analysis, Lean and Six Sigma into their quality divisions and are seeing significant cost reductions and outcomes improvements. The review will discuss the process for creating an effective quality program for an obstetric anesthesia division. Sustainable improvements in delivered care need to be based on an evaluation of service line needs, defining appropriate metrics, understanding current process flows, changing and measuring those processes, and developing mechanisms to ensure the new processes are maintained.

ISO 9001 in a neonatal intensive care unit (NICU).

PubMed

Vitner, Gad; Nadir, Erez; Feldman, Michael; Yurman, Shmuel

2011-01-01

The aim of this paper is to present the process for approving and certifying a neonatal intensive care unit to ISO 9001 standards. The process started with the department head's decision to improve services quality before deciding to achieve ISO 9001 certification. Department processes were mapped and quality management mechanisms were developed. Process control and performance measurements were defined and implemented to monitor the daily work. A service satisfaction review was conducted to get feedback from families. In total, 28 processes and related work instructions were defined. Process yields showed service improvements. Family satisfaction improved. The paper is based on preparing only one neonatal intensive care unit to the ISO 9001 standard. The case study should act as an incentive for hospital managers aiming to improve service quality based on the ISO 9001 standard. ISO 9001 is becoming a recommended tool to improve clinical service quality.

Piloting Psychology Annual Reviews as a Method of Measuring Psychological Distress and Quality of Life in Paediatric Renal Transplant Patients

PubMed Central

2016-01-01

Psychosocial distress and poorer quality of life after renal transplantation are common in children and young people. This has implications for medication adherence and survival. Posttransplant psychology annual reviews were introduced in one Paediatric Renal Service in the UK as a means of measuring psychological distress and quality of life, as well as facilitating identification of patients and parents/carers who would benefit from psychological intervention. The process of completing posttransplant psychology annual reviews is discussed within this paper. The posttransplant psychology annual review appointments identified patients experiencing depression and/or anxiety and problems in quality of life. These assessments have led to appropriate referrals to, and engagement with, the renal psychology service as well as with community tier 3 child and adolescent mental health services. The posttransplant psychology annual review will continue to be completed at this UK site and discussions will be undertaken with other paediatric renal transplant services to consider whether these could be introduced at a national level to facilitate collection of longitudinal data regarding long-term psychosocial impact of paediatric renal transplantation and its effect on quality of life. PMID:27965973

A review of maturation diets for mud crab genus Scylla broodstock: Present research, problems and future perspective.

PubMed

Azra, Mohamad N; Ikhwanuddin, Mhd

2016-03-01

Study of broodstock maturation diets is important in order to increase the quality of berried females, which indirectly improve the larval quantity in the hatchery production of cultured species. This paper reviewed the studies on the maturation diets for mud crab broodstock, genus Scylla and compared independently to identify their effect on reproductive performance and larval quality. The broodstock is usually caught from the wild and held in the spawning or maturation tank for further use of hatchery seed production. Mud crab broodstock was fed either natural diet, artificial diet or mixed diet. Trash fishes were commonly used as a natural feed for mud crab broodstock; meanwhile artificial diets are from formulated fish meal and various kinds of feed. The results indicated that mud crab broodstock has a high dietary requirement for lipids, fatty acids and protein which are to be used during the maturation and breeding processes. However, the natural diet produce better larval quality compared to the artificial diet. The mixed diet is the better diet which resulted in better reproductive performances such as growth, survival, fecundity and maturation processes. This review also discusses the problems in the previous studies for the potential future research to develop very high quality and cost-effective formulated diet for the enhancement of broodstock and seed production technology. Information from this review can be useful in developing a better quality of crustacean broodstock's diet for commercial hatchery production.

A review of maturation diets for mud crab genus Scylla broodstock: Present research, problems and future perspective

PubMed Central

Azra, Mohamad N.; Ikhwanuddin, Mhd

2015-01-01

Study of broodstock maturation diets is important in order to increase the quality of berried females, which indirectly improve the larval quantity in the hatchery production of cultured species. This paper reviewed the studies on the maturation diets for mud crab broodstock, genus Scylla and compared independently to identify their effect on reproductive performance and larval quality. The broodstock is usually caught from the wild and held in the spawning or maturation tank for further use of hatchery seed production. Mud crab broodstock was fed either natural diet, artificial diet or mixed diet. Trash fishes were commonly used as a natural feed for mud crab broodstock; meanwhile artificial diets are from formulated fish meal and various kinds of feed. The results indicated that mud crab broodstock has a high dietary requirement for lipids, fatty acids and protein which are to be used during the maturation and breeding processes. However, the natural diet produce better larval quality compared to the artificial diet. The mixed diet is the better diet which resulted in better reproductive performances such as growth, survival, fecundity and maturation processes. This review also discusses the problems in the previous studies for the potential future research to develop very high quality and cost-effective formulated diet for the enhancement of broodstock and seed production technology. Information from this review can be useful in developing a better quality of crustacean broodstock’s diet for commercial hatchery production. PMID:26981008

Cross-cultural adaptation and measurement properties of generic and cancer-related patient-reported outcome measures (PROMs) for use with cancer patients in Brazil: a systematic review.

PubMed

Albach, Carlos Augusto; Wagland, Richard; Hunt, Katherine J

2018-04-01

This systematic review (1) identifies the current generic and cancer-related patient-reported outcome measures (PROMs) that have been cross-culturally adapted to Brazilian Portuguese and applied to cancer patients and (2) critically evaluates their cross-cultural adaptation (CCA) and measurement properties. Seven databases were searched for articles regarding the translation and evaluation of measurement properties of generic and cancer-related PROMs cross-culturally adapted to Brazilian Portuguese that are applied in adult (≥18 years old) cancer patients. The methodological quality of included studies was assessed using the COSMIN checklist. The bibliographic search retrieved 1674 hits, of which seven studies analysing eight instruments were included in this review. Data on the interpretability of scores were poorly reported. Overall, the quality of the CCA process was inconsistent throughout the studies. None of the included studies performed a cross-cultural validation. The evidence concerning the quality of measurement properties is limited by poor or fair methodological quality. Moreover, limited information regarding measurement properties was provided within the included papers. This review aids the selection process of Brazilian Portuguese PROMs for use in cancer patients. After acknowledging the methodological caveats and strengths of each tool, our opinion is that for quality of life and symptoms assessment the adapted FACT-G version and the ESAS could be recommended, respectively. Future research should rely on the already accepted standards of CCA and validation studies.

Value stream mapping of the Pap test processing procedure: a lean approach to improve quality and efficiency.

PubMed

Michael, Claire W; Naik, Kalyani; McVicker, Michael

2013-05-01

We developed a value stream map (VSM) of the Papanicolaou test procedure to identify opportunities to reduce waste and errors, created a new VSM, and implemented a new process emphasizing Lean tools. Preimplementation data revealed the following: (1) processing time (PT) for 1,140 samples averaged 54 hours; (2) 27 accessioning errors were detected on review of 357 random requisitions (7.6%); (3) 5 of the 20,060 tests had labeling errors that had gone undetected in the processing stage. Four were detected later during specimen processing but 1 reached the reporting stage. Postimplementation data were as follows: (1) PT for 1,355 samples averaged 31 hours; (2) 17 accessioning errors were detected on review of 385 random requisitions (4.4%); and (3) no labeling errors were undetected. Our results demonstrate that implementation of Lean methods, such as first-in first-out processes and minimizing batch size by staff actively participating in the improvement process, allows for higher quality, greater patient safety, and improved efficiency.

FRAMEWORK FOR DEVELOPING SUSPENDED AND BEDDED SEDIMENT (SABS) WATER QUALITY CRITERIA: STEP 4 - DEFINE POTENTIAL RANGES IN VALUE OF THE SABS AND RESPONSE INDICATORS, AND CLASSIFICATION OF WATERBODIES USING AN EMPIRICAL APPROACH

EPA Science Inventory

After reviewing existing water quality criteria and consulting stakeholders, EPA developed a process that states, tribes, and regions can use to develop scientifically defensible SABS criteria. The process is flexible, can be adapted to utilize existing data sets, and can be gea...

Freshwater resources in designated wilderness areas of the United States: A state-of-knowledge review

Treesearch

Adam N. Johnson; David R. Spildie

2014-01-01

Clean water is essential for ecosystem processes and for the maintenance of human populations. However, fresh water accounts for less than three percent of the world’s total water volume. Numerous anthropogenic and natural processes impact the quality and quantity of the available resource. The value of high-quality water will likely increase as threats to water...

Enhancing the role of case-oriented peer review to improve quality and safety in radiation oncology: Executive summary

PubMed Central

Marks, Lawrence B.; Adams, Robert D.; Pawlicki, Todd; Blumberg, Albert L.; Hoopes, David; Brundage, Michael D.; Fraass, Benedick A.

2013-01-01

This report is part of a series of white papers commissioned for the American Society for Radiation Oncology (ASTRO) Board of Directors as part of ASTRO's Target Safely Campaign, focusing on the role of peer review as an important component of a broad safety/quality assurance (QA) program. Peer review is one of the most effective means for assuring the quality of qualitative, and potentially controversial, patient-specific decisions in radiation oncology. This report summarizes many of the areas throughout radiation therapy that may benefit from the application of peer review. Each radiation oncology facility should evaluate the issues raised and develop improved ways to apply the concept of peer review to its individual process and workflow. This might consist of a daily multidisciplinary (eg, physicians, dosimetrists, physicists, therapists) meeting to review patients being considered for, or undergoing planning for, radiation therapy (eg, intention to treat and target delineation), as well as meetings to review patients already under treatment (eg, adequacy of image guidance). This report is intended to clarify and broaden the understanding of radiation oncology professionals regarding the meaning, roles, benefits, and targets for peer review as a routine quality assurance tool. It is hoped that this work will be a catalyst for further investigation, development, and study of the efficacy of peer review techniques and how these efforts can help improve the safety and quality of our treatments. PMID:24175002

Time Required for Institutional Review Board Review at One Veterans Affairs Medical Center

PubMed Central

Hall, Daniel E.; Hanusa, Barbara H.; Stone, Roslyn A.; Ling, Bruce S.; Arnold, Robert M.

2015-01-01

IMPORTANCE Despite growing concern that institutional review boards (IRBs) impose burdensome delays on research, little is known about the time required for IRB review across different types of research. OBJECTIVE To measure the overall and incremental process times for IRB review as a process of quality improvement. DESIGN, SETTING, AND PARTICIPANTS After developing a detailed process flowchart of the IRB review process, 2 analysts abstracted temporal data from the records pertaining to all 103 protocols newly submitted to the IRB at a large urban Veterans Affairs medical center from June 1, 2009, through May 31, 2011. Disagreements were reviewed with the principal investigator to reach consensus. We then compared the review times across review types using analysis of variance and post hoc Scheffé tests after achieving normally distributed data through logarithmic transformation. MAIN OUTCOMES AND MEASURES Calendar days from initial submission to final approval of research protocols. RESULTS Initial IRB review took 2 to 4 months, with expedited and exempt reviews requiring less time (median [range], 85 [23–631] and 82 [16–437] days, respectively) than full board reviews (median [range], 131 [64–296] days; P = .008). The median time required for credentialing of investigators was 1 day (range, 0–74 days), and review by the research and development committee took a median of 15 days (range, 0–184 days). There were no significant differences in credentialing or research and development times across review types (exempt, expedited, or full board). Of the extreme delays in IRB review, 80.0% were due to investigators' slow responses to requested changes. There were no systematic delays attributable to the information security officer, privacy officer, or IRB chair. CONCLUSIONS AND RELEVANCE Measuring and analyzing review times is a critical first step in establishing a culture and process of continuous quality improvement among IRBs that govern research programs. The review times observed at this IRB are substantially longer than the 60-day target recommended by expert panels. The method described here could be applied to other IRBs to begin identifying and improving inefficiencies. PMID:25494359

Do author-suggested reviewers rate submissions more favorably than editor-suggested reviewers? A study on atmospheric chemistry and physics.

PubMed

Bornmann, Lutz; Daniel, Hans-Dieter

2010-10-14

Ratings in journal peer review can be affected by sources of bias. The bias variable investigated here was the information on whether authors had suggested a possible reviewer for their manuscript, and whether the editor had taken up that suggestion or had chosen a reviewer that had not been suggested by the authors. Studies have shown that author-suggested reviewers rate manuscripts more favorably than editor-suggested reviewers do. Reviewers' ratings on three evaluation criteria and the reviewers' final publication recommendations were available for 552 manuscripts (in total 1145 reviews) that were submitted to Atmospheric Chemistry and Physics, an interactive open access journal using public peer review (authors' and reviewers' comments are publicly exchanged). Public peer review is supposed to bring a new openness to the reviewing process that will enhance its objectivity. In the statistical analysis the quality of a manuscript was controlled for to prevent favorable reviewers' ratings from being attributable to quality instead of to the bias variable. Our results agree with those from other studies that editor-suggested reviewers rated manuscripts between 30% and 42% less favorably than author-suggested reviewers. Against this backdrop journal editors should consider either doing without the use of author-suggested reviewers or, if they are used, bringing in more than one editor-suggested reviewer for the review process (so that the review by author-suggested reviewers can be put in perspective).

Do Author-Suggested Reviewers Rate Submissions More Favorably than Editor-Suggested Reviewers? A Study on Atmospheric Chemistry and Physics

PubMed Central

Bornmann, Lutz; Daniel, Hans-Dieter

2010-01-01

Background Ratings in journal peer review can be affected by sources of bias. The bias variable investigated here was the information on whether authors had suggested a possible reviewer for their manuscript, and whether the editor had taken up that suggestion or had chosen a reviewer that had not been suggested by the authors. Studies have shown that author-suggested reviewers rate manuscripts more favorably than editor-suggested reviewers do. Methodology/Principal Findings Reviewers' ratings on three evaluation criteria and the reviewers' final publication recommendations were available for 552 manuscripts (in total 1145 reviews) that were submitted to Atmospheric Chemistry and Physics, an interactive open access journal using public peer review (authors' and reviewers' comments are publicly exchanged). Public peer review is supposed to bring a new openness to the reviewing process that will enhance its objectivity. In the statistical analysis the quality of a manuscript was controlled for to prevent favorable reviewers' ratings from being attributable to quality instead of to the bias variable. Conclusions/Significance Our results agree with those from other studies that editor-suggested reviewers rated manuscripts between 30% and 42% less favorably than author-suggested reviewers. Against this backdrop journal editors should consider either doing without the use of author-suggested reviewers or, if they are used, bringing in more than one editor-suggested reviewer for the review process (so that the review by author-suggested reviewers can be put in perspective). PMID:20976226

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

PubMed

Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

2013-10-01

The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

Halal and kosher slaughter methods and meat quality: a review.

PubMed

Farouk, M M; Al-Mazeedi, H M; Sabow, A B; Bekhit, A E D; Adeyemi, K D; Sazili, A Q; Ghani, A

2014-11-01

There are many slaughter procedures that religions and cultures use around the world. The two that are commercially relevant are the halal and kosher methods practiced by Muslims and Jews respectively. The global trade in red meat and poultry produced using these two methods is substantial, thus the importance of the quality of the meat produced using the methods. Halal and kosher slaughter per se should not affect meat quality more than their industrial equivalents, however, some of their associated pre- and post-slaughter processes do. For instance, the slow decline in blood pressure following a halal pre-slaughter head-only stun and neck cut causes blood splash (ecchymosis) in a range of muscles and organs of slaughtered livestock. Other quality concerns include bruising, hemorrhages, skin discoloration and broken bones particularly in poultry. In addition to these conventional quality issues, the "spiritual quality" of the meat can also be affected when the halal and kosher religious requirements are not fully met during the slaughter process. The nature, causes, importance and mitigations of these and other quality issues related to halal and kosher slaughtering and meat production using these methods are the subjects of this review. Copyright © 2014 Elsevier Ltd. All rights reserved.

Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

PubMed

Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

2017-03-01

The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error, criterion validity), whereas others were frequently estimated, but using different coefficients and statistical analyses (e.g., internal consistency, structural validity), thus rendering comparison across instruments difficult. Moreover, the methodological quality adopted in the property assessments was poor or fair in most studies, compromising the goodness of the psychometric values estimated. Clinical learning placements represent the key strategies in educating the future nursing workforce: instruments evaluating the quality of the settings, as well as their capacity to promote significant learning, are strongly recommended. Studies estimating psychometric properties, using an increased quality of research methodologies are needed in order to support nursing educators in the process of clinical placements accreditation and quality improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed Central

Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles

2014-01-01

Objectives To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design A systematic review of the literature. Methods A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions There is some evidence that managers’ time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance. PMID:25192876

Our Application of ISO 9000.

ERIC Educational Resources Information Center

Hammond, Jane

2000-01-01

Since a large, underfunded urban Colorado district initiated ISO 9000 reforms, administrators and staff have reviewed 14 central-office departments' processes to improve efficiency and enhance student outcomes. Jefferson County has saved $900,000 annually on purchasing processes, developed a quality curriculum-development process, and improved…

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.

The Hepatitis Testing and Linkage-to-Care Data Review Process: An Approach to Ensuring the Quality of Program Data.

PubMed

Mezzo, Jennifer L; Lamia, Tamara L; Danelski, Lisa L; Schipani, Anne Marie; Stokes, Scott A; Jacobs-Ware, Elizabeth D

2016-01-01

CDC's 2012 Hepatitis Testing and Linkage to Care (HepTLC) initiative was a nationally coordinated effort to conduct hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites. This project provided support for data management and monthly data reviews between awardees and a data manager, which facilitated monitoring of awardee progress and regular program improvement opportunities. CDC provided technical assistance to awardees for testing processes and program improvement, including Internet-based data submission, reporting software and data management to awardees, offering assistance with submitting, and reviewing data in real time. We describe how one awardee, AIDS Resource Center of Wisconsin (ARCW), used the data management process to improve data quality, inform testing processes and implementation, and measure and report missing variables from an online database. From October 2012 through July 2014, ARCW performed 2,255 HCV antibody (anti-HCV) tests and 244 HCV ribonucleic acid (RNA) tests as part of the HepTLC initiative. Participants who tested HCV RNA positive (n=189) were referred to medical care. At the end of the study, no records were missing for the anti-HCV test result or HCV RNA test result variables, and only one record was missing for those who were referred to medical care. Regular data review and monitoring by awardees and CDC-supported data managers provided opportunities for data quality and program improvement. Through regular data review, ARCW reduced the amount of missing data and promoted timely follow-up with participants testing positive for HCV to ensure receipt of results and linkage to care. Other programs can adopt a similar data management model.

What is actually measured in process evaluations for worksite health promotion programs: a systematic review

PubMed Central

2013-01-01

Background Numerous worksite health promotion program (WHPPs) have been implemented the past years to improve employees’ health and lifestyle (i.e., physical activity, nutrition, smoking, alcohol use and relaxation). Research primarily focused on the effectiveness of these WHPPs. Whereas process evaluations provide essential information necessary to improve large scale implementation across other settings. Therefore, this review aims to: (1) further our understanding of the quality of process evaluations alongside effect evaluations for WHPPs, (2) identify barriers/facilitators affecting implementation, and (3) explore the relationship between effectiveness and the implementation process. Methods Pubmed, EMBASE, PsycINFO, and Cochrane (controlled trials) were searched from 2000 to July 2012 for peer-reviewed (randomized) controlled trials published in English reporting on both the effectiveness and the implementation process of a WHPP focusing on physical activity, smoking cessation, alcohol use, healthy diet and/or relaxation at work, targeting employees aged 18-65 years. Results Of the 307 effect evaluations identified, twenty-two (7.2%) published an additional process evaluation and were included in this review. The results showed that eight of those studies based their process evaluation on a theoretical framework. The methodological quality of nine process evaluations was good. The most frequently reported process components were dose delivered and dose received. Over 50 different implementation barriers/facilitators were identified. The most frequently reported facilitator was strong management support. Lack of resources was the most frequently reported barrier. Seven studies examined the link between implementation and effectiveness. In general a positive association was found between fidelity, dose and the primary outcome of the program. Conclusions Process evaluations are not systematically performed alongside effectiveness studies for WHPPs. The quality of the process evaluations is mostly poor to average, resulting in a lack of systematically measured barriers/facilitators. The narrow focus on implementation makes it difficult to explore the relationship between effectiveness and implementation. Furthermore, the operationalisation of process components varied between studies, indicating a need for consensus about defining and operationalising process components. PMID:24341605

How to Assess Quality of Research in Iran, From Input to Impact? Introduction of Peer-Based Research Evaluation Model in Iran.

PubMed

Ebadifar, Asghar; Baradaran Eftekhari, Monir; Owlia, Parviz; Habibi, Elham; Ghalenoee, Elham; Bagheri, Mohammad Reza; Falahat, Katayoun; Eltemasi, Masoumeh; Sobhani, Zahra; Akhondzadeh, Shahin

2017-11-01

Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing. This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact. The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers' levels. Peer review evaluation can improve the quality of research.

Automotive HMI design and participatory user involvement: review and perspectives.

PubMed

François, Mathilde; Osiurak, François; Fort, Alexandra; Crave, Philippe; Navarro, Jordan

2017-04-01

Automotive human-machine interface (HMI) design is facing new challenges due to the technological advances of the last decades. The design process has to be adapted in order to address human factors and road safety challenges. It is now widely accepted that user involvement in the HMI design process is valuable. However, the current form of user involvement in industry remains at the stages of concept assessment and usability tests. Moreover, the literature in other fields (e.g. information systems) promotes a broader user involvement with participatory design (i.e. the user is fully involved in the development process). This article reviews the established benefits of participatory design and reveals perspectives for automotive HMI quality improvement in a cognitive ergonomic framework. Practitioner Summary: Automotive HMI quality determines, in part, drivers' ability to perform primary driving tasks while using in-vehicle devices. User involvement in the design process is a key point to contribute to HMI quality. This article reports the potential benefits of a broad involvement from drivers to meet automotive HMI design challenges.

48 CFR 1401.7001-4 - Acquisition performance measurement systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-pronged approach that includes self assessment, statistical data for validation and flexible quality... regulations governing the acquisition process; and (3) Identify and implement changes necessary to improve the... through the review and oversight process. ...

48 CFR 1401.7001-4 - Acquisition performance measurement systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-pronged approach that includes self assessment, statistical data for validation and flexible quality... regulations governing the acquisition process; and (3) Identify and implement changes necessary to improve the... through the review and oversight process. ...

48 CFR 1401.7001-4 - Acquisition performance measurement systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-pronged approach that includes self assessment, statistical data for validation and flexible quality... regulations governing the acquisition process; and (3) Identify and implement changes necessary to improve the... through the review and oversight process. ...

48 CFR 1401.7001-4 - Acquisition performance measurement systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-pronged approach that includes self assessment, statistical data for validation and flexible quality... regulations governing the acquisition process; and (3) Identify and implement changes necessary to improve the... through the review and oversight process. ...

Premarital Predictors of Marital Quality and Stability.

ERIC Educational Resources Information Center

Larson, Jeffry H.; Holman, Thomas B.

1994-01-01

Reviews research on premarital factors associated with later marital quality and stability in first marriages. Three major categories of factors are described, including background and context, individual traits and behaviors, and couple interactional processes. Both cross-sectional and longitudinal research are summarized. Recommendations for…

Software Reviews Since Acquisition Reform - The Artifact Perspective

DTIC Science & Technology

2004-01-01

Risk Management OLD NEW Slide 13Acquisition of Software Intensive Systems 2004 – Peter Hantos Single, basic software paradigm Single processor Low...software risk mitigation related trade-offs must be done together Integral Software Engineering Activities Process Maturity and Quality Frameworks Quality

10 CFR 830.122 - Quality assurance criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... control design interfaces. (4) Verify or validate the adequacy of design products using individuals or... quality problems. (2) Identify, control, and correct items, services, and processes that do not meet..., specify requirements, or establish design. (2) Specify, prepare, review, approve, and maintain records. (e...

10 CFR 830.122 - Quality assurance criteria.

Code of Federal Regulations, 2013 CFR

2013-01-01

... control design interfaces. (4) Verify or validate the adequacy of design products using individuals or... quality problems. (2) Identify, control, and correct items, services, and processes that do not meet..., specify requirements, or establish design. (2) Specify, prepare, review, approve, and maintain records. (e...

10 CFR 830.122 - Quality assurance criteria.

Code of Federal Regulations, 2014 CFR

2014-01-01

... control design interfaces. (4) Verify or validate the adequacy of design products using individuals or... quality problems. (2) Identify, control, and correct items, services, and processes that do not meet..., specify requirements, or establish design. (2) Specify, prepare, review, approve, and maintain records. (e...

10 CFR 830.122 - Quality assurance criteria.

Code of Federal Regulations, 2012 CFR

2012-01-01

... control design interfaces. (4) Verify or validate the adequacy of design products using individuals or... quality problems. (2) Identify, control, and correct items, services, and processes that do not meet..., specify requirements, or establish design. (2) Specify, prepare, review, approve, and maintain records. (e...

10 CFR 830.122 - Quality assurance criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

... control design interfaces. (4) Verify or validate the adequacy of design products using individuals or... quality problems. (2) Identify, control, and correct items, services, and processes that do not meet..., specify requirements, or establish design. (2) Specify, prepare, review, approve, and maintain records. (e...

Is Your Ethics Committee Efficient? Using “IRB Metrics” as a Self-Assessment Tool for Continuous Improvement at the Faculty of Tropical Medicine, Mahidol University, Thailand

PubMed Central

Adams, Pornpimon; Kaewkungwal, Jaranit; Limphattharacharoen, Chanthima; Prakobtham, Sukanya; Pengsaa, Krisana; Khusmith, Srisin

2014-01-01

Tensions between researchers and ethics committees have been reported in several institutions. Some reports suggest researchers lack confidence in the quality of institutional review board (IRB) reviews, and that emphasis on strict procedural compliance and ethical issues raised by the IRB might unintentionally lead to delays in correspondence between researchers and ethics committees, and/or even encourage prevarication/equivocation, if researchers perceive committee concerns and criticisms unjust. This study systematically analyzed the efficiency of different IRB functions, and the relationship between efficiency and perceived quality of the decision-making process. The major purposes of this study were thus (1) to use the IRB Metrics developed by the Faculty of Tropical Medicine, Mahidol University, Thailand (FTM-EC) to assess the operational efficiency and perceived effectiveness of its ethics committees, and (2) to determine ethical issues that may cause the duration of approval process to be above the target limit of 60 days. Based on a literature review of definitions and methods used and proposed for use, in assessing aspects of IRB quality, an “IRB Metrics” was developed to assess IRB processes using a structure-process-outcome measurement model. To observe trends in the indicators evaluated, data related to all protocols submitted to the two panels of the FTM-EC (clinical and non-clinical), between January 2010–September 2013, were extracted and analyzed. Quantitative information based on IRB Metrics structure-process-outcome illuminates different areas for internal-process improvement. Ethical issues raised with researchers by the IRB, which were associated with the duration of the approval process in protocol review, could be considered root causes of tensions between the parties. The assessment of IRB structure-process-outcome thus provides a valuable opportunity to strengthen relationships and reduce conflicts between IRBs and researchers, with positive outcomes for all parties involved in the conduct of human-subject research. PMID:25406085

Software Quality Evaluation Models Applicable in Health Information and Communications Technologies. A Review of the Literature.

PubMed

Villamor Ordozgoiti, Alberto; Delgado Hito, Pilar; Guix Comellas, Eva María; Fernandez Sanchez, Carlos Manuel; Garcia Hernandez, Milagros; Lluch Canut, Teresa

2016-01-01

Information and Communications Technologies in healthcare has increased the need to consider quality criteria through standardised processes. The aim of this study was to analyse the software quality evaluation models applicable to healthcare from the perspective of ICT-purchasers. Through a systematic literature review with the keywords software, product, quality, evaluation and health, we selected and analysed 20 original research papers published from 2005-2016 in health science and technology databases. The results showed four main topics: non-ISO models, software quality evaluation models based on ISO/IEC standards, studies analysing software quality evaluation models, and studies analysing ISO standards for software quality evaluation. The models provide cost-efficiency criteria for specific software, and improve use outcomes. The ISO/IEC25000 standard is shown as the most suitable for evaluating the quality of ICTs for healthcare use from the perspective of institutional acquisition.

Reviewing Manuscripts for Biomedical Journals

PubMed Central

Garmel, Gus M

2010-01-01

Writing for publication is a complex task. For many professionals, producing a well-executed manuscript conveying one's research, ideas, or educational wisdom is challenging. Authors have varying emotions related to the process of writing for scientific publication. Although not studied, a relationship between an author's enjoyment of the writing process and the product's outcome is highly likely. As with any skill, practice generally results in improvements. Literature focused on preparing manuscripts for publication and the art of reviewing submissions exists. Most journals guard their reviewers' anonymity with respect to the manuscript review process. This is meant to protect them from direct or indirect author demands, which may occur during the review process or in the future. It is generally accepted that author identities are masked in the peer-review process. However, the concept of anonymity for reviewers has been debated recently; many editors consider it problematic that reviewers are not held accountable to the public for their decisions. The review process is often arduous and underappreciated, one reason why biomedical journals acknowledge editors and frequently recognize reviewers who donate their time and expertise in the name of science. This article describes essential elements of a submitted manuscript, with the hopes of improving scientific writing. It also discusses the review process within the biomedical literature, the importance of reviewers to the scientific process, responsibilities of reviewers, and qualities of a good review and reviewer. In addition, it includes useful insights to individuals who read and interpret the medical literature. PMID:20740129

Induction of labour: a continuous quality improvement and peer review program to improve the quality of care

PubMed Central

Harris, Susan; Buchinski, Bev; Gryzbowski, Stefan; Janssen, Patti; Mitchell, G.W. Erle; Farquharson, Duncan

2000-01-01

This article describes a program developed to improve the process of planned induction of labour and to reduce the rates of inappropriate induction. The setting is a tertiary-care maternity hospital in urban Vancouver, BC, in which 7000 deliveries take place annually. Approximately 65% of these can be considered primary care; the remainder are secondary- or tertiary-level cases. Continuous quality improvement (CQI) methods were used by a multidisciplinary team, which included nursing staff, physicians, health records personnel and a CQI facilitator. Interventions included the development of a new induction-booking process, clear criteria for induction, feedback to caregivers about changes and a peer review system to oversee and maintain improvement. The overall induction rate for the institution decreased, and this change has been maintained. PMID:11079064

[Reviewing an article for Radiología: who and how].

PubMed

García Santos, J M

2011-01-01

The reviewer's job is fundamental to the editorial process in a scientific journal. The quality of the review will determine the quality of the journal. Therefore, it is very important for the reviewers to make this mission their own and to contribute to the development of science and of the journal. On the other hand, the focus of a review will depend largely on the type of journal for which one is reviewing. In this article, we explain what the journal Radiología, the scientific journal of the Spanish Society of Medical Radiology, expects of its reviewers and their reviews of original articles. We aim to establish some basic rules to lay the groundwork for the development of more detailed guidelines for reviewing articles for the journal Radiología. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Innovative tools for quality assessment: integrated quality criteria for review of multiple study designs (ICROMS).

PubMed

Zingg, W; Castro-Sanchez, E; Secci, F V; Edwards, R; Drumright, L N; Sevdalis, N; Holmes, A H

2016-04-01

With the aim to facilitate a more comprehensive review process in public health including patient safety, we established a tool that we have termed ICROMS (Integrated quality Criteria for the Review Of Multiple Study designs), which unifies, integrates and refines current quality criteria for a large range of study designs including qualitative research. Review, pilot testing and expert consensus. The tool is the result of an iterative four phase process over two years: 1) gathering of established criteria for assessing controlled, non-controlled and qualitative study designs; 2) pilot testing of a first version in two systematic reviews on behavioural change in infection prevention and control and in antibiotic prescribing; 3) further refinement and adding of additional study designs in the context of the European Centre for Disease Prevention and Control funded project 'Systematic review and evidence-based guidance on organisation of hospital infection control programmes' (SIGHT); 4) scrutiny by the pan-European expert panel of the SIGHT project, which had the objective of ensuring robustness of the systematic review. ICROMS includes established quality criteria for randomised studies, controlled before-and-after studies and interrupted time series, and incorporates criteria for non-controlled before-and-after studies, cohort studies and qualitative studies. The tool consists of two parts: 1) a list of quality criteria specific for each study design, as well as criteria applicable across all study designs by using a scoring system; 2) a 'decision matrix', which specifies the robustness of the study by identifying minimum requirements according to the study type and the relevance of the study to the review question. The decision matrix directly determines inclusion or exclusion of a study in the review. ICROMS was applied to a series of systematic reviews to test its feasibility and usefulness in the appraisal of multiple study designs. The tool was applicable across a wide range of study designs and outcome measures. ICROMS is a comprehensive yet feasible appraisal of a large range of study designs to be included in systematic reviews addressing behaviour change studies in patient safety and public health. The tool is sufficiently flexible to be applied to a variety of other domains in health-related research. Beyond its application to systematic reviews, we envisage that ICROMS can have a positive effect on researchers to be more rigorous in their study design and more diligent in their reporting. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Quality improvement in neurology: AAN Parkinson disease quality measures

PubMed Central

Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

2010-01-01

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY AAN = American Academy of Neurology; ABPN = American Board of Psychiatry and Neurology; AMA = American Medical Association; CPT II = Current Procedural Terminology; PCPI = Physician Consortium for Performance Improvement; PD = Parkinson disease; PMAG = Performance Measurement Advisory Group; PQRI = Physician Quality Reporting Initiative; QMR = Quality Measurement and Reporting Subcommittee. PMID:21115958

A review of evolution of electrospun tissue engineering scaffold: From two dimensions to three dimensions.

PubMed

Ngadiman, Nor Hasrul Akhmal; Noordin, M Y; Idris, Ani; Kurniawan, Denni

2017-07-01

The potential of electrospinning process to fabricate ultrafine fibers as building blocks for tissue engineering scaffolds is well recognized. The scaffold construct produced by electrospinning process depends on the quality of the fibers. In electrospinning, material selection and parameter setting are among many factors that contribute to the quality of the ultrafine fibers, which eventually determine the performance of the tissue engineering scaffolds. The major challenge of conventional electrospun scaffolds is the nature of electrospinning process which can only produce two-dimensional electrospun mats, hence limiting their applications. Researchers have started to focus on overcoming this limitation by combining electrospinning with other techniques to fabricate three-dimensional scaffold constructs. This article reviews various polymeric materials and their composites/blends that have been successfully electrospun for tissue engineering scaffolds, their mechanical properties, and the various parameters settings that influence the fiber morphology. This review also highlights the secondary processes to electrospinning that have been used to develop three-dimensional tissue engineering scaffolds as well as the steps undertaken to overcome electrospinning limitations.

A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39.

PubMed

Reeves, Scott; Fletcher, Simon; Barr, Hugh; Birch, Ivan; Boet, Sylvain; Davies, Nigel; McFadyen, Angus; Rivera, Josette; Kitto, Simon

2016-07-01

Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education. The overall aim of this review is to update a previous BEME review published in 2007. In doing so, this update sought to synthesize the evolving nature of the IPE evidence. Medline, CINAHL, BEI, and ASSIA were searched from May 2005 to June 2014. Also, journal hand searches were undertaken. All potential abstracts and papers were screened by pairs of reviewers to determine inclusion. All included papers were assessed for methodological quality and those deemed as "high quality" were included. The presage-process-product (3P) model and a modified Kirkpatrick model were employed to analyze and synthesize the included studies. Twenty-five new IPE studies were included in this update. These studies were added to the 21 studies from the previous review to form a complete data set of 46 high-quality IPE studies. In relation to the 3P model, overall the updated review found that most of the presage and process factors identified from the previous review were further supported in the newer studies. In regard to the products (outcomes) reported, the results from this review continue to show far more positive than neutral or mixed outcomes reported in the included studies. Based on the modified Kirkpatrick model, the included studies suggest that learners respond well to IPE, their attitudes and perceptions of one another improve, and they report increases in collaborative knowledge and skills. There is more limited, but growing, evidence related to changes in behavior, organizational practice, and benefits to patients/clients. This updated review found that key context (presage) and process factors reported in the previous review continue to have resonance on the delivery of IPE. In addition, the newer studies have provided further evidence for the effects on IPE related to a number of different outcomes. Based on these conclusions, a series of key implications for the development of IPE are offered.

Readiness Review of BWXT for Fabrication of AGR 5/6/7 Compacts

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

Marshall, Douglas William; Sharp, Michelle Tracy

In support of preparations for fabricating compacts for the Advanced Gas Reactor (AGR) fuel qualification irradiation experiments (AGR-5/6/7), Idaho National Laboratory (INL) conducted a readiness review of the BWX Technology (BWXT) procedures, processes, and equipment associated with compact fabrication activities at the BWXT Nuclear Operations Group (BWXT-NOG) facility outside Lynchburg, VirginiaVA. The readiness review used quality assurance requirements taken from the American Society of Mechanical Engineers (ASME) Nuclear Quality Assurance Standard (NQA-1-2008/1a-2009) as a basis to assess readiness to start compact fabrication.

Post Processing Methods used to Improve Surface Finish of Products which are Manufactured by Additive Manufacturing Technologies: A Review

NASA Astrophysics Data System (ADS)

Kumbhar, N. N.; Mulay, A. V.

2016-08-01

The Additive Manufacturing (AM) processes open the possibility to go directly from Computer-Aided Design (CAD) to a physical prototype. These prototypes are used as test models before it is finalized as well as sometimes as a final product. Additive Manufacturing has many advantages over the traditional process used to develop a product such as allowing early customer involvement in product development, complex shape generation and also save time as well as money. Additive manufacturing also possess some special challenges that are usually worth overcoming such as Poor Surface quality, Physical Properties and use of specific raw material for manufacturing. To improve the surface quality several attempts had been made by controlling various process parameters of Additive manufacturing and also applying different post processing techniques on components manufactured by Additive manufacturing. The main objective of this work is to document an extensive literature review in the general area of post processing techniques which are used in Additive manufacturing.

Involving mental health service users in quality assurance

PubMed Central

Weinstein, Jenny

2006-01-01

Abstract Objective  This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. Background  QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. Design  This retrospective small‐scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection‐type event and one that took place in 2000 as a collaborative process with a user‐led QA agenda. Setting and participants  The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention  The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user‐led QA process for service development. Results  The first traditional top–down inspection‐type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user‐led agenda focused on different priorities, evolving a new approach to seeking users’ views and achieving a higher response rate. Conclusions  Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization. PMID:16677189

Interdisciplinary Coordination Reviews: A Process to Reduce Construction Costs.

ERIC Educational Resources Information Center

Fewell, Dennis A.

1998-01-01

Interdisciplinary Coordination design review is instrumental in detecting coordination errors and omissions in construction documents. Cleansing construction documents of interdisciplinary coordination errors reduces time extensions, the largest source of change orders, and limits exposure to liability claims. Improving the quality of design…

Review of the Primary National Ambient Air Quality Standards ...

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for nitrogen dioxide (NO2). The major phases of the process for reviewing NAAQS include the following: (1) planning, (2) science assessment, (3) risk and exposure assessment, and (4) policy assessment. As an initial step in the risk and exposure assessment phase, EPA staff has considered the extent to which updated quantitative analyses of NO2 exposures and/or NO2-attributable health risks are warranted in the current review, based on the available scientific evidence and technical information. These considerations focus on the degree to which important uncertainties identified in quantitative analyses from the last review have been addressed by newly available evidence, tools, or information. The purpose of the REA planning document is to present staff's considerations and preliminary conclusions regarding potential updated quantitative analyses in the current review of the primary NO2 NAAQS. Provide opportunity for CASAC feedback on EPA's plans for the risk and exposure assessment for the Nitrogen Oxides NAAQS review

Quality assurance of technical specification approval process

NASA Astrophysics Data System (ADS)

Antsev, V. Yu; Antseva, N. V.; Chernecova, E. A.

2018-03-01

The paper reviews the issue of increasing the efficiency of contract analysis on machine-building plants in accordance with process approach principles and on the basis of better interaction between marketing, finance and accounting, and R&D departments.

Systematic review for geo-authentic Lonicerae Japonicae Flos.

PubMed

Yang, Xingyue; Liu, Yali; Hou, Aijuan; Yang, Yang; Tian, Xin; He, Liyun

2017-06-01

In traditional Chinese medicine, Lonicerae Japonicae Flos is commonly used as anti-inflammatory, antiviral, and antipyretic herbal medicine, and geo-authentic herbs are believed to present the highest quality among all samples from different regions. To discuss the current situation and trend of geo-authentic Lonicerae Japonicae Flos, we searched Chinese Biomedicine Literature Database, Chinese Journal Full-text Database, Chinese Scientific Journal Full-text Database, Cochrane Central Register of Controlled Trials, Wanfang, and PubMed. We investigated all studies up to November 2015 pertaining to quality assessment, discrimination, pharmacological effects, planting or processing, or ecological system of geo-authentic Lonicerae Japonicae Flos. Sixty-five studies mainly discussing about chemical fingerprint, component analysis, planting and processing, discrimination between varieties, ecological system, pharmacological effects, and safety were systematically reviewed. By analyzing these studies, we found that the key points of geo-authentic Lonicerae Japonicae Flos research were quality and application. Further studies should focus on improving the quality by selecting the more superior of all varieties and evaluating clinical effectiveness.

Potential impacts of changing supply-water quality on drinking water distribution: A review.

PubMed

Liu, Gang; Zhang, Ya; Knibbe, Willem-Jan; Feng, Cuijie; Liu, Wentso; Medema, Gertjan; van der Meer, Walter

2017-06-01

Driven by the development of water purification technologies and water quality regulations, the use of better source water and/or upgraded water treatment processes to improve drinking water quality have become common practices worldwide. However, even though these elements lead to improved water quality, the water quality may be impacted during its distribution through piped networks due to the processes such as pipe material release, biofilm formation and detachment, accumulation and resuspension of loose deposits. Irregular changes in supply-water quality may cause physiochemical and microbiological de-stabilization of pipe material, biofilms and loose deposits in the distribution system that have been established over decades and may harbor components that cause health or esthetical issues (brown water). Even though it is clearly relevant to customers' health (e.g., recent Flint water crisis), until now, switching of supply-water quality is done without any systematic evaluation. This article reviews the contaminants that develop in the water distribution system and their characteristics, as well as the possible transition effects during the switching of treated water quality by destabilization and the release of pipe material and contaminants into the water and the subsequent risks. At the end of this article, a framework is proposed for the evaluation of potential transition effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

A systematic review of Human Factors and Ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety

PubMed Central

Xie, Anping; Carayon, Pascale

2014-01-01

Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how Human Factors and Ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified twelve projects representing 23 studies and addressing different physical, cognitive and organizational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care. Practitioner Summary Existing evidence shows that HFE-based healthcare system redesign has the potential to improve quality of care and patient safety. Healthcare organizations need to recognize the importance of HFE-based healthcare system redesign to quality of care and patient safety, and invest resources to integrate HFE in healthcare improvement activities. PMID:25323570

Use of osmotic dehydration to improve fruits and vegetables quality during processing.

PubMed

Maftoonazad, Neda

2010-11-01

Osmotic treatment describes a preparation step to further processing of foods involving simultaneous transient moisture loss and solids gain when immersing in osmotic solutions, resulting in partial drying and improving the overall quality of food products. The different aspects of the osmotic dehydration (OD) technology namely the solutes employed, solutions characteristics used, process variables influence, as well as, the quality characteristics of the osmodehydrated products will be discussed in this review. As the process is carried out at mild temperatures and the moisture is removed by a liquid diffusion process, phase change that would be present in the other drying processes will be avoided, resulting in high quality products and may also lead to substantial energy savings. To optimize this process, modeling of the mass transfer phenomenon can improve high product quality. Several techniques such as microwave heating, vacuum, high pressure, pulsed electric field, etc. may be employed during or after osmotic treatment to enhance performance of the osmotic dehydration. Moreover new technologies used in osmotic dehydration will be discussed. Patents on osmotic dehydration of fruits and vegetables are also discussed in this article.

Thermal pasteurization of ready-to-eat foods and vegetables: Critical factors for process design and effects on quality.

PubMed

Peng, Jing; Tang, Juming; Barrett, Diane M; Sablani, Shyam S; Anderson, Nathan; Powers, Joseph R

2017-09-22

Increasing consumer desire for high quality ready-to-eat foods makes thermal pasteurization important to both food producers and researchers. To be in compliance with the Food Safety Modernization Act (FSMA), food companies seek regulatory and scientific guidelines to ensure that their products are safe. Clearly understanding the regulations for chilled or frozen foods is of fundamental importance to the design of thermal pasteurization processes for vegetables that meet food safety requirements. This article provides an overview of the current regulations and guidelines for pasteurization in the U.S. and in Europe for control of bacterial pathogens. Poorly understood viral pathogens, in terms of their survival in thermal treatments, are an increasing concern for both food safety regulators and scientists. New data on heat resistance of viruses in different foods are summarized. Food quality attributes are sensitive to thermal degradation. A review of thermal kinetics of inactivation of quality-related enzymes in vegetables and the effects of thermal pasteurization on vegetable quality is presented. The review also discusses shelf-life of thermally pasteurized vegetables.

Quality of nursing diagnoses: evaluation of an educational intervention.

PubMed

Florin, Jan; Ehrenberg, Anna; Ehnfors, Margareta

2005-01-01

To investigate the effects on the quality of nursing diagnostic statements in patient records after education in the nursing process and implementation of new forms for recording. Quasi-experimental design. Randomly selected patient records reviewed before and after intervention from one experimental unit (n = 70) and three control units (n = 70). A scale with 14 characteristics pertaining to nursing diagnoses was developed and used together with the instrument (CAT-CH-ING) for record review. Quality of nursing diagnostic statements improved in the experimental unit, whereas no improvement was found in the control units. Serious flaws in the use of the etiology component were found. CONCLUSION. Nurses must be more concerned with the accuracy and quality of the nursing diagnoses and the etiology component needs to be given special attention. Education of RNs in nursing diagnostic statements and peer review using standardized evaluation instruments can be means to further enhance RNs' documentation practice.

Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature.

PubMed

Mathes, Tim; Walgenbach, Maren; Antoine, Sunya-Lee; Pieper, Dawid; Eikermann, Michaela

2014-10-01

The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE. To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed. Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data. The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE. © The Author(s) 2014.

[Quality by design approaches for pharmaceutical development and manufacturing of Chinese medicine].

PubMed

Xu, Bing; Shi, Xin-Yuan; Wu, Zhi-Sheng; Zhang, Yan-Ling; Wang, Yun; Qiao, Yan-Jiang

2017-03-01

The pharmaceutical quality was built by design, formed in the manufacturing process and improved during the product's lifecycle. Based on the comprehensive literature review of pharmaceutical quality by design (QbD), the essential ideas and implementation strategies of pharmaceutical QbD were interpreted. Considering the complex nature of Chinese medicine, the "4H" model was innovated and proposed for implementing QbD in pharmaceutical development and industrial manufacture of Chinese medicine product. "4H" corresponds to the acronym of holistic design, holistic information analysis, holistic quality control, and holistic process optimization, which is consistent with the holistic concept of Chinese medicine theory. The holistic design aims at constructing both the quality problem space from the patient requirement and the quality solution space from multidisciplinary knowledge. Holistic information analysis emphasizes understanding the quality pattern of Chinese medicine by integrating and mining multisource data and information at a relatively high level. The batch-to-batch quality consistence and manufacturing system reliability can be realized by comprehensive application of inspective quality control, statistical quality control, predictive quality control and intelligent quality control strategies. Holistic process optimization is to improve the product quality and process capability during the product lifecycle management. The implementation of QbD is useful to eliminate the ecosystem contradictions lying in the pharmaceutical development and manufacturing process of Chinese medicine product, and helps guarantee the cost effectiveness. Copyright© by the Chinese Pharmaceutical Association.

Analysis of quality raw data of second generation sequencers with Quality Assessment Software.

PubMed

Ramos, Rommel Tj; Carneiro, Adriana R; Baumbach, Jan; Azevedo, Vasco; Schneider, Maria Pc; Silva, Artur

2011-04-18

Second generation technologies have advantages over Sanger; however, they have resulted in new challenges for the genome construction process, especially because of the small size of the reads, despite the high degree of coverage. Independent of the program chosen for the construction process, DNA sequences are superimposed, based on identity, to extend the reads, generating contigs; mismatches indicate a lack of homology and are not included. This process improves our confidence in the sequences that are generated. We developed Quality Assessment Software, with which one can review graphs showing the distribution of quality values from the sequencing reads. This software allow us to adopt more stringent quality standards for sequence data, based on quality-graph analysis and estimated coverage after applying the quality filter, providing acceptable sequence coverage for genome construction from short reads. Quality filtering is a fundamental step in the process of constructing genomes, as it reduces the frequency of incorrect alignments that are caused by measuring errors, which can occur during the construction process due to the size of the reads, provoking misassemblies. Application of quality filters to sequence data, using the software Quality Assessment, along with graphing analyses, provided greater precision in the definition of cutoff parameters, which increased the accuracy of genome construction.

[Quality of care in nursing homes: a review of literature regarding structure, process and outcome indicators related to the risk of malnutrition].

PubMed

Lorini, C; Mencacci, M; Bonaccorsi, G

2012-01-01

The admissions and the demands for entering nursing homes (NHs) are gradually increasing. Focusing on the quality of care in NHs, the risk of protein- calorie malnutrition has a key role. The purpose of this paper is to select and describe structure, process of care and outcome indicators, as well as individual risk factors (confounders), related to malnutrition in NHs. We have analyzed scientific articles found in MEDLINE, published from 2000 to 2011, identified through four different string selections. 505 articles have been collected, 17 of whom were chosen because they included specific malnutrition indicators in the framework of quality of care indicators. Three papers specifically deal with malnutrition as one of the elements of the quality of care in NHs linked to structure, processes and outcome. From this review, it clearly emerges that scientific articles addressing malnutrition as one of the requirements of healthcare quality in NHs are scarce, compared with a rather large number of publications concerning the prevalence and/or the description of interventions related to--and made to solve or reduce--malnutrition already in place. It is therefore necessary to spread the culture and the approach of nutritional risk analysis within the systems aimed at evaluating the quality of care in NHs, by selecting and monitoring appropriate malnutrition indicators.

A case study: application of statistical process control tool for determining process capability and sigma level.

PubMed

Chopra, Vikram; Bairagi, Mukesh; Trivedi, P; Nagar, Mona

2012-01-01

Statistical process control is the application of statistical methods to the measurement and analysis of variation process. Various regulatory authorities such as Validation Guidance for Industry (2011), International Conference on Harmonisation ICH Q10 (2009), the Health Canada guidelines (2009), Health Science Authority, Singapore: Guidance for Product Quality Review (2008), and International Organization for Standardization ISO-9000:2005 provide regulatory support for the application of statistical process control for better process control and understanding. In this study risk assessments, normal probability distributions, control charts, and capability charts are employed for selection of critical quality attributes, determination of normal probability distribution, statistical stability, and capability of production processes, respectively. The objective of this study is to determine tablet production process quality in the form of sigma process capability. By interpreting data and graph trends, forecasting of critical quality attributes, sigma process capability, and stability of process were studied. The overall study contributes to an assessment of process at the sigma level with respect to out-of-specification attributes produced. Finally, the study will point to an area where the application of quality improvement and quality risk assessment principles for achievement of six sigma-capable processes is possible. Statistical process control is the most advantageous tool for determination of the quality of any production process. This tool is new for the pharmaceutical tablet production process. In the case of pharmaceutical tablet production processes, the quality control parameters act as quality assessment parameters. Application of risk assessment provides selection of critical quality attributes among quality control parameters. Sequential application of normality distributions, control charts, and capability analyses provides a valid statistical process control study on process. Interpretation of such a study provides information about stability, process variability, changing of trends, and quantification of process ability against defective production. Comparative evaluation of critical quality attributes by Pareto charts provides the least capable and most variable process that is liable for improvement. Statistical process control thus proves to be an important tool for six sigma-capable process development and continuous quality improvement.

Raising the quality of rheumatology management recommendations: lessons from the EULAR process 10 years after provision of standard operating procedures.

PubMed

Colebatch-Bourn, Alexandra N; Conaghan, Philip G; Arden, Nigel K; Cooper, Cyrus; Dougados, Maxime; Edwards, Christopher J

2015-08-01

To increase understanding of how to raise the quality of rheumatology guidelines by reviewing European League Against Rheumatism (EULAR) management recommendations, using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, 10 years after publication of the EULAR standardized operating procedures (SOP) for the production of recommendations. It was hoped that this work could help inform improvements in guideline development by other societies and organizations. The SOP were published in 2004 to ensure the quality of EULAR-endorsed recommendations. We reviewed 27 published EULAR recommendations for management using the AGREE II tool. This provides a framework to assess the quality of guidelines across six broad domains using 23 specific questions. Overall the EULAR recommendations reviewed have been performed to a high standard. There are particular strengths in the methodology and presentation of the guidelines; however, the results indicate areas for development in future recommendations: in particular, stakeholder involvement and applicability of the recommendations. Improvements in quality were evident in recent years, with patient representation in 9 of 15 (60.0%) recommendations published 2010-14 compared with 4 of 12 (33.3%) published 2000-09. In the last 10 years the overall quality of recommendations was good, with standards improving over the decade following publication of the SOP. However, this review process has identified potential areas for improvement, especially in patient representation and provision of implementation tools. The lessons from this work can be applied to the development of rheumatology guidelines by other societies and organizations. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Opening the black box of ethics policy work: evaluating a covert practice.

PubMed

Frolic, Andrea; Drolet, Katherine; Bryanton, Kim; Caron, Carole; Cupido, Cynthia; Flaherty, Barb; Fung, Sylvia; McCall, Lori

2012-01-01

Hospital ethics committees (HECs) and ethicists generally describe themselves as engaged in four domains of practice: case consultation, research, education, and policy work. Despite the increasing attention to quality indicators, practice standards, and evaluation methods for the other domains, comparatively little is known or published about the policy work of HECs or ethicists. This article attempts to open the "black box" of this health care ethics practice by providing two detailed case examples of ethics policy reviews. We also describe the development and application of an evaluation strategy to assess the quality of ethics policy review work, and to enable continuous improvement of ethics policy review processes. Given the potential for policy work to impact entire patient populations and organizational systems, it is imperative that HECs and ethicists develop clearer roles, responsibilities, procedural standards, and evaluation methods to ensure the delivery of consistent, relevant, and high-quality ethics policy reviews.

Quality of Mental Health Care for Nursing Home Residents: A Literature Review

PubMed Central

Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

2010-01-01

Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

Interspecific and intergeneric hybridization as a source of variation for wheat grain quality improvement.

PubMed

Alvarez, Juan B; Guzmán, Carlos

2018-02-01

The hybridization events with wild relatives and old varieties are an alternative source for enlarging the wheat quality variability. This review describes these process and their effects on the technological and nutritional quality. Wheat quality and its end-uses are mainly based on variation in three traits: grain hardness, gluten quality and starch. In recent times, the importance of nutritional quality and health-related aspects has increased the range of these traits with the inclusion of other grain components such as vitamins, fibre and micronutrients. One option to enlarge the genetic variability in wheat for all these components has been the use of wild relatives, together with underutilised or neglected wheat varieties or species. In the current review, we summarise the role of each grain component in relation to grain quality, their variation in modern wheat and the alternative sources in which wheat breeders have found novel variation.

[Effect and regulation of drying on quality of traditional Chinese medicine pills].

PubMed

Qi, Ya-Ru; Li, Yuan-Hui; Han, Li; Wu, Zhen-Feng; Yue, Peng-Fei; Wang, Xue-Cheng; Xiong, Yao-Kun; Yang, Ming

2017-06-01

The dry quality of traditional Chinese medicine pills is the hot spot of pills research, because their quality has a crucial effect on the efficacy and development of dosage forms. Through literature research and statistical analysis, we would review the current problems on the drying of traditional Chinese medicine pills in this paper, and surrounding the evaluation system for traditional Chinese medicine pills, analyze the characteristics of common drying equipment and processes as well as their effect on quality of pills, discuss the problems in drying equipment and process as well as quality, and put forward the corresponding strategies, hoping to provide new ideas and new methods for the quality improvement of traditional Chinese medicine pills and quality standards. Copyright© by the Chinese Pharmaceutical Association.

INFORMATION: Audit Report on "Accounting and Reporting for the American Recovery and Reinvestment Act by the Department of Energy's Funding Recipients"

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

None

2010-04-01

The American Recovery and Reinvestment Act of 2009 (Recovery Act) was established to jumpstart the U.S. economy, create or save millions of jobs, and invest in the Nation's energy future. The Department of Energy received approximately $37 billion through the Recovery Act to support a variety of science, energy and environmental initiatives. The Office of Management and Budget (OMB) issued guidance for carrying out stimulus-related activities which requires, among other things, that recipients ensure funds provided by the Recovery Act are clearly distinguishable from non-Recovery Act funds in all reporting systems and that recipients' actions are transparent to the public.more » To meet these requirements, the Department's recipients must clearly and accurately track and report on 18 separate data elements. In addition, the Department was to develop and implement a process to ensure that recipient information reported to the public was free from material omissions and significant reporting errors. Our recent report (OAS-RA-10-01, October 2009) noted that the Department had developed a quality assurance process to facilitate the quarterly reviews of recipient data and planned to test it during the first quarterly reporting cycle. To determine whether the Department's quality assurance process was effective, we examined information reported by recipients of Departmental funding as of September 30, 2009. We also sought to determine whether the Department's prime contractors were prepared to track and report on Recovery Act activities. The Department had taken a number of actions designed to ensure the accuracy and transparency of reported Recovery Act results. This process identified potential anomalies with information reported by 1,113 of 2,038, or 55 percent of recipients. We view the Department's data quality assurance efforts as both timely and significant. As noted by our audit testing, however, opportunities exist to strengthen the process. In particular: (1) Site officials did not always ensure that anomalies, once identified during the quality assurance process, were actually resolved. For example, the Department's process identified that about 740 of the approximately 10,000 jobs reported in the first quarter of Fiscal Year 2010 as created/retained were for projects reported as having no funds spent. Although these problems were referred to site officials for follow-up and/or correction, the information was never actually changed; (2) The Department did not always utilize the correct basis when evaluating the accuracy of 'funds provided' data submitted by grant recipients. For example, in its analysis process, the Department used data reflecting 'funds obligated' rather than the correct amount of 'total grant awards'. This generated a number of potential false positives; and, (3) Duplicate reports by certain recipients, resulting in overstatements of as much as $137 million of the more than $18 billion obligated, were not corrected. We observed that the Department had taken prompt action to ensure that its prime facility management contractors could properly report Recovery Act information. Notably, the seven contractors in this category included in our review had modified their accounting systems, as necessary, to ensure that they could accurately track and report on Recovery Act activities. The systems at each of these entities had been restructured so that they: (i) could separate Recovery Act and non-Recovery Act funds; and, (ii) had adequate processing capacity to handle the projected increase in transactions. We found the Department's decision to limit its reviews to the four elements that it considered to be critical (award amount, invoiced amount, jobs created/retained, and project status) to be reasonable. We concluded, however, other elements or dependent relationships should not be completely excluded from review. Beyond its initial development and implementation of its quality assurance process, the Department had taken steps to improve its ability to ensure that Recovery Act information was both accurate and transparent to the public. Specifically, officials changed the quality assurance plan based on initial data reviews. Department officials also informed us that they are in the process of updating their quality assurance process to meet new OMB requirements. For example, recent guidance directed agencies to focus on certain data elements, such as award number and recipient name, during their quality assurance reviews. In addition, subsequent to our review, the Department added two more data elements and comparisons to its quarterly assurance process, including an analysis of costs/expenditures and a comparison of the recipient reported project status to the Department's data contained in its financial system.« less

Preventing Harm in the ICU-Building a Culture of Safety and Engaging Patients and Families.

PubMed

Thornton, Kevin C; Schwarz, Jennifer J; Gross, A Kendall; Anderson, Wendy G; Liu, Kathleen D; Romig, Mark C; Schell-Chaple, Hildy; Pronovost, Peter J; Sapirstein, Adam; Gropper, Michael A; Lipshutz, Angela K M

2017-09-01

Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts. Literature review using PubMed including evaluation of key studies assessing large-scale quality improvement efforts in the ICU, impact of safety culture on patient outcomes, methodologies for quality improvement commonly used in healthcare, and patient and family engagement. Print and web-based resources from leading patient safety organizations were also searched. Our group completed a review of original studies, review articles, book chapters, and recommendations from leading patient safety organizations. Our group determined by consensus which resources would best inform this review. A strong safety culture is associated with reduced adverse events, lower mortality rates, and lower costs. Quality improvement efforts have been shown to be more effective and sustainable when paired with a strong safety culture. Different methodologies exist for quality improvement in the ICU; a thoughtful approach to implementation that engages frontline providers and administrative leadership is essential for success. Efforts to substantively include patients and families in the processes of quality improvement work in the ICU should be expanded. Efforts to establish a culture of safety and meaningfully engage patients and families should form the foundation for all safety interventions in the ICU. This review describes an approach that integrates components of several proven quality improvement methodologies to enhance safety culture in the ICU and highlights opportunities to include patients and families.

Ten tools of continuous quality improvement: a review and case example of hospital discharge.

PubMed

Ziegenfuss, J T; McKenna, C K

1995-01-01

Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

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

Australian Aboriginal and Torres Strait Islander-focused primary healthcare social and emotional wellbeing research: a systematic review protocol.

PubMed

Farnbach, Sara; Eades, Anne-Marie; Hackett, Maree Lisa

2015-12-30

Research with a focus on Aboriginal and Torres Strait Islander Australian's (hereafter referred to as Indigenous(1)) needs is crucial to ensure culturally appropriate evidence-based strategies are developed to improve health. However, concerns surrounding this research exist, arising from some previous research lacking community consultation, resulting in little community benefit or infringing on important cultural values. Values and Ethics: Guidelines for Ethical conduct in Aboriginal and Torres Strait Islander Health Research (hereafter referred to as Values and Ethics), developed by The National Health and Medical Research Council of Australia in 2003, is the ethical standard for Indigenous-focused health research. Researchers must address its Values in research design and conduct. However, its impact on research processes is unclear. Local Protocols should also be considered. This review aims to systematically examine practices related to Values and Ethics, Local Protocols and the processes of conducting Indigenous-focused primary healthcare research in collaboration with external researchers. The following electronic databases and grey literature will be searched (2003 to current): MEDLINE, EMBASE, CINAHL, Informit and HealthInfoNet--an Indigenous-specific research and program website. Indigenous-focused research will be included. Research must be conducted in one or more primary healthcare services, in collaboration with external researchers and with a focus on social and emotional well being. One reviewer will review titles and abstracts to remove obviously irrelevant research articles. Full-text research articles will be retrieved and independently examined by two reviewers. Data and quality assessment will be completed by one reviewer and verified by a second reviewer. Quality will be assessed using modified versions of established quality assessment tools. This review will provide information on research processes and the impact of Values and Ethics on Indigenous-focused primary healthcare research, informing communities and primary healthcare staff around research practices, and researchers and policy makers of strengths and weaknesses of practice. PROSPERO CRD42015024994.

Methods used and lessons learnt in conducting document reviews of medical and allied health curricula - a key step in curriculum evaluation.

PubMed

Rohwer, Anke; Schoonees, Anel; Young, Taryn

2014-11-02

This paper describes the process, our experience and the lessons learnt in doing document reviews of health science curricula. Since we could not find relevant literature to guide us on how to approach these reviews, we feel that sharing our experience would benefit researchers embarking on similar projects. We followed a rigorous, transparent, pre-specified approach that included the preparation of a protocol, a pre-piloted data extraction form and coding schedule. Data were extracted, analysed and synthesised. Quality checks were included at all stages of the process. The main lessons we learnt related to time and project management, continuous quality assurance, selecting the software that meets the needs of the project, involving experts as needed and disseminating the findings to relevant stakeholders. A complete curriculum evaluation comprises, apart from a document review, interviews with students and lecturers to assess the learnt and taught curricula respectively. Rigorous methods must be used to ensure an objective assessment.

SU-E-T-103: Development and Implementation of Web Based Quality Control Software

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

Studinski, R; Taylor, R; Angers, C

Purpose: Historically many radiation medicine programs have maintained their Quality Control (QC) test results in paper records or Microsoft Excel worksheets. Both these approaches represent significant logistical challenges, and are not predisposed to data review and approval. It has been our group's aim to develop and implement web based software designed not just to record and store QC data in a centralized database, but to provide scheduling and data review tools to help manage a radiation therapy clinics Equipment Quality control program. Methods: The software was written in the Python programming language using the Django web framework. In order tomore » promote collaboration and validation from other centres the code was made open source and is freely available to the public via an online source code repository. The code was written to provide a common user interface for data entry, formalize the review and approval process, and offer automated data trending and process control analysis of test results. Results: As of February 2014, our installation of QAtrack+ has 180 tests defined in its database and has collected ∼22 000 test results, all of which have been reviewed and approved by a physicist via QATrack+'s review tools. These results include records for quality control of Elekta accelerators, CT simulators, our brachytherapy programme, TomoTherapy and Cyberknife units. Currently at least 5 other centres are known to be running QAtrack+ clinically, forming the start of an international user community. Conclusion: QAtrack+ has proven to be an effective tool for collecting radiation therapy QC data, allowing for rapid review and trending of data for a wide variety of treatment units. As free and open source software, all source code, documentation and a bug tracker are available to the public at https://bitbucket.org/tohccmedphys/qatrackplus/.« less

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

PubMed

Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2018-03-07

To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Recent advances in electronic nose techniques for monitoring of fermentation process.

PubMed

Jiang, Hui; Zhang, Hang; Chen, Quansheng; Mei, Congli; Liu, Guohai

2015-12-01

Microbial fermentation process is often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, the monitoring of the process is critical for discovering unfavorable deviations as early as possible and taking the appropriate measures. However, the use of traditional analytical techniques is often time-consuming and labor-intensive. In this sense, the most effective way of developing rapid, accurate and relatively economical method for quality assurance in microbial fermentation process is the use of novel chemical sensor systems. Electronic nose techniques have particular advantages in non-invasive monitoring of microbial fermentation process. Therefore, in this review, we present an overview of the most important contributions dealing with the quality control in microbial fermentation process using the electronic nose techniques. After a brief description of the fundamentals of the sensor techniques, some examples of potential applications of electronic nose techniques monitoring are provided, including the implementation of control strategies and the combination with other monitoring tools (i.e. sensor fusion). Finally, on the basis of the review, the electronic nose techniques are critically commented, and its strengths and weaknesses being highlighted. In addition, on the basis of the observed trends, we also propose the technical challenges and future outlook for the electronic nose techniques.

The development of a land use inventory for regional planning using satellite imagery

NASA Technical Reports Server (NTRS)

Hessling, A. H.; Mara, T. G.

1975-01-01

Water quality planning in Ohio, Kentucky, and Indiana is reviewed in terms of use of land use data and satellite imagery. A land use inventory applicable to water quality planning and developed through computer processing of LANDSAT-1 imagery is described.

Microfilm Permanence and Archival Quality

ERIC Educational Resources Information Center

Avedon, Don M.

1972-01-01

The facts about microfilm permanence and archival quality are presented in simple terms. The major factors, including the film base material, the film emulsion, processing, and storage conditions are reviewed. The designations on the edge of the film are explained and a list of refernces provided. (14 references) (Author)

Evaluating software development characteristics: Assessment of software measures in the Software Engineering Laboratory. [reliability engineering

NASA Technical Reports Server (NTRS)

Basili, V. R.

1981-01-01

Work on metrics is discussed. Factors that affect software quality are reviewed. Metrics is discussed in terms of criteria achievements, reliability, and fault tolerance. Subjective and objective metrics are distinguished. Product/process and cost/quality metrics are characterized and discussed.

Assessment of quality and relevance of curricula development in health training institutions: a case study of Kenya.

PubMed

Mumbo, Hazel M; Kinaro, Joyce W

2015-08-13

The World Health Organization lists Kenya among African countries experiencing health workforce crisis catalysed through immigration, underproduction, inconsistent quality of production and unequal distribution. Strengthening health training institutions to increase production of high-quality health workers is acknowledged as a measure to mitigate the crisis.IntraHealth International's USAID-funded FUNZOKenya Project (2012-2017) undertook an assessment to identify the bottlenecks to increasing the number and quality of pre-service graduates in Kenya. The assessment, a cross-sectional descriptive study, collected data through structured respondent interviews among faculty, students in health training institutions, key informants and desk review. The assessment purposively selected 14 institutions from 18 institutions identified for initial collaboration with the project towards strengthening health workforce training. The statistical package for social sciences (SPSS) application helped analyse quantitative data and quotes used to illustrate perceptions on the quality of curricula.The findings revealed major gaps in quality and adequacy of curricula in the training institutions. A national standard framework to guide curricula review process is lacking. Further, curricula did not adequately prepare students for clinical placement, as most failed to directly respond to national health needs. The study recommended reviews of curricula to ensure their responsiveness to emerging issues in the health sector, the formation of curriculum committees to review curricula, development of official curricula review standards and an integrated mechanism to disseminate policies and guidelines.

Integrating information from disparate sources: the Walter Reed National Surgical Quality Improvement Program Data Transfer Project.

PubMed

Nelson, Victoria; Nelson, Victoria Ruth; Li, Fiona; Green, Susan; Tamura, Tomoyoshi; Liu, Jun-Min; Class, Margaret

2008-11-06

The Walter Reed National Surgical Quality Improvement Program Data Transfer web module integrates with medical and surgical information systems, and leverages outside standards, such as the National Library of Medicine's RxNorm, to process surgical and risk assessment data. Key components of the project included a needs assessment with nurse reviewers and a data analysis for federated (standards were locally controlled) data sources. The resulting interface streamlines nurse reviewer workflow by integrating related tasks and data.

Sterile products: advances and challenges in formulation, manufacturing and regulatory aspects--a regulatory review perspective.

PubMed

Hussong, David

2010-09-01

For several decades, the FDA has undertaken many initiatives to improve the quality and safety of sterile drug products. In recent years, efforts have also been undertaken to accelerate the rate for application approval by adding earlier involvement of microbiology reviewers in drug development. Product and manufacturing process development, as well as safe use and product design, are among the elements of enhanced technical involvement. An overview of the product quality microbiology aspects for sterile drugs is provided.

A longitudinal study of clinical peer review's impact on quality and safety in U.S. hospitals.

PubMed

Edwards, Marc T

2013-01-01

Clinical peer review is the dominant method of event analysis in U.S. hospitals. It is pivotal to medical staff efforts to improve quality and safety, yet the quality assurance process model that has prevailed for the past 30 years evokes fear and is fundamentally antithetical to a culture of safety. Two prior national studies characterized a quality improvement model that corrects this dysfunction but failed to demonstrate progress toward its adoption despite a high rate of program change between 2007 and 2009. This study's online survey of 470 organizations participating in either of the prior studies further assessed relationships between clinical peer review program factors, including the degree of conformance to the quality improvement model (the QI model score), and subjectively measured program impact variables. Among the 300 hospitals (64%) that responded, the median QI model score was only 60 on a 100-point scale. Scores increased somewhat for the 2007 cohort (mean pair-wise difference of 5.9 [2-10]), but not for the 2009 cohort. The QI model is expanded as the result of the finding that self-reporting of adverse events, near misses, and hazardous conditions--an essential practice in high-reliability organizations--is no longer rare in hospitals. Self-reporting and the quality of case review are additional multivariate predictors of the perceived ongoing impact of clinical peer review on quality and safety, medical staff perceptions of the program, and medical staff engagement in quality and safety initiatives. Hospital leaders and trustees who seek to improve patient outcomes should facilitate the adoption of this best practice model for clinical peer review.

Effect of psychosocial interventions on the quality of life of patients with colorectal cancer: a systematic review and meta-analysis.

PubMed

Son, Heesook; Son, Youn-Jung; Kim, Hyerang; Lee, Yoonju

2018-06-08

We conducted a systematic review and meta-analysis of randomized controlled trials examining the effect of psychosocial interventions on the quality of life of patients with colorectal cancer. We searched the main health-related databases for relevant papers. Then, we examined the titles and abstracts of the retrieved papers, applying exclusion criteria to filter out irrelevant papers; a more in-depth filtering process was then conducted by reading the full texts. Eight studies remained at the end of this process. Next, we performed data extraction and assessed the methodological quality of the selected studies. This was followed by computation of effect sizes and the heterogeneity of the results, and then an assessment of the potential bias. The systematic review found that most of the interventions in these eight studies did not have a significant effect on quality of life. Meanwhile, the meta-analysis, the overall effect of psychosocial interventions at the post-intervention period was found to be statistically significant but small. This meta-analysis provides evidence for the beneficial effect of face-to-face psychosocial interventions on the quality of life of colorectal cancer patients. It is, however, suggested that further studies be conducted on this topic to assess the roles of physical functioning and severity of symptoms before utilizing such face-to-face interventions.

The use of bibliometrics to measure research quality in UK higher education institutions.

PubMed

Adams, Jonathan

2009-01-01

Research assessment in the UK has evolved over a quarter of a century from a loosely structured, peer-review based process to one with a well understood data portfolio and assessment methodology. After 2008, the assessment process will shift again, to the use of indicators based largely on publication and citation data. These indicators will in part follow the format introduced in 2008, with a profiling of assessment outcomes at national and international levels. However, the shift from peer assessment to a quantitative methodology raises critical issues about which metrics are appropriate and informative and how such metrics should be managed to produce weighting factors for funding formulae. The link between publication metrics and other perceptions of research quality needs to be thoroughly tested and reviewed, and may be variable between disciplines. Many of the indicators that drop out of publication data are poorly linked to quality and should not be used at all. There are also issues about which publications are the correct base for assessment, which staff should be included in a review, how subjects should be structured and how the citation data should be normalised to account for discipline-dependent variables. Finally, it is vital to consider the effect that any assessment process will have on the behaviour of those to be assessed.

The science of quality improvement implementation: developing capacity to make a difference.

PubMed

Alexander, Jeffrey A; Hearld, Larry R

2011-12-01

Quality improvement (QI) holds promise to improve quality of care; however, organizations often struggle with its implementation. It has been recommended that practitioners, managers, and researchers attempt to increase systematic understanding of the structure, practices, and context of organizations that facilitate or impede the implementation of QI innovations. To critically review the empirical research on QI implementation in health care organizations. A literature review of 107 studies that examined the implementation of QI innovations in health care organizations. Studies were classified into 4 groups based on the types of predictors that were assumed to affect implementation (content of QI innovation, organizational processes, internal context, and external context). Internal context and organizational processes were the most frequently studied categories. External context and organizational process categories exhibited the highest rate of positive effects on QI implementation. The review revealed several important gaps in the QI implementation literature. Studies often lacked clear conceptual frameworks to guide the research, which may hinder efforts to compare relationships across studies. Studies also tended to adopt designs that were narrowly focused on independent effects of predictors and did not include holistic frameworks to capture interactions among the many factors involved in implementation. Other design limitations included the use of cross-sectional designs, single-source data collection, and potential selection bias among study participants.

System of error detection in the manufacture of garments using artificial vision

NASA Astrophysics Data System (ADS)

Moreno, J. J.; Aguila, A.; Partida, E.; Martinez, C. L.; Morales, O.; Tejeida, R.

2017-12-01

A computer vision system is implemented to detect errors in the cutting stage within the manufacturing process of garments in the textile industry. It provides solution to errors within the process that cannot be easily detected by any employee, in addition to significantly increase the speed of quality review. In the textile industry as in many others, quality control is required in manufactured products and this has been carried out manually by means of visual inspection by employees over the years. For this reason, the objective of this project is to design a quality control system using computer vision to identify errors in the cutting stage within the garment manufacturing process to increase the productivity of textile processes by reducing costs.

A modeling analysis program for the JPL Table Mountain Io sodium cloud data

NASA Technical Reports Server (NTRS)

Smyth, W. H.; Goldberg, B. A.

1986-01-01

Progress and achievements in the second year are discussed in three main areas: (1) data quality review of the 1981 Region B/C images; (2) data processing activities; and (3) modeling activities. The data quality review revealed that almost all 1981 Region B/C images are of sufficient quality to be valuable in the analyses of the JPL data set. In the second area, the major milestone reached was the successful development and application of complex image-processing software required to render the original image data suitable for modeling analysis studies. In the third area, the lifetime description of sodium atoms in the planet magnetosphere was improved in the model to include the offset dipole nature of the magnetic field as well as an east-west electric field. These improvements are important in properly representing the basic morphology as well as the east-west asymmetries of the sodium cloud.

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

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.

The quality of instruments to assess the process of shared decision making: A systematic review

PubMed Central

Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

2018-01-01

Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations. PMID:29447193

Nitrogen Oxides (NOx) Primary NAAQS REVIEW: Integrated ...

EPA Pesticide Factsheets

The NOx Integrated Review Plan is the first document generated as part of the National Ambient Air Quality Standards (NAAQS) review process. The Plan presents background information, the schedule for the review, the process to be used in conducting the review, and the key policy-relevant science issues that will guide the review. The integrated review plan also discusses the frameworks for the various assessment documents to be prepared by the EPA as part of the review, including an Integrated Science Assessment (ISA), and as warranted, a Risk/Exposure Assessment (REA), and a Policy Assessment (PA). The primary purpose of the NOx Integrated Review Plan is to highlight the key policy-relevant issues to be considered in the Review of the NO2 primary NAAQS. A draft of the integrated review plan will be the subject of an advisory review with the Clean Air Scientific Advisory Committee (CASAC) and made available to the public for review and comment.

[To what extent do reviewers of multiple-choice questions need to be trained? A comparison between handing out information sheets and brief workshop sessions].

PubMed

Öchsner, Wolfgang; Böckers, Anja

2016-01-01

A competent review process is crucial to ensure the quality of multiple-choice (MC) questions. However, the acquisition of reviewing skills should not cause any unnecessary additional burden for a medical staff that is already facing heavy workloads. 100 MC questions, for which an expert review existed, were presented to 12 novices. In advance, six participants received a specific information sheet covering critical information for high-calibre review; the other six participants attended a 2.5-hour workshop covering the same information. The review results of both groups were analysed with a licensed version of the IBM software SPSS 19.0 (SPSS Inc., Chicago, IL). The results of the workshop group were distinctly closer to the experts' results (gold standard) than those of the information sheet group. For the quantitatively important category of medium quality MC questions, the results of the workshop group did not significantly differ from the experts' results. In the information sheet group the results were significantly poorer than the experts', regardless of the quality of the questions. Distributing specific information sheets to MC question reviewers is not sufficient for ensuring the quality of the review so that - regardless of the increased effort involved - a recommendation to conduct specific workshops must be made. Copyright © 2014. Published by Elsevier GmbH.

Systematic review of interventions to improve prescribing.

PubMed

Ostini, Remo; Hegney, Desley; Jackson, Claire; Williamson, Margaret; Mackson, Judith M; Gurman, Karin; Hall, Wayne; Tett, Susan E

2009-03-01

To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions. Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed (1951-May 2007), EMBASE (1974-March 2008), International Pharmaceutical Abstracts (1970-March 2008), and 11 other bibliographic databases of medical, social science, and business research. Following an initial title screening process and after selecting 6 specific intervention categories (identified from the previous reviews) in community settings, 2 reviewers independently assessed abstracts and then full studies for relevance and quality and extracted relevant data using formal assessment and data extraction tools. Results were then methodically incorporated into the findings of the 2 earlier reviews of systematic reviews. DATA SELECTION AND SYNTHESIS: Twenty-nine of 26,314 articles reviewed were assessed to be of relevant, high-quality research. Audit and feedback, together with educational outreach visits, were the focus of the majority of recent, high-quality research into prescribing interventions. These interventions were also the most effective in improving prescribing practice. A smaller number of studies included a patient-mediated intervention; this intervention was not consistently effective. There is insufficient recent research into manual reminders to confidently update earlier reviews and there remains insufficient evidence to draw conclusions regarding the effectiveness of local consensus processes or multidisciplinary teams. Educational outreach as well as audit and feedback continue to dominate research into prescribing interventions. These 2 prescribing interventions also most consistently show positive results. Much less research is conducted into other types of interventions and there is still very little effort to systematically test why interventions do or do not work.

Effect of food processing on plant DNA degradation and PCR-based GMO analysis: a review.

PubMed

Gryson, Nicolas

2010-03-01

The applicability of a DNA-based method for GMO detection and quantification depends on the quality and quantity of the DNA. Important food-processing conditions, for example temperature and pH, may lead to degradation of the DNA, rendering PCR analysis impossible or GMO quantification unreliable. This review discusses the effect of several food processes on DNA degradation and subsequent GMO detection and quantification. The data show that, although many of these processes do indeed lead to the fragmentation of DNA, amplification of the DNA may still be possible. Length and composition of the amplicon may, however, affect the result, as also may the method of extraction used. Also, many techniques are used to describe the behaviour of DNA in food processing, which occasionally makes it difficult to compare research results. Further research should be aimed at defining ingredients in terms of their DNA quality and PCR amplification ability, and elaboration of matrix-specific certified reference materials.

Optimization of composite wood structural components : processing and design choices

Treesearch

Theodore L. Laufenberg

1985-01-01

Decreasing size and quality of the world's forest resources are responsible for interest in producing composite wood structural components. Process and design optimization methods are offered in this paper. Processing concepts for wood composite structural products are reviewed to illustrate manufacturing boundaries and areas of high potential. Structural...

A Review of the Quality and Safety of Irradiated Food.

DTIC Science & Technology

1987-01-01

Construction or Planned.................16 Figure 4: Changes in the Levels of Certain Vitamins in Different Meats Irradiated at High Doses..........24...In the twenty year5 prior to this action, irradiation had been approved for wheat, wheat products, and white potatoes but the process wa- * never used...restriu-t the ujse of . this process or require some type ol labeling. Conumri %>:~ concern about the safety and quality of irradiated food - ha

Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

PubMed

Eklund, J

1997-10-01

This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

Proposal of quality indicators for cardiac rehabilitation after acute coronary syndrome in Japan: a modified Delphi method and practice test.

PubMed

Ohtera, Shosuke; Kanazawa, Natsuko; Ozasa, Neiko; Ueshima, Kenji; Nakayama, Takeo

2017-01-27

Cardiac rehabilitation is underused and its quality in practice is unclear. A quality indicator is a measurable element of clinical practice performance. This study aimed to propose a set of quality indicators for cardiac rehabilitation following an acute coronary event in the Japanese population and conduct a small-size practice test to confirm feasibility and applicability of the indicators in real-world clinical practice. This study used a modified Delphi technique (the RAND/UCLA appropriateness method), a consensus method which involves an evidence review, a face-to-face multidisciplinary panel meeting and repeated anonymous rating. Evidence to be reviewed included clinical practice guidelines available in English or Japanese and existing quality indicators. Performance of each indicator was assessed retrospectively using medical records at a university hospital in Japan. 10 professionals in cardiac rehabilitation for the consensus panel. In the literature review, 23 clinical practice guidelines and 16 existing indicators were identified to generate potential indicators. Through the consensus-building process, a total of 30 indicators were assessed and finally 13 indicators were accepted. The practice test (n=39) revealed that 74% of patients underwent cardiac rehabilitation. Median performance of process measures was 93% (IQR 46-100%). 'Communication with the doctor who referred the patient to cardiac rehabilitation' and 'continuous participation in cardiac rehabilitation' had low performance (32% and 38%, respectively). A modified Delphi technique identified a comprehensive set of quality indicators for cardiac rehabilitation. The single-site, small-size practice test confirmed that most of the proposed indicators were measurable in real-world clinical practice. However, some clinical processes which are not covered by national health insurance in Japan had low performance. Further studies will be needed to clarify and improve the quality of care in cardiac rehabilitation. 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/.

Teachers' Social-Emotional Capacity: Factors Associated with Teachers' Responsiveness and Professional Commitment

ERIC Educational Resources Information Center

Buettner, Cynthia K.; Jeon, Lieny; Hur, Eunhye; Garcia, Rachel E.

2016-01-01

Research Findings: Early care and education has pronounced implications for young children's social-emotional learning. Although program structural and classroom process quality indicators have been widely explored, teachers' personal social-emotional capacity has only recently been recognized as an indicator of quality. This study reviewed and…

Guiding and Modelling Quality Improvement in Higher Education Institutions

ERIC Educational Resources Information Center

Little, Daniel

2015-01-01

The article considers the process of creating quality improvement in higher education institutions from the point of view of current organisational theory and social-science modelling techniques. The author considers the higher education institution as a functioning complex of rules, norms and other organisational features and reviews the social…

External Review Teams Training in Central America

ERIC Educational Resources Information Center

Silva-Trivino; Moises; Ramirez-Gatica, Soledad

2004-01-01

Many Latin American countries have started actions to promote a higher education quality assurance system. Central America appears as a regional effort that includes universities from all seven countries under the initiative of Central American University Higher Council (CSUCA). After focusing in quality management and self-study processes, CSUCA…

Product quality considerations for mammalian cell culture process development and manufacturing.

PubMed

Gramer, Michael J

2014-01-01

The manufacturing of a biologic drug from mammalian cells results in not a single substance, but an array of product isoforms, also known as variants. These isoforms arise due to intracellular or extracellular events as a result of biological or chemical modification. The most common examples related to biomanufacturing include amino acid modifications (glycosylation, isomerization, oxidation, adduct formation, pyroglutamate formation, phosphorylation, sulfation, amidation), amino acid sequence variants (genetic mutations, amino acid misincorporation, N- and C-terminal heterogeneity, clipping), and higher-order structure modifications (misfolding, aggregation, disulfide pairing). Process-related impurities (HCP, DNA, media components, viral particles) are also important quality attributes related to product safety. The observed ranges associated with each quality attribute define the product quality profile. A biologic drug must have a correct and consistent quality profile throughout clinical development and scale-up to commercial production to ensure product safety and efficacy. In general, the upstream process (cell culture) defines the quality of product-related substances, whereas the downstream process (purification) defines the residual level of process- and product-related impurities. The purpose of this chapter is to review the impact of the cell culture process on product quality. Emphasis is placed on studies with industrial significance and where the direct mechanism of product quality impact was determined. Where possible, recommendations for maintaining consistent or improved quality are provided.

Peer Reviewing of OER in a Contested Domain--An Activity Theoretical Analysis

ERIC Educational Resources Information Center

Algers, Anne; Ljung, Magnus

2015-01-01

Globally, we experience numerous initiatives to increase the adoption of open educational resources (OER), but quality concerns challenge the adoption. In this study we present an analysis of the peer review process of an OER. The OER under review is produced by the European Commission (EU). It has the goal to teach children about farm animal…

Sulfur Dioxide (SO2) Primary NAAQS Review: Integrated ...

EPA Pesticide Factsheets

The SO2 Integrated Review Plan is the first document generated as part of the National Ambient Air Quality Standards (NAAQS) review process. The Plan presents background information, the schedule for the review, the process to be used in conducting the review, and the key policy-relevant science issues that will guide the review. The integrated review plan also discusses the frameworks for the various assessment documents to be prepared by the EPA as part of the review, including an Integrated Science Assessment (ISA), and as warranted, a Risk/Exposure Assessment (REA), and a Policy Assessment (PA). The primary purpose of the SO2 Integrated Review Plan is to highlight the key policy-relevant issues to be considered in the Review of the SO2 primary NAAQS. A draft of the integrated review plan will be the subject of an advisory with the Clean Air Scientific Advisory Committee (CASAC) and made available to the public for review and comment.

OPEN-SOURCE SOFTWARE IN DENTISTRY: A SYSTEMATIC REVIEW.

PubMed

Chruściel-Nogalska, Małgorzata; Smektała, Tomasz; Tutak, Marcin; Sporniak-Tutak, Katarzyna; Olszewski, Raphael

2017-01-01

Technological development and the need for electronic health records management resulted in the need for a computer with dedicated, commercial software in daily dental practice. The alternative for commercial software may be open-source solutions. Therefore, this study reviewed the current literature on the availability and use of open-source software (OSS) in dentistry. A comprehensive database search was performed on February 1, 2017. Only articles published in peer-reviewed journals with a focus on the use or description of OSS were retrieved. The level of evidence, according to Oxford EBM Centre Levels of Evidence Scale was classified for all studies. Experimental studies underwent additional quality reporting assessment. The screening and evaluation process resulted in twenty-one studies from 1,940 articles found, with 10 of them being experimental studies. None of the articles provided level 1 evidence, and only one study was considered high quality following quality assessment. Twenty-six different OSS programs were described in the included studies of which ten were used for image visualization, five were used for healthcare records management, four were used for educations processes, one was used for remote consultation and simulation, and six were used for general purposes. Our analysis revealed that the dental literature on OSS consists of scarce, incomplete, and methodologically low quality information.

Statistical Reviewers Improve Reporting in Biomedical Articles: A Randomized Trial

PubMed Central

Cobo, Erik; Selva-O'Callagham, Albert; Ribera, Josep-Maria; Cardellach, Francesc; Dominguez, Ruth; Vilardell, Miquel

2007-01-01

Background Although peer review is widely considered to be the most credible way of selecting manuscripts and improving the quality of accepted papers in scientific journals, there is little evidence to support its use. Our aim was to estimate the effects on manuscript quality of either adding a statistical peer reviewer or suggesting the use of checklists such as CONSORT or STARD to clinical reviewers or both. Methodology and Principal Findings Interventions were defined as 1) the addition of a statistical reviewer to the clinical peer review process, and 2) suggesting reporting guidelines to reviewers; with “no statistical expert” and “no checklist” as controls. The two interventions were crossed in a 2×2 balanced factorial design including original research articles consecutively selected, between May 2004 and March 2005, by the Medicina Clinica (Barc) editorial committee. We randomized manuscripts to minimize differences in terms of baseline quality and type of study (intervention, longitudinal, cross-sectional, others). Sample-size calculations indicated that 100 papers provide an 80% power to test a 55% standardized difference. We specified the main outcome as the increment in quality of papers as measured on the Goodman Scale. Two blinded evaluators rated the quality of manuscripts at initial submission and final post peer review version. Of the 327 manuscripts submitted to the journal, 131 were accepted for further review, and 129 were randomized. Of those, 14 that were lost to follow-up showed no differences in initial quality to the followed-up papers. Hence, 115 were included in the main analysis, with 16 rejected for publication after peer review. 21 (18.3%) of the 115 included papers were interventions, 46 (40.0%) were longitudinal designs, 28 (24.3%) cross-sectional and 20 (17.4%) others. The 16 (13.9%) rejected papers had a significantly lower initial score on the overall Goodman scale than accepted papers (difference 15.0, 95% CI: 4.6–24.4). The effect of suggesting a guideline to the reviewers had no effect on change in overall quality as measured by the Goodman scale (0.9, 95% CI: −0.3–+2.1). The estimated effect of adding a statistical reviewer was 5.5 (95% CI: 4.3–6.7), showing a significant improvement in quality. Conclusions and Significance This prospective randomized study shows the positive effect of adding a statistical reviewer to the field-expert peers in improving manuscript quality. We did not find a statistically significant positive effect by suggesting reviewers use reporting guidelines. PMID:17389922

Towards an effective data peer review

NASA Astrophysics Data System (ADS)

Düsterhus, André; Hense, Andreas

2014-05-01

Peer review is an established procedure to ensure the quality of scientific publications and is currently used as a prerequisite for acceptance of papers in the scientific community. In the past years the publication of raw data and its metadata got increased attention, which led to the idea of bringing it to the same standards the journals for traditional publications have. One missing element to achieve this is a comparable peer review scheme. This contribution introduces the idea of a quality evaluation process, which is designed to analyse the technical quality as well as the content of a dataset. It bases on quality tests, which results are evaluated with the help of the knowledge of an expert. The results of the tests and the expert knowledge are evaluated probabilistically and are statistically combined. As a result the quality of a dataset is estimated with a single value only. This approach allows the reviewer to quickly identify the potential weaknesses of a dataset and generate a transparent and comprehensible report. To demonstrate the scheme, an application on a large meteorological dataset will be shown. Furthermore, potentials and risks of such a scheme will be introduced and practical implications for its possible introduction to data centres investigated. Especially, the effects of reducing the estimate of quality of a dataset to a single number will be critically discussed.

Communication in healthcare: a narrative review of the literature and practical recommendations.

PubMed

Vermeir, P; Vandijck, D; Degroote, S; Peleman, R; Verhaeghe, R; Mortier, E; Hallaert, G; Van Daele, S; Buylaert, W; Vogelaers, D

2015-11-01

Effective and efficient communication is crucial in healthcare. Written communication remains the most prevalent form of communication between specialised and primary care. We aimed at reviewing the literature on the quality of written communication, the impact of communication inefficiencies and recommendations to improve written communication in healthcare. Narrative literature review. A search was carried out on the databases PubMed, Web of Science and The Cochrane Library by means of the (MeSH)terms 'communication', 'primary health care', 'correspondence', 'patient safety', 'patient handoff' and 'continuity of patient care'. Reviewers screened 4609 records and 462 full texts were checked according following inclusion criteria: (1) publication between January 1985 and March 2014, (2) availability as full text in English, (3) categorisation as original research, reviews, meta-analyses or letters to the editor. A total of 69 articles were included in this review. It was found that poor communication can lead to various negative outcomes: discontinuity of care, compromise of patient safety, patient dissatisfaction and inefficient use of valuable resources, both in unnecessary investigations and physician worktime as well as economic consequences. There is room for improvement of both content and timeliness of written communication. The delineation of ownership of the communication process should be clear. Peer review, process indicators and follow-up tools are required to measure the impact of quality improvement initiatives. Communication between caregivers should feature more prominently in graduate and postgraduate training, to become engraved as an essential skill and quality characteristic of each caregiver. © 2015 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

Acetic Acid Bacteria and the Production and Quality of Wine Vinegar

PubMed Central

Torija, María Jesús; García-Parrilla, María del Carmen; Troncoso, Ana María

2014-01-01

The production of vinegar depends on an oxidation process that is mainly performed by acetic acid bacteria. Despite the different methods of vinegar production (more or less designated as either “fast” or “traditional”), the use of pure starter cultures remains far from being a reality. Uncontrolled mixed cultures are normally used, but this review proposes the use of controlled mixed cultures. The acetic acid bacteria species determine the quality of vinegar, although the final quality is a combined result of technological process, wood contact, and aging. This discussion centers on wine vinegar and evaluates the effects of these different processes on its chemical and sensory properties. PMID:24574887

Performance characterization of water recovery and water quality from chemical/organic waste products

NASA Technical Reports Server (NTRS)

Moses, W. M.; Rogers, T. D.; Chowdhury, H.; Cullingford, H. S.

1989-01-01

The water reclamation subsystems currently being evaluated for the Space Shuttle Freedom are briefly reviewed with emphasis on a waste water management system capable of processing wastes containing high concentrations of organic/inorganic materials. The process combines low temperature/pressure to vaporize water with high temperature catalytic oxidation to decompose volatile organics. The reclaimed water is of potable quality and has high potential for maintenance under sterile conditions. Results from preliminary experiments and modifications in process and equipment required to control reliability and repeatability of system operation are presented.

Peer review in hematopoietic cell transplantation: are we doing our fair share?

PubMed

Giralt, S; Korngold, R; Lazarus, H M

2016-09-01

Peer review is believed to be important in maintaining the quality and integrity of research in academic endeavors. Recently, the value of the current peer review process, which is more than 100 years old has come into question. In the field of hematopoietic cell transplantation (HCT), peer review was unable to prevent the publication of the largest and most notorious scientific fraud in our field. In order to assess how the HCT community views and how engaged it is with the peer review process, the American Society of Blood and Marrow Transplantation conducted a survey of all of its members in 2014. The survey was sent to all active members through multiple email communications in August and September 2014. Of a total of 1183 members, 149 responded. Almost all of the respondents had participated in the peer review process, with few respondents declining ever to review manuscripts. The most common cause for declining review requests was lack of time. Most respondents (68%) thought that the current peer review process was relatively fair and unbiased, whereas only 9% of the respondents stated that they did not believe in the peer review process. In conclusion, among the respondents of this survey most felt the peer review process to be valuable and fair, however, the lack of response suggests that further study into improving the peer review process in the field of HCT is warranted in the era of electronic publishing and communication.

Clinical audit: shining a light on good practice.

PubMed

Grainger, Angela

2010-07-01

Healthcare organisations undertake quality assurance to produce safe and effective patient care systems. Statutory quality assurance requirements are met through external reviews, monitoring and inspection processes, and each NHS trust must produce a corporate annual quality account. However, this can result in approaching audits as if they are 'tick-box activities'. This article discusses how organisations can avoid this trap by applying audit results to practice.

Evidence for the impact of quality improvement collaboratives: systematic review

PubMed Central

2008-01-01

Objective To evaluate the effectiveness of quality improvement collaboratives in improving the quality of care. Data sources Relevant studies through Medline, Embase, PsycINFO, CINAHL, and Cochrane databases. Study selection Two reviewers independently extracted data on topics, participants, setting, study design, and outcomes. Data synthesis Of 1104 articles identified, 72 were included in the study. Twelve reports representing nine studies (including two randomised controlled trials) used a controlled design to measure the effects of the quality improvement collaborative intervention on care processes or outcomes of care. Systematic review of these nine studies showed moderate positive results. Seven studies (including one randomised controlled trial) reported an effect on some of the selected outcome measures. Two studies (including one randomised controlled trial) did not show any significant effect. Conclusions The evidence underlying quality improvement collaboratives is positive but limited and the effects cannot be predicted with great certainty. Considering that quality improvement collaboratives seem to play a key part in current strategies focused on accelerating improvement, but may have only modest effects on outcomes at best, further knowledge of the basic components effectiveness, cost effectiveness, and success factors is crucial to determine the value of quality improvement collaboratives. PMID:18577559

Determinants of quality management systems implementation in hospitals.

PubMed

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

2009-03-01

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

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

PubMed

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

2010-01-01

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

Image reconstruction: an overview for clinicians.

PubMed

Hansen, Michael S; Kellman, Peter

2015-03-01

Image reconstruction plays a critical role in the clinical use of magnetic resonance imaging (MRI). The MRI raw data is not acquired in image space and the role of the image reconstruction process is to transform the acquired raw data into images that can be interpreted clinically. This process involves multiple signal processing steps that each have an impact on the image quality. This review explains the basic terminology used for describing and quantifying image quality in terms of signal-to-noise ratio and point spread function. In this context, several commonly used image reconstruction components are discussed. The image reconstruction components covered include noise prewhitening for phased array data acquisition, interpolation needed to reconstruct square pixels, raw data filtering for reducing Gibbs ringing artifacts, Fourier transforms connecting the raw data with image space, and phased array coil combination. The treatment of phased array coils includes a general explanation of parallel imaging as a coil combination technique. The review is aimed at readers with no signal processing experience and should enable them to understand what role basic image reconstruction steps play in the formation of clinical images and how the resulting image quality is described. © 2014 Wiley Periodicals, Inc.

Expert panel reviews of research centers: the site visit process.

PubMed

Lawrenz, Frances; Thao, Mao; Johnson, Kelli

2012-08-01

Site visits are used extensively in a variety of settings within the evaluation community. They are especially common in making summative value decisions about the quality and worth of research programs/centers. However, there has been little empirical research and guidance about how to appropriately conduct evaluative site visits of research centers. We review the processes of two site visit examples using an expert panel review: (1) a process to evaluate four university research centers and (2) a process to review a federally sponsored research center. A set of 14 categories describing the expert panel review process was obtained through content analysis and participant observation. Most categories were addressed differently through the two processes highlighting the need for more research about the most effective processes to use within different contexts. Decisions about how to structure site visits appear to depend on the research context, practical considerations, the level at which the review is being conducted and the intended impact of the report. Future research pertaining to the selection of site visitors, the autonomy of the visitors in data collection and report writing, and the amount and type of information provided would be particularly valuable. Copyright © 2012 Elsevier Ltd. All rights reserved.

Incident reviews in UK maternity units: a systematic appraisal of the quality of local guidelines.

PubMed

Shah, Anjali; Mohamed-Ahmed, Olaa; Peirsegaele, Philippe; McClymont, Charlotte; Knight, Marian

2015-03-14

Maternity care is recognised as a particularly high-risk speciality that is subject to investigation and inquiry, and improvements in risk management have been recommended. However, the quality of guidelines for local reviews of maternity incidents is unknown. The aim of the study is to appraise the quality of local guidance on conducting reviews of severe maternity incidents in the National Health Service. Guidelines for incident reviews were requested from all 211 consultant-led maternity units in the UK during 2012. The Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) was used to evaluate the quality of guidelines. The methods used for reviewing an incident, the people involved in the review and the methods for disseminating the outcomes of the reviews were also examined. Guidelines covering 148 (70%) of all NHS maternity units in the UK were received for evaluation. Most guidelines (55%) received were of good or high quality. The median score on 'scope and purpose' (86%), concerned with the aims and target population of the guideline, was higher than for other domains. Median scores were: 'stakeholder involvement' (representation of users' views) 56%, 'rigour of development' (process used to develop guideline) 34%, 'clarity of presentation' 78%, 'applicability' (organisational and cost implications of applying guideline) 56% and 'editorial independence' 0%. Most guidelines (81%) recommended a range of health professionals review serious maternity incidents using root cause analysis. Findings were most often disseminated at meetings, in reports and in newsletters. Many guidelines (69%) stated lessons learnt from incidents would be audited. Overall, local guidance for the review of maternity incidents was mostly of good or high quality. Stakeholder participation in guideline development could be widened, and editorial independence more clearly stated. It was unclear in over a quarter of guidelines whether changes in practice in response to review recommendations were audited or monitored; such auditing should be mandatory. Further research is required to examine the translation of guidance into practice by evaluating the quality of local reviews of maternity incidents.

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

PubMed

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

2018-04-27

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

Effects of watershed topography, soils, land use, and climate on baseflow hydrology in humid regions: A review

EPA Science Inventory

Baseflow is the portion of streamflow that is sustained between precipitation events, fed to stream channels by delayed (usually subsurface) pathways. Understanding baseflow processes is critical to issues of water quality, supply, and habitat. This review synthesizes the body of...

Helping the Public Decide: The Case of Radioactive Waste Management.

ERIC Educational Resources Information Center

Abrams, Nancy E.; Primack, Joel R.

1980-01-01

The model proposed in the article"critical review of public assessment" would encourage participation of varied publics in the review process at stages most appropriate for their own special interests and expertise. The authors suggest the outcome would be a high quality technical plan enjoying widespread public understanding and…

Understanding Peer Review of Scientific Research

ERIC Educational Resources Information Center

Association of American Universities, 2011

2011-01-01

An important factor in the success of America's national research system is that federal funds for university-based research are awarded primarily through peer review, which uses panels of scientific experts, or "peers," to evaluate the quality of grant proposals. In this competitive process, proposals compete for resources based on their…

30 CFR 550.304 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND... facilities. (a) Process leading to review of an existing facility. (1) An affected State may request that the... further air quality review, the lessee shall use the highest annual total amount of emissions from the...

30 CFR 550.304 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND... facilities. (a) Process leading to review of an existing facility. (1) An affected State may request that the... further air quality review, the lessee shall use the highest annual total amount of emissions from the...

30 CFR 550.304 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND... facilities. (a) Process leading to review of an existing facility. (1) An affected State may request that the... further air quality review, the lessee shall use the highest annual total amount of emissions from the...

Review and Analysis of Curricula for Occupations in Metalworking.

ERIC Educational Resources Information Center

Snyder, Thomas R.; Butler, Roy L.

To provide curriculum specialists and practitioners with specific information on the source and quality of instructional materials for the metal trades and area and to suggest areas of needed curriculum development, a selected review and analysis of previously processed Educational Resources Information Center (ERIC) documents were made.…

76 FR 57742 - National Registry of Evidence-Based Programs and Practices

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... research in these areas more effectively and more rapidly into the general health care system. The National... registry undergo two independent review processes in which their (1) Quality of research and (2) readiness... presents ratings and descriptive information about the intervention. Anyone that consents to a review is...

Soil erosion in humid regions: a review

Treesearch

Daniel J. Holz; Karl W.J. Williard; Pamela J. Edwards; Jon E. Schoonover

2015-01-01

Soil erosion has significant implications for land productivity and surface water quality, as sediment is the leading water pollutant worldwide. Here, erosion processes are defined. The dominant factors influencing soil erosion in humid areas are reviewed, with an emphasis on the roles of precipitation, soil moisture, soil porosity, slope steepness and length,...

Fact Sheets on Review of National Ambient Air Quality Standards for Ozone Staff Papers

EPA Pesticide Factsheets

The second draft Staff Paper points to an expanded body of health effects evidence suggesting a wide range of adverse health effects associated with exposure to ambient ozone. This is part of the process for review of the NAAQS for ground-level ozone.

Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi.

PubMed

Agyeman-Duah, Josephine Nana Afrakoma; Theurer, Antje; Munthali, Charles; Alide, Noor; Neuhann, Florian

2014-01-02

Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher's perspectives by means of document review and participatory observation. Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.

[Try to improve journal quality by improving standards and editing process].

PubMed

Zheng, Jia-wei

2005-04-01

The quality of medical journals depends on several factors involving 3 groups of people with their independent but relevant roles: the authors, the reviewers and the editors. Peer review and editing is the key factor to improve the quality of medical publications and journals. Shanghai Journal of Stomatology (SJS) has been regarded as a leading journal for publishing high-quality work in the field of stomatology in China. In October 2003, it was accepted by the National Library of Medicine, USA, to be indexed and included in Index Medicus and MEDLINE. To further improve the journal's overall quality, the Editorial Agency led by Professor Zheng Jia-wei has made great efforts to formulate its essential requirements in paper style, bilingual abstract writing and statistical analysis for the manuscripts submitted for possible publication. Strict independent peer review system has been adopted to assess the quality of the manuscripts received since it was founded in 1992. The reviewer is required to address detailed aspects of the paper under review and to resend his or her opinion on the paper. The editorial management is a crucial part of the publishing process. The editors begin action with the receipt of the manuscript, direct the various steps of evaluation, correction and re-submission, until a decision is made to accept or reject the paper at the regular meeting of Decision Making Group on Manuscripts of SJS led by the Editor-in-Chief. Once a paper is accepted and carefully revised, the editors will make necessary text and layout editing. Due consideration is given to the statistical, bilingual and ethical aspects as well as to the overall uniformity of the terminology, nomenclatures and style throughout the volume as a whole in the promotion of standards. The journal has not been cited by Science Citation Index (SCI) till now, further steps should be taken to make this journal better known throughout the World, to improve the quality of the publications and reduce the delay between the initial receipt and the final publication of manuscripts.

Developing a 360-degree, value-based performance review model.

PubMed

Allen, M L

1997-01-01

In healthcare, competency assessment continues to be a concern. Even the JCAHO stresses its importance, along with ongoing education for employees. Many healthcare facilities have developed specific technical-competency requirements to ensure quality of service. The leadership at the University of Kansas Hospital (UKMC) wanted to develop a value-driven performance review process that focused on values and interpersonal skills for its employees. The current set of values lacked focus on key quality, behavior and service values, and it was felt employees had not committed to these values. A task force, made up of representatives from key hospital groups, was formed to create a process that would emphasize and assess key leadership skills and values. This team discussed various review mechanisms, including Micheli's 360-degree review process, which uses various sources (supervisors, colleagues and peers, for example) to give input that will be broader and more comprehensive of employee performance. The team incorporated such key leadership expectations as visioning, empowering, modeling, communication, stewardship and self-development into the tool. Called Leadership Enhancement And Development (LEAD), the tool could be completed by a peer, supervisor, direct report or even used for self-review. Results were kept confidential through the use of numbers and letters yet could be incorporated into a spreadsheet for analysis. Starting with managers and supervisors, the process has been piloted in a few larger departments at UKMC where it has been well received. Over time, the process will be used for all employees where it will continue to stress the importance of hospital values and commitment to patients and other employees.

[Quality process control system of Chinese medicine preparation based on "holistic view"].

PubMed

Wang, Ya-Qi; Jiao, Jiao-Jiao; Wu, Zhen-Feng; Zheng, Qin; Yang, Ming

2018-01-01

"High quality, safety and effectiveness" are the primary principles for the pharmaceutical research and development process in China. The quality of products relies not only on the inspection method, but also on the design and development, process control and standardized management. The quality depends on the process control level. In this paper, the history and current development of quality control of traditional Chinese medicine (TCM) preparations are reviewed systematically. Based on the development model of international drug quality control and the misunderstanding of quality control of TCM preparations, the reasons for impacting the homogeneity of TCM preparations are analyzed and summarized. According to TCM characteristics, efforts were made to control the diversity of TCM, make "unstable" TCM into "stable" Chinese patent medicines, put forward the concepts of "holistic view" and "QbD (quality by design)", so as to create the "holistic, modular, data, standardized" model as the core of TCM preparation quality process control model. Scientific studies shall conform to the actual production of TCM preparations, and be conducive to supporting advanced equipment and technology upgrade, thoroughly applying the scientific research achievements in Chinese patent medicines, and promoting the cluster application and transformation application of TCM pharmaceutical technology, so as to improve the quality and effectiveness of the TCM industry and realize the green development. Copyright© by the Chinese Pharmaceutical Association.

Measurement properties of rheumatoid arthritis-specific quality-of-life questionnaires: systematic review of the literature.

PubMed

Lee, Jiyeon; Kim, Soo Hyun; Moon, Seung Hei; Lee, Eun-Hyun

2014-12-01

This study conducted a systematic review of the methodological quality of the psychometric evaluation process and the quality of measurement properties of rheumatoid arthritis (RA)-specific health-related quality-of-life (HRQOL) questionnaires with the purpose of obtaining the best evidence to help in the selection of the most appropriate instrument for measuring HRQOL in RA patients. A systematic literature search was performed to identify RA-specific HRQOL questionnaires in databases. The methodological quality of the studies was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The quality of the measurement properties was assessed using quality criteria. The evidence regarding the measurement properties was pooled using best-evidence synthesis, with considerations of the number and methodological quality of the studies, and the consistency of their findings in terms of the quality of the measurement properties. The search identified 37 studies describing 9 instruments. Best-evidence synthesis suggested that the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire had the strongest positive evidence, especially with respect to reliability, measurement error, and content validity, and moderate positive evidence with respect to hypothesis testing and responsiveness. The current evidence suggests that the best-validated instrument among the RA-specific HRQOL measures is the RAQoL questionnaire in terms of both methodological quality in the process of psychometric evaluation and the quality of the measurement properties. However, there is limited evidence regarding internal consistency and structural validity of the RAQoL. Further efforts are warranted to establish the psychometric quality of this questionnaire.

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products.

PubMed

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-02-12

To examine the volume, relevance and quality of transnational tobacco corporations' (TTCs) evidence that standardised packaging of tobacco products 'won't work', following the UK government's decision to 'wait and see' until further evidence is available. Content analysis. We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging 'won't work'. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging 'won't work' lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria-subject matter, independence and peer-review status-to critically assess evidence submitted to them by corporate interests via Better Regulation processes.

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products

PubMed Central

Hatchard, Jenny L; Fooks, Gary J; Evans-Reeves, Karen A; Ulucanlar, Selda; Gilmore, Anna B

2014-01-01

Objectives To examine the volume, relevance and quality of transnational tobacco corporations’ (TTCs) evidence that standardised packaging of tobacco products ‘won't work’, following the UK government's decision to ‘wait and see’ until further evidence is available. Design Content analysis. Setting We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. Outcome measures The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. Results 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging ‘won't work’. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). Conclusions With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging ‘won't work’ lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria—subject matter, independence and peer-review status—to critically assess evidence submitted to them by corporate interests via Better Regulation processes. PMID:24523419

National Quality Measures for Child Mental Health Care: Background, Progress, and Next Steps

PubMed Central

Murphy, J. Michael; Scholle, Sarah Hudson; Hoagwood, Kimberly Eaton; Sachdeva, Ramesh C.; Mangione-Smith, Rita; Woods, Donna; Kamin, Hayley S.; Jellinek, Michael

2013-01-01

OBJECTIVE: To review recent health policies related to measuring child health care quality, the selection processes of national child health quality measures, the nationally recommended quality measures for child mental health care and their evidence strength, the progress made toward developing new measures, and early lessons learned from these national efforts. METHODS: Methods used included description of the selection process of child health care quality measures from 2 independent national initiatives, the recommended quality measures for child mental health care, and the strength of scientific evidence supporting them. RESULTS: Of the child health quality measures recommended or endorsed during these national initiatives, only 9 unique measures were related to child mental health. CONCLUSIONS: The development of new child mental health quality measures poses methodologic challenges that will require a paradigm shift to align research with its accelerated pace. PMID:23457148

A multicentre randomised controlled trial of reciprocal lung cancer peer review and supported quality improvement: results from the improving lung cancer outcomes project

PubMed Central

Russell, G K; Jimenez, S; Martin, L; Stanley, R; Peake, M D; Woolhouse, I

2014-01-01

Background: Results from the National Lung Cancer Audit demonstrate unexplained variation in outcomes. Peer review with supported quality improvement has been shown to reduce variation in other areas of health care but has not been formally tested in cancer multidisciplinary teams. The aim of the current study is to assess the impact of reciprocal peer-to-peer review visits with supported quality improvement and collaborative working on lung cancer process and outcome measures. Methods: English lung cancer teams were randomised to usual care or facilitated reciprocal peer review visits followed by 12 months of supported quality improvement. The primary outcome was change in the following national audit indicators; mulitdisciplinary team discussion, histological confirmation, active treatment, surgical resection, small-cell chemotherapy and specialist nurse review. Patient experience was measured using a new lung cancer patient questionnaire in the intervention group. Results: Thirty teams (31 trusts) entered the intervention group and 29 of these submitted a total of 67 quality improvement plans. Active treatment increased in the intervention group (n=31) by 5.2% compared with 1.2% in the control group (n=48, mean difference 4.1%, 95% CI −0.1 to 8.2%, P=0.055). The remaining audit indicators improved similarly in all groups. Mean patient experience scores in the intervention group did not change significantly during the study but a significant improvement was seen in the scores for the five teams with the worst baseline scores (0.86 to 0.22, P<0.001). Conclusions: Reciprocal peer review with supported quality improvement was feasible and effective in stimulating quality improvement activity but resulted in only modest improvements in lung cancer treatment rates and patient experience. PMID:24651386

Total Quality Management in Space Shuttle Main Engine manufacturing

NASA Technical Reports Server (NTRS)

Ding, J.

1992-01-01

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

Demystifying process mapping: a key step in neurosurgical quality improvement initiatives.

PubMed

McLaughlin, Nancy; Rodstein, Jennifer; Burke, Michael A; Martin, Neil A

2014-08-01

Reliable delivery of optimal care can be challenging for care providers. Health care leaders have integrated various business tools to assist them and their teams in ensuring consistent delivery of safe and top-quality care. The cornerstone to all quality improvement strategies is the detailed understanding of the current state of a process, captured by process mapping. Process mapping empowers caregivers to audit how they are currently delivering care to subsequently strategically plan improvement initiatives. As a community, neurosurgery has clearly shown dedication to enhancing patient safety and delivering quality care. A care redesign strategy named NERVS (Neurosurgery Enhanced Recovery after surgery, Value, and Safety) is currently being developed and piloted within our department. Through this initiative, a multidisciplinary team led by a clinician neurosurgeon has process mapped the way care is currently being delivered throughout the entire episode of care. Neurosurgeons are becoming leaders in quality programs, and their education on the quality improvement strategies and tools is essential. The authors present a comprehensive review of process mapping, demystifying its planning, its building, and its analysis. The particularities of using process maps, initially a business tool, in the health care arena are discussed, and their specific use in an academic neurosurgical department is presented.

Understanding the uncertainty associated with particle-bound pollutant build-up and wash-off: A critical review.

PubMed

Wijesiri, Buddhi; Egodawatta, Prasanna; McGree, James; Goonetilleke, Ashantha

2016-09-15

Accurate prediction of stormwater quality is essential for developing effective pollution mitigation strategies. The use of models incorporating simplified mathematical replications of pollutant processes is the common practice for determining stormwater quality. However, an inherent process uncertainty arises due to the intrinsic variability associated with pollutant processes, which has neither been comprehensively understood, nor well accounted for in uncertainty assessment of stormwater quality modelling. This review provides the context for defining and quantifying the uncertainty associated with pollutant build-up and wash-off on urban impervious surfaces based on the hypothesis that particle size is predominant in influencing process variability. Critical analysis of published research literature brings scientific evidence together in order to establish the fact that particle size changes with time, and different sized particles exhibit distinct behaviour during build-up and wash-off, resulting in process variability. Analysis of the different adsorption behaviour of particles confirmed that the variations in pollutant load and composition are influenced by particle size. Particle behaviour and variations in pollutant load and composition are related due to the strong affinity of pollutants such as heavy metals and hydrocarbons for specific particle size ranges. As such, the temporal variation in particle size is identified as the key to establishing a basis for assessing build-up and wash-off process uncertainty. Therefore, accounting for pollutant build-up and wash-off process variability, which is influenced by particle size, would facilitate the assessment of the uncertainty associated with modelling outcomes. Furthermore, the review identified fundamental knowledge gaps where further research is needed in relation to: (1) the aggregation of particles suspended in the atmosphere during build-up; (2) particle re-suspension during wash-off; (3) pollutant re-adsorption by different particle size fractions; and (4) development of evidence-based techniques for assessing uncertainty; and (5) methods for translating the knowledge acquired from the investigation of process mechanisms at small scale into catchment scale for stormwater quality modelling. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Reevaluation for systematic reviews for traditional Chinese medicine injections for coronary disease].

PubMed

Yin, Xiu-Ping; Xie, Yan-Ming; Liao, Xing; Luo, Man

2016-11-01

To reevaluate the systematic reviews for traditional Chinese medicine(TCM) injections for treating coronary disease, data in four Chinese databases and PubMed, Embase, Cochrane Library, Wed of Science OVID from inception until May 2016 were searched. We extracted data according to the AMSTAR and PRISMA checklists to evaluate the methodological quality and reporting characteristics of included literatures. A total of 69 systematic reviews were included, involving 24 TCM injections, which showed certain efficacy in treating coronary disease, and whose main outcome indexes included alleviation of symptoms of angina pectoris and electrocardiogram. In all of the systematic reviews, the duration of follow-up were not reported. Six systematic reviews reported TCM typing. In the 44 system reviews, 1 335 reports mentioned 4 137 adverse events. According to the results of AMSTAR and PRISMA checklists, the quality assessment scores about included studies were not high, and most of the systematic reviews suffered heterogeneity and irrational processing of forest plots. In conclusion, TCM injections in the treatment of coronary disease have a wide range and positive effects. However, affected by the low quality of systematic reviews and the production of reevaluation, the study had some limitations. Therefore, the systematic reviews shall be further improved, in order to provide more advanced clinical evidences to clinicians. Copyright© by the Chinese Pharmaceutical Association.

The FAA's Approach to Quality Assurance in the Flight Safety Analysis of Launch and Reentry Vehicles

NASA Astrophysics Data System (ADS)

Murray, Daniel P.; Weil, Andre

2010-09-01

The U.S. Federal Aviation Administration(FAA) Office of Commercial Space Transportation’s safety mission is to ensure protection of the public, property, and the national security and foreign policy interests of the United States during commercial launch and reentry activities. As part of this mission, the FAA issues licenses to the operators of launch and reentry vehicles who successfully demonstrate compliance with FAA regulations. To meet these regulations, vehicle operators submit an application that contains, among other things, flight safety analyses of their proposed missions. In the process of evaluating these submitted analyses, the FAA often conducts its own independent analyses, using input data from the submitted license application. These analyses are conducted according to approved procedures using industry developed tools. To assist in achieving the highest levels of quality in these independent analyses, the FAA has developed a quality assurance program that consists of multiple levels of review. These reviews rely on the work of multiple teams, as well as additional, independently performed work of support contractors. This paper describes the FAA’s quality assurance process for flight safety analyses. Members of the commercial space industry may find that elements of this process can be easily applied to their own analyses, improving the quality of the material they submit to the FAA in their license applications.

77 FR 47573 - Approval and Promulgation of Implementation Plans; Mississippi; 110(a)(2)(E)(ii) Infrastructure...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... Mississippi Department of Environmental Quality (MDEQ), on July 13, 2012, for parallel processing. This... of Contents I. What is parallel processing? II. Background III. What elements are required under... Executive Order Reviews I. What is parallel processing? Consistent with EPA regulations found at 40 CFR Part...

Journal peer review: a bar or bridge? An analysis of a paper's revision history and turnaround time, and the effect on citation.

PubMed

Rigby, J; Cox, D; Julian, K

2018-01-01

Journal peer review lies at the heart of academic quality control. This article explores the journal peer review process and seeks to examine how the reviewing process might itself contribute to papers, leading them to be more highly cited and to achieve greater recognition. Our work builds on previous observations and views expressed in the literature about (a) the role of actors involved in the research and publication process that suggest that peer review is inherent in the research process and (b) on the contribution reviewers themselves might make to the content and increased citation of papers. Using data from the journal peer review process of a single journal in the Social Sciences field (Business, Management and Accounting), we examine the effects of peer review on papers submitted to that journal including the effect upon citation, a novel step in the study of the outcome of peer review. Our detailed analysis suggests, contrary to initial assumptions, that it is not the time taken to revise papers but the actual number of revisions that leads to greater recognition for papers in terms of citation impact. Our study provides evidence, albeit limited to the case of a single journal, that the peer review process may constitute a form of knowledge production and is not the simple correction of errors contained in submitted papers.

Peer review.

PubMed

Twaij, H; Oussedik, S; Hoffmeyer, P

2014-04-01

The maintenance of quality and integrity in clinical and basic science research depends upon peer review. This process has stood the test of time and has evolved to meet increasing work loads, and ways of detecting fraud in the scientific community. However, in the 21st century, the emphasis on evidence-based medicine and good science has placed pressure on the ways in which the peer review system is used by most journals. This paper reviews the peer review system and the problems it faces in the digital age, and proposes possible solutions.

Scaleable processes for the manufacture of therapeutic quantities of plasmid DNA.

PubMed

Shamlou, Parviz Ayazi

2003-06-01

The need for scaleable processes to manufacture therapeutic plasmid DNA (pDNA) is easy to overlook when attention is focused primarily on vector design and establishment of early clinical results. pDNA is a large molecule and has properties that are similar to those of the contaminating chromosomal DNA. These, combined with the low initial concentration of plasmids in the host cell, provide unique process challenges that require significant upfront design to establish robust manufacturing processes that can also comply with current Good Manufacturing Practice ('cGMP') and produce milligram-to-kilogram quantities of pDNA product. This review describes promising scaleable processes that are currently being assessed for production of therapeutic supercoiled pDNA. Fermentation strategies for improving supercoiled plasmid yield and reducing contaminant concentrations are reviewed, and downstream processes are assessed for their ability to efficiently remove cellular contaminants, separate the supercoiled form of the pDNA from its open circular and linear forms, and prepare the purified drug substance for formulation. Current strategies are presented for developing stable delivery systems, and approaches to quality assurance and quality control are discussed.

Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

2017-03-23

Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

"I sleep better at night:" How peer review of radiation treatment plans indirectly improves quality of care across radiation treatment programs.

PubMed

Brundage, Michael D; Hart, Margaret; O'Donnell, Jennifer; Reddeman, Lindsay; Gutierrez, Eric; Foxcroft, Sophie; Warde, Padraig

Peer review of radiation oncology treatment plans is increasingly recognized as an important component of quality assurance in radiation treatment planning and delivery. Peer review of treatment plans can directly improve the quality of those plans and can also have indirect effects on radiation treatment programs. We undertook a systematic, qualitative approach to describing the indirect benefits of peer review, factors that were seen to facilitate or act as barriers to the implementation of peer review, and strategies to address these barriers across a provincial jurisdiction of radiation oncology programs (ROPs). Semistructured qualitative interviews were held with radiation oncology department heads and radiation therapy managers (or delegates) in all 14 ROPs in Ontario, Canada. We used a theoretically guided phenomenological qualitative approach to design and analyze the interview content. Themes were recorded by 2 independent reviewers, and any discordance was resolved by consensus. A total of 28 interviews were completed with 32 interviewees. Twenty-two unique themes addressed perceived benefits of peer review, relating to either peer review structure (n = 3), process (n = 9), or outcome (n = 10). Of these 22 themes, 19 related to indirect benefits to ROPs. In addition, 18 themes related to factors that facilitated peer review activities and 30 themes related to key barriers to implementing peer review were identified. Findings were consistent with, and enhanced the understanding of, previous survey-based assessments of the benefits and challenges of implementing peer review programs. Although challenges and concerns regarding the implementation of peer review were evident, the indirect benefits to radiation programs are numerous, far outweigh the implementation challenges, and strongly complement the direct individual-patient benefits that result from peer review quality assurance of radiation treatment plans. Copyright © 2016. Published by Elsevier Inc.

Efficacy of Carcass Electrical Stimulation in Meat Quality Enhancement: A Review

PubMed Central

Adeyemi, Kazeem Dauda; Sazili, Awis Qurni

2014-01-01

The use of electrical stimulation (ES) as a management tool to improve meat quality and efficiency of meat processing is reviewed. The basis of the efficacy of ES is its ability to fast track postmortem glycolysis, which in turn stimulates myriad histological, physical, biochemical, biophysical and physiological changes in the postmortem muscle. Electrical stimulation hastens the onset and resolution of rigor mortis thereby reducing processing time and labor and plays a vital role in improving meat tenderness and other meat quality traits. However, ES may have negative impacts on some meat quality traits such as color stability and water holding capacity in some animals. Electrical stimulation is not an end in itself. In order to achieve the desired benefits from its application, the technique must be properly used in conjunction with various intricate antemortem, perimortem and postmortem management practices. Despite extensive research on ES, the fundamental mechanisms and the appropriate commercial applications remained obscured. In addition, muscles differ in their response to ES. Thus, elementary knowledge of the various alterations with respect to muscle type is needed in order to optimize the effectiveness of ES in the improvement of meat quality. PMID:25049973

A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews.

PubMed

Pluye, Pierre; Gagnon, Marie-Pierre; Griffiths, Frances; Johnson-Lafleur, Janique

2009-04-01

A new form of literature review has emerged, Mixed Studies Review (MSR). These reviews include qualitative, quantitative and mixed methods studies. In the present paper, we examine MSRs in health sciences, and provide guidance on processes that should be included and reported. However, there are no valid and usable criteria for concomitantly appraising the methodological quality of the qualitative, quantitative and mixed methods studies. To propose criteria for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies or study components. A three-step critical review was conducted. 2322 references were identified in MEDLINE, and their titles and abstracts were screened; 149 potentially relevant references were selected and the full-text papers were examined; 59 MSRs were retained and scrutinized using a deductive-inductive qualitative thematic data analysis. This revealed three types of MSR: convenience, reproducible, and systematic. Guided by a proposal, we conducted a qualitative thematic data analysis of the quality appraisal procedures used in the 17 systematic MSRs (SMSRs). Of 17 SMSRs, 12 showed clear quality appraisal procedures with explicit criteria but no SMSR used valid checklists to concomitantly appraise qualitative, quantitative and mixed methods studies. In two SMSRs, criteria were developed following a specific procedure. Checklists usually contained more criteria than needed. In four SMSRs, a reliability assessment was described or mentioned. While criteria for quality appraisal were usually based on descriptors that require specific methodological expertise (e.g., appropriateness), no SMSR described the fit between reviewers' expertise and appraised studies. Quality appraisal usually resulted in studies being ranked by methodological quality. A scoring system is proposed for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies for SMSRs. This scoring system may also be used to appraise the methodological quality of qualitative, quantitative and mixed methods components of mixed methods research.

Description and Evaluation of the Research Ethics Review Process in Japan: Proposed Measures for Improvement.

PubMed

Suzuki, Mika; Sato, Keiko

2016-07-01

Research Ethics Committees (RECs) are designed to protect human subjects in research. It is essential to recognize whether the RECs are achieving this goal. Several studies have reported on RECs; however, detailed data regarding the quality of research protocols and the review process of RECs have not been reported in Japan. We examine research protocols reviewed by RECs and the review processes at three institutions using a novel checklist we developed. The data show that approximately half of all examined protocols lacked a clearly written "Background" section that defines the study rationale and design. These results reiterate suggestions made in previous research regarding educational programs and support departments that could enhance responsible conduct in clinical research to protect human subjects in Japan. © The Author(s) 2016.

Effects of Cold Plasma on Food Quality: A Review.

PubMed

Pankaj, Shashi K; Wan, Zifan; Keener, Kevin M

2018-01-01

Cold plasma (CP) technology has proven very effective as an alternative tool for food decontamination and shelf-life extension. The impact of CP on food quality is very crucial for its acceptance as an alternative food processing technology. Due to the non-thermal nature, CP treatments have shown no or minimal impacts on the physical, chemical, nutritional and sensory attributes of various products. This review also discusses the negative impacts and limitations posed by CP technology for food products. The limited studies on interactions of CP species with food components at the molecular level offers future research opportunities. It also highlights the need for optimization studies to mitigate the negative impacts on visual, chemical, nutritional and functional properties of food products. The design versatility, non-thermal, economical and environmentally friendly nature of CP offers unique advantages over traditional processing technologies. However, CP processing is still in its nascent form and needs further research to reach its potential.

Using quality assessment tools to critically appraise ageing research: a guide for clinicians.

PubMed

Harrison, Jennifer Kirsty; Reid, James; Quinn, Terry J; Shenkin, Susan Deborah

2017-05-01

Evidence based medicine tells us that we should not accept published research at face value. Even research from established teams published in the highest impact journals can have methodological flaws, biases and limited generalisability. The critical appraisal of research studies can seem daunting, but tools are available to make the process easier for the non-specialist. Understanding the language and process of quality assessment is essential when considering or conducting research, and is also valuable for all clinicians who use published research to inform their clinical practice.We present a review written specifically for the practising geriatrician. This considers how quality is defined in relation to the methodological conduct and reporting of research. Having established why quality assessment is important, we present and critique tools which are available to standardise quality assessment. We consider five study designs: RCTs, non-randomised studies, observational studies, systematic reviews and diagnostic test accuracy studies. Quality assessment for each of these study designs is illustrated with an example of published cognitive research. The practical applications of the tools are highlighted, with guidance on their strengths and limitations. We signpost educational resources and offer specific advice for use of these tools.We hope that all geriatricians become comfortable with critical appraisal of published research and that use of the tools described in this review - along with awareness of their strengths and limitations - become a part of teaching, journal clubs and practice. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.

Report: EPA Oversight Addresses Thermal Variance and Cooling Water Permit Deficiencies But Needs to Address Compliance With Public Notice Requirements

EPA Pesticide Factsheets

Report #13-P-0264, May 23, 2013. Since the 1980s, EPA has had an oversight process, known as Permit Quality Reviews (PQRs), to promote permit quality and ensure a reasonable degree of national consistency with regard to core program requirements.

Professionalization in Universities and European Convergence

ERIC Educational Resources Information Center

Vivas, Amparo Jimenez; Hevia, David Menendez Alvarez

2009-01-01

The constant assessment of the quality of higher education within the framework of European convergence is a challenge for all those universities that wish their degrees and diplomas to reflect a unified Europe. As is the case in any assessment, change and review process, the quest to improve quality implies measuring achievement of the objectives…

Assuring Quality in Online Course Delivery

ERIC Educational Resources Information Center

Matuga, Julia M.; Wooldridge, Deborah G.; Poirier, Sandra

2011-01-01

This paper examines the critical issue of assuring quality online course delivery by examining four key components of online teaching and learning. The topic of course delivery is viewed as a cultural issue that permeates processes from the design of an online course to its evaluation. First, the authors examine and review key components of and…

A six sigma review of miniature optics alignment

NASA Astrophysics Data System (ADS)

Tesar, John

2009-08-01

The key to high quality optics is a set of guidelines. Create an understanding of the Criteria for Quality. Focus on understanding and controlling process variation. Examine verification and validation of methods. Take a view of the horizon as well as drilling down so you know when to put down the shovel.

Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

ERIC Educational Resources Information Center

Copa, George H.

1993-01-01

Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

Water quantity and quality at the urban-rural interface

Treesearch

Ge Sun; B. Graeme Lockaby

2012-01-01

Population growth and urban development dramatically alter natural watershed ecosystem structure and functions and stress water resources. We review studies on the impacts of urbanization on hydrologic and biogeochemical processes underlying stream water quantity and water quality issues, as well as water supply challenges in an urban environment. We conclude that...

[Post-marketing reevaluation for potential quality risk and quality control in clinical application of traditional Chinese medicines].

PubMed

Li, Hong-jiao; He, Li-yun; Liu, Bao-yan

2015-06-01

The effective quality control in clinical practices is an effective guarantee for the authenticity and scientificity of the findings. The post-marketing reevaluation for traditional Chinese medicines (TCM) focuses on the efficacy, adverse reaction, combined medication and effective dose of drugs in the market by expanded clinical trials, and requires a larger sample size and a wider range of patients. Therefore, this increases the difficulty of quality control in clinical practices. With the experience in quality control in clinical practices for the post-marketing reevaluation for Kangbingdu oral for cold, researchers in this study reviewed the study purpose, project, scheme design and clinical practice process from an overall point of view, analyzed the study characteristics of the post-marketing reevaluation for TCMs and the quality control risks, designed the quality control contents with quality impacting factors, defined key review contents and summarized the precautions in clinical practices, with the aim to improve the efficiency of quality control of clinical practices. This study can provide reference to clinical units and quality control-related personnel in the post-marketing reevaluation for TCMs.

Evaluating the Pros and Cons of Different Peer Review Policies via Simulation.

PubMed

Zhu, Jia; Fung, Gabriel; Wong, Wai Hung; Li, Zhixu; Xu, Chuanhua

2016-08-01

In the academic world, peer review is one of the major processes in evaluating a scholars contribution. In this study, we are interested in quantifying the merits of different policies in a peer review process, such as single-blind review, double-blind review, and obtaining authors feedback. Currently, insufficient work has been undertaken to evaluate the benefits of different peer review policies. One of the major reasons for this situation is the inability to conduct any empirical study because data are presently unavailable. In this case, a computer simulation is one of the best ways to conduct a study. We perform a series of simulations to study the effects of different policies on a peer review process. In this study, we focus on the peer review process of a typical computer science conference. Our results point to the crucial role of program chairs in determining the quality and diversity of the articles to be accepted for publication. We demonstrate the importance of discussion among reviewers, suggest circumstances in which the double-blind review policy should be adopted, and question the credibility of the authors feedback mechanism. Finally, we stress that randomness plays an important role in the peer review process, and this role cannot be eliminated. Although our model may not capture every component of a peer review process, it covers some of the most essential elements. Thus, even the simulation results clearly cannot be taken as literal descriptions of an actual peer review process. However, we can at least still use them to identify alternative directions for future study.

Structure, Process, and Outcome Quality of Surgical Site Infection Surveillance in Switzerland.

PubMed

Kuster, Stefan P; Eisenring, Marie-Christine; Sax, Hugo; Troillet, Nicolas

2017-10-01

OBJECTIVE To assess the structure and quality of surveillance activities and to validate outcome detection in the Swiss national surgical site infection (SSI) surveillance program. DESIGN Countrywide survey of SSI surveillance quality. SETTING 147 hospitals or hospital units with surgical activities in Switzerland. METHODS Site visits were conducted with on-site structured interviews and review of a random sample of 15 patient records per hospital: 10 from the entire data set and 5 from a subset of patients with originally reported infection. Process and structure were rated in 9 domains with a weighted overall validation score, and sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the identification of SSI. RESULTS Of 50 possible points, the median validation score was 35.5 (range, 16.25-48.5). Public hospitals (P<.001), hospitals in the Italian-speaking region of Switzerland (P=.021), and hospitals with longer participation in the surveillance (P=.018) had higher scores than others. Domains that contributed most to lower scores were quality of chart review and quality of data extraction. Of 49 infections, 15 (30.6%) had been overlooked in a random sample of 1,110 patient records, accounting for a sensitivity of 69.4% (95% confidence interval [CI], 54.6%-81.7%), a specificity of 99.9% (95% CI, 99.5%-100%), a positive predictive value of 97.1% (95% CI, 85.1%-99.9%), and a negative predictive value of 98.6% (95% CI, 97.7%-99.2%). CONCLUSIONS Irrespective of a well-defined surveillance methodology, there is a wide variation of SSI surveillance quality. The quality of chart review and the accuracy of data collection are the main areas for improvement. Infect Control Hosp Epidemiol 2017;38:1172-1181.

Review of nuclear pharmacy practice in hospitals

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

Kawada, T.K.; Tubis, M.; Ebenkamp, T.

1982-02-01

An operational profile for nuclear pharmacy practice is presented, and the technical and professional role of nuclear pharmacists is reviewed. Key aspects of nuclear pharmacy practice in hospitals discussed are the basic facilities and equipment for the preparation, quality control, and distribution of radioactive drug products. Standards for receiving, storing, and processing radioactive material are described. The elements of a radiopharmaceutical quality assurance program, including the working procedures, documentation systems, data analysis, and specific control tests, are presented. Details of dose preparation and administration and systems of inventory control for radioactive products are outlined.

The balance sheet technique. Volume I. The balance sheet analysis technique for preconstruction review of airports and highways

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

LaBelle, S.J.; Smith, A.E.; Seymour, D.A.

1977-02-01

The technique applies equally well to new or existing airports. The importance of accurate accounting of emissions, cannot be overstated. The regional oxidant modelling technique used in conjunction with a balance sheet review must be a proportional reduction technique. This type of emission balancing presumes equality of all sources in the analysis region. The technique can be applied successfully in the highway context, either in planning at the system level or looking only at projects individually. The project-by-project reviews could be used to examine each project in the same way as the airport projects are examined for their impact onmore » regional desired emission levels. The primary limitation of this technique is that it should not be used when simulation models have been used for regional oxidant air quality. In the case of highway projects, the balance sheet technique might appear to be limited; the real limitations are in the transportation planning process. That planning process is not well-suited to the needs of air quality forecasting. If the transportation forecasting techniques are insensitive to change in the variables that affect HC emissions, then no internal emission trade-offs can be identified, and the initial highway emission forecasts are themselves suspect. In general, the balance sheet technique is limited by the quality of the data used in the review. Additionally, the technique does not point out effective trade-off strategies, nor does it indicate when it might be worthwhile to ignore small amounts of excess emissions. Used in the context of regional air quality plans based on proportional reduction models, the balance sheet analysis technique shows promise as a useful method by state or regional reviewing agencies.« less

COMP report: CPQR technical quality control guidelines for low-dose-rate permanent seed brachytherapy.

PubMed

Beaulieu, Luc; Radford, Dee-Ann; Eduardo Villarreal-Barajas, J

2018-03-14

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low-dose-rate (LDR) permanent seed brachytherapy. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Organizational change to transfer knowledge and improve quality and outcomes of care for patients with severe mental illness: a systematic overview of reviews.

PubMed

Franx, Gerdien; Kroon, Hans; Grimshaw, Jeremy; Drake, Robert; Grol, Richard; Wensing, Michel

2008-05-01

To provide a comprehensive overview of the research on organizational changes aimed at improving health care for patients with severe mental illness and to learn lessons for mental health practice from the results. We searched for systematic literature reviews published in English during 2000 to 2007 in PubMed, PsycINFO, CINAHL, EMBASE, and the Cochrane Central Register of Systematic Reviews. Three reviewers independently selected and assessed the studies' quality. Studies involving changes of who delivers health care, how care is organized, or where care is delivered were included. We categorized the studies using an existing taxonomy of 6 broad categories of strategies for organizational change. A total of 21 reviews were included. Among these, 17 had reasonably good methodological quality, Almost all reviews included or intended to include randomized controlled trials (RCTs), 6 reviews did not identify studies that met eligibility criteria. Multidisciplinary teams and integrated care models had been reviewed most frequently (a total of 15 reviews). In most studies, these types of changes showed better outcomes in terms of symptom severity, functioning, employment, and housing, compared with conventional services. Different results were found on cost savings. Other types of organizational changes, such as changing professional roles or introducing quality management or knowledge management, were much less frequently reviewed. Very few reviews looked at effects of organizational changes on professional performance. There is a fairly large body of evidence of the positive impact of multidisciplinary teams and integrated care changes on symptom severity, functioning, employment, and housing of people with severe mental illness, compared with conventional services. Other strategies, such as changes in professional roles, quality or knowledge management, have either not been the subject of systematic reviews or have not been evaluated in RCTs. There is still a lack of insight in the so-called black box of change processes and the impact of change on professional performance.

Aspiring to Unintended Consequences of Natural Language Processing: A Review of Recent Developments in Clinical and Consumer-Generated Text Processing.

PubMed

Demner-Fushman, D; Elhadad, N

2016-11-10

This paper reviews work over the past two years in Natural Language Processing (NLP) applied to clinical and consumer-generated texts. We included any application or methodological publication that leverages text to facilitate healthcare and address the health-related needs of consumers and populations. Many important developments in clinical text processing, both foundational and task-oriented, were addressed in community- wide evaluations and discussed in corresponding special issues that are referenced in this review. These focused issues and in-depth reviews of several other active research areas, such as pharmacovigilance and summarization, allowed us to discuss in greater depth disease modeling and predictive analytics using clinical texts, and text analysis in social media for healthcare quality assessment, trends towards online interventions based on rapid analysis of health-related posts, and consumer health question answering, among other issues. Our analysis shows that although clinical NLP continues to advance towards practical applications and more NLP methods are used in large-scale live health information applications, more needs to be done to make NLP use in clinical applications a routine widespread reality. Progress in clinical NLP is mirrored by developments in social media text analysis: the research is moving from capturing trends to addressing individual health-related posts, thus showing potential to become a tool for precision medicine and a valuable addition to the standard healthcare quality evaluation tools.

An institutional review board-based clinical research quality assurance program.

PubMed

Lad, Pramod M; Dahl, Rebecca

2013-01-01

Despite the acknowledged importance of quality assurance in the clinical research process, the problem of how such a program should be implemented at the level of an academic teaching hospital or a similar institution has not been addressed in the literature. Despite the fact that quality assurance is expected in programs which certify and accredit Institutional Review Boards (IRBs), very little is known about the role of the IRB in programs of clinical research quality assurance. In this article we consider the definition of clinical research quality assurance, and describe a program designed to achieve it. The key elements of such a program are education at the site level, which has both mandatory and voluntary components, and an auditing and monitoring program, which reinforces the education on quality assurance. The role of the IRB in achieving the program goals and the organizational placement of the quality assurance program within the IRB structure and function are important items of discussion.

System review: a method for investigating medical errors in healthcare settings.

PubMed

Alexander, G L; Stone, T T

2000-01-01

System analysis is a process of evaluating objectives, resources, structure, and design of businesses. System analysis can be used by leaders to collaboratively identify breakthrough opportunities to improve system processes. In healthcare systems, system analysis can be used to review medical errors (system occurrences) that may place patients at risk for injury, disability, and/or death. This study utilizes a case management approach to identify medical errors. Utilizing an interdisciplinary approach, a System Review Team was developed to identify trends in system occurrences, facilitate communication, and enhance the quality of patient care by reducing medical errors.

Opinion mining on book review using CNN-L2-SVM algorithm

NASA Astrophysics Data System (ADS)

Rozi, M. F.; Mukhlash, I.; Soetrisno; Kimura, M.

2018-03-01

Review of a product can represent quality of a product itself. An extraction to that review can be used to know sentiment of that opinion. Process to extract useful information of user review is called Opinion Mining. Review extraction model that is enhancing nowadays is Deep Learning model. This Model has been used by many researchers to obtain excellent performance on Natural Language Processing. In this research, one of deep learning model, Convolutional Neural Network (CNN) is used for feature extraction and L2 Support Vector Machine (SVM) as classifier. These methods are implemented to know the sentiment of book review data. The result of this method shows state-of-the art performance in 83.23% for training phase and 64.6% for testing phase.

Understanding patients' behavioral intentions: evidence from Iran's private hospitals industry.

PubMed

Zarei, Ehsan; Arab, Mohammad; Tabatabaei, Seyed Mahmoud Ghazi; Rashidian, Arash; Forushani, Abbas Rahimi; Khabiri, Roghayeh

2014-01-01

In the ever-increasing competitive market of private hospital industry, creating a strong relationship with the customers that shapes patients' loyalty has been considered a key factor in obtaining market share. The purpose of this paper is to test a model of customer loyalty among patients of private hospitals in Iran. This cross-sectional study was carried out in Tehran, the capital of the Islamic Republic of Iran in 2010. The study samples composed of 969 patients who were consecutively selected from eight private hospitals. The survey instrument was designed based on a review of the related literature and included 36 items. Data analysis was performed using structural equation modeling. For the service quality construct, three dimensions extracted: Process, interaction, and environment. Both process and interaction quality had significant effects on perceived value. Perceived value along with the process and interaction quality were the most important antecedents of patient overall satisfaction. The direct effect of the process and interaction quality on behavioral intentions was insignificant. Perceived value and patient overall satisfaction were the direct antecedents of patient behavioral intentions and the mediators between service quality and behavioral intentions. Environment quality of service delivery had no significant effect on perceived value, overall satisfaction, and behavioral intentions. Contrary to previous similar studies, the role of service quality was investigated not in a general sense, but in the form of three types of qualities including quality of environment, quality of process, and quality of interaction.

The drug regulatory and review process in Guyana.

PubMed

Woo-Ming, R B

1993-01-01

After the old "Sale of Food and Drugs" Ordinance, Cap. 144 was repealed, the new Food and Drugs Act was enacted in 1971. This new Act has considerable flexibility and gives the Minister extensive authority to make Regulations (for carrying out the purposes and provisions of the Act). The Act controls the manufacture, importation, sale, advertising, labeling, packaging, and distribution of drug samples, and the testing of drugs. The Act also controls raw materials and finished products of drugs at the point of entry into the country, with a single agency coordinating both the inspection and analytical services. Developing countries could ensure the procurement of safe, good quality, and effective drugs and devices with the enactment of a similar Food and Drugs Act only. Rapid assessment of Drug Safety, Quality and Efficacy is done through Guyana's participation in the WHO Certification Scheme on the Quality of Pharmaceutical Products moving in International Commerce. This certification scheme is highly commendable especially to third-world countries. The Food and Drug Regulations (1977) have several unique features for drug, cosmetic and device control and they allow for a system of centralized control with limited staff to enforce the legislation. In summary, enforcement of legislative control of imported pharmaceuticals and product evaluation can be considered strong points in the drug regulatory and review process in Guyana. A cautious attitude is observed so as to ensure efficacy, safety, and quality of drugs entering the market. This Drug Regulatory and Review Process is recommended for implementation by third-world countries with outdated drug legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

Multiscale image processing and antiscatter grids in digital radiography.

PubMed

Lo, Winnie Y; Hornof, William J; Zwingenberger, Allison L; Robertson, Ian D

2009-01-01

Scatter radiation is a source of noise and results in decreased signal-to-noise ratio and thus decreased image quality in digital radiography. We determined subjectively whether a digitally processed image made without a grid would be of similar quality to an image made with a grid but without image processing. Additionally the effects of exposure dose and of a using a grid with digital radiography on overall image quality were studied. Thoracic and abdominal radiographs of five dogs of various sizes were made. Four acquisition techniques were included (1) with a grid, standard exposure dose, digital image processing; (2) without a grid, standard exposure dose, digital image processing; (3) without a grid, half the exposure dose, digital image processing; and (4) with a grid, standard exposure dose, no digital image processing (to mimic a film-screen radiograph). Full-size radiographs as well as magnified images of specific anatomic regions were generated. Nine reviewers rated the overall image quality subjectively using a five-point scale. All digitally processed radiographs had higher overall scores than nondigitally processed radiographs regardless of patient size, exposure dose, or use of a grid. The images made at half the exposure dose had a slightly lower quality than those made at full dose, but this was only statistically significant in magnified images. Using a grid with digital image processing led to a slight but statistically significant increase in overall quality when compared with digitally processed images made without a grid but whether this increase in quality is clinically significant is unknown.

Effects of technical editing in biomedical journals: a systematic review.

PubMed

Wager, Elizabeth; Middleton, Philippa

2002-06-05

Technical editing supposedly improves the accuracy and clarity of journal articles. We examined evidence of its effects on research reports in biomedical journals. Subset of a systematic review using Cochrane methods, searching MEDLINE, EMBASE, and other databases from earliest entries to February 2000 by using inclusive search terms; hand searching relevant journals. We selected comparative studies of the effects of editorial processes on original research articles between acceptance and publication in biomedical journals. Two reviewers assessed each study and performed independent data extraction. The 11 studies on technical editing indicate that it improves the readability of articles slightly (as measured by Gunning Fog and Flesch reading ease scores), may improve other aspects of their quality, can increase the accuracy of references and quotations, and raises the quality of abstracts. Supplying authors with abstract preparation instructions had no discernible effect. Considering the time and resources devoted to technical editing, remarkably little is know about its effects or the effects of imposing different house styles. Studies performed at 3 journals employing relatively large numbers of professional technical editors suggest that their editorial processes are associated with increases in readability and quality of articles, but these findings may not be generalizable to other journals.

A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life.

PubMed

Kidd, Tara; Carey, Nicola; Mold, Freda; Westwood, Sue; Miklaucich, Maria; Konstantara, Emmanouela; Sterr, Annette; Cooke, Debbie

2017-01-01

Self-management interventions have become increasingly popular in the management of long-term health conditions; however, little is known about their impact on psychological well-being in people with Multiple Sclerosis (MS). To examine the effectiveness of self-management interventions on improving depression, anxiety and health related quality of life in people with MS. A structured literature search was conducted for the years 2000 to 2016. The review process followed the PRISMA guidelines, and is registered with PROSPERO (no. CRD42016033925). The review identified 10 RCT trials that fulfilled selection criteria and quality appraisal. Self-management interventions improved health-related quality of life in 6 out of 7 studies, with some evidence of improvement in depression and anxiety symptoms. Although the results are promising more robust evaluation is required in order to determine the effectiveness of self-management interventions on depression, anxiety and quality of life in people with MS. Evaluation of the data was impeded by a number of methodological issues including incomplete content and delivery information for the intervention and the exclusion of participants representing the disease spectrum. Recommendations are made for service development and research quality improvement.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review.

PubMed

Domínguez-Mayo, F J; Escalona, M J; Mejías, M; Aragón, G; García-García, J A; Torres, J; Enríquez, J G

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

PubMed Central

Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656

ToxCast Data Generation: Chemical Workflow

EPA Pesticide Factsheets

This page describes the process EPA follows to select chemicals, procure chemicals, register chemicals, conduct a quality review of the chemicals, and prepare the chemicals for high-throughput screening.

77 FR 68155 - Sunshine Act Meeting Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

...-Quality Control Compliance/3rd Party CPA XII. National Foreclosure Mitigation Counseling (NFMC) Compliance Update XIII. OHTS Watch List and Overview of Organizational Assessment Review Process XIV. Adjournment...

REVIEW OF NATIONAL AMBIENT AIR QUALITY STANDARDS (NAAQS) FOR CARBON MONOXIDE (CO) - EXPOSURE ANALYSIS

EPA Science Inventory

As part of the review process, a CO Exposure Analysis will also be conducted to assess the extent of human exposure posed by current ambient CO concentrations and, upon meeting the current CO NAAQS. The results of this analysis will be incorporated into the Staff Paper. (This w...

Some Aspects of Revealingness and Disclosure: A Review.

ERIC Educational Resources Information Center

Epting, Franz R.; And Others

In extending the concept of self-disclosure which is concerned with the content of personal communication, the focus of this review is on a process conception of disclosure called revealingness. Revealingness deals with the communication of self as measured by linguistic style, and in some cases, voice quality, as well as the content of the…

Librarian contributions to clinical practice guidelines.

PubMed

Cruse, Peggy; Protzko, Shandra

2014-01-01

Librarians have become more involved in developing high quality systematic reviews. Evidence-based practice guidelines are an extension of systematic reviews and offer another significant area for librarian involvement. This column highlights opportunities and challenges for the librarian working on guideline panels and provides practical considerations for meaningful contributions to the guideline creation process.

Knowledge Translation Efforts in Child and Youth Mental Health: A Systematic Review

PubMed Central

SCHACHTER, HOWARD M.; BENNETT, LINDSAY M.; McGOWAN, JESSIE; LY, MYLAN; WILSON, ANGELA; BENNETT, KATHRYN; BUCHANAN, DON H.; FERGUSSON, DEAN; MANION, IAN

2012-01-01

The availability of knowledge translation strategies that have been empirically studied and proven useful is a critical prerequisite to narrowing the research-to-practice gap in child and youth mental health. Through this review the authors sought to determine the current state of scientific knowledge of the effectiveness of knowledge translation approaches in child and youth mental health by conducting a systematic review of the research evidence. The findings and quality of the 12 included studies are discussed. Future work of high methodological quality that explores a broader range of knowledge translation strategies and practitioners to which they are applied and that also attends to implementation process is recommended. PMID:22830938

Team learning and innovation in nursing, a review of the literature.

PubMed

Timmermans, Olaf; Van Linge, Roland; Van Petegem, Peter; Van Rompaey, Bart; Denekens, Joke

2012-01-01

The capability to learn and innovate has been recognized as a key-factor for nursing teams to deliver high quality performance. Researchers suggest there is a relation between team-learning activities and changes in nursing teams throughout the implementation of novelties. A review of the literature was conducted in regard to the relation between team learning and implementation of innovations in nursing teams and to explore factors that contribute or hinder team learning. The search was limited to studies that were published in English or Dutch between 1998 and 2010. Eight studies were included in the review. The results of this review revealed that research on team learning and innovation in nursing is limited. The included studies showed moderate methodological quality and low levels of evidence. Team learning included processes to gather, process, and store information from different innovations within the nursing team and the prevalence of team-learning activities was contributed or hindered by individual and contextual factors. Further research is needed on the relation between team learning and implementation of innovations in nursing. Copyright © 2011 Elsevier Ltd. All rights reserved.

Measuring attitudes towards the dying process: A systematic review of tools.

PubMed

Groebe, Bernadette; Strupp, Julia; Eisenmann, Yvonne; Schmidt, Holger; Schlomann, Anna; Rietz, Christian; Voltz, Raymond

2018-04-01

At the end of life, anxious attitudes concerning the dying process are common in patients in Palliative Care. Measurement tools can identify vulnerabilities, resources and the need for subsequent treatment to relieve suffering and support well-being. To systematically review available tools measuring attitudes towards dying, their operationalization, the method of measurement and the methodological quality including generalizability to different contexts. Systematic review according to the PRISMA Statement. Methodological quality of tools assessed by standardized review criteria. MEDLINE, PsycINFO, PsyndexTests and the Health and Psychosocial Instruments were searched from their inception to April 2017. A total of 94 identified studies reported the development and/or validation of 44 tools. Of these, 37 were questionnaires and 7 alternative measurement methods (e.g. projective measures). In 34 of 37 questionnaires, the emotional evaluation (e.g. anxiety) towards dying is measured. Dying is operationalized in general items ( n = 20), in several specific aspects of dying ( n = 34) and as dying of others ( n = 14). Methodological quality of tools was reported inconsistently. Nine tools reported good internal consistency. Of 37 tools, 4 were validated in a clinical sample (e.g. terminal cancer; Huntington disease), indicating questionable generalizability to clinical contexts for most tools. Many tools exist to measure attitudes towards the dying process using different endpoints. This overview can serve as decision framework on which tool to apply in which contexts. For clinical application, only few tools were available. Further validation of existing tools and potential alternative methods in various populations is needed.

Technical aspects of CT imaging of the spine.

PubMed

Tins, Bernhard

2010-11-01

This review article discusses technical aspects of computed tomography (CT) imaging of the spine. Patient positioning, and its influence on image quality and movement artefact, is discussed. Particular emphasis is placed on the choice of scan parameters and their relation to image quality and radiation burden to the patient. Strategies to reduce radiation burden and artefact from metal implants are outlined. Data acquisition, processing, image display and steps to reduce artefact are reviewed. CT imaging of the spine is put into context with other imaging modalities for specific clinical indications or problems. This review aims to review underlying principles for image acquisition and to provide a rough guide for clinical problems without being prescriptive. Individual practice will always vary and reflect differences in local experience, technical provisions and clinical requirements.

Automatic Review of Abstract State Machines by Meta Property Verification

NASA Technical Reports Server (NTRS)

Arcaini, Paolo; Gargantini, Angelo; Riccobene, Elvinia

2010-01-01

A model review is a validation technique aimed at determining if a model is of sufficient quality and allows defects to be identified early in the system development, reducing the cost of fixing them. In this paper we propose a technique to perform automatic review of Abstract State Machine (ASM) formal specifications. We first detect a family of typical vulnerabilities and defects a developer can introduce during the modeling activity using the ASMs and we express such faults as the violation of meta-properties that guarantee certain quality attributes of the specification. These meta-properties are then mapped to temporal logic formulas and model checked for their violation. As a proof of concept, we also report the result of applying this ASM review process to several specifications.

Discharge documentation of patients discharged to subacute facilities: a three-year quality improvement process across an integrated health care system.

PubMed

Gandara, Esteban; Ungar, Jonathan; Lee, Jason; Chan-Macrae, Myrna; O'Malley, Terrence; Schnipper, Jeffrey L

2010-06-01

Effective communication among physicians during hospital discharge is critical to patient care. Partners Healthcare (Boston) has been engaged in a multi-year process to measure and improve the quality of documentation of all patients discharged from its five acute care hospitals to subacute facilities. Partners first engaged stakeholders to develop a consensus set of 12 required data elements for all discharges to subacute facilities. A measurement process was established and later refined. Quality improvement interventions were then initiated to address measured deficiencies and included education of physicians and nurses, improvements in information technology, creation of or improvements in discharge documentation templates, training of hospitalists to serve as role models, feedback to physicians and their service chiefs regarding reviewed cases, and case manager review of documentation before discharge. To measure improvement in quality as a result of these efforts, rates of simultaneous inclusion of all 12 applicable data elements ("defect-free rate") were analyzed over time. Some 3,101 discharge documentation packets of patients discharged to subacute facilities from January 1, 2006, through September 2008 were retrospectively studied. During the 11 monitored quarters, the defect-free rate increased from 65% to 96% (p < .001 for trend). The largest improvements were seen in documentation of preadmission medication lists, allergies, follow-up, and warfarin information. Institution of rigorous measurement, feedback, and multidisciplinary, multimodal quality improvement processes improved the inclusion of data elements in discharge documentation required for safe hospital discharge across a large integrated health care system.

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

Malkoske, Kyle; Nielsen, Michelle; Brown, Erika

The Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist’s (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) have worked together in the development of a suite of Technical Quality Control (TQC) Guidelines for radiation treatment equipment and technologies, that outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. Early community engagement and uptake survey data showed 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing the way Canadian radiation treatmentmore » centres run their technical quality control programs. As the TQC development framework matured as a cross-country initiative, guidance documents have been developed in many clinical technologies. Recently, there have been new TQC documents initiated for Gamma Knife and Cyberknife technologies where the entire communities within Canada are involved in the review process. At the same time, QARSAC reviewed the suite as a whole for the first time and it was found that some tests and tolerances overlapped across multiple documents as single tests could pertain to multiple quality control areas. The work to streamline the entire suite has allowed for improved usability of the suite while keeping the integrity of single quality control areas. The suite will be published by the JACMP, in the coming year.« less

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

PubMed

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when it simplifies their daily working routines and as a burden when it complicates their working processes. Whether IT complicates or simplifies their routines depends on influencing factors. The line between benefit and burden is semipermeable. The experiences differ according to duties and responsibilities.

Improving and monitoring air quality.

PubMed

DuPont, André

2018-05-01

Since the authorization of the Clean Air Act Amendments of 1990, the air quality in the USA has significantly improved because of strong public support. The lessons learned over the last 25 years are being shared with the policy analysts, technical professionals, and scientist who endeavor to improve air quality in their communities. This paper will review how the USA has achieved the "high" standard of air quality that was envisioned in the early 1990s. This document will describe SO 2 gas emission reduction technology and highlight operation of emission monitoring technology. This paper describes the basic process operation of an air pollution control scrubber. A technical review of measures required to operate and maintain a large-scale pollution control system will be described. Also, the author explains how quality assurance procedures in performance of continuous emission monitoring plays a significant role in reducing air pollution.

Beyond the false negative rate: development of quality indicators for sentinel lymph node biopsy in breast cancer.

PubMed

Quan, May Lynn; Wells, Bryan J; McCready, David; Wright, Frances C; Fraser, Novlette; Gagliardi, Anna R

2010-02-01

Sentinel lymph node biopsy (SNLB) has been adopted as the standard method of axillary staging for women with clinically node-negative early-stage breast cancer. The false negative rate as a quality indicator is impractical given the need for a completion axillary dissection to calculate. The objective of this study was to develop practical quality indicators for SLNB using an expert consensus method and to determine if they were feasible to measure. We used a modified Delphi consensus process to develop quality indicators for SLNB. A multidisciplinary expert panel reviewed potential indicators extracted from the medical literature to select quality indicators that were relevant and measurable. Feasibility was determined by abstracting the quality indicator variables from a retrospective chart review. The expert panel prioritized 11 quality indicators as benchmarks for assessing the quality of surgical care in SNLB. Nine of the indicators were measurable at the chart or institutional level. A systematic evidence- and consensus-based approach was used to develop measurable quality indicators that could be used by practicing surgeons and administrators to evaluate performance of SLNB in breast cancer.

The utilization of six sigma and statistical process control techniques in surgical quality improvement.

PubMed

Sedlack, Jeffrey D

2010-01-01

Surgeons have been slow to incorporate industrial reliability techniques. Process control methods were applied to surgeon waiting time between cases, and to length of stay (LOS) after colon surgery. Waiting times between surgeries were evaluated by auditing the operating room records of a single hospital over a 1-month period. The medical records of 628 patients undergoing colon surgery over a 5-year period were reviewed. The average surgeon wait time between cases was 53 min, and the busiest surgeon spent 291/2 hr in 1 month waiting between surgeries. Process control charting demonstrated poor overall control of the room turnover process. Average LOS after colon resection also demonstrated very poor control. Mean LOS was 10 days. Weibull's conditional analysis revealed a conditional LOS of 9.83 days. Serious process management problems were identified in both analyses. These process issues are both expensive and adversely affect the quality of service offered by the institution. Process control mechanisms were suggested or implemented to improve these surgical processes. Industrial reliability and quality management tools can easily and effectively identify process control problems that occur on surgical services. © 2010 National Association for Healthcare Quality.

NOx SOx Secondary NAAQS: Integrated Review Plan ...

EPA Pesticide Factsheets

The NOx SOx Secondary NAAQS Integrated Review Plan is the first document generated as part of the National Ambient Air Quality Standards (NAAQS) review process. The Plan presents background information, the schedule for the review, the process to be used in conducting the review, and the key policy-relevant science issues that will guide the review. The integrated review plan also discusses the frameworks for the various assessment documents to be prepared by the EPA as part of the review, including an Integrated Science Assessment (ISA), and as warranted, a Risk/Exposure Assessment (REA), and a Policy Assessment (PA). The primary purpose of the NOx SOx Secondary NAAQS Integrated Review Plan is to highlight the key policy-relevant issues to be considered in the Review of the Oxides of Nitrogen and Oxides of Sulfur Secondary NAAQS. A draft of the integrated review plan will be the subject of an advisory review with the Clean Air Scientific Advisory Committee (CASAC) and made available to the public for review and comment.

PRISM Software: Processing and Review Interface for Strong‐Motion Data

USGS Publications Warehouse

Jones, Jeanne M.; Kalkan, Erol; Stephens, Christopher D.; Ng, Peter

2017-01-01

A continually increasing number of high‐quality digital strong‐motion records from stations of the National Strong Motion Project (NSMP) of the U.S. Geological Survey, as well as data from regional seismic networks within the United States, calls for automated processing of strong‐motion records with human review limited to selected significant or flagged records. The NSMP has developed the Processing and Review Interface for Strong Motion data (PRISM) software to meet this need. In combination with the Advanced National Seismic System Quake Monitoring System (AQMS), PRISM automates the processing of strong‐motion records. When used without AQMS, PRISM provides batch‐processing capabilities. The PRISM software is platform independent (coded in Java), open source, and does not depend on any closed‐source or proprietary software. The software consists of two major components: a record processing engine composed of modules for each processing step, and a review tool, which is a graphical user interface for manual review, edit, and processing. To facilitate use by non‐NSMP earthquake engineers and scientists, PRISM (both its processing engine and review tool) is easy to install and run as a stand‐alone system on common operating systems such as Linux, OS X, and Windows. PRISM was designed to be flexible and extensible to accommodate implementation of new processing techniques. All the computing features have been thoroughly tested.

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

Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

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

Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca; Straube, William; Laurie, Fran

2013-10-01

Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Diseasemore » sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.« less

Is open access sufficient? A review of the quality of open-access nursing journals.

PubMed

Crowe, Marie; Carlyle, Dave

2015-02-01

The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes. © 2014 Australian College of Mental Health Nurses Inc.

Development of Quality Indicators to Address Abuse and Neglect in Home-Based Primary Care and Palliative Care.

PubMed

Sheehan, Orla C; Ritchie, Christine S; Fathi, Roya; Garrigues, Sarah K; Saliba, Debra; Leff, Bruce

2016-12-01

To develop candidate quality indicators (QIs) for the quality standard of "addressing abuse and neglect" in the setting of home-based medical care. Systematic literature review of both the peer-reviewed and gray literature. Home-based primary and palliative care practices. Homebound community-dwelling older adults. Articles were identified to inform the development of candidate indicators of the quality by which home-based primary and palliative care practices addressed abuse and neglect. The literature guided the development of patient-level QIs and practice-level quality standards. A technical expert panel (TEP) representing exemplary home-based primary care and palliative care providers then participated in a modified Delphi process to assess the validity and feasibility of each measure and identify candidate QIs suitable for testing in the field. The literature review yielded 4,371 titles and abstracts that were reviewed; 25 publications met final inclusion criteria and informed development of nine candidate QIs. The TEP rated all but one of the nine candidate indicators as having high validity and feasibility. Translating the complex problem of addressing abuse and neglect into QIs may ultimately serve to improve care delivered to vulnerable home-limited adults who receive home-based medical care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Does Quality of Radiotherapy Predict Outcomes of Multicentre Cooperative Group Trials? A Literature Review

PubMed Central

Fairchild, Alysa; Straube, William; Laurie, Fran; Followill, David

2013-01-01

Central review of radiotherapy (RT) delivery within multicentre clinical trials was initiated in the early 1970’s in the USA. Early quality assurance (QA) publications often focused on metrics related to process, logistics and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. Medline search was performed to identify multicentre studies which described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicentre studies (1980–2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast and pancreas. Between 0% and 97% of treatment plans received an overall grade of acceptable. In seven trials, failure rates were significantly higher after inadequate versus adequate RT. 5/9 and 2/5 trials reported significantly worse overall and progression-free survival after poor quality RT, respectively. One reported a significant correlation and two reported non-significant trends towards increased toxicity with non-compliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question. PMID:23683829

Integrating Safety and Mission Assurance in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safety and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

Predicting plot soil loss by empirical and process-oriented approaches: A review

USDA-ARS?s Scientific Manuscript database

Soil erosion directly affects the quality of the soil, its agricultural productivity and its biological diversity. Many mathematical models have been developed to estimate plot soil erosion at different temporal scales. At present, empirical soil loss equations and process-oriented models are consid...

Pulsed electric field processing for fruit and vegetables

USDA-ARS?s Scientific Manuscript database

This month’s column reviews the theory and current applications of pulsed electric field (PEF) processing for fruits and vegetables to improve their safety and quality. This month’s column coauthor, Stefan Toepfl, is advanced research manager at the German Institute of Food Technologies and professo...

14 CFR 21.143 - Quality control data requirements; prime manufacturer.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., purchased items, and parts and assemblies produced by manufacturers' suppliers including methods used to... special manufacturing processes involved, the means used to control the processes, the final test... procedure for recording review board decisions and disposing of rejected parts; (5) An outline of a system...

Emerging developments in the standardized chemical characterization of indoor air quality.

PubMed

Nehr, Sascha; Hösen, Elisabeth; Tanabe, Shin-Ichi

2017-01-01

Despite the fact that the special characteristics of indoor air pollution make closed environments quite different from outdoor environments, the conceptual ideas for assessing air quality indoors and outdoors are similar. Therefore, the elaboration of International Standards for air quality characterization in view of controlling indoor air quality should resort to this common basis. In this short review we describe the possibilities of standardization of tools dedicated to indoor air quality characterization with a focus on the tools permitting to study the indoor air chemistry. The link between indoor exposure and health as well as the critical processes driving the indoor air quality are introduced. Available International Standards for the assessment of indoor air quality are depicted. The standards comprise requirements for the sampling on site, the analytical procedures, and the determination of material emissions. To date, these standardized procedures assure that indoor air, settled dust and material samples are analyzed in a comparable manner. However, existing International Standards exclusively specify conventional, event-driven target-screening using discontinuous measurement methods for long-lived pollutants. Therefore, this review draws a parallel between physico-chemical processes in indoor and outdoor environments. The achievements in atmospheric sciences also improve our understanding of indoor environments. The community of atmospheric scientists can be both ideal and supporter for researchers in the area of indoor air quality characterization. This short review concludes with propositions for future standardization activities for the chemical characterization of indoor air quality. Future standardization efforts should focus on: (i) the elaboration of standardized measurement methods and measurement strategies for online monitoring of long-lived and short-lived pollutants, (ii) the assessment of the potential and the limitations of non-target screening, (iii) the paradigm shift from event-driven investigations to systematic approaches to characterize indoor environments, and (iv) the development of tools for policy implementation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Colometer: a real-time quality feedback system for screening colonoscopy.

PubMed

Filip, Dobromir; Gao, Xuexin; Angulo-Rodríguez, Leticia; Mintchev, Martin P; Devlin, Shane M; Rostom, Alaa; Rosen, Wayne; Andrews, Christopher N

2012-08-28

To investigate the performance of a new software-based colonoscopy quality assessment system. The software-based system employs a novel image processing algorithm which detects the levels of image clarity, withdrawal velocity, and level of the bowel preparation in a real-time fashion from live video signal. Threshold levels of image blurriness and the withdrawal velocity below which the visualization could be considered adequate have initially been determined arbitrarily by review of sample colonoscopy videos by two experienced endoscopists. Subsequently, an overall colonoscopy quality rating was computed based on the percentage of the withdrawal time with adequate visualization (scored 1-5; 1, when the percentage was 1%-20%; 2, when the percentage was 21%-40%, etc.). In order to test the proposed velocity and blurriness thresholds, screening colonoscopy withdrawal videos from a specialized ambulatory colon cancer screening center were collected, automatically processed and rated. Quality ratings on the withdrawal were compared to the insertion in the same patients. Then, 3 experienced endoscopists reviewed the collected videos in a blinded fashion and rated the overall quality of each withdrawal (scored 1-5; 1, poor; 3, average; 5, excellent) based on 3 major aspects: image quality, colon preparation, and withdrawal velocity. The automated quality ratings were compared to the averaged endoscopist quality ratings using Spearman correlation coefficient. Fourteen screening colonoscopies were assessed. Adenomatous polyps were detected in 4/14 (29%) of the collected colonoscopy video samples. As a proof of concept, the Colometer software rated colonoscope withdrawal as having better visualization than the insertion in the 10 videos which did not have any polyps (average percent time with adequate visualization: 79% ± 5% for withdrawal and 50% ± 14% for insertion, P < 0.01). Withdrawal times during which no polyps were removed ranged from 4-12 min. The median quality rating from the automated system and the reviewers was 3.45 [interquartile range (IQR), 3.1-3.68] and 3.00 (IQR, 2.33-3.67) respectively for all colonoscopy video samples. The automated rating revealed a strong correlation with the reviewer's rating (ρ coefficient= 0.65, P = 0.01). There was good correlation of the automated overall quality rating and the mean endoscopist withdrawal speed rating (Spearman r coefficient= 0.59, P = 0.03). There was no correlation of automated overall quality rating with mean endoscopists image quality rating (Spearman r coefficient= 0.41, P = 0.15). The results from a novel automated real-time colonoscopy quality feedback system strongly agreed with the endoscopists' quality assessments. Further study is required to validate this approach.

7 CFR 275.14 - Review processing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... addition, the sample of active and negative cases shall be selected in accordance with the sampling techniques described in the Quality Control Sampling Handbook, FNS Handbook 311. (c) Worksheets. The...

Clinical intuition in the nursing process and decision-making-A mixed-studies review.

PubMed

Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

2017-12-01

To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise. © 2017 John Wiley & Sons Ltd.

Essentials of total quality management: a meta-analysis.

PubMed

Mosadeghrad, Ali Mohammad

2014-01-01

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

The Australian government's review of positron emission tomography: evidence-based policy-making in action.

PubMed

Ware, Robert E; Francis, Hilton W; Read, Kenneth E

2004-06-21

The Commonwealth Government constituted the Medicare Services Advisory Committee (MSAC) to implement its commitment to entrench the principles of evidence-based medicine in Australian clinical practice. With its recent review of positron emission tomography (PETReview), the Commonwealth intervened in an established MSAC process, and sanctioned the stated objective to restrict expenditure on the technology. In our opinion: The evaluation of evidence by PETReview was fundamentally compromised by a failure to meet the terms of reference, poor science, poor process and unique decision-making benchmarks. By accepting the recommendations of PETReview, the Commonwealth is propagating information which is not of the highest quality. The use of inferior-quality information for decision-making by doctors, patients and policy-makers is likely to harm rather than enhance healthcare outcomes.

Distributed Information System Development: Review of Some Management Issues

NASA Astrophysics Data System (ADS)

Mishra, Deepti; Mishra, Alok

Due to the proliferation of the Internet and globalization, distributed information system development is becoming popular. In this paper we have reviewed some significant management issues like process management, project management, requirements management and knowledge management issues which have received much attention in distributed development perspective. In this literature review we found that areas like quality and risk management issues could get only scant attention in distributed information system development.

Improving outcomes using German Inpatient Quality Indicators in conjunction with peer review procedures.

PubMed

Mansky, Thomas; Völzke, Tatjana; Nimptsch, Ulrike

2015-01-01

Some hospital comparisons seem to generate confusion because different methods of outcome comparisons lead to different results in hospital rankings. This article questions the concept of overall comparisons of hospitals, which are multiproduct enterprises and may have specialties that provide good results in some areas despite having worse outcomes in others. Therefore, the authors argue for a disease specific view of outcome measurement. The concept of the German Inpatient Quality Indicators is explained. These indicators cover volume, mortality, and other information by a disease specific approach, which includes information for potential patients as well as specific feedback to the physicians responsible for the respective specialty. This article focuses on the feedback to the hospitals and explains how these indicators can be used for improvement in conjunction with a peer review process. The indicators provide information to the hospitals regarding their relative position because German reference values are available for all indicators. Thus, the indicators can serve as a trigger instrument for identifying possible quality problems. Based on these indications, peer review can be used to analyze the treatment processes and to eventually verify weaknesses and define actions for improvement. The first studies indicate that the use of this approach within hospital quality management can largely improve hospital outcomes in hospitals with subpar results compared to the German average. Copyright © 2015. Published by Elsevier GmbH.

The quality of the evidence base for clinical pathway effectiveness: room for improvement in the design of evaluation trials.

PubMed

Rotter, Thomas; Kinsman, Leigh; James, Erica; Machotta, Andreas; Steyerberg, Ewout W

2012-06-18

The purpose of this article is to report on the quality of the existing evidence base regarding the effectiveness of clinical pathway (CPW) research in the hospital setting. The analysis is based on a recently published Cochrane review of the effectiveness of CPWs. An integral component of the review process was a rigorous appraisal of the methodological quality of published CPW evaluations. This allowed the identification of strengths and limitations of the evidence base for CPW effectiveness. We followed the validated Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria for randomized and non-randomized clinical pathway evaluations. In addition, we tested the hypotheses that simple pre-post studies tend to overestimate CPW effects reported. Out of the 260 primary studies meeting CPW content criteria, only 27 studies met the EPOC study design criteria, with the majority of CPW studies (more than 70 %) excluded from the review on the basis that they were simple pre-post evaluations, mostly comparing two or more annual patient cohorts. Methodologically poor study designs are often used to evaluate CPWs and this compromises the quality of the existing evidence base. Cochrane EPOC methodological criteria, including the selection of rigorous study designs along with detailed descriptions of CPW development and implementation processes, are recommended for quantitative evaluations to improve the evidence base for the use of CPWs in hospitals.