Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

Generalized variables for controlling Government Transfer Services with respect to performance measures

NASA Technical Reports Server (NTRS)

Johnson, F. D.

1981-01-01

The term Government Transfer Services is used in reference to any of the organized streams of public resources that flow into private economic activity. This includes such activities as offshore leasing, Social Security, and NASA technology transfer services. This paper describes a performance measure, empirical results, a theory, and a control model for such services. These are illustrated by a specific example (NASA). An agenda for developing this service control method is also presented.

Measuring Quality in Special Libraries: Lessons from Service Marketing.

ERIC Educational Resources Information Center

White, Marilyn Domas; Abels, Eileen G.

1995-01-01

Surveys the service marketing literature for models and data-gathering instruments measuring service quality, particularly the instruments SERVQUAL and SERVPERF, and assesses their applicability to special libraries and information centers. Topics include service characteristics and definitions of service; performance-minus-expectations and…

Measuring the performance of G2G services in Iran

NASA Astrophysics Data System (ADS)

Zarei, Behrouz; Safdari, Maryam

To highlight the growth of e-government and the importance of its services it is essential to evaluate the performance of the service delivery to customers. Research indicates that traditional performance indexes are not suitable for this evaluation; moreover, it is noticeable that the e-government services are intangible and invisible. Among different e-government services, measurement of quality government to government (G2G) services has been less attractive for researchers while crucial for government policy-makers. This calls for a better understanding of the specific needs of users of these services in order to provide appropriate type and level of services that meets those needs. In this paper, the performance of the G2G services is measured in the Iranian context. For this purpose, SERVQUAL, which is a well-known method for assessing service quality, is employed. This study proposes and tests a five-factor of SERVQUAL instrument to explain user satisfaction and gap analysis, between expectations and perceptions of its customers, consisting thirty ministries and main governmental organizations. Based on a Chi-square test, factor analysis, gap analysis and correlations, it is concluded the gap between expectations and perceptions of G2G customers is significant and customer satisfaction of G2G services is at low level.

26 CFR 801.2 - Measuring organizational performance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 20 2011-04-01 2011-04-01 false Measuring organizational performance. 801.2... REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL REVENUE SERVICE § 801.2 Measuring organizational performance. The performance measures that comprise the...

Observing practice leadership in intellectual and developmental disability services.

PubMed

Beadle-Brown, J; Bigby, C; Bould, E

2015-12-01

Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures. This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia. The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support. The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

IoT Service Clustering for Dynamic Service Matchmaking.

PubMed

Zhao, Shuai; Yu, Le; Cheng, Bo; Chen, Junliang

2017-07-27

As the adoption of service-oriented paradigms in the IoT (Internet of Things) environment, real-world devices will open their capabilities through service interfaces, which enable other functional entities to interact with them. In an IoT application, it is indispensable to find suitable services for satisfying users' requirements or replacing the unavailable services. However, from the perspective of performance, it is inappropriate to find desired services from the service repository online directly. Instead, clustering services offline according to their similarity and matchmaking or discovering service online in limited clusters is necessary. This paper proposes a multidimensional model-based approach to measure the similarity between IoT services. Then, density-peaks-based clustering is employed to gather similar services together according to the result of similarity measurement. Based on the service clustering, the algorithms of dynamic service matchmaking, discovery, and replacement will be performed efficiently. Evaluating experiments are conducted to validate the performance of proposed approaches, and the results are promising.

IoT Service Clustering for Dynamic Service Matchmaking

PubMed Central

Yu, Le; Cheng, Bo; Chen, Junliang

2017-01-01

As the adoption of service-oriented paradigms in the IoT (Internet of Things) environment, real-world devices will open their capabilities through service interfaces, which enable other functional entities to interact with them. In an IoT application, it is indispensable to find suitable services for satisfying users’ requirements or replacing the unavailable services. However, from the perspective of performance, it is inappropriate to find desired services from the service repository online directly. Instead, clustering services offline according to their similarity and matchmaking or discovering service online in limited clusters is necessary. This paper proposes a multidimensional model-based approach to measure the similarity between IoT services. Then, density-peaks-based clustering is employed to gather similar services together according to the result of similarity measurement. Based on the service clustering, the algorithms of dynamic service matchmaking, discovery, and replacement will be performed efficiently. Evaluating experiments are conducted to validate the performance of proposed approaches, and the results are promising. PMID:28749431

Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services. Monograph

ERIC Educational Resources Information Center

Stecher, Brian M.; Camm, Frank; Damberg, Cheryl L.; Hamilton, Laura S.; Mullen, Kathleen J.; Nelson, Christopher; Sorensen, Paul; Wachs, Martin; Yoh, Allison; Zellman, Gail L.

2010-01-01

Performance-based accountability systems (PBASs), which link incentives to measured performance as a means of improving services to the public, have gained popularity. While PBASs can vary widely across sectors, they share three main components: goals, incentives, and measures. Research suggests that PBASs influence provider behaviors, but little…

75 FR 38725 - Service Performance Measurement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... of Customer Sastisfaction A. General Considerations B. Rule 3055.91--Consumer Access to Postal Services C. Rule 3055.92--Customer Experience Measurement Surveys D. Rule 3055.93--Mystery Shopper Program... Commission is adopting a final rule on service perfomance measurement and customer satisfaction. The final...

Implementation of ANP Method in Determining Supplier to Improve Service towards Supermarket Consumers

NASA Astrophysics Data System (ADS)

Mulyanto, A.; Amalia, T. H.; Novian, D.; Kaluku, M. R. A.

2017-03-01

Performance assessment on the supplier by the supermarket manager is relatively difficult to conduct and implies subjectivity, because there is no measureable and objective performance indicator. This study aims to assist in the decision making process and to look for alternative solutions in assessing the performance of each supplier, so that the service towards the customers will improve as well. ANP method is used to find the weight of each sub-criteria that will be used to measure the supplier performance. The weight result of each sub-criteria derived from the ANP method is used again in measuring the performance and to rank the performance of each supplier by using TOPSIS method. Performance measuring by using the ANP and TOPSIS that generates the highest value of the supplier is 0.71666 while the lowest value is 0.24825. The result of this study shows that the ANP and TOPSIS methods can be used to measure the supplier performance therefore it can assist the selection of supplier which can increase service towards the mart’s consumers.

77 FR 24740 - Senior Community Service Employment Program (SCSEP) Performance Measurement System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... Employment Program (SCSEP); Final Rule, Additional Indicator on Volunteer Work. See 77 FR 4654. [[Page 24741... DEPARTMENT OF LABOR Senior Community Service Employment Program (SCSEP) Performance Measurement System AGENCY: Department of Labor, Employment and Training Administration, Division of National Programs...

Data envelopment analysis in service quality evaluation: an empirical study

NASA Astrophysics Data System (ADS)

Najafi, Seyedvahid; Saati, Saber; Tavana, Madjid

2015-09-01

Service quality is often conceptualized as the comparison between service expectations and the actual performance perceptions. It enhances customer satisfaction, decreases customer defection, and promotes customer loyalty. Substantial literature has examined the concept of service quality, its dimensions, and measurement methods. We introduce the perceived service quality index (PSQI) as a single measure for evaluating the multiple-item service quality construct based on the SERVQUAL model. A slack-based measure (SBM) of efficiency with constant inputs is used to calculate the PSQI. In addition, a non-linear programming model based on the SBM is proposed to delineate an improvement guideline and improve service quality. An empirical study is conducted to assess the applicability of the method proposed in this study. A large number of studies have used DEA as a benchmarking tool to measure service quality. These models do not propose a coherent performance evaluation construct and consequently fail to deliver improvement guidelines for improving service quality. The DEA models proposed in this study are designed to evaluate and improve service quality within a comprehensive framework and without any dependency on external data.

Predicting competency in automated machine use in an acquired brain injury population using neuropsychological measures.

PubMed

Crowe, Simon F; Mahony, Kate; Jackson, Martin

2004-08-01

The purpose of the current study was to explore whether performance on standardised neuropsychological measures could predict functional ability with automated machines and services among people with an acquired brain injury (ABI). Participants were 45 individuals who met the criteria for mild, moderate or severe ABI and 15 control participants matched on demographic variables including age- and education. Each participant was required to complete a battery of neuropsychological tests, as well as performing three automated service delivery tasks: a transport automated ticketing machine, an automated teller machine (ATM) and an automated telephone service. The results showed consistently high relationship between the neuropsychological measures, both as single predictors and in combination, and level of competency with the automated machines. Automated machines are part of a relatively new phenomena in service delivery and offer an ecologically valid functional measure of performance that represents a true indication of functional disability.

Scenarios and performance measures for advanced ISDN satellite design and experiments

NASA Technical Reports Server (NTRS)

Pepin, Gerard R.

1991-01-01

Described here are the contemplated input and expected output for the Interim Service Integrated Services Digital Network (ISDN) Satellite (ISIS) and Full Service ISDN Satellite (FSIS) Models. The discrete event simulations of these models are presented with specific scenarios that stress ISDN satellite parameters. Performance measure criteria are presented for evaluating the advanced ISDN communication satellite designs of the NASA Satellite Communications Research (SCAR) Program.

76 FR 76541 - Medicare Program; Availability of Medicare Data for Performance Measurement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

... Centers for Medicare & Medicaid Services 42 CFR Part 401 Medicare Program; Availability of Medicare Data...; Availability of Medicare Data for Performance Measurement AGENCY: Centers for Medicare & Medicaid Services (CMS... regarding the release and use of standardized extracts of Medicare claims data for qualified entities to...

Performance-Based Service Quality Model: An Empirical Study on Japanese Universities

ERIC Educational Resources Information Center

Sultan, Parves; Wong, Ho

2010-01-01

Purpose: This paper aims to develop and empirically test the performance-based higher education service quality model. Design/methodology/approach: The study develops 67-item instrument for measuring performance-based service quality with a particular focus on the higher education sector. Scale reliability is confirmed using the Cronbach's alpha.…

API REST Web service and backend system Of Lecturer’s Assessment Information System on Politeknik Negeri Bali

NASA Astrophysics Data System (ADS)

Manuaba, I. B. P.; Rudiastini, E.

2018-01-01

Assessment of lecturers is a tool used to measure lecturer performance. Lecturer’s assessment variable can be measured from three aspects : teaching activities, research and community service. Broad aspect to measure the performance of lecturers requires a special framework, so that the system can be developed in a sustainable manner. Issues of this research is to create a API web service data tool, so the lecturer assessment system can be developed in various frameworks. The research was developed with web service and php programming language with the output of json extension data. The conclusion of this research is API web service data application can be developed using several platforms such as web, mobile application

Inadequate performance measures affecting practices, organizations and outcomes of Ontario's family health teams.

PubMed

Ashcroft, Rachelle

2014-01-01

Emphasis on quantity as the main performance measure may be posing challenges for Family Health Team (FHT) practices and organizational structures. This study asked: What healthcare practices and organizational structures are encouraged by the FHT model? An exploratory qualitative design guided by discourse analysis was used. This paper presents findings from in-depth semi-structured interviews conducted with seven policy informants and 29 FHT leaders. Participants report that performance measures value quantity and are not inclusive of the broad scope of attributes that comprise primary healthcare. Performance measures do not appear to be accurately capturing the demand for healthcare services, or the actual amount of services being provided by FHTs. RESULTS suggest that unintended consequences of performance measures may be posing challenges to access and health outcomes. It is recommended that performance measures be developed and used to measure, support and encourage FHTs to achieve the goals of PHC. Copyright © 2014 Longwoods Publishing.

The comprehensive care project: measuring physician performance in ambulatory practice.

PubMed

Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S

2010-12-01

To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Ambulatory-based general internists in 13 states participated in the assessment. We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Performance on the individual and composite measures varied substantially within (range 5-86 percent compliance on 46 measures) and between physicians (ICC range 0.12-0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; p<.01), chronic care (r = 0.14, p = .04), and preventive services composites (r = 0.17, p = .01). Our results suggest that reliable and valid comprehensive assessment of the quality of chronic and preventive care can be achieved by creating composite measures and by sampling feasible numbers of patients for each condition. © Health Research and Educational Trust.

26 CFR 801.3 - Measuring employee performance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL REVENUE SERVICE § 801.3 Measuring employee performance. (a) In general. All employees of the IRS will be... 26 Internal Revenue 20 2011-04-01 2011-04-01 false Measuring employee performance. 801.3 Section...

Quality of Care for PTSD and Depression in the Military Health System

DTIC Science & Technology

evaluate the receipt of recommended assessments and treatments. These measures draw on multiple data sources including administrative encounter data...services are effective in reducing symptoms. When comparing performance between 20122013 and 20132014, most measures demonstrated slight improvement ...in 20132014 for over 38,000 active-component service members with PTSD or depression. The assessment includes performance on 30 quality measures to

Service Quality: An Unobtrusive Investigation of Interlibrary Loan in Large Public Libraries in Canada.

ERIC Educational Resources Information Center

Hebert, Francoise

1994-01-01

Describes a study that investigated the quality of interlibrary loan services in Canadian public libraries from the library's and the user's perspectives and then compared results. Measures of interlibrary loan performance are reviewed; an alternative conceptualization of service quality is discussed; and SERVQUAL, a measure of service quality, is…

76 FR 1471 - FY 2010 Annual Compliance Report; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-10

... issued rules on periodic reporting of service performance measurement and customer satisfaction in FY...-FY10- 29. Id. at 12. Customer satisfaction. The FY 2010 ACR discusses the Postal Service's transition... filing; service performance results; levels of customer satisfaction achieved; progress toward goals...

The PESPERF Scale: An Instrument for Measuring Service Quality in the School of Physical Education and Sports Sciences (PESS)

ERIC Educational Resources Information Center

Yildiz, Suleyman M.; Kara, Ali

2009-01-01

Purpose: HEdPERF (Higher Education PERFormance) is one of the most recently developed scales in the literature to measure service quality in higher education. However, HEdPERF is designed to measure service quality at a macro level (university level) and may be considered as a more generic measurement instrument. In higher education, new scales…

47 CFR 73.1590 - Equipment performance measurements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Equipment performance measurements. 73.1590... RADIO BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.1590 Equipment performance... equipment performance measurements for each main transmitter as follows: (1) Upon initial installation of a...

Emergency medical services key performance measurement in Asian cities.

PubMed

Rahman, Nik Hisamuddin; Tanaka, Hideharu; Shin, Sang Do; Ng, Yih Yng; Piyasuwankul, Thammapad; Lin, Chih-Hao; Ong, Marcus Eng Hock

2015-01-01

One of the key principles in the recommended standards is that emergency medical service (EMS) providers should continuously monitor the quality and safety of their services. This requires service providers to implement performance monitoring using appropriate and relevant measures including key performance indicators. In Asia, EMS systems are at different developmental phases and maturity. This will create difficultly in benchmarking or assessing the quality of EMS performance across the region. An attempt was made to compare the EMS performance index based on the structure, process, and outcome analysis. The data was collected from the Pan-Asian Resuscitation Outcome Study (PAROS) data among few Asian cities, namely, Tokyo, Osaka, Singapore, Bangkok, Kuala Lumpur, Taipei, and Seoul. The parameters of inclusions were broadly divided into structure, process, and outcome measurements. The data was collected by the site investigators from each city and keyed into the electronic web-based data form which is secured strictly by username and passwords. Generally, there seems to be a more uniformity for EMS performance parameters among the more developed EMS systems. The major problem with the EMS agencies in the cities of developing countries like Bangkok and Kuala Lumpur is inadequate or unavailable data pertaining to EMS performance. There is non-uniformity in the EMS performance measurement across the Asian cities. This creates difficulty for EMS performance index comparison and benchmarking. Hopefully, in the future, collaborative efforts such as the PAROS networking group will further enhance the standardization in EMS performance reporting across the region.

Improving the provision of language services at an academic medical center: ensuring high-quality health communication for limited-English-proficient patients.

PubMed

Standiford, Connie J; Nolan, Elizabeth; Harris, Michelle; Bernstein, Steven J

2009-12-01

To evaluate and improve the provision of language services at an academic medicine center caring for a diverse population including many limited-English-proficient (LEP) patients. The authors performed a prospective observational study between November 2006 and December 2008 evaluating the provision of language services at the University of Michigan Health System. The primary performance measures were (1) screening patients for their preferred language for health care, (2) assessing the proportion of LEP patients receiving language services from a qualified language services provider, and (3) assessing whether there were any disparities in diabetes care for LEP patients compared with English-speaking patients. The proportion of patients screened for preferred language increased from 59% to 96% with targeted inventions, such as training staff to capture preferred language for health care and correcting prior inaccurate primary language data entry. The proportion of LEP outpatients with a qualified language services provider increased from 19% to 83% through the use of staff and contract interpreters, over-the-phone interpreting and bilingual providers. There were no systematic differences in diabetes quality performance measures between LEP and English-proficient patients. Academic medical centers should measure their provision of language services and compare quality and safety data (e.g., performance measures and adverse events) between LEP and English-speaking patients to identify disparities in care. Leadership support and ongoing training are needed to ensure language-specific services are embedded into clinical care to meet the needs of our diverse patient populations.

Reassurance as a key outcome valued by emergency ambulance service users: a qualitative interview study.

PubMed

Togher, Fiona J; O'Cathain, Alicia; Phung, Viet-Hai; Turner, Janette; Siriwardena, Aloysius Niroshan

2015-12-01

There is an increasing need to assess the performance of emergency ambulance services using measures other than the time taken for an ambulance to arrive on scene. In line with government policy, patients and carers can help to shape new measures of ambulance service performance. To investigate the aspects of emergency ambulance service care valued by users. Qualitative interview study. One of 11 ambulance services in England. Twenty-two users and eight of their spouses (n = 30). Users of the emergency ambulance service, experiencing different types of ambulance service response, valued similar aspects of their pre-hospital care. Users were often extremely anxious about their health, and the outcome they valued was reassurance provided by ambulance service staff that they were receiving appropriate advice, treatment and care. This sense of being reassured was enhanced by the professional behaviour of staff, which instilled confidence in their care; communication; a short wait for help; and continuity during transfers. A timely response was valued in terms of allaying anxiety quickly. The ability of the emergency ambulance service to allay the high levels of fear and anxiety felt by users is crucial to the delivery of a high quality service. Measures developed to assess and monitor the performance of emergency ambulance services should include the proportion of users reporting feeling reassured by the response they obtained. © 2014 John Wiley & Sons Ltd.

Using DEMATEL approach to develop relationships of performance indicators on sustainable service only supply chain performance measurement

NASA Astrophysics Data System (ADS)

Leksono, EB; Suparno; Vanany, I.

2018-04-01

Service only supply chain (SOSC) concept is service supply chain (SSC) implementation on pure services. The globalization and stakeholder pressure makes operation of SSC should give the attention to the environment effect, community, economic and intangibility assets. SOSC performance measurement (SOSCPM) may be developed for measuring of performance for sustainability aspects and intangibility assets to meet customer satisfaction. This article discusses sustainable SOSCPM based on balanced scorecard (BSC), include sustainability aspects, intangibility and relations between perspectives and indicators. From literature review, it is found 34 performance indicators that must be confirm to expert and SC actors by survey. From survey validation using weighted average and level of consensus, it is found 29 valid indicators for processed by DEMATEL. From DEMATEL, it is found 26 indicators can be used on sustainable SOSCPM. Furthermore, innovation and growth perspective most influence to other, and customer perspective most important. Intangibility indicators incorporated on innovation and growth perspective very related with human resources. Finally, relations between perspectives and indicator used to design of BSC strategy maps.

Home Economics. Exploration of Clothing Management, Production and Service Occupations. Performance Objectives. Criterion Measures.

ERIC Educational Resources Information Center

Duval County School Board, Jacksonville, FL.

Several intermediate performance objectives and corresponding criterion measures are presented for each of five terminal objectives for a 12- to 18-week course designed to provide students in grades 8 or 9 with opportunities to explore a broad range of clothing management, production, and service occupations. The course was designed to provide…

Evaluating Library Staff: A Performance Appraisal System.

ERIC Educational Resources Information Center

Belcastro, Patricia

This manual provides librarians and library managers with a performance appraisal system that measures staff fairly and objectively and links performance to the goals of the library. The following topics are addressed: (1) identifying expectations for quality service or standards of performance; (2) the importance of a library's code of service,…

The Comprehensive Care Project: Measuring Physician Performance in Ambulatory Practice

PubMed Central

Holmboe, Eric S; Weng, Weifeng; Arnold, Gerald K; Kaplan, Sherrie H; Normand, Sharon-Lise; Greenfield, Sheldon; Hood, Sarah; Lipner, Rebecca S

2010-01-01

Objective To investigate the feasibility, reliability, and validity of comprehensively assessing physician-level performance in ambulatory practice. Data Sources/Study Setting Ambulatory-based general internists in 13 states participated in the assessment. Study Design We assessed physician-level performance, adjusted for patient factors, on 46 individual measures, an overall composite measure, and composite measures for chronic, acute, and preventive care. Between- versus within-physician variation was quantified by intraclass correlation coefficients (ICC). External validity was assessed by correlating performance on a certification exam. Data Collection/Extraction Methods Medical records for 236 physicians were audited for seven chronic and four acute care conditions, and six age- and gender-appropriate preventive services. Principal Findings Performance on the individual and composite measures varied substantially within (range 5–86 percent compliance on 46 measures) and between physicians (ICC range 0.12–0.88). Reliabilities for the composite measures were robust: 0.88 for chronic care and 0.87 for preventive services. Higher certification exam scores were associated with better performance on the overall (r = 0.19; p <.01), chronic care (r = 0.14, p = .04), and preventive services composites (r = 0.17, p = .01). Conclusions Our results suggest that reliable and valid comprehensive assessment of the quality of chronic and preventive care can be achieved by creating composite measures and by sampling feasible numbers of patients for each condition. PMID:20819110

Configuring balanced scorecards for measuring health system performance: evidence from 5 years' evaluation in Afghanistan.

PubMed

Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H

2011-07-01

In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0-100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3-84.5, p<0.0001); provider satisfaction (65.4-79.2, p<0.01); capacity for service provision (47.4-76.4, p<0.0001); quality of services (40.5-67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0-52.6). The financial domain also showed improvement until 2007 (84.4-95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary.

Doing the right thing without being told: joint effects of initiative climate and general self-efficacy on employee proactive customer service performance.

PubMed

Raub, Steffen; Liao, Hui

2012-05-01

We developed and tested a cross-level model of the antecedents and outcomes of proactive customer service performance. Results from a field study of 900 frontline service employees and their supervisors in 74 establishments of a multinational hotel chain located in Europe, the Middle East, Africa, and Asia demonstrated measurement equivalence and suggested that, after controlling for service climate, initiative climate at the establishment level and general self-efficacy at the individual level predicted employee proactive customer service performance and interacted in a synergistic way. Results also showed that at the establishment level, controlling for service climate and collective general service performance, initiative climate was positively and indirectly associated with customer service satisfaction through the mediation of aggregated proactive customer service performance. We discuss important theoretical and practical implications of these findings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Measurements of the Received Signal Level and Service Coverage Area at the IEEE 802.11 Access Point in the Building

NASA Astrophysics Data System (ADS)

Gunantara, N.; Sudiarta, P. K.; Prasetya, AAN A. I.; Dharma, A.; Gde Antara, I. N.

2018-04-01

Access point (AP) is part of a Wireless Local Access Network (WLAN) with its communications using WiFi. AP is used to transmit and receive data to users/clients. The ability of AP to serve users/clients depends on many factors. Moreover, if AP is applied in conditions inside the building. In this study, AP is installed at two points inside the building and then measured in the form of the received signal level (RSL) and service coverage area. One AP measured its performance by 26 measurement points and the other AP measured its performance by 20 measurement points. When AP has measured its performance then another AP position is switched off. Based on the measurement result, the received signal level value is the highest value is about -47 dBm at a distance of 3.2 m, while the lowest is about -79 dBm at a 9.21 m because it is on barrier 2 walls. While based on service coverage area, the area which is far away from the AP then the quality of service becomes bad because the transmitted signal is weakening caused by the distance and the loss of the wall.

Aerobic performance and body composition changes during military service

PubMed Central

Mikkola, Ilona; Keinänen-Kiukaanniemi, Sirkka; Jokelainen, Jari; Peitso, Ari; Härkönen, Pirjo; Timonen, Markku; Ikäheimo, Tiina

2012-01-01

Objective To examine the association between aerobic performance and body composition changes by body mass index (BMI). Design 6–12 months’ follow-up during military service. Setting Conscripts entering military service in 2005 in Sodankylä Jaeger Brigade (Finland). Subjects 945 men (19 years, SD 1 years). Main outcome measures Height, weight, waist circumference, BMI, and aerobic performance (Cooper test) were recorded. Body composition was measured by bioelectrical impedance analysis (BIA). The measured parameters were fat mass (FM), fat free mass (FFM), and visceral fat area (VFA). All the measurements were performed at the beginning and end of service. Results On average, the military training period improved the running distance by 6.8% (169 m, p < 0.001) and the improvements were more pronounced in overweight (223.9 m/9.5%, p < 0.001) and obese (273.3 m/13.6 %, p < 0.001) conscripts. A strong inverse correlation between aerobic performance and body composition changes was observed, especially for weight (r = –0.305, p < 0.001) and VFA (r = –0.465, p < 0.001). A significant association between aerobic performance and changes in weight (p < 0.001), waist circumference (p < 0.001), FM (p < 0.001), and VFA (p < 0.001) by BMI was detected. The associated decrease in weight, waist circumference, FM, and VFA with improved aerobic performance was more substantial between overweight and obese compared with normal-weight subjects. Conclusions Favourable changes in body composition are associated with improved aerobic performance during a physical training period such as military service. These findings are pronounced among overweight and obese men and can be applied at the population level in reducing obesity and co-morbidities. PMID:22643154

Identifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa

PubMed Central

2014-01-01

Background A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development. Methods Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions. Results Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system. Conclusion Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented. PMID:24499037

Hand skill measurement: a gauge for treatment.

PubMed

Bell, E; Jurek, K; Wilson, T

1976-02-01

Objective measurements of performance are vital with the increasing necessity to justify the need for occupational therapy services, and to conduct studies that measure the effectiveness of treatment procedures. This paper reports on a measurement of hand skill that was standardized by comparing hand skill performance among the able-bodied, or normal, population. The performance on this test o patients with various types of disabilities and the implications for treatment are discussed. For the paraplegic, the hand skill test indicates the need for occupational therapy services; for the quadriplegic, the test measures the effectiveness of functional orthotic devices; and for the hemiplegic, the hand skill test determines the potential for success in one aspect of self-care, dressing.

The Impact of Performance Measurement on Library and Information Services: A Decade of Experience.

ERIC Educational Resources Information Center

Willemse, John

Performance measurement at the University of South Africa (Unisa) library is integrated in its planning and review procedures and is continuously adapted and improved. This paper traces the development of performance measurement at Unisa over more than a decade. Performance measurement provides an indication of how good or bad the library is doing…

Vessel traffic service watchstander performance in routine operations

DOT National Transportation Integrated Search

1979-10-01

Human factors specialists observed and measured the performance of watchstanders at four Vessel Traffic Service (VTS) centers: Houston-Galveston, Puget Sound, New Orleans, and San Francisco. Analysis of the data yielded results amenable to mathematic...

Problems in air traffic management. VII., Job training performance of air traffic control specialists - measurement, structure, and prediction.

DOT National Transportation Integrated Search

1965-07-01

A statistical study of training- and job-performance measures of several hundred Air Traffic Control Specialists (ATCS) representing Enroute, Terminal, and Flight Service Station specialties revealed that training-performance measures reflected: : 1....

26 CFR 801.2 - Measuring organizational performance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 20 2010-04-01 2010-04-01 false Measuring organizational performance. 801.2 Section 801.2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INTERNAL REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL...

Freight performance measures : a yardstick for Minnesota's transportation system : recommendations of the Minnesota Freight Advisory Committee

DOT National Transportation Integrated Search

1999-11-01

Performance measures tell public officials and citizens how well services are meeting customer needs. In this report, the Minnesota Freight Advisory Committee recommends performance measures for Minnesota's freight transportation system. MFAC is a gr...

Analysis on preemptive priority retrial queue with two types of customers, balking, optional re-service, single vacation and service interruption

NASA Astrophysics Data System (ADS)

Yuvarani, S.; Saravanarajan, M. C.

2017-11-01

This paper concerned with performance analysis of single server preemptive priority retrial queue with a single vacation where two types of customers are considered and they are called priority customers and ordinary customers. The ordinary customers arrive in batch into the system. The priority customers do not form any queue. After the completion of regular service, the customers may demand re-service for the previous service without joining the orbit or may leave the system. As soon as the system is empty, the server goes for vacation and the regular busy server can be subjected to breakdown. By using the supplementary variable technique, we obtain the steady-state probability generating functions for the system/orbit size. Some important system performance measures and the stochastic decomposition are discussed. Finally, numerical examples are presented to visualize the effect of parameters on system performance measures.

Analysis of Student Satisfaction in The Process of Teaching and Learning Using Importance Performance Analysis

NASA Astrophysics Data System (ADS)

Sembiring, P.; Sembiring, S.; Tarigan, G.; Sembiring, OD

2017-12-01

This study aims to determine the level of student satisfaction in the learning process at the University of Sumatra Utara, Indonesia. The sample size of the study consisted 1204 students. Students’ response measured through questionnaires an adapted on a 5-point likert scale and interviews directly to the respondent. SERVQUAL method used to measure the quality of service with five dimensions of service characteristics, namely, physical evidence, reliability, responsiveness, assurance and concern. The result of Importance Performance Analysis reveals that six services attributes must be corrected by policy maker of University Sumatera Utara. The quality of service is still considered low by students.

NPS national transit inventory and performance report, 2015

DOT National Transportation Integrated Search

2017-02-01

This document summarizes key highlights and performance measures relating to the National Park Service (NPS) 2015 National Transit Inventory, by presenting data for NPS transit systems and vehicles nationwide. These highlights and performance measure...

NPS National Transit Inventory and Performance Report, 2016

DOT National Transportation Integrated Search

2017-12-01

This document summarizes key highlights and performance measures relating to the National Park Service (NPS) 2016 National Transit Inventory, by presenting data for NPS transit systems and vehicles nationwide. These highlights and performance measure...

Incentive regulation and performance measurement of the Portuguese solid waste management services.

PubMed

Marques, Rui Cunha; Simões, Pedro

2009-03-01

Measuring the performance of solid waste management services usually uncovers very high potential for gains in efficiency and productivity. This circumstance occurs, naturally, due to the fact that these services are outside the market and because they are subjected to various market failures in their organizational framework. The aim of this study was to examine the Portuguese regulatory model and to measure the performance of the Portuguese solid waste management services in order to identify the major reforms carried out and their outcomes. As a first objective, the sunshine regulatory approach adopted in Portugal, in which performance comparison and its public discussion are the main tools, was investigated. The second objective was to compute the efficiency of the Portuguese solid waste management services by means of the non-parametric technique of data envelopment analysis (DEA), evaluating the Portuguese regulatory model and the existing market structure, as well as the influence of the operational environment on efficiency. The benchmarking frontier technique of DEA is particularly useful in the efficiency measurement of public utilities, in which knowledge of the production function is relatively scarce. Several DEA models were used and they all depicted significant inefficiency. The study also proved that efficiency did not depend on ownership (public or private) and that there was no difference in efficiency between the players, irrespective of whether they were regulated or not.

Guiding Principles and Checklist for Population-Based Quality Metrics

PubMed Central

Brunelli, Steven M.; Maddux, Franklin W.; Parker, Thomas F.; Johnson, Douglas; Nissenson, Allen R.; Collins, Allan; Lacson, Eduardo

2014-01-01

The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect what represents the best care to improve patient outcomes. PMID:24558050

Measuring Integration of Cancer Services to Support Performance Improvement: The CSI Survey

PubMed Central

Dobrow, Mark J.; Paszat, Lawrence; Golden, Brian; Brown, Adalsteinn D.; Holowaty, Eric; Orchard, Margo C.; Monga, Neerav; Sullivan, Terrence

2009-01-01

Objective: To develop a measure of cancer services integration (CSI) that can inform clinical and administrative decision-makers in their efforts to monitor and improve cancer system performance. Methods: We employed a systematic approach to measurement development, including review of existing cancer/health services integration measures, key-informant interviews and focus groups with cancer system leaders. The research team constructed a Web-based survey that was field- and pilot-tested, refined and then formally conducted on a sample of cancer care providers and administrators in Ontario, Canada. We then conducted exploratory factor analysis to identify key dimensions of CSI. Results: A total of 1,769 physicians, other clinicians and administrators participated in the survey, responding to a 67-item questionnaire. The exploratory factor analysis identified 12 factors that were linked to three broader dimensions: clinical, functional and vertical system integration. Conclusions: The CSI Survey provides important insights on a range of typically unmeasured aspects of the coordination and integration of cancer services, representing a new tool to inform performance improvement efforts. PMID:20676250

Measuring the performance of maintenance service outsourcing.

PubMed

Cruz, Antonio Miguel; Rincon, Adriana Maria Rios; Haugan, Gregory L

2013-01-01

The aims of this paper are (1) to identify the characteristics of maintenance service providers that directly impact maintenance service quality, using 18 independent covariables; (2) to quantify the change in risk these covariables present to service quality, measured in terms of equipment turnaround time (TAT). A survey was applied to every maintenance service provider (n = 19) for characterization purposes. The equipment inventory was characterized, and the TAT variable recorded and monitored for every work order of each service provider (N = 1,025). Finally, the research team conducted a statistical analysis to accomplish the research objectives. The results of this study offer strong empirical evidence that the most influential variables affecting the quality of maintenance service performance are the following: type of maintenance, availability of spare parts in the country, user training, technological complexity of the equipment, distance between the company and the hospital, and the number of maintenance visits performed by the company. The strength of the results obtained by the Cox model built are supported by the measure of the Rp,e(2) = 0.57 with a value of Rp,e= 0.75. Thus, the model explained 57% of the variation in equipment TAT, with moderate high positive correlation between the dependent variable (TAT) and independent variables.

A Look at How Agencies Can Utilize Outcome and Performance Data To Enhance Service Delivery.

ERIC Educational Resources Information Center

Resources for Welfare Decisions, 2002

2002-01-01

This issue focuses on a variety of performance measurement and outcome data resources as they relate to evaluating service delivery performance in areas that include employment (welfare-to-work and performance bonuses for work participation) and child welfare, as well as some general Temporary Assistance to Needy Families program areas. It also…

PZEh-MO-8/Body Mass Measurement in Service Module

NASA Image and Video Library

2009-05-06

ISS019-E-014222 (6 May 2009) --- Japan Aerospace Exploration Agency (JAXA) astronaut Koichi Wakata, Expedition 19/20 flight engineer, uses the IM mass measurement device to perform the PZEh-MO-8/Body Mass Measurement Russian biomedical routine assessments in the Zvezda Service Module of the International Space Station.

PZEh-MO-8/Body Mass Measurement in Service Module

NASA Image and Video Library

2009-05-06

ISS019-E-014216 (6 May 2009) --- Japan Aerospace Exploration Agency (JAXA) astronaut Koichi Wakata, Expedition 19/20 flight engineer, uses the IM mass measurement device to perform the PZEh-MO-8/Body Mass Measurement Russian biomedical routine assessments in the Zvezda Service Module of the International Space Station.

Early stages of development of a peer specialist fidelity measure

PubMed Central

Chinman, Matthew; McCarthy, Sharon; Mitchell-Miland, Chantele; Daniels, Karin; Youk, Ada; Edelen, Maria

2017-01-01

OBJECTIVE Research on peer specialists (individuals with serious mental illness supporting others with serious mental illness in clinical and other settings), has not yet included the measurement of fidelity. Without measuring fidelity, it’s unclear if the absence of impact in some studies is attributable to ineffective peer specialist services or because the services were not true to the intended role. This paper describes the initial development of a peer specialist fidelity measure for two content areas: services provided by peer specialists and factors that either support or hamper the performance of those services. METHODS A literature search identified 40 domains; an expert panel narrowed the number of domains and helped generate and then review survey items to operationalize those domains. Twelve peer specialists, individuals with whom they work, and their supervisors participated in a pilot test and cognitive interviews regarding item content. RESULTS Peer specialists tended to rate themselves as having engaged in various peer service activities more than supervisors and individuals with whom they work. A subset of items tapping peer specialist services “core” to the role regardless of setting had higher ratings. Participants stated the measure was clear, appropriate, and could be useful in performance improvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although preliminary, findings were consistent with organizational research on performance ratings of supervisors and employees made in the workplace. Several changes in survey content and administration were identified. With continued work, the measure could crystalize the role of peer specialists and aid in research and clinical administration. PMID:27618462

Service collaboration and hospital cost performance: direct and moderating effects.

PubMed

Proenca, E Jose; Rosko, Michael D; Dismuke, Clara E

2005-12-01

Growing reliance on service provision through systems and networks creates the need to better understand the nature of the relationship between service collaboration and hospital performance and the conditions that affect this relationship. We examine 1) the effects of service provision through health systems and health networks on hospital cost performance and 2) the moderating effects of market conditions and service differentiation on the collaboration-cost relationship. We used moderated regression analysis to test the direct and moderating effects. Data on 1368 private hospitals came from the 1998 AHA Annual Survey, Medicare Cost Reports, and Solucient. Service collaboration was measured as the proportion of hospital services provided at the system level and at the network level. Market conditions were measured by the levels of managed care penetration and competition in the hospital's market. The proportion of hospital services provided at the system level had a negative relationship with hospital cost. The relationship was curvilinear for network use. Degree of managed care penetration moderated the relationship between network-based collaboration and hospital cost. The benefits of service collaboration through systems and networks, as measured by reduced cost, depend on degree of collaboration rather than mere membership. In loosely structured collaborations such as networks, costs reduce initially but increase later as the extent of collaboration increases. The effect of network-based collaboration is also tempered by managed care penetration. These effects are not seen in more tightly integrated forms such as systems.

Productive efficiency and its determinants in the Community Dental Service in the north-west of England.

PubMed

Hill, H; Birch, S; Tickle, M; McDonald, R; Brocklehurst, P

2017-06-01

To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England. 40 Community Dental Services sites operating across the North-West of England. A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency. Relative efficiency rankings in Community Dental Services production of dental healthcare. Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services. Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels. Copyright© 2017 Dennis Barber Ltd.

Performance Analysis of MYSEA

DTIC Science & Technology

2012-09-01

Services FSD Federated Services Daemon I&A Identification and Authentication IKE Internet Key Exchange KPI Key Performance Indicator LAN Local Area...spection takes place in different processes in the server architecture. Key Performance Indica- tor ( KPI )s associated with the system need to be...application and risk analysis of security controls. Thus, measurement of the KPIs is needed before an informed tradeoff between the performance penalties

Good veterinary governance: definition, measurement and challenges.

PubMed

Msellati, L; Commault, J; Dehove, A

2012-08-01

Good veterinary governance assumes the provision of veterinary services that are sustainably financed, universally available, and provided efficiently without waste or duplication, in a manner that is transparent and free of fraud or corruption. Good veterinary governance is a necessary condition for sustainable economic development insomuch as it promotes the effective delivery of services and improves the overall performance of animal health systems. This article defines governance in Veterinary Services and proposes a framework for its measurement. It also discusses the role of Veterinary Services and analyses the governance dimensions of the performance-assessment tools developed by the World Organisation for Animal Health (OIE). These tools (OIE PVS Tool and PVS Gap Analysis) track the performance of Veterinary Services across countries (a harmonised tool) and over time (the PVS Pathway). The article shows the usefulness of the OIE PVS Tool for measuring governance, but also points to two shortcomings, namely (i) the lack of clear outcome indicators, which is an impediment to a comprehensive assessment of the performance of Veterinary Services, and (ii) the lack of specific measures for assessing the extent of corruption within Veterinary Services and the extent to which demand for better governance is being strengthened within the animal health system. A discussion follows on the drivers of corruption and instruments for perception-based assessments of country governance and corruption. Similarly, the article introduces the concept of social accountability, which is an approach to enhancing government transparency and accountability, and shows how supply-side and demand-side mechanisms complement each other in improving the governance of service delivery. It further elaborates on two instruments--citizen report card surveys and grievance redress mechanisms--because of their wider relevance and their possible applications in many settings, including Veterinary Services. Also, central to improving transparency and accountability is access to information and a discussion on the appropriate level of decentralisation of Veterinary Services. Bringing Veterinary Services into compliance with OIE international standards would contribute to improving governance and providing economic benefits through increased animal productivity, the expansion of trade and improved food security. It would also help to increase public health benefits, through greater food safety and better prevention and control of zoonoses.

Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

PubMed Central

Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

2011-01-01

Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

Primary Care Performance Measurement and Reporting at a Regional Level: Could a Matrix Approach Provide Actionable Information for Policy Makers and Clinicians?

PubMed

Langton, Julia M; Wong, Sabrina T; Johnston, Sharon; Abelson, Julia; Ammi, Mehdi; Burge, Fred; Campbell, John; Haggerty, Jeannie; Hogg, William; Wodchis, Walter P; McGrail, Kimberlyn

2016-11-01

Primary care services form the foundation of modern healthcare systems, yet the breadth and complexity of services and diversity of patient populations may present challenges for creating comprehensive primary care information systems. Our objective is to develop regional-level information on the performance of primary care in Canada. A scoping review was conducted to identify existing initiatives in primary care performance measurement and reporting across 11 countries. The results of this review were used by our international team of primary care researchers and clinicians to propose an approach for regional-level primary care reporting. We found a gap between conceptual primary care performance measurement frameworks in the peer-reviewed literature and real-world primary care performance measurement and reporting activities. We did not find a conceptual framework or analytic approach that could readily form the foundation of a regional-level primary care information system. Therefore, we propose an approach to reporting comprehensive and actionable performance information according to widely accepted core domains of primary care as well as different patient population groups. An approach that bridges the gap between conceptual frameworks and real-world performance measurement and reporting initiatives could address some of the potential pitfalls of existing ways of presenting performance information (i.e., by single diseases or by age). This approach could produce meaningful and actionable information on the quality of primary care services. Copyright © 2016 Longwoods Publishing.

Primary Care Performance Measurement and Reporting at a Regional Level: Could a Matrix Approach Provide Actionable Information for Policy Makers and Clinicians?

PubMed Central

Langton, Julia M.; Wong, Sabrina T.; Johnston, Sharon; Abelson, Julia; Ammi, Mehdi; Burge, Fred; Campbell, John; Haggerty, Jeannie; Hogg, William; Wodchis, Walter P.

2016-01-01

Objective: Primary care services form the foundation of modern healthcare systems, yet the breadth and complexity of services and diversity of patient populations may present challenges for creating comprehensive primary care information systems. Our objective is to develop regional-level information on the performance of primary care in Canada. Methods: A scoping review was conducted to identify existing initiatives in primary care performance measurement and reporting across 11 countries. The results of this review were used by our international team of primary care researchers and clinicians to propose an approach for regional-level primary care reporting. Results: We found a gap between conceptual primary care performance measurement frameworks in the peer-reviewed literature and real-world primary care performance measurement and reporting activities. We did not find a conceptual framework or analytic approach that could readily form the foundation of a regional-level primary care information system. Therefore, we propose an approach to reporting comprehensive and actionable performance information according to widely accepted core domains of primary care as well as different patient population groups. Conclusions: An approach that bridges the gap between conceptual frameworks and real-world performance measurement and reporting initiatives could address some of the potential pitfalls of existing ways of presenting performance information (i.e., by single diseases or by age). This approach could produce meaningful and actionable information on the quality of primary care services. PMID:28032823

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

PubMed

Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

2016-02-01

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

Evaluating Service Quality from Patients' Perceptions: Application of Importance-performance Analysis Method.

PubMed

Mohebifar, Rafat; Hasani, Hana; Barikani, Ameneh; Rafiei, Sima

2016-08-01

Providing high service quality is one of the main functions of health systems. Measuring service quality is the basic prerequisite for improving quality. The aim of this study was to evaluate the quality of service in teaching hospitals using importance-performance analysis matrix. A descriptive-analytic study was conducted through a cross-sectional method in six academic hospitals of Qazvin, Iran, in 2012. A total of 360 patients contributed to the study. The sampling technique was stratified random sampling. Required data were collected based on a standard questionnaire (SERVQUAL). Data analysis was done through SPSS version 18 statistical software and importance-performance analysis matrix. The results showed a significant gap between importance and performance in all five dimensions of service quality (p < 0.05). In reviewing the gap, "reliability" (2.36) and "assurance" (2.24) dimensions had the highest quality gap and "responsiveness" had the lowest gap (1.97). Also, according to findings, reliability and assurance were in Quadrant (I), empathy was in Quadrant (II), and tangibles and responsiveness were in Quadrant (IV) of the importance-performance matrix. The negative gap in all dimensions of quality shows that quality improvement is necessary in all dimensions. Using quality and diagnosis measurement instruments such as importance-performance analysis will help hospital managers with planning of service quality improvement and achieving long-term goals.

Institutional and Economic Determinants of Public Health System Performance

PubMed Central

Mays, Glen P.; McHugh, Megan C.; Shim, Kyumin; Perry, Natalie; Lenaway, Dennis; Halverson, Paul K.; Moonesinghe, Ramal

2006-01-01

Objectives. Although a growing body of evidence demonstrates that availability and quality of essential public health services vary widely across communities, relatively little is known about the factors that give rise to these variations. We examined the association of institutional, financial, and community characteristics of local public health delivery systems and the performance of essential services. Methods. Performance measures were collected from local public health systems in 7 states and combined with secondary data sources. Multivariate, linear, and nonlinear regression models were used to estimate associations between system characteristics and the performance of essential services. Results. Performance varied significantly with the size, financial resources, and organizational structure of local public health systems, with some public health services appearing more sensitive to these characteristics than others. Staffing levels and community characteristics also appeared to be related to the performance of selected services. Conclusions. Reconfiguring the organization and financing of public health systems in some communities—such as through consolidation and enhanced intergovernmental coordination—may hold promise for improving the performance of essential services. PMID:16449584

45 CFR 2522.620 - How do I report my performance measures to the Corporation?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false How do I report my performance measures to the Corporation? 2522.620 Section 2522.620 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE AMERICORPS PARTICIPANTS, PROGRAMS, AND APPLICANTS Evaluation Requirements Performance Measures:...

76 FR 55619 - Performance Measurement for Special Postal Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

..., Corporate & Postal Business Law, United States Postal Service to Shoshana M. Grove, Secretary, Postal... & Postal Business Law, United States Postal Service. III. Background of Postal Service Proposals A...), Public Law 109-435, 120 Stat. 3198 (2006). The proposed rules described herein would establish reporting...

Software-defined Radio Based Measurement Platform for Wireless Networks

PubMed Central

Chao, I-Chun; Lee, Kang B.; Candell, Richard; Proctor, Frederick; Shen, Chien-Chung; Lin, Shinn-Yan

2015-01-01

End-to-end latency is critical to many distributed applications and services that are based on computer networks. There has been a dramatic push to adopt wireless networking technologies and protocols (such as WiFi, ZigBee, WirelessHART, Bluetooth, ISA100.11a, etc.) into time-critical applications. Examples of such applications include industrial automation, telecommunications, power utility, and financial services. While performance measurement of wired networks has been extensively studied, measuring and quantifying the performance of wireless networks face new challenges and demand different approaches and techniques. In this paper, we describe the design of a measurement platform based on the technologies of software-defined radio (SDR) and IEEE 1588 Precision Time Protocol (PTP) for evaluating the performance of wireless networks. PMID:27891210

Software-defined Radio Based Measurement Platform for Wireless Networks.

PubMed

Chao, I-Chun; Lee, Kang B; Candell, Richard; Proctor, Frederick; Shen, Chien-Chung; Lin, Shinn-Yan

2015-10-01

End-to-end latency is critical to many distributed applications and services that are based on computer networks. There has been a dramatic push to adopt wireless networking technologies and protocols (such as WiFi, ZigBee, WirelessHART, Bluetooth, ISA100.11a, etc. ) into time-critical applications. Examples of such applications include industrial automation, telecommunications, power utility, and financial services. While performance measurement of wired networks has been extensively studied, measuring and quantifying the performance of wireless networks face new challenges and demand different approaches and techniques. In this paper, we describe the design of a measurement platform based on the technologies of software-defined radio (SDR) and IEEE 1588 Precision Time Protocol (PTP) for evaluating the performance of wireless networks.

QoS measurement of workflow-based web service compositions using Colored Petri net.

PubMed

Nematzadeh, Hossein; Motameni, Homayun; Mohamad, Radziah; Nematzadeh, Zahra

2014-01-01

Workflow-based web service compositions (WB-WSCs) is one of the main composition categories in service oriented architecture (SOA). Eflow, polymorphic process model (PPM), and business process execution language (BPEL) are the main techniques of the category of WB-WSCs. Due to maturity of web services, measuring the quality of composite web services being developed by different techniques becomes one of the most important challenges in today's web environments. Business should try to provide good quality regarding the customers' requirements to a composed web service. Thus, quality of service (QoS) which refers to nonfunctional parameters is important to be measured since the quality degree of a certain web service composition could be achieved. This paper tried to find a deterministic analytical method for dependability and performance measurement using Colored Petri net (CPN) with explicit routing constructs and application of theory of probability. A computer tool called WSET was also developed for modeling and supporting QoS measurement through simulation.

42 CFR 486.342 - Condition: Requesting consent.

Code of Federal Regulations, 2010 CFR

2010-10-01

....342 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE OF SPECIALIZED SERVICES FURNISHED BY... Organizations Organ Procurement Organization Process Performance Measures § 486.342 Condition: Requesting...

75 FR 33303 - Comment Sought on Measurement of Mobile Broadband Network Performance and Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

...; DA 10-988] Comment Sought on Measurement of Mobile Broadband Network Performance and Coverage AGENCY... broadband services. The Bureau seeks comment on whether and how to pursue a measurement program for mobile... and coverage, and continue to work with measurement companies, application designers, device...

Building capacity to implement cognitive pharmaceutical services: Quantifying the needs of community pharmacies.

PubMed

Feletto, Eleonora; Wilson, Laura Kate; Roberts, Alison Sarah; Benrimoj, Shalom Isaac

2010-09-01

Community pharmacy is an industry undergoing a transformation, evolving from a traditional product supply orientation to a business capable of incorporating services. The theoretical framework of organizational flexibility is used to understand how pharmacies' capacity can be built to provide services and identify key areas needing improvement. To determine the needs of pharmacies that were important and the elements requiring improvement when implementing and delivering services. A mail survey of 2006 Australian community pharmacies was used to identify needs for service implementation. A 25-item scale was used to measure the level of importance (importance measure) of the items and the level of improvement (improvement measure) when implementing services. An exploratory factor analysis was conducted to assess the construct validity and reliability. Responses were received from a total of 395 community pharmacies, with 355 usable responses (17.7%). Factor analysis yielded 3 factors on the importance measure, explaining 42.6% of the variance: (1) planning and performance (item loading range 0.749-0.455; Cronbach's alpha 0.806), (2) people and processes (0.829-0.392; 0.713), and (3) service awareness and infrastructure (0.723-0.310; 0.705). For the improvement measure, 46.9% of the variance was explained by 3 factors: (1) planning, performance, and service awareness (0.827-0.447; 0.858), (2) infrastructure (0.900-0.637; 0.822), and (3) people and processes (0.903-0.311; 0.707). The analyses showed that there are gaps in the capacity of community pharmacy that could be addressed through business and management programs. The theoretical framework of organizational flexibility was useful in highlighting the key areas for stimulating change. To effectively implement services and sustain service delivery, more sophisticated planning and performance monitoring systems are required, supported by changes to infrastructure and staff mix. The critical area for policy makers is the speed at which programs can be restructured to include these issues to encourage the widespread implementation of services. Copyright 2010 Elsevier Inc. All rights reserved.

How to measure the QoS of a web-based EHRs system: development of an instrument.

PubMed

de la Torre-Díez, Isabel; López-Coronado, Miguel; Rodrigues, Joel J P C

2012-12-01

The quality of service (QoS) can be treated as a set of concepts whose satisfaction/dissatisfaction generates a global positive/negative vision about the service provided by any application. The different nature of the services and its features require an analysis of the factors that have the greatest influence on the users' opinion and, therefore, measuring the quality of service in each application requires a specific instrument. This paper will introduce an instrument to measure the QoS offered to users by a general Web application for Electronic Health Records (EHRs). The collection of opinions from a pilot sample and the performance of an explanatory factor analysis will bring together the factors that best sum up the quality of an EHRs application. Subsequently, a confirmatory factor analysis will be performed to make the study reliable and, as its name suggests, to confirm that indeed the structure of the instrument developed measures the QoS in accordance with the requirements of the users.

How does a servant leader fuel the service fire? A multilevel model of servant leadership, individual self identity, group competition climate, and customer service performance.

PubMed

Chen, Zhijun; Zhu, Jing; Zhou, Mingjian

2015-03-01

Building on a social identity framework, our cross-level process model explains how a manager's servant leadership affects frontline employees' service performance, measured as service quality, customer-focused citizenship behavior, and customer-oriented prosocial behavior. Among a sample of 238 hairstylists in 30 salons and 470 of their customers, we found that hair stylists' self-identity embedded in the group, namely, self-efficacy and group identification, partially mediated the positive effect of salon managers' servant leadership on stylists' service performance as rated by the customers, after taking into account the positive influence of transformational leadership. Moreover, group competition climate strengthened the positive relationship between self-efficacy and service performance. PsycINFO Database Record (c) 2015 APA, all rights reserved.

[Financing, organization, costs and services performance of the Argentinean health sub-systems.

PubMed

Yavich, Natalia; Báscolo, Ernesto Pablo; Haggerty, Jeannie

2016-01-01

To analyze the relationship between health system financing and services organization models with costs and health services performance in each of Rosario's health sub-systems. The financing and organization models were characterized using secondary data. Costs were calculated using the WHO/SHA methodology. Healthcare quality was measured by a household survey (n=822). Public subsystem:Vertically integrated funding and primary healthcare as a leading strategy to provide services produced low costs and individual-oriented healthcare but with weak accessibility conditions and comprehensiveness. Private subsystem: Contractual integration and weak regulatory and coordination mechanisms produced effects opposed to those of the public sub-system. Social security: Contractual integration and strong regulatory and coordination mechanisms contributed to intermediate costs and overall high performance. Each subsystem financing and services organization model had a strong and heterogeneous influence on costs and health services performance.

Factors Impacting Student Service Utilization at Ontario Colleges: Key Performance Indicators as a Measure of Success: A Niagara College View

ERIC Educational Resources Information Center

Veres, David

2015-01-01

Student success in Ontario College is significantly influenced by the utilization of student services. At Niagara College there has been a significant investment in student services as a strategy to support student success. Utilizing existing KPI data, this quantitative research project is aimed at measuring factors that influence both the use of…

Guiding principles and checklist for population-based quality metrics.

PubMed

Krishnan, Mahesh; Brunelli, Steven M; Maddux, Franklin W; Parker, Thomas F; Johnson, Douglas; Nissenson, Allen R; Collins, Allan; Lacson, Eduardo

2014-06-06

The Centers for Medicare and Medicaid Services oversees the ESRD Quality Incentive Program to ensure that the highest quality of health care is provided by outpatient dialysis facilities that treat patients with ESRD. To that end, Centers for Medicare and Medicaid Services uses clinical performance measures to evaluate quality of care under a pay-for-performance or value-based purchasing model. Now more than ever, the ESRD therapeutic area serves as the vanguard of health care delivery. By translating medical evidence into clinical performance measures, the ESRD Prospective Payment System became the first disease-specific sector using the pay-for-performance model. A major challenge for the creation and implementation of clinical performance measures is the adjustments that are necessary to transition from taking care of individual patients to managing the care of patient populations. The National Quality Forum and others have developed effective and appropriate population-based clinical performance measures quality metrics that can be aggregated at the physician, hospital, dialysis facility, nursing home, or surgery center level. Clinical performance measures considered for endorsement by the National Quality Forum are evaluated using five key criteria: evidence, performance gap, and priority (impact); reliability; validity; feasibility; and usability and use. We have developed a checklist of special considerations for clinical performance measure development according to these National Quality Forum criteria. Although the checklist is focused on ESRD, it could also have broad application to chronic disease states, where health care delivery organizations seek to enhance quality, safety, and efficiency of their services. Clinical performance measures are likely to become the norm for tracking performance for health care insurers. Thus, it is critical that the methodologies used to develop such metrics serve the payer and the provider and most importantly, reflect what represents the best care to improve patient outcomes. Copyright © 2014 by the American Society of Nephrology.

Investigation of the mediating effects of IT governance-value delivery on service quality and ERP performance

NASA Astrophysics Data System (ADS)

Tsai, Wen-Hsien; Chou, Yu-Wei; Leu, Jun-Der; Chao Chen, Der; Tsaur, Tsen-Shu

2015-02-01

This study aimed to explore the mediating effects of IT governance (ITG)-value delivery in the relationships among the quality of vendor service, the quality of consultant services, ITG-value delivery and enterprise resource planning (ERP) performance. The sampling of this research was acquired from a questionnaire survey concerning ERP implementations in Taiwan. In this survey, 4366 questionnaires were sent to manufacturing and service companies listed in the TOP 5000: The Largest Corporations in Taiwan 2009. The results showed that an ERP system will exhibit a decreased error rate and improved performance if ERP system vendors and consultants provide good service quality. The results also demonstrated that significant relationships exist among the quality of vendor service, the quality of consultant services and value delivery. The contribution of this article is twofold. First, it found that value delivery provides an effective measure of ERP performance under an ITG framework. Second, it provides evidence of the partial mediating effects of value delivery between service quality and ERP performance. In other words, if enterprises want to improve ERP performance, they need to consider factors such as value delivery and the quality of a vendor/consultant's service.

Defining and Measuring the Occupational Performance of Children

ERIC Educational Resources Information Center

Mulligan, Shelley

2017-01-01

Occupational performance assessments of children are essential for guiding occupational therapy intervention and for measuring the effectiveness of occupational therapy services for children. A review of relevant research and of occupational performance assessments designed for children was conducted to determine and describe how the occupational…

Assessment of community satisfaction index of population and civil registration office in Malang municipal

NASA Astrophysics Data System (ADS)

Hakim, A. N.

2017-06-01

The demands and needs of the community will be the quality of public services in Malang increased, so that the Government of Malang as organizers and executors of public services must meet these demands. The Municipal Government in its efforts to improve public service performance, forming the regional One Stop Operator (PPTSP) with the goal will be to simplify and improve efficiency in administrative proceedings. But the existence of the one stop service is still not optimal because of the persistence of public complaints about the performance of the one stop service. This study will discuss the performance of services in service counter of Population and Civil Registration through community satisfaction index to measure the service level and the perception of satisfaction and interest to determine which variables are less optimal and need to be improved using IPA method. The results showed that the level of service at the service counter of Population and Civil Registration quite good. Meanwhile, according the results of IPA analysis, there are two important variables for the community on the performance / quality was lacking, namely the service procedure and time.

Department of Revenue > Administrative Services

Science.gov Websites

implementation of process improvement and performance measurement systems that enhance the quality, productivity , certification, RSA's (Reimbursable Service Agreements), budget preparation, travel accounting, and professional

Supportive Measures: An Analysis of the Trio Program--Student Support Services at East Tennessee State University from 2001-2004

ERIC Educational Resources Information Center

Strode, Christopher N.

2013-01-01

The purpose of this study was to examine the academic performance of the first-time, full-time, traditional-aged students in the Student Support Services program at East Tennessee State University. This was accomplished by comparing their academic performance with the academic performance of first-time, full-time, traditional-aged non-SSS…

Service Station Attendant. Performance Objectives. Basic Course.

ERIC Educational Resources Information Center

Davis, John

Several intermediate performance objectives and corresponding criterion measures are listed for each of 24 terminal objectives for a basic secondary level service station attendant course. The materials were developed for a two-semester course (2 and 3 hours daily). The specialized classroom and shop experiences are designed to enable the student…

THE CONCEPT OF A COMMUNITY INFORMATION SYSTEM TO MEASURE THE QUALITY OF PUBLIC SERVICES,

DTIC Science & Technology

The community information system would consist of the collection of data relevant to public service quality , the periodic reporting of this data in a summarized, sharply focused form, and the application of reliable performance measures to it. The primary purpose of the CIS...groups in forming balanced judgments and making decisions concerning the service they receive. A secondary purpose would be to increase service quality by making it more visible to the public. (Author)

Dynamic Modelling of User Decision-Making in Selecting Information Services at a University Research Center.

ERIC Educational Resources Information Center

Evans, John E.

This research is concerned with the pragmatic performance characteristics of competing information technologies (ITs) and services in the university research center, as measured by user demand and choice. Technologies and services studied include: (1) mediated search service operating at cost recovery, open to all; (2) end-user service collecting…

The art of customer service.

PubMed

Williams, Jeni

2007-10-01

Strategies for improving the consumer service skills of finance staff include: Hire employees who have a customer service background. Work with your human resources department to provide customer service training. Monitor new hires extensively. Offer front-end employees scripted language for situations they may face on the job. Measure the quality of customer service provided. Provide incentives for performance.

45 CFR 2522.700 - How does evaluation differ from performance measurement?

Code of Federal Regulations, 2013 CFR

2013-10-01

... progress, evaluation uses scientifically-based research methods to assess the effectiveness of programs by... services from your program who increase their reading ability from “below grade level” to “at or above grade level”. This measure indicates something good is happening to your program's service beneficiaries...

45 CFR 2522.700 - How does evaluation differ from performance measurement?

Code of Federal Regulations, 2014 CFR

2014-10-01

... progress, evaluation uses scientifically-based research methods to assess the effectiveness of programs by... services from your program who increase their reading ability from “below grade level” to “at or above grade level”. This measure indicates something good is happening to your program's service beneficiaries...

45 CFR 2522.700 - How does evaluation differ from performance measurement?

Code of Federal Regulations, 2012 CFR

2012-10-01

... progress, evaluation uses scientifically-based research methods to assess the effectiveness of programs by... services from your program who increase their reading ability from “below grade level” to “at or above grade level”. This measure indicates something good is happening to your program's service beneficiaries...

45 CFR 2522.700 - How does evaluation differ from performance measurement?

Code of Federal Regulations, 2011 CFR

2011-10-01

... progress, evaluation uses scientifically-based research methods to assess the effectiveness of programs by... services from your program who increase their reading ability from “below grade level” to “at or above grade level”. This measure indicates something good is happening to your program's service beneficiaries...

The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

PubMed

Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

2016-01-01

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision.ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. © Georg Thieme Verlag KG Stuttgart · New York.

Assisting allied health in performance evaluation: a systematic review.

PubMed

Lizarondo, Lucylynn; Grimmer, Karen; Kumar, Saravana

2014-11-14

Performance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation. A systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings from individual articles. A total of 37 articles were included in the review. The literature suggests there are core elements involved in performance evaluation which include prioritising clinical areas for measurement, setting goals, selecting performance measures, identifying sources of feedback, undertaking performance measurement, and reporting the results to relevant stakeholders. The literature describes performance evaluation as multi-dimensional, requiring information or data from more than one perspective to provide a rich assessment of performance. A range of tools or instruments are available to capture various perspectives and gather a comprehensive picture of health care quality. Every allied health care delivery system has different performance needs and will therefore require different approaches. However, there are core processes that can be used as a framework to evaluate allied health performance. A careful examination of barriers to performance evaluation and subsequent tailoring of strategies to overcome these barriers should be undertaken to achieve the aims of performance evaluation. The findings of this review should inform the development of a standardised framework that can be used to measure and evaluate allied health performance. Future research should explore the utility and overall impact of such framework in allied health service delivery.

Evaluating Innovations in Home Care for Performance Accountability.

PubMed

Collister, Barbara; Gutscher, Abram; Ambrogiano, Jana

2016-01-01

Concerns about rising costs and the sustainability of our healthcare system have led to a drive for innovative solutions and accountability for performance. Integrated Home Care, Calgary Zone, Alberta Health Services went beyond traditional accountability measures to use evaluation methodology to measure the progress of complex innovations to its organization structure and service delivery model. This paper focuses on the first two phases of a three-phase evaluation. The results of the first two phases generated learning about innovation adoption and sustainability, and performance accountability at the program-level of a large publicly funded healthcare organization.

Performance management of the public healthcare services in Ireland: a review.

PubMed

Mesabbah, Mohammed; Arisha, Amr

2016-01-01

Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services. An extensive review of relevant HSE's publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented. PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals' management systems. The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE's PM framework, with a particular interest in acute hospitals and emergency services. This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

Understanding Variations in Medicare Consumer Assessment of Health Care Providers and Systems Scores: California as an Example

PubMed Central

Farley, Donna O; Elliott, Marc N; Haviland, Amelia M; Slaughter, Mary Ellen; Heller, Amy

2011-01-01

Objective To understand reasons why California has lower Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores than the rest of the country, including differing patterns of CAHPS scores between Medicare Advantage (MA) and fee-for-service, effects of additional demographic characteristics of beneficiaries, and variation across MA plans within California. Study Design/Data Collection Using 2008 CAHPS survey data for fee-for-service Medicare beneficiaries and MA members, we compared mean case mix adjusted Medicare CAHPS scores for California and the remainder of the nation. Principal Findings California fee-for-service Medicare had lower scores than non-California fee-for-service on 11 of 14 CAHPS measures; California MA had lower scores only for physician services measures and higher scores for other measures. Adding race/ethnicity and urbanity to risk adjustment improved California standing for all measures in both MA and fee-for-service. Within the MA plans, one large plan accounted for the positive performance in California MA; other California plans performed below national averages. Conclusions This study shows that the mix of fee-for-service and MA enrollees, demographic characteristics of populations, and plan-specific factors can all play a role in observed regional variations. Anticipating value-based payments, further study of successful MA plans could generate lessons for enhancing patient experience for the Medicare population. PMID:21644970

Using provider performance incentives to increase HIV testing and counseling services in Rwanda.

PubMed

de Walque, Damien; Gertler, Paul J; Bautista-Arredondo, Sergio; Kwan, Ada; Vermeersch, Christel; de Dieu Bizimana, Jean; Binagwaho, Agnès; Condo, Jeanine

2015-03-01

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient. Copyright © 2014. Published by Elsevier B.V.

45 CFR 2553.106 - How does a sponsor report performance measures to the Corporation?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false How does a sponsor report performance measures to the Corporation? 2553.106 Section 2553.106 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE THE RETIRED AND SENIOR VOLUNTEER PROGRAM Performance Measurement § 2553.106 How does a sponso...

45 CFR 305.62 - Disregard of a failure which is of a technical nature.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND... adversely affect the performance of the State's IV-D program or does not adversely affect the determination of the level of the State's paternity establishment or other performance measures percentages. ...

Outsourcing Security Services for Low Performance Portable Devices

NASA Astrophysics Data System (ADS)

Szentgyörgyi, Attila; Korn, András

The number of portable devices using wireless network technologies is on the rise. Some of these devices are incapable of, or at a disadvantage at using secure Internet services, because secure communication often requires comparatively high computing capacity. In this paper, we propose a solution which can be used to offer secure network services for low performance portable devices without severely degrading data transmission rates. We also show that using our approach these devices can utilize some secure network services which were so far unavailable to them due to a lack of software support. In order to back up our claims, we present performance measurement results obtained in a test network.

An unsupervised method for estimating the global horizontal irradiance from photovoltaic power measurements

NASA Astrophysics Data System (ADS)

Nespoli, Lorenzo; Medici, Vasco

2017-12-01

In this paper, we present a method to determine the global horizontal irradiance (GHI) from the power measurements of one or more PV systems, located in the same neighborhood. The method is completely unsupervised and is based on a physical model of a PV plant. The precise assessment of solar irradiance is pivotal for the forecast of the electric power generated by photovoltaic (PV) plants. However, on-ground measurements are expensive and are generally not performed for small and medium-sized PV plants. Satellite-based services represent a valid alternative to on site measurements, but their space-time resolution is limited. Results from two case studies located in Switzerland are presented. The performance of the proposed method at assessing GHI is compared with that of free and commercial satellite services. Our results show that the presented method is generally better than satellite-based services, especially at high temporal resolutions.

The Performance Blueprint: An Integrated Logic Model Developed To Enhance Performance Measurement Literacy: The Case of Performance-Based Contract Management.

ERIC Educational Resources Information Center

Longo, Paul J.

This study explored the mechanics of using an enhanced, comprehensive multipurpose logic model, the Performance Blueprint, as a means of building evaluation capacity, referred to in this paper as performance measurement literacy, to facilitate the attainment of both service-delivery oriented and community-oriented outcomes. The application of this…

An Efficient Power Saving Mechanism for Delay-Guaranteed Services in IEEE 802.16e

NASA Astrophysics Data System (ADS)

Park, Yunju; Hwang, Gang Uk

As the IEEE 802.16e Wireless Metropolitan Access Network (WMAN) supports the mobility of a mobile station (MS), increasing MS power efficiency has become an important issue. In this paper, we analyze the sleep-mode operation for an efficient power saving mechanism for delay-guaranteed services in the IEEE 802.16e WMAN and observe the effects of the operating parameters related to this operation. For the analysis we use the M/GI/1/K queueing system with multiple vacations, exhaustive services and setup times. In the analysis, we consider the power consumption during the wake-mode period as well as the sleep-mode period. As a performance measure for the power consumption, we propose the power consumption per unit time per effective arrival which considers the power consumption and the packet blocking probability simultaneously. In addition, since we consider delay-guaranteed services, the average packet response delay is also considered as a performance measure. Based on the performance measures, we obtain the optimal sleep-mode operation which minimizes the power consumption per unit time per effective arrival with a given delay requirement. Numerical studies are also provided to investigate the system performance and to show how to achieve our objective.

Measuring and Investigating Pretrial Multi-Expectations of Service Quality within the Higher Education Context

ERIC Educational Resources Information Center

Prugsamatz, Sunita; Heaney, Joo-Gim; Alpert, Frank

2007-01-01

Understanding what consumers expect from a service provider prior to consumption is necessary for marketers because expectations provide a standard of comparison against which consumers judge the performance of that service provider. This study is an in-depth investigation into consumers' pretrial multi-expectations of service quality within a…

Associations between nursing home performance and hospital 30-day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States.

PubMed

Pandolfi, Michelle M; Wang, Yun; Spenard, Ann; Johnson, Florence; Bonner, Alice; Ho, Shih-Yieh; Elwell, Timothy; Bakullari, Anila; Galusha, Deron; Leifheit-Limson, Erica; Lichtman, Judith H; Krumholz, Harlan M

2017-12-01

To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. Medicare-certified nursing homes and acute care hospitals. 12,542 nursing homes and 3,039 hospitals treating 30 or more Medicare fee-for-service patients for all three conditions across 2,032 hospital service areas in the United States. Community-specific hospital 30-day risk-standardised readmission rates. Community-specific nursing home performance measures: health inspection, staffing, Registered Nurses and quality performance; and an aggregated performance score. Mixed-effects models evaluated associations between nursing home performance and hospital 30-day risk-standardised readmission rates for all three conditions. The relationship between community-specific hospital risk-standardised readmission rates and community-specific overall nursing home performance was statistically significant for all three conditions. Increasing nursing home performance by one star resulted in decreases of 0.29% point (95% CI: 0.12-0.47), 0.78% point (95% CI: 0.60-0.95) and 0.46% point (95% CI: 0.33-0.59) of risk-standardised readmission rates for AMI, HF and pneumonia, respectively. Among the specific measures, higher performance in nursing home overall staffing and Registered Nurse staffing measures was statistically significantly associated with lower hospital readmission rates for all three conditions. Notable geographic variation in the community-specific nursing home performance was observed. Community-specific nursing home performance is associated with community-specific hospital 30-day readmission rates for Medicare fee-for-service patients for acute myocardial infarction, heart failure or pneumonia. Coordinated care between hospitals and nursing homes is essential to reduce readmissions. Nursing homes can improve performance and reduce readmissions by increasing registered nursing homes. Further, communities can work together to create cross-continuum care teams comprised of hospitals, nursing homes, patients and their families, and other community-based service providers to reduce unplanned readmissions. © 2017 John Wiley & Sons Ltd.

Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy.

PubMed

Sandhu, Sharmila; Furniss, Jeremy; Metzler, Christina

As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy's distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Web service discovery among large service pools utilising semantic similarity and clustering

NASA Astrophysics Data System (ADS)

Chen, Fuzan; Li, Minqiang; Wu, Harris; Xie, Lingli

2017-03-01

With the rapid development of electronic business, Web services have attracted much attention in recent years. Enterprises can combine individual Web services to provide new value-added services. An emerging challenge is the timely discovery of close matches to service requests among large service pools. In this study, we first define a new semantic similarity measure combining functional similarity and process similarity. We then present a service discovery mechanism that utilises the new semantic similarity measure for service matching. All the published Web services are pre-grouped into functional clusters prior to the matching process. For a user's service request, the discovery mechanism first identifies matching services clusters and then identifies the best matching Web services within these matching clusters. Experimental results show that the proposed semantic discovery mechanism performs better than a conventional lexical similarity-based mechanism.

Method for assessing in-service motor efficiency and in-service motor/load efficiency

DOEpatents

Kueck, John D.; Otaduy, Pedro J.

1997-01-01

A method and apparatus for assessing the efficiency of an in-service motor. The operating characteristics of the in-service motor are remotely measured. The operating characteristics are then applied to an equivalent circuit for electrical motors. Finally the equivalent circuit is evaluated to determine the performance characteristics of said in-service motor. Based upon the evaluation an individual is able to determine the rotor speed, power output, efficiency, and toque of the in-service motor. Additionally, an individual is able to confirm the calculations by comparing measured values with values obtained as a result of the motor equivalent circuit evaluation.

Custodial Services and Building Maint: Performance Objectives.

ERIC Educational Resources Information Center

Downing, Charles; And Others

Several intermediate performance objectives and corresponding criterion measures are listed for each of 14 terminal objectives for high school custodial service and building maintenance course (the third year of a 3-year program). The materials were developed for a 36-week course (3 hours daily) designed to prepare 12th graders with entry level…

Clustering techniques: measuring the performance of contract service providers.

PubMed

Cruz, Antonio Miguel; Perilla, Sandra Patricia Usaquén; Pabón, Nidia Nelly Vanegas

2010-01-01

This paper investigates the use of clustering technique to characterize the providers of maintenance services in a health-care institution according to their performance. A characterization of the inventory of equipment from seven pilot areas was carried out first (including 264 medical devices). The characterization study concluded that the inventory on a whole is old [exploitation time (ET)/useful life (UL) average is 0.78] and has high maintenance service costs relative to the original cost of acquisition (service cost /acquisition cost average 8.61%). A monitoring of the performance of maintenance service providers was then conducted. The variables monitored were response time (RT), service time (ST), availability, and turnaround time (TAT). Finally, the study grouped maintenance service providers into clusters according to performance. The study grouped maintenance service providers into the following clusters. Cluster 0: Identified with the best performance, the lowest values of TAT, RT, and ST, with an average TAT value of 1.46 days; Clusters 1 and 2: Identified with the poorest performance, highest values of TAT, RT, and ST, and an average TAT value of 9.79 days; and Cluster 3: Identified by medium-quality performance, intermediate values of TAT, RT, and ST, and an average TAT value of 2.56 days.

Measuring relational security in forensic mental health services

PubMed Central

Chester, Verity; Alexander, Regi T.; Morgan, Wendy

2017-01-01

Aims and method Relational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE). Results The STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure. Clinical implications The measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment. PMID:29234515

Measuring relational security in forensic mental health services.

PubMed

Chester, Verity; Alexander, Regi T; Morgan, Wendy

2017-12-01

Aims and method Relational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE). Results The STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure. Clinical implications The measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment.

A measurement-driven approach to assess power line telecommunication (PLT) network quality of service (QoS) performance parameters

NASA Astrophysics Data System (ADS)

Betta, G.; Capriglione, D.; Ferrigno, L.; Laracca, M.

2009-10-01

Power line telecommunication (PLT) technology offers cheap and fast ways for providing in-home broadband services and local area networking. Its main advantage is due to the possibility of using the pre-existing electrical grid as a communication channel. Nevertheless, technical challenges arise from the difficulty of operating on a hostile medium, not designed for communication purposes, characterized by complex channel modeling and by varying time response. These aspects put practical problems for designers and testers in the assessment of network quality of service performance parameters such as the throughput, the latency, the jitter, and the reliability. The measurement of these parameters has not yet been standardized so that there do not exist reference test set-ups and measurement methodologies (i.e. the type of isolation from the ac main, the observation time and the number of experiments, the measurement uncertainty and so on). Consequently, experiments executed by adopting different methods may lead to incompatible measurement results, thus making it also impossible to have reliable comparisons of different PLT modems. Really, the development of standard procedures is a very difficult task because the scenarios in which the PLT modems can work are very wide and then the application of an exhaustive approach (in which all the parameters influencing the PLT performance should be considered) would be very complex and time consuming, thus making the modem characterization very expensive. In this paper, the authors propose a methodological approach to develop an efficient measurement procedure able to reliably assess the performance of PLT modems (in terms of network quality of service parameters) with a minimum number of experiments. It is based on both creating a reconfigurable grid to which real disturbing loads are connected and implementing an original design of the experiment technique based on the effects of the uncertainty of the measurement results. Methods are also provided to analyze measurement results and to estimate the measurement uncertainty.

47 CFR 73.154 - AM directional antenna partial proof of performance measurements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 4 2013-10-01 2013-10-01 false AM directional antenna partial proof of...) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES AM Broadcast Stations § 73.154 AM directional antenna... measurements are to be made within 3 to 15 kilometers from the center of the antenna array. When a monitoring...

47 CFR 73.154 - AM directional antenna partial proof of performance measurements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 4 2012-10-01 2012-10-01 false AM directional antenna partial proof of...) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES AM Broadcast Stations § 73.154 AM directional antenna... measurements are to be made within 3 to 15 kilometers from the center of the antenna array. When a monitoring...

47 CFR 73.154 - AM directional antenna partial proof of performance measurements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 4 2014-10-01 2014-10-01 false AM directional antenna partial proof of...) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES AM Broadcast Stations § 73.154 AM directional antenna... measurements are to be made within 3 to 15 kilometers from the center of the antenna array. When a monitoring...

47 CFR 73.154 - AM directional antenna partial proof of performance measurements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 4 2011-10-01 2011-10-01 false AM directional antenna partial proof of...) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES AM Broadcast Stations § 73.154 AM directional antenna... measurements are to be made within 3 to 15 kilometers from the center of the antenna array. When a monitoring...

42 CFR 476.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care facility or facility means an organization involved in the delivery of health care services for... the delivery of health care services that is typical for a specified group. Norms means numerical or statistical measures of average observed performance in the delivery of health care services. Outliers means...

Distributor- Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale.

PubMed

Mehralian, Gholamhossein; Babapour, Jafar; Peiravian, Farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor-retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor-retailer interface.

Distributor– Retailer Interface in Pharmaceutical Supply Chain: Service Quality Measurement Scale

PubMed Central

Mehralian, Gholamhossein; Babapour, Jafar; peiravian, farzad

2016-01-01

In the current competitive market, service quality management is the key to the survival and success of businesses. SERVQUAL is a popular service quality measurement scale (SQMS) that has served as a basis for subsequent research on service quality; it has been used for testing different aspects of service quality in a market. The purpose of our study is, therefore, to develop a service quality measurement scale (SQMS) for the distributor–retailer interface of Pharm supply chains (PSC) in Iran. A survey was performed to collect data from pharmacies located in Tehran. A valid and reliable questionnaire delivered to pharmacies, and 400 pharmacies were intended to participate in our survey. Confirmatory factor analysis (CFA) was used to develop an SQMS in this study. Sufficient sampling was undertaken to do CFA. Consistent with other service quality studies, this Res developed an SQMS with five dimensions and 20 items for PSC, and contributes to mangers to regularly measure service quality. This is an initial study to develop a framework for measuring service quality in Iranian PCS. The framework can be used effectively to achieve competitive advantage at the distributor–retailer interface. PMID:28243297

Heterogenous customer satisfaction index for evaluating university food service

NASA Astrophysics Data System (ADS)

Aziz, Nazrina; Zain, Zakiyah; Syarifi, Nadia Asyikin Mohammad; Klivon, Julia; Ap, Nurasiah Che; Zaki, Mahirah

2017-11-01

This paper aims to measure the performance of university food service based on students' perception. Two cafeterias were chosen for comparison: one located at student residential hall (Café 1) and another at the university administration centre (Café 2). By considering the components of importance and satisfaction, the Heterogeneous Customer Satisfaction Index-HCSI was computed to measure the performance of quality items in both cafeterias. Stratified sampling method was used to select 278 students and the DINESERVE instrument was used to assess customer perception on service quality. The findings show that the customer rate these two cafeterias as quite satisfied only, with the HCSI for Café 1 slightly higher than that for Café 2.

Reduced SWAP-C VICTORY Services Execution and Performance Evaluation

DTIC Science & Technology

2012-08-01

NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) UBT, Inc.,3250 W Big Beaver Rd, Suite 329, Troy ,Mi,48084 8. PERFORMING...Symposium August 14-16 Troy , Michigan 14. ABSTRACT -Executing multiple VICTORY data services, and reading multiple VICTORY-compliant sensors at the...same time resulted in the following performance measurements for the system -0.64 Amps / 3.15 Watts Power Consumption at run-time. -Roughly 0.77% System

Assessing the multidimensional and hierarchical structure of SERVQUAL.

PubMed

Ma, Jun; Harvey, Milton E; Hu, Michael Y

2007-10-01

Parasuraman, Zeithaml, and Berry introduced SERVQUAL in 1998 as a scale to measure service quality. Since then, researchers have proposed several variations. This study examines the development of the tool. Marketing researchers have first challenged the conceptualization of a perceptions-expectations gap and have concluded that the performance-based measures are adequate to capture consumers' perception of service quality. Some researchers have argued that the five dimensions of the SERVQUAL scale only focus on the process of service delivery and have extended the SERVQUAL scale into six dimensions by including the service outcome dimension. Others have proposed that service quality is a multilevel construct and should be measured accordingly. From a sample of 467 undergraduate students data on service quality toward up-scale restaurants were collected. Using the structural equation approach, two measurement models of service quality were compared, the extended SERVQUAL model and the restructured multilevel SERVQUAL model. Analysis suggested that the latter model fits the data better than the extended one.

Inmate Recidivism as a Measure of Private Prison Performance

ERIC Educational Resources Information Center

Spivak, Andrew L.; Sharp, Susan F.

2008-01-01

The growth of the private corrections industry has elicited interest in the comparative performance of state and private prisons. One way to measure the service quality of private prisons is to examine inmates' postrelease performance. Current empirical evidence is limited to four studies, all conducted in Florida. This analysis replicates and…

Models of Dynamic Relations Among Service Activities, System State and Service Quality on Computer and Network Systems

DTIC Science & Technology

2010-01-01

Service quality on computer and network systems has become increasingly important as many conventional service transactions are moved online. Service quality of computer and network services can be measured by the performance of the service process in throughput, delay, and so on. On a computer and network system, competing service requests of users and associated service activities change the state of limited system resources which in turn affects the achieved service ...relations of service activities, system state and service

[Marketing in health service].

PubMed

Ameri, Cinzia; Fiorini, Fulvio

2014-01-01

The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.

Case-Mix Adjusting Performance Measures in a Veteran Population: Pharmacy- and Diagnosis-Based Approaches

PubMed Central

Liu, Chuan-Fen; Sales, Anne E; Sharp, Nancy D; Fishman, Paul; Sloan, Kevin L; Todd-Stenberg, Jeff; Nichol, W Paul; Rosen, Amy K; Loveland, Susan

2003-01-01

Objective To compare the rankings for health care utilization performance measures at the facility level in a Veterans Health Administration (VHA) health care delivery network using pharmacy- and diagnosis-based case-mix adjustment measures. Data Sources/Study Setting The study included veterans who used inpatient or outpatient services in Veterans Integrated Service Network (VISN) 20 during fiscal year 1998 (October 1997 to September 1998; N=126,076). Utilization and pharmacy data were extracted from VHA national databases and the VISN 20 data warehouse. Study Design We estimated concurrent regression models using pharmacy or diagnosis information in the base year (FY1998) to predict health service utilization in the same year. Utilization measures included bed days of care for inpatient care and provider visits for outpatient care. Principal Findings Rankings of predicted utilization measures across facilities vary by case-mix adjustment measure. There is greater consistency within the diagnosis-based models than between the diagnosis- and pharmacy-based models. The eight facilities were ranked differently by the diagnosis- and pharmacy-based models. Conclusions Choice of case-mix adjustment measure affects rankings of facilities on performance measures, raising concerns about the validity of profiling practices. Differences in rankings may reflect differences in comparability of data capture across facilities between pharmacy and diagnosis data sources, and unstable estimates due to small numbers of patients in a facility. PMID:14596393

76 FR 70653 - Performance Measurement

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-15

... Regulations as follows: PART 3055--SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING 0 1. The authority... entered into the National Customer Management System (NCMS). NCMS manages SFS inventory, general ledger, order history, and customer accounts. A measurement ends when the order is logically closed out in the...

Changes in Upper-Extremity Functional Capacity and Daily Performance During Outpatient Occupational Therapy for People With Stroke

PubMed Central

Doman, Caitlin A.; Waddell, Kimberly J.; Bailey, Ryan R.; Moore, Jennifer L.

2016-01-01

OBJECTIVE. This study explored how upper-extremity (UE) functional capacity and daily performance change during the course of outpatient rehabilitation in people with stroke. METHOD. Fifteen participants receiving outpatient occupational therapy services for UE paresis poststroke were enrolled. UE motor capacity was measured with the Action Research Arm Test (ARAT), and UE performance was measured using bilateral, wrist-worn accelerometers. Measurements were taken at or near the start of therapy, at every 10th visit or every 30 days throughout the duration of services, and at discharge. RESULTS. Three patterns were observed: (1) increase in ARAT scores and more normalized accelerometry profiles, (2) increase in ARAT scores but no change in accelerometry profiles, and (3) no change in ARAT scores or in accelerometry profiles. CONCLUSION. UE performance in daily life was highly variable, with inconsistencies between change in UE capacity and change in UE performance. UE capacity and performance are important constructs to assess separately during rehabilitation. PMID:27089298

The Analysis of Basic Public Service Supply Regional Equalization in China’s Provinces——Based on the Theil Index Evaluation

NASA Astrophysics Data System (ADS)

Liao, Zangyi

2017-12-01

Accomplishing the regional equalization of basic public service supply among the provinces in China is an important objective that can promote the people’s livelihood construction. In order to measure the problem which is about the non-equalization of basic public service supply, this paper takes these aspects as the first index, such as the infrastructure construction, basic education services, public employment services, public health service and social security service. At the same time, it cooperates with 16 index as the second index to construct the performance evaluation systems, and then use the Theil index to evaluate the performance in provinces that using the panel data from the year 2000 to 2012.

Proposed Performance Measures and Strategies for Implementation of the Fatigue Risk Management Guidelines for Emergency Medical Services.

PubMed

Martin-Gill, Christian; Higgins, J Stephen; Van Dongen, Hans P A; Buysse, Daniel J; Thackery, Ronald W; Kupas, Douglas F; Becker, David S; Dean, Bradley E; Lindbeck, George H; Guyette, Francis X; Penner, Josef H; Violanti, John M; Lang, Eddy S; Patterson, P Daniel

2018-02-15

Performance measures are a key component of implementation, dissemination, and evaluation of evidence-based guidelines (EBGs). We developed performance measures for Emergency Medical Services (EMS) stakeholders to enable the implementation of guidelines for fatigue risk management in the EMS setting. Panelists associated with the Fatigue in EMS Project, which was supported by the National Highway Traffic Safety Administration (NHTSA), used an iterative process to develop a draft set of performance measures linked to 5 recommendations for fatigue risk management in EMS. We used a cross-sectional survey design and the Content Validity Index (CVI) to quantify agreement among panelists on the wording and content of draft measures. An anonymous web-based tool was used to solicit the panelists' perceptions of clarity and relevance of draft measures. Panelists rated the clarity and relevance separately for each draft measure on a 4-point scale. CVI scores ≥0.78 for clarity and relevance were specified a priori to signify agreement and completion of measurement development. Panelists judged 5 performance measures for fatigue risk management as clear and relevant. These measures address use of fatigue and/or sleepiness survey instruments, optimal duration of shifts, access to caffeine as a fatigue countermeasure, use of napping during shift work, and the delivery of education and training on fatigue risk management for EMS personnel. Panelists complemented performance measures with suggestions for implementation by EMS agencies. Performance measures for fatigue risk management in the EMS setting will facilitate the implementation and evaluation of the EBG for Fatigue in EMS.

Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

PubMed

Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

2017-11-21

Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in sites offering community outreach and those trained in intervention year two. The number of in-person contacts was significantly associated with achievement of three of four measures. Post-training support holds promise for strengthening health worker performance. Further research is needed to compare this intervention with other approaches and assess how post-training contacts could be incorporated into current health system supervision.

Does hospital financial performance measure up?

PubMed

Cleverley, W O; Harvey, R K

1992-05-01

Comparisons are continuously being made between the financial performance, products and services, of the healthcare industry and those of non-healthcare industries. Several useful measures of financial performance--profitability, liquidity, financial risk, asset management and replacement, and debt capacity, are used by the authors to compare the financial performance of the hospital industry with that of the industrial, transportation and utility sectors. Hospitals exhibit weaknesses in several areas. Goals are suggested for each measure to bring hospitals closer to competitive levels.

A practical approach to competency assessment.

PubMed

Claflin, N

1997-01-01

Assessing clinical performance is difficult. Members of the Nursing Service Clinical Practice Committee at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix developed a comprehensive program of competency assessment based on performance measures. This article describes the committee's process of developing and implementing the program and includes a blueprint for competency assessment and selected performance measures for all nursing staff who provide patient care. The approach to competency assessment includes performance measures specific to patients' ages.

Performance needs assessment of maternal and newborn health service delivery in urban and rural areas of Osun State, South-West, Nigeria.

PubMed

Esan, Oluwaseun T; Fatusi, Adesegun O

2014-06-01

The study aimed to determine performance and compare gaps in maternal and newborn health (MNH) services in urban and rural areas of Osun State, Nigeria, to inform decisions for improved services. This study involved 14 urban and 10 rural-based randomly selected PHC facilities. Using a Performance Needs Assessment framework, desired performances were determined by key stakeholders and actual performances measured by conducting facility survey. Questionnaire interview of 143 health workers and 153 antenatal clients were done. Performance gaps were determined for the urban and rural areas and compared using Chi-square tests with SPSS version 17. PHC facilities and health workers in Osun State, Nigeria, were found to have significant gaps in MNH service performance and this was worse in the rural areas. Root cause of most of the performance gaps was poor political will of local government authorities. Improved government commitment to MNH is needful to address most of the gaps.

Problems with measuring satisfaction with social care.

PubMed

Willis, Rosalind; Evandrou, Maria; Pathak, Pathik; Khambhaita, Priya

2016-09-01

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under-theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012-2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses. © 2015 John Wiley & Sons Ltd.

Rapid core measure improvement through a "business case for quality".

PubMed

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

Measuring corporate culture to ensure mission fulfillment.

PubMed

Hulsebus-Fong, C

1988-11-01

Ancilla Systems, Inc., Elk Grove Village, Il, developed a mission-based performance evaluation program to provide tangible evidence of mission fulfillment and ensure the provision of high-quality healthcare. the program--Characteristics of Service--translates the language of healthcare action and evaluates corporate culture to ensure that it fulfills the expectations of its sponsor. The nine Characteristics of Service are: Respect for the dignity of all persons. Orientation toward the family unit. Quality and personalized services. Local health systems with a spectrum of services responsive to the unique needs of the community. Formal and informal partnerships with physicians. Active participation and collaboration with related community service agencies and other healthcare providers. Faithfulness to Catholic identity through close relationships with Church and religious institute resources. Effective political advocacy through education. Research and development of innovative approaches to healthcare. In establishing the behavior standards that would exemplify the characteristics, program developers used terms that correspond to specific, observable, measurable performance. All healthcare facilities are evaluated on how well they meet the behavior standards. The evaluation process includes data collection, analysis, and a final report. Data collection begins with a review of regular hospital-conducted surveys, which provide quantifiable information to measure performance against key expected behaviors. Additional data are derived from medical staff development plans and the monthly quality assurance audit. On-site surveys fill information gaps that remain after all written reports are collected.

Strategic plans open for comment

NASA Astrophysics Data System (ADS)

Under the Government Performance and Results Act (the Results Act), agencies of the U.S. government are required to submit a 5-year strategic plan to the U.S. Congress by September 30, 1997 explaining how, when, and why they are spending tax dollars.Enacted in 1993, the Results Act is in tended to "improve efficiency and effective ness of Federal programs by establishing a system to set goals for program performance and to measure results." Thus according to the U.S. House of Representatives Committee on Science, the aim is for agencies to measure their performances by the results of their task and services, not by the number of tasks and services performed. Toward that goal, the Act requires that federal entities complete the following 3-step process:

Developing Measures of Job Performance for Support Staff in Housing Services for People with Intellectual Disabilities

ERIC Educational Resources Information Center

Hatton, Chris; Wigham, Sarah; Craig, Jaime

2009-01-01

Background: There is an absence of research concerning the assessment of housing support worker job performance, particularly in the development of job performance measures that reflect the priorities of people with intellectual disabilities and their families. Method: A worker-oriented job analysis method was used to develop four short job…

Comprehensiveness of care from the patient perspective: comparison of primary healthcare evaluation instruments.

PubMed

Haggerty, Jeannie L; Beaulieu, Marie-Dominique; Pineault, Raynald; Burge, Frederick; Lévesque, Jean-Frédéric; Santor, Darcy A; Bouharaoui, Fatima; Beaulieu, Christine

2011-12-01

Comprehensiveness relates both to scope of services offered and to a whole-person clinical approach. Comprehensive services are defined as "the provision, either directly or indirectly, of a full range of services to meet most patients' healthcare needs"; whole-person care is "the extent to which a provider elicits and considers the physical, emotional and social aspects of a patient's health and considers the community context in their care." Among instruments that evaluate primary healthcare, two had subscales that mapped to comprehensive services and to the community component of whole-person care: the Primary Care Assessment Tool - Short Form (PCAT-S) and the Components of Primary Care Index (CPCI, a limited measure of whole-person care). To examine how well comprehensiveness is captured in validated instruments that evaluate primary healthcare from the patient's perspective. 645 adults with at least one healthcare contact in the previous 12 months responded to six instruments that evaluate primary healthcare. Scores were normalized for descriptive comparison. Exploratory and confirmatory (structural equation modelling) factor analysis examined fit to operational definition, and item response theory analysis examined item performance on common constructs. Over one-quarter of respondents had missing responses on services offered or doctor's knowledge of the community. The subscales did not load on a single factor; comprehensive services and community orientation were examined separately. The community orientation subscales did not perform satisfactorily. The three comprehensive services subscales fit very modestly onto two factors: (1) most healthcare needs (from one provider) (CPCI Comprehensive Care, PCAT-S First-Contact Utilization) and (2) range of services (PCAT-S Comprehensive Services Available). Individual item performance revealed several problems. Measurement of comprehensiveness is problematic, making this attribute a priority for measure development. Range of services offered is best obtained from providers. Whole-person care is not addressed as a separate construct, but some dimensions are covered by attributes such as interpersonal communication and relational continuity.

48 CFR 37.602 - Performance work statement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... on the use of measurable performance standards and financial incentives in a competitive environment... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Performance work statement... CATEGORIES OF CONTRACTING SERVICE CONTRACTING Performance-Based Acquisition 37.602 Performance work statement...

Impact of Appointment-Based Medication Synchronization on Proportion of Days Covered for Chronic Medications.

PubMed

Dao, Nancy; Lee, Sun; Hata, Micah; Sarino, Lord

2018-05-22

Appointment-based medication synchronization (ABMS) programs have been associated with increased adherence and persistence to chronic medications. Adherence to statin therapy, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and non-insulin antidiabetic medications (NIDM) are used to determine a health plan's Centers for Medicare and Medicaid Services (CMS) Star Rating under a pay-for-performance model. The objective of this study was to evaluate the impact of implementing an ABMS program on overall pharmacy adherence measures for statins, ACEI/ARBs, and NIDM, as presented through the Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP©) platform. This retrospective, pre-post ABMS program study evaluated EQuIPP© generated adherence performance measures, represented as proportion of days covered (PDC), 6-months before and 6- and 12-months after the ABMS service for statin therapy, ACEIs/ARBs, and NIDM. All adherence measures showed statistically significant improvement in PDC percentage post ABMS implementation, except for NIDM percentage in 6-months post-ABMS service. This study shows that a comprehensive medication synchronization program can enhance adherence measures that are important to health plans to increase CMS Star Rating under a pay-for-performance model.

Overall ED efficiency is associated with decreased time to percutaneous coronary intervention for ST-segment elevation myocardial infarction.

PubMed

Jones, Christopher W; Sonnad, Seema S; Augustine, James J; Reese, Charles L

2014-10-01

Performance of percutaneous coronary intervention (PCI) within 90 minutes of hospital arrival for ST-segment elevation myocardial infarction patients is a commonly cited clinical quality measure. The Centers for Medicare and Medicaid Services use this measure to adjust hospital reimbursement via the Value-Based Purchasing Program. This study investigated the relationship between hospital performance on this quality measure and emergency department (ED) operational efficiency. Hospital-level data from Centers for Medicare and Medicaid Services on PCI quality measure performance was linked to information on operational performance from 272 US EDs obtained from the Emergency Department Benchmarking Alliance annual operations survey. Standard metrics of ED size, acuity, and efficiency were compared across hospitals grouped by performance on the door-to-balloon time quality measure. Mean hospital performance on the 90-minute arrival to PCI measure was 94.0% (range, 42-100). Among hospitals failing to achieve the door-to-balloon time performance standard, median ED length of stay was 209 minutes, compared with 173 minutes among those hospitals meeting the benchmark standard (P < .001). Similarly, median time from ED patient arrival to physician evaluation was 39 minutes for hospitals below the performance standard and 23 minutes for hospitals at the benchmark standard (P < .001). Markers of ED size and acuity, including annual patient volume, admission rate, and the percentage of patients arriving via ambulance did not vary with door-to-balloon time. Better performance on measures associated with ED efficiency is associated with more timely PCI performance. Copyright © 2014 Elsevier Inc. All rights reserved.

Demystifying Results-Based Performance Measurement.

ERIC Educational Resources Information Center

Jorjani, Hamid

Many evaluators are convinced that Results-based Performance Measurement (RBPM) is an effective tool to improve service delivery and cost effectiveness in both public and private sectors. Successful RBPM requires self-directed and cross-functional work teams and the supporting infrastructure to make it work. There are many misconceptions and…

20 CFR 669.500 - What performance measures and standards apply to the NFJP?

Code of Federal Regulations, 2010 CFR

2010-04-01

... must be included in the approved plan. (b) We may develop additional performance indicators with... service area economy and local demographics of eligible MSFW's. The levels of performance for these...

Measurement framework for product service system performance of generator set distributors

NASA Astrophysics Data System (ADS)

Sofianti, Tanika D.

2017-11-01

Selling Generator Set (Genset) in B2B market, distributors assisted manufacturers to sell products. This is caused by the limited resources owned by the manufacturer for adding service elements. These service elements are needed to enhance the competitiveness of the generator sets. Some genset distributors often sell products together with supports to their customers. Industrial distributor develops services to meet the needs of the customer. Generator set distributors support machines and equipment produced by manufacturer. The services delivered by the distributors could enhance value obtained by the customers from the equipment. Services provided to customers in bidding process, ordering process of the equipment from the manufacturer, equipment delivery, installations, and the after sales stage. This paper promotes framework to measure Product Service System (PSS) of Generator Set distributors in delivering their products and services for the customers. The methodology of conducting this research is by adopting the perspective of the providers and customers and by taking into account the tangible and intangible products. This research leads to the idea of improvement of current Product Service System of a Genset distributor. This research needs further studies in more detailed measures and the implementation of measurement tools.

Design and Implementation of a Threaded Search Engine for Tour Recommendation Systems

NASA Astrophysics Data System (ADS)

Lee, Junghoon; Park, Gyung-Leen; Ko, Jin-Hee; Shin, In-Hye; Kang, Mikyung

This paper implements a threaded scan engine for the O(n!) search space and measures its performance, aiming at providing a responsive tour recommendation and scheduling service. As a preliminary step of integrating POI ontology, mobile object database, and personalization profile for the development of new vehicular telematics services, this implementation can give a useful guideline to design a challenging and computation-intensive vehicular telematics service. The implemented engine allocates the subtree to the respective threads and makes them run concurrently exploiting the primitives provided by the operating system and the underlying multiprocessor architecture. It also makes it easy to add a variety of constraints, for example, the search tree is pruned if the cost of partial allocation already exceeds the current best. The performance measurement result shows that the service can run even in the low-power telematics device when the number of destinations does not exceed 15, with an appropriate constraint processing.

Internal Stress Monitoring of In-Service Structural Steel Members with Ultrasonic Method

PubMed Central

Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying

2016-01-01

Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members. PMID:28773347

Internal Stress Monitoring of In-Service Structural Steel Members with Ultrasonic Method.

PubMed

Li, Zuohua; He, Jingbo; Teng, Jun; Wang, Ying

2016-03-23

Internal stress in structural steel members is an important parameter for steel structures in their design, construction, and service stages. However, it is hard to measure via traditional approaches. Among the existing non-destructive testing (NDT) methods, the ultrasonic method has received the most research attention. Longitudinal critically refracted (Lcr) waves, which propagate parallel to the surface of the material within an effective depth, have shown great potential as an effective stress measurement approach. This paper presents a systematic non-destructive evaluation method to determine the internal stress in in-service structural steel members using Lcr waves. Based on theory of acoustoelasticity, a stress evaluation formula is derived. Factor of stress to acoustic time difference is used to describe the relationship between stress and measurable acoustic results. A testing facility is developed and used to demonstrate the performance of the proposed method. Two steel members are measured by using the proposed method and the traditional strain gauge method for verification. Parametric studies are performed on three steel members and the aluminum plate to investigate the factors that influence the testing results. The results show that the proposed method is effective and accurate for determining stress in in-service structural steel members.

A Critique of Health System Performance Measurement.

PubMed

Lynch, Thomas

2015-01-01

Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

Using the balanced scorecard to align strategy and performance in long-term care.

PubMed

Macdonald, M

1998-01-01

The Sisters of Charity of Ottawa Health Service (SCOHS) is a Canadian health care corporation that has adapted Kaplan and Norton's balanced scorecard to enhance strategic management and measurement in a multisite health care facility comprising long term care, continuing complex care, rehabilitative services, palliative care and ambulatory care. This article discusses how the SCOHS has incorporated the following principles into the balanced scorecard: demonstration of cause and effect; inclusion of outcomes and performance drivers; linkage to fiscal and utilization indicators; and integration of the mission and values of the organization. Examples of corporate level outcomes and performance measures are provided in the form of lead and lag indicators.

Library Economic Metrics: Examples of the Comparison of Electronic and Print Journal Collections and Collection Services.

ERIC Educational Resources Information Center

King, Donald W.; Boyce, Peter B.; Montgomery, Carol Hansen; Tenopir, Carol

2003-01-01

Focuses on library economic metrics, and presents a conceptual framework for library economic metrics including service input and output, performance, usage, effectiveness, outcomes, impact, and cost and benefit comparisons. Gives examples of these measures for comparison of library electronic and print collections and collection services.…

A Surgical Business Composite Score for Army Medicine.

PubMed

Stoddard, Douglas R; Robinson, Andrew B; Comer, Tracy A; Meno, Jenifer A; Welder, Matthew D

2016-06-01

Measuring surgical business performance for Army military treatment facilities is currently done through 6 business metrics developed by the Army Medical Command (MEDCOM) Surgical Services Service Line (3SL). Development of a composite score for business performance has the potential to simplify and synthesize measurement, improving focus for strategic goal setting and implementation. However, several considerations, ranging from data availability to submetric selection, must be addressed to ensure the score is accurate and representative. This article presents the methodology used in the composite score's creation and presents a metric based on return on investment and a measure of cases recaptured from private networks. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Managing for Results--Linking Performance Measures and Budgets.

ERIC Educational Resources Information Center

McGee, William L.; Fountain, James R., Jr.

1995-01-01

The Government Accounting Standards Board notion of service efforts and accomplishments reporting is one step in a process of managing for results that includes strategic planning, development and use of performance measures of managing ongoing programs, and outputs to budgetary appropriation. Reports a trial application to one school district.…

45 CFR 2522.610 - What is the difference in performance measurements requirements for competitive and formula...

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirements for competitive and formula programs? 2522.610 Section 2522.610 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE AMERICORPS... Procedures § 2522.610 What is the difference in performance measurements requirements for competitive and...

20 CFR 641.690 - How is the performance of section 502(e) grantees measured?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How is the performance of section 502(e) grantees measured? 641.690 Section 641.690 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Private Sector...

Identification of Commercial Items Risk Factors

DTIC Science & Technology

2003-03-01

performance measures, vendors availability of support, testing and managing organizational change . 1. Process Risk Factor: Commercial Standards Military...support, testing and managing organizational change . C. ASSESSING RESULTS Completing the questions and assessing/compiling the results should help...to performance measures, vendors availability of support, testing and managing organizational change . SECTION I Service

DOD Advertising: Better Coordination, Performance Measurement, and Oversight Needed to Help Meet Recruitment Goals

DTIC Science & Technology

2016-05-01

DOD ADVERTISING Better Coordination, Performance Measurement, and Oversight Needed to Help Meet Recruitment Goals...Accountability Office Highlights of GAO-16-396, a report to congressional committees May 2016 DOD ADVERTISING Better Coordination, Performance...the military, DOD requested almost $575 million in fiscal year 2017 to conduct advertising intended to increase awareness of military service and

48 CFR 42.1501 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... System (CPARS) and Past Performance Information Retrieval System (PPIRS) metric tools to measure the... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1501 General. (a) Past performance information (including the ratings and supporting narratives) is relevant information, for future...

48 CFR 42.1501 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Reporting System (CPARS) and Past Performance Information Retrieval System (PPIRS) metric tools to measure... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1501 General. (a) Past performance information (including the ratings and supporting narratives) is relevant information, for future...

Benchmarking reference services: an introduction.

PubMed

Marshall, J G; Buchanan, H S

1995-01-01

Benchmarking is based on the common sense idea that someone else, either inside or outside of libraries, has found a better way of doing certain things and that your own library's performance can be improved by finding out how others do things and adopting the best practices you find. Benchmarking is one of the tools used for achieving continuous improvement in Total Quality Management (TQM) programs. Although benchmarking can be done on an informal basis, TQM puts considerable emphasis on formal data collection and performance measurement. Used to its full potential, benchmarking can provide a common measuring stick to evaluate process performance. This article introduces the general concept of benchmarking, linking it whenever possible to reference services in health sciences libraries. Data collection instruments that have potential application in benchmarking studies are discussed and the need to develop common measurement tools to facilitate benchmarking is emphasized.

Improving Customer Satisfaction in an R and D Environment

NASA Technical Reports Server (NTRS)

Alexander, Anita; Liou, Y. H. Andrew

1998-01-01

Satisfying customer needs is critical to the sustained competitive advantage of service suppliers. It is therefore important to understand the types of customer needs which, if fulfilled or exceeded, add value and contribute to overall customer satisfaction. This study identifies the needs of various research and development (R&D) customers who contract for engineering and design support services. The Quality Function Deployment (QFD) process was used to organize and translate each customer need into performance measures that, if implemented, can improve customer satisfaction. This study also provides specific performance measures that will more accurately guide the efforts of the engineering supplier. These organizations can either implement the QFD methodology presented herein or extract a few performance measures that are specific to the quality dimensions in need of improvement. Listening to 'what' customers talk about is a good first start.

26 CFR 801.4 - Customer satisfaction measures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL... taxpayers, organizational units, or employees within the IRS and external groups affected by the services...

48 CFR 37.601 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

48 CFR 37.601 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

48 CFR 37.601 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... a performance work statement or a statement of objectives (see 37.602). (b) Performance-based contracts for services shall include— (1) A performance work statement (PWS); (2) Measurable performance standards (i.e., in terms of quality, timeliness, quantity, etc.) and the method of assessing contractor...

Cheques and challenges: business performance in New Zealand general practice.

PubMed

Greatbanks, Richard; Doolan-Noble, Fiona; McKenna, Alex

2017-09-01

INTRODUCTION New Zealand general practice mainly functions as small businesses, usually owned by a single or small group of doctors. Consequently, owners often have to balance the provision of patient care with varying funding priorities, changing patient needs and the pressures of running a sustainable business. Such balancing inevitably leads to tensions developing between these factors. AIM To explore and understand these tensions and responses to them, by examining the business performance measurements used by general practice. METHODS For this study, the unit of analysis and focus were individual practices, but qualitative semi-structured interviews with general practitioners (GPs) and practice managers were used to gather the data. RESULTS All participating practices had some form of governance or board review, where high-level aggregated business performance data were presented. More sophisticated business performance measures were evident in the larger, more developed practices and in practices functioning as community trusts. Examples of such measures included doctor utilisation and efficiency, appraisal of risk, patient satisfaction with services and responses to changes in patient demand. DISCUSSION As the number of general practices based on the traditional model decrease, a corresponding increase is likely in the establishment and development of 'super practices' based on a corporatized, multi-service, single-location model. Consequently, service delivery will become increasingly complex and will drive a need for increased sophistication in how general practice measures its business performance, thus ensuring a balance between high-quality, safe patient care and the maintenance of a sustainable business.

A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures.

PubMed

Irving, Andy; Turner, Janette; Marsh, Maggie; Broadway-Parkinson, Andrea; Fall, Dan; Coster, Joanne; Siriwardena, A Niroshan

2018-02-01

Patient and public involvement (PPI) is recognized as an important component of high-quality health services research. PPI is integral to the Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. The PPI event described in detail in this article focusses on the process of involving patients and public representatives in identifying, prioritizing and refining a set of outcome measures that can be used to support ambulance service performance measurement. To obtain public feedback on little known, complex aspects of ambulance service performance measurement. The event was codesigned and coproduced with the PhOEBE PPI reference group and PhOEBE research team. The event consisted of brief researcher-led presentations, group discussions facilitated by the PPI reference group members and electronic voting. Data were collected from eighteen patient and public representatives who attended an event venue in Yorkshire. The results of the PPI event showed that this interactive format and mode of delivery was an effective method to obtain public feedback and produced a clear indication of which ambulance performance measures were most highly favoured by event participants. The event highlighted valuable contributions the PPI reference group made to the design process, supporting participant recruitment and facilitation of group discussions. In addition, the positive team working experience of the event proved a catalyst for further improvements in PPI within the PhOEBE project. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

A method for developing outcome measures in the clinical laboratory.

PubMed

Jones, J

1996-01-01

Measuring and reporting outcomes in health care is becoming more important for quality assessment, utilization assessment, accreditation standards, and negotiating contracts in managed care. How does one develop an outcome measure for the laboratory to assess the value of the services? A method is described which outlines seven steps in developing outcome measures for a laboratory service or process. These steps include the following: 1. Identify the process or service to be monitored for performance and outcome assessment. 2. If necessary, form an multidisciplinary team of laboratory staff, other department staff, physicians, and pathologists. 3. State the purpose of the test or service including a review of published data for the clinical pathological correlation. 4. Prepare a process cause and effect diagram including steps critical to the outcome. 5. Identify key process variables that contribute to positive or negative outcomes. 6. Identify outcome measures that are not process measures. 7. Develop an operational definition, identify data sources, and collect data. Examples, including a process cause and effect diagram, process variables, and outcome measures, are given using the Therapeutic Drug Monitoring service (TDM). A summary of conclusions and precautions for outcome measurement is then provided.

An End of Service Life Assessment of PMMA Lenses from Veteran Concentrator Photovoltaic Systems

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

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebecca

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. Molecular weight was compared between the incident and faceted surfaces of the lenses.« less

[Organizational climate in management teams and its relationship with health care outcomes].

PubMed

Peña-Viveros, Raúl; Hernández-Hernández, Dulce María; Vélez-Moreno, Ana María Luz; García-Sandoval, Martha Gabriela; Reyes-Tellez, María Araceli; Ureña-Bogarin, Enrique L

2015-01-01

To identify the relationship between organizational climate of management teams and the performance of health services. A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). The organizational climate of the health services managers (JSPM) is directly related with performance in health care.

Transformation of the title V maternal and child health services block grant.

PubMed

Lu, Michael C; Lauver, Cassie B; Dykton, Christopher; Kogan, Michael D; Lawler, Michele H; Raskin-Ramos, Lauren; Watters, Kathy; Wilson, Lee A

2015-05-01

This paper describes the transformation of the Title V Maternal and Child Health (MCH) Services Block Grant. The Maternal and Child Health Bureau of the Health Resources and Services Administration led a 21-month visioning process to engage input from MCH stakeholders and other national, state and local MCH leaders, families and other partners to improve, innovate, and transform the Title V MCH Services Block Grant. The process has helped inform the development of a new grant guidance for the next 5-year cycle beginning in fiscal year 2016. The triple aims of the transformation are to reduce burden, maintain flexibility, and increase accountability. State reporting burden is reduced by aligning and streamlining the needs assessment, annual report and application, reducing the number of forms States have to fill out, eliminating Health Systems Capacity Indicators, and prepopulating the annual report and application with State data using national data sources. State flexibility is maintained through the needs assessment process whereby State needs and priorities drive the selection of National Performance Measures and State-specific Performance Measures, and the development of State Action Plan and Evidence-based/informed Strategy Measures. Accountability is increased through the new three-tiered performance measurement framework, which will help States tell a more coherent and compelling story about the impact of Title V on the health of the Nation's mothers, children, and families. The ultimate success of the transformation will be measured by how much the transformed Title V program moves the needle in MCH in the States and for the Nation.

4 CFR 9.1 - GAO Senior Executive Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... measured on the basis of individual and organizational performance (including such factors as improvements... performance and success in meeting equal employment opportunity goals); (3) Assure that senior executives are...

A statewide model program to improve emergency department readiness for pediatric care.

PubMed

Cichon, Mark E; Fuchs, Susan; Lyons, Evelyn; Leonard, Daniel

2009-08-01

Pediatric emergency patients have unique needs, requiring specialized personnel, training, equipment, supplies, and medications. Deficiencies in these areas have resulted in historically poorer outcomes for pediatric patients versus adults. Since 1985, federally funded Emergency Medical Services for Children (EMSC) programs in each state have been working to improve the quality of pediatric emergency care. The Health Resources and Services Administration now requires that all EMSC grantees report on specific performance measures. This includes implementation of a standardized system recognizing hospitals that are able to stabilize or manage pediatric medical emergencies and trauma cases. We describe the steps involved in implementing Illinois' 3-level facility recognition process to illustrate a model that other states might use to provide appropriate pediatric care and comply with new Health Resources and Services Administration performance measures.

Service Quality in Higher Education--A Case Study of Universiti Brunei Darussalam

ERIC Educational Resources Information Center

Alani, Farooq; Yaqoub, Yasir; Hamdan, Mahani

2015-01-01

No one doubts the value and importance of quality education, and quality assurance is one major driving force to achieve this. Measuring the performance of service quality of education services of Universiti Brunei Darussalam (UBD), as part of the quality assessment, was assessed based on Parasuraman's five Servqual dimensions. The assessment was…

The structure of service quality perceptions for multiple-encounter services.

PubMed

Andaleeb, Syed Saad; Kara, Ali

2013-01-01

The objective of this study was to examine a complex service environment-hospitals-to suggest how service quality could be reframed and measured for multiple-encounter service situations more effectively. In this cross-sectional study, a sample of 371 patients completed the survey instrument. Service quality measures were guided by the literature but allowed to flow from the respondents at the preliminary stage. Confirmatory factor analysis, along with structural equation modeling, was used to test the hypothesized relationships among key actors' performance metrics (KAPMs). Patient satisfaction is significantly influenced by perceived service quality based on KAPMs. For multiple-encounter services, service quality dimensions and measures ought to be tied to KAPMs. Primary actors-ie, doctors-need knowledge and skills about patient psychology, negotiation, handling difficult patients, and, importantly, "putting the customer first." Sensitivity training on such matters should be provided. The secondary actors are the nurses who have more frequent contact with the patients. Nurses need to be perceived as "patient advocates." Effective advocacy begins with prompt and caring services to build trust. The tertiary actors in their support role also ought to be integrated into becoming vital part of the service provided.

7 CFR 205.505 - Statement of agreement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... qualities of products labeled as organically produced; (3) Conduct an annual performance evaluation of all... certification decisions and implement measures to correct any deficiencies in certification services; (4) Have...

Evaluation of an institutional project to improve venous thromboembolism prevention.

PubMed

Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

2016-12-01

Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Using benchmarking to assist the improvement of service quality in home support services for older people-IN TOUCH (Integrated Networks Towards Optimising Understanding of Community Health).

PubMed

Jacobs, Stephen P; Parsons, Matthew; Rouse, Paul; Parsons, John; Gunderson-Reid, Michelle

2018-04-01

Service providers and funders need ways to work together to improve services. Identifying critical performance variables provides a mechanism by which funders can understand what they are purchasing without getting caught up in restrictive service specifications that restrict the ability of service providers to meet the needs of the clients. An implementation pathway and benchmarking programme called IN TOUCH provided contracted providers of home support and funders with a consistent methodology to follow when developing and implementing new restorative approaches for service delivery. Data from performance measurement was used to triangulate the personal and social worlds of the stakeholders enabling them to develop a shared understanding of what is working and what is not. The initial implementation of IN TOUCH involved five District Health Boards. The recursive dialogue encouraged by the IN TOUCH programme supports better and more sustainable service development because performance management is anchored to agreed data that has meaning to all stakeholders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service.

PubMed

Solomons, Luke C; Thachil, Ajoy; Burgess, Caroline; Hopper, Adrian; Glen-Day, Vicky; Ranjith, Gopinath; Hodgkiss, Andrew

2011-01-01

To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures. Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis. Twenty-five referrers were interviewed. Four key themes were identified - benefits of the liaison service, potential areas of improvement, indices of service performance such as speed and quality of response and expanded substance misuse service. Respondents felt the liaison service benefited patients, staff and service delivery in the general hospital. Medical consultants wanted stepped management plans devised by consultant liaison psychiatrists. Senior nurses, who perceived themselves as frontline crisis managers, valued on-the-spot input on patient management. Consultants and senior nurses differed in their expectations of liaison psychiatry. Referrers valued speed of response and regarded time from referral to definitive management plan as a key performance indicator for benchmarking services. Copyright © 2011 Elsevier Inc. All rights reserved.

The Australian radiation protection and nuclear safety agency megavoltage photon thermoluminescence dosimetry postal audit service 2007-2010.

PubMed

Oliver, C P; Butler, D J; Webb, D V

2012-03-01

The Australian radiation protection and nuclear safety agency (ARPANSA) has continuously provided a level 1 mailed thermoluminescence dosimetry audit service for megavoltage photons since 2007. The purpose of the audit is to provide an independent verification of the reference dose output of a radiotherapy linear accelerator in a clinical environment. Photon beam quality measurements can also be made as part of the audit in addition to the output measurements. The results of all audits performed between 2007 and 2010 are presented. The average of all reference beam output measurements calculated as a clinically stated dose divided by an ARPANSA measured dose is 0.9993. The results of all beam quality measurements calculated as a clinically stated quality divided by an ARPANSA measured quality is 1.0087. Since 2011 the provision of all auditing services has been transferred from the Ionizing Radiation Standards section to the Australian Clinical Dosimetry Service (ACDS) which is currently housed within ARPANSA.

A new performance measurement system for maternal and child health in the United States.

PubMed

Kogan, Michael D; Dykton, Christopher; Hirai, Ashley H; Strickland, Bonnie B; Bethell, Christina D; Naqvi, Iran; Cano, Carlos E; Downing-Futrell, Sheri L; Lu, Michael C

2015-05-01

The Title V Maternal and Child Health (MCH) Block Grant is the linchpin for US MCH services. The first national performance measures (NPMs) for MCH were instituted in 1997. Changing trends in MCH risk factors, outcomes, health services, data sources, and advances in scientific knowledge, in conjunction with budgetary constraints led the Maternal and Child Health Bureau (MCHB) to design a new performance measurement system. A workgroup was formed to develop a new system. The following guiding principles were used: (1) Afford States more flexibility and reduce the overall reporting burden; (2) Improve accountability to better document Title V's impact; (3) Develop NPMs that encompass measures in: maternal and women's health, perinatal health, child health, children with special health care needs, adolescent health, and cross-cutting areas. A three-tiered performance measurement system was proposed with national outcome measures (NOMs), NPMs and evidence-based/informed strategy measures (ESMs). NOMs are the ultimate goals that MCHB and States are attempting to achieve. NPMs are measures, generally associated with processes or programs, shown to affect NOMs. ESMs are evidence-based or informed measures that each State Title V program develops to affect the NPMs. There are 15 NPMs from which States select eight, with at least one from each population area. MCHB will provide the data for the NOMs and NPMs, when possible. The new performance measurement system increases the flexibility and reduces the reporting burden for States by allowing them to choose 8 NPMs to target, and increases accountability by having States develop actionable ESMs. The new national performance measure framework for maternal and child health will allow States more flexibility to address their areas of greatest need, reduce their data reporting burden by having the Maternal and Child Health Bureau provide data for the National Outcome and Performance Measures, yet afford States the opportunity to develop measurable strategies to address their selected performance measures.

Key performance indicators for Australian mental health court liaison services.

PubMed

Davidson, Fiona; Heffernan, Ed; Greenberg, David; Butler, Tony; Burgess, Philip

2017-12-01

The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Operationalisation of service quality in household waste collection.

PubMed

Schulte, Nico Alexander; Gellenbeck, Klaus; Nelles, Michael

2017-04-01

Since 2007, there has been intensive discussion at European and national levels concerning the standardisation of services including those in the sector of waste management. The drafts of the European standard prEN 16250 and the German preliminary standard DIN SPEC 1108 are intended to establish a uniform definition of corresponding services and their (minimum) service levels. Their binding application in practice requires that systematic inspections be provided to ascertain to what degree a service has been carried out as agreed upon. However, both standardisation projects give only a few examples of potential quality characteristics and offer no concrete information concerning methods of measurement. Because intersectoral or cross-service quality inspections do not exist, there is a need for the development of specific quality inspections. The study introduced in this article examines the question of how the service quality of door-to-door waste collection can be systematically measured. To this end, the quality concept applied to the process of waste collection was first concretised and then operationalised using indicators. Based upon this, the methods of the quality inspections were developed and subjected to a trial of their applicability in a German waste management company. The methods for measuring and evaluating take into account, in addition to the different boundary conditions of collection, also the possible customer influence on the collection process and consequently on the service performed by the collection crew. In order to avoid time- and therefore cost-intensive exhaustive surveys, a multilevel random-controlled selection of survey units was developed, too. Based on the analysis of the measurement data, it was possible to determine specific time requirement values for the regular performance of the data surveys, as well as minimum sample sizes as a function of the number of container locations of the waste collection tours. On the basis of this information, it has been possible to make initial statements concerning the personnel requirement for quality inspections. Moreover, it is possible to make recommendations concerning the daily working-time schedule for a quality manager in order to achieve the most efficient performance of quality inspections possible. Copyright © 2017 Elsevier Ltd. All rights reserved.

45 CFR 305.61 - Penalty for failure to meet IV-D requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.61 Penalty for failure to meet IV-D requirements. (a) A State will be subject to a financial... order establishment and current collections performance measures as set forth in § 305.40 of this part...

Comparative Performance Data for Critical Access Hospitals

ERIC Educational Resources Information Center

Pink, George H.; Slifkin, Rebecca T.; Coburn, Andrew F.; Gale, John A.

2004-01-01

Context: Among small rural hospitals, there is a growing recognition of the need to measure and report on the use of resources and the safety and quality of the services provided. Dashboards, clinical value compasses, and balanced scorecards are approaches to performance measurement that have been adopted by many health care organizations.…

The Utility of Curriculum-Based Measurement and Performance Assessment as Alternatives to Traditional Intelligence and Achievement Tests.

ERIC Educational Resources Information Center

Elliott, Stephen N.; Fuchs, Lynn S.

1997-01-01

Curriculum-based measurement and performance assessments can provide valuable data for making special-education eligibility decisions. Reviews applied research on these assessment approaches and discusses the practical context of treatment validation and decisions about instructional services for students with diverse academic needs. (Author/JDM)

AAL service development loom--from the idea to a marketable business model.

PubMed

Kriegel, Johannes; Auinger, Klemens

2015-01-01

The Ambient Assisted Living (AAL) market is still in an early stage of development. Previous approaches of comprehensive AAL services are mostly supply-side driven and focused on hardware and software. Usually this type of AAL solutions does not lead to a sustainable success on the market. Research and development increasingly focuses on demand and customer requirements in addition to the social and legal framework. The question is: How can a systematic performance measurement strategy along a service development process support the market-ready design of a concrete business model for AAL service? Within the EU funded research project DALIA (Assistant for Daily Life Activities at Home) an iterative service development process uses an adapted Osterwalder business model canvas. The application of a performance measurement index (PMI) to support the process has been developed and tested. Development of an iterative service development model using a supporting PMI. The PMI framework is developed throughout the engineering of a virtual assistant (AVATAR) as a modular interface to connect informal carers with necessary and useful services. Future research should seek to ensure that the PMI enables meaningful transparency regarding targeting (e.g. innovative AAL service), design (e.g. functional hybrid AAL service) and implementation (e.g. marketable AAL support services). To this end, a further reference to further testing practices is required. The aim must be to develop a weighted PMI in the context of further research, which supports both the service engineering and the subsequent service management process.

Cooling Tower (Evaporative Cooling System) Measurement and Verification Protocol

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

Kurnik, Charles W.; Boyd, Brian; Stoughton, Kate M.

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with cooling tower efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

Outdoor Irrigation Measurement and Verification Protocol

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M&V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with outdoor irrigation efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M&V plan, and details the procedures to use to determine water savings.

Quality of asthma care under different primary care models in Canada: a population-based study.

PubMed

To, Teresa; Guan, Jun; Zhu, Jingqin; Lougheed, M Diane; Kaplan, Alan; Tamari, Itamar; Stanbrook, Matthew B; Simatovic, Jacqueline; Feldman, Laura; Gershon, Andrea S

2015-02-14

Previous research has shown variations in quality of care and patient outcomes under different primary care models. The objective of this study was to use previously validated, evidence-based performance indicators to measure quality of asthma care over time and to compare quality of care between different primary care models. Data were obtained for years 2006 to 2010 from the Ontario Asthma Surveillance Information System, which uses health administrative databases to track individuals with asthma living in the province of Ontario, Canada. Individuals with asthma (n=1,813,922) were divided into groups based on the practice model of their primary care provider (i.e., fee-for-service, blended fee-for-service, blended capitation). Quality of asthma care was measured using six validated, evidence-based asthma care performance indicators. All of the asthma performance indicators improved over time within each of the primary care models. Compared to the traditional fee-for-service model, the blended fee-for-service and blended capitation models had higher use of spirometry for asthma diagnosis and monitoring, higher rates of inhaled corticosteroid prescription, and lower outpatient claims. Emergency department visits were lowest in the blended fee-for-service group. Quality of asthma care improved over time within each of the primary care models. However, the amount by which they improved differed between the models. The newer primary care models (i.e., blended fee-for-service, blended capitation) appear to provide better quality of asthma care compared to the traditional fee-for-service model.

Assessment of population coverage of hypertension screening in Thailand based on the effective coverage framework.

PubMed

Charoendee, Kulpimol; Sriratanaban, Jiruth; Aekplakorn, Wichai; Hanvoravongchai, Piya

2018-03-27

Hypertension (HT) is a major risk factor, and accessible and effective HT screening services are necessary. The effective coverage framework is an assessment tool that can be used to assess health service performance by considering target population who need and receive quality service. The aim of this study is to measure effective coverage of hypertension screening services at the provincial level in Thailand. Over 40 million individual health service records in 2013 were acquired. Data on blood pressure measurement, risk assessment, HT diagnosis and follow up were analyzed. The effectiveness of the services was assessed based on a set of quality criteria for pre-HT, suspected HT, and confirmed HT cases. Effective coverage of HT services for all non-HT Thai population aged 15 or over was estimated for each province and for all Thailand. Population coverage of HT screening is 54.6%, varying significantly across provinces. Among those screened, 28.9% were considered pre-HT, and another 6.0% were suspected HT cases. The average provincial effective coverage was at 49.9%. Around four-fifths (82.6%) of the pre-HT group received HT and Cardiovascular diseases (CVD) risk assessment. Among the suspected HT cases, less than half (38.0%) got a follow-up blood pressure measurement within 60 days from the screening date. Around 9.2% of the suspected cases were diagnosed as having HT, and only one-third of them (36.5%) received treatment within 6 months. Within this group, 21.8% obtained CVD risk assessment, and half of them had their blood pressure under control (50.8%) with less than 1 % (0.7%) of them managed to get the CVD risk reduced. Our findings suggest that hypertension screening coverage, post-screening service quality, and effective coverage of HT screening in Thailand were still low and they vary greatly across provinces. It is imperative that service coverage and its effectiveness are assessed, and both need improvement. Despite some limitations, measurement of effective coverage could be done with existing data, and it can serve as a useful tool for performance measurement of public health services.

The effects of organization on medical utilization: an analysis of service line organization.

PubMed

Byrne, Margaret M; Charns, Martin P; Parker, Victoria A; Meterko, Mark M; Wray, Nelda P

2004-01-01

To determine whether clinical service lines in primary care and mental health reduces inpatient and urgent care utilization. All VHA medical centers were surveyed to determine whether service lines had been established in primary care or mental health care prior to the beginning of fiscal year 1997 (FY97). Facility-level data on medical utilization from Veterans Health Affairs (VHA) administrative databases were used for descriptive and multivariate regression analyses of utilization and of changes in measures between FY97 and FY98. Nine primary care-related and 5 mental health-related variables were analyzed. Primary care and mental health service lines had been established in approximately half of all facilities. Service lines varied in duration and extent of restructuring. Mere presence of a service line had no positive and several negative effects on measured outcome variables. More detailed analyses showed that some types of service lines have statistically significant and mostly negative effects on both mental health and primary care-related measures. Newly implemented service lines had significantly less improvement in measures over time than facilities with no service line. Health care organizations are implementing innovative organizational structures in hopes of improving quality of care and reducing resource utilization. We found that service lines in primary care and mental health may lead to an initial period of disruption, with little evidence of a beneficial effect on performance for longer duration service lines.

The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

PubMed

Tukey, Melissa H; Wiener, Renda Soylemez

2014-03-01

At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

Benchmarking surgeon satisfaction at academic health centers: a nationwide comparative survey.

PubMed

Drachman, D A

1996-01-01

Forty-six academic health centers (AHCs) belonging to the University HealthSystem consortium joined forces to compare the efficiency of their surgical services and to identify best practices. In addition to measures of operational performance, surgeon satisfaction with the surgical services provided was measured by using a standardized questionnaire. From hospital records, indicators of the efficiency of surgical services were collected in three main areas: scheduling, preoperative testing and assessment, and the intraoperative process. Responding to a mail questionnaire, a sample of surgeons rated their satisfaction with key aspects of surgical services including scheduling, operating room staff, and equipment/supplies. On the basis of a review of the operational measures and the survey results, high performers were identified. Site visits were made to several of these high performers to uncover the critical factors responsible for their success. The survey revealed distinct variations in surgeon satisfaction across the participating institutions. Numerical benchmarks were obtained for surgeon satisfaction with each key component of surgical services. Scheduling was the most important component of overall surgeon satisfaction, explaining 71% of the variance in the rating of overall satisfaction with surgical services. High operational efficiency and high surgeon satisfaction were not incompatible. Several of the participating institutions were able to achieve both. These results were disseminated to all of the participants at a national meeting as well as in written form. The surgeon satisfaction survey allowed the participants to establish benchmarks for surgeon satisfaction for each key component of the surgical services they receive. The site visits revealed several common characteristics of highly efficient surgical services. Taken by themselves, the participating institutions might have been reluctant to consider adopting these best practices for fear of alienating the surgical staff. The availability of data on surgeon satisfaction showed the participants that these best practices can coexist with high levels of surgeon satisfaction. This has helped to promote their adoption by the other participating institutions.

Digital Microwave System Design Guide.

DTIC Science & Technology

1984-02-01

traffic analysis is a continuous effort, setting parameters for subsequent stages of expansion after the system design is finished. 2.1.3 Quality of...operational structure of the user for whom he is providing service. 2.2.3 Quality of Service. In digital communications, the basic performance parameter ...the basic interpretation of system performance is measured in terms of a single parameter , throughput. Throughput can be defined as the number of

26 CFR 801.7 - Examples.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 20 2010-04-01 2010-04-01 false Examples. 801.7 Section 801.7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INTERNAL REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL REVENUE SERVICE § 801.7...

Improving Rural Emergency Medical Services (EMS) through transportation system enhancements Phase II.

DOT National Transportation Integrated Search

2015-12-01

Providing acute medical care outside of the hospital, Emergency Medical Services (EMS) is crucial in rural environments where hospitals are not close by and are difficult to access. Establishing EMS performance measures is critical in improving a rur...

[Nusing-sensitive indicadors: an opportunity for measuring the nurse contribution].

PubMed

Planas-Campmany, Carme; Icart-Isern, M Teresa

2014-01-01

The measures directed at improving the management and funding of health services that justify the measurement of performance and the purchase of services based on results, have a direct influence on nursing. In this context, concerns about the value and contribution of nursing have been demonstrated worldwide over the last decades. Therefore efforts are being made to ensure that nurses contribute to promote the transformation of health systems. This requires identifying their contribution to the health system and, specifically, in relation to health outcomes. In recent decades, there has been a growing demand to achieve measures which allow nurses to demonstrate and assume responsibility for their contribution. The research and development of nursing-sensitive indicators and results, and its application, provide an opportunity to measure the contribution and professional performance in achieving these set objectives, in order to improve population health. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Performance retention of the RB211 powerplant in service

NASA Technical Reports Server (NTRS)

Astridge, B. L.; Pinder, J. T.

1981-01-01

An understanding of the mechanisms of deterioration is essential in order that features to counteract performance degradation can be built into the basic design of an engine and nacelle. Furthermore, the interpretation must be continued in service for effective feedback to provide modifications which may be necessary in maintaining a satisfactory performance retention program. The in service assessment must be accurate as to magnitude and causes and this requires consideration of: (1) the powerplant as a complete entity, i.e., the engine components and nacelle including the thrust reverser; (2) measurement of performance in flight rather than by sole reliance on the scaling of test cell data to flight conditions (although some correlation should be possible); and (3) the relationship of engine parts condition to overhaul performance and in flight deterioration level of that engine. These aspects are addressed by consideration of the RB211 engine in service in both the Lockheed L1011 Tristar and Boeing 747 aircraft.

CF6 jet engine performance deterioration results

NASA Technical Reports Server (NTRS)

Lewis, R. J.; Humerickhouse, C. E.; Paas, J. E.

1978-01-01

The use of the performance baseline from the flight planning manual as a reference to measure changes in cruise fuel flow rates was discussed. For the CF6-6D engine, the introduction of design changes for performance and durability reasons was seen to introduce an average increment relative to this baseline of 3.2% WFM increase at Nl, 2.5% Fn increase at Nl, 0.8% specific fuel consumption (SFC) increase at Fn, and 7 C EGT increase at Nl, while maintaining sufficient SFC margin of the delivered airplane. The effect of revenue service deterioration and performance restoration relative to the reference was shown to be an adder on top of these design effects. A schematic of typical CF6-6D performance through revenue service and airline maintenance is presented in terms of percent cruise SFC relative to an airline datum point (average level upon entering revenue service). The typical changes in SFC margin are shown for airline revenue service through for installations and refurbishments.

Performance measures for public transit mobility management.

DOT National Transportation Integrated Search

2011-12-01

"Mobility management is an innovative approach for managing and delivering coordinated public : transportation services that embraces the full family of public transit options. At a national level, there are : currently no industry recognized perform...

76 FR 80312 - Periodic Reporting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... establishing a docket to consider new measurement of Flats Sequencing Systems operations, a change in the... Mail cost model in periodic reporting of service performance measurement. Establishing this docket will...: proposed productivity measurement for Flats Sequencing System. Proposal Sixteen introduces a new method for...

Optimising the changing role of the community pharmacist: a randomised trial of the impact of audit and feedback

PubMed Central

Winslade, Nancy; Eguale, Tewodros; Tamblyn, Robyn

2016-01-01

Objective To evaluate the impact of comparative performance feedback to community pharmacists on provision of professional services and the quality of patients’ medication use. Design Randomised, controlled, single-blind trial. Setting All 1833 community pharmacies in the Quebec province, Canada. Participants 1814 pharmacies not opting out and with more than 5 dispensings of the target medications during the 6-month baseline were randomised by a 2×2 factorial design to feedback first for hypertension adherence (907 control, 907 intervention) followed by randomisation for asthma adherence (791 control, 807 intervention). 1422 of 1814 pharmacies had complete information available during the follow-up for hypertension intervention (706 intervention, 716 control), and 1301 of 1598 had the follow-up information for asthma (657 intervention, 644 control). Intervention Using provincial billing data to measure performance, mailed comparative feedback reported the pharmacy-level percentage of dispensings to patients non-adherent to antihypertensive medications or overusing asthma rescue inhalers. Primary and secondary outcome measures The number of hypertension/asthma services billed per pharmacy and percentage of dispensings to non-adherent patients over the 12 months post intervention. Results Feedback on the asthma measure led to increased provision of asthma services (control 0.2, intervention 0.4, RR 1.58, 95% CI 1.02 to 2.46). However, this did not translate into reductions in patients’ overuse of rescue inhalers (control 45.5%, intervention 44.6%, RR 0.99, 95% CI 0.98 to 1.01). For non-adherence to antihypertensive medications, feedback resulted in no difference in either provision of hypertension services (control 0.7, intervention 0.8, RR 1.25, 95% CI 0.86 to 1.82) or antihypertensive treatment adherence (control 27.9%, intervention 28.0%, RR 1.0, 95% CI 0.99 to 1.00). Baseline performance did not influence results, and there was no evidence of a cumulative effect with repeated feedback. Conclusions Comparative pharmacy performance feedback increased the provision of asthma pharmacists’ services but did not improve the performance on medication-use measures. Billing data can be used to evaluate the impact of billable services rendered by pharmacists on the quality of patients’ medication use. PMID:27207626

Long-Term In-Service Monitoring and Performance Assessment of the Main Cables of Long-Span Suspension Bridges

PubMed Central

Deng, Yang; Liu, Yang; Chen, Suren

2017-01-01

Despite the recent developments in structural health monitoring, there remain great challenges for accurately, conveniently, and economically assessing the in-service performance of the main cables for long-span suspension bridges. A long-term structural health monitoring technique is developed to measure the tension force with a conventional sensing technology and further provide the in-service performance assessment strategy of the main cable. The monitoring system adopts conventional vibrating strings transducers to monitor the tension forces of separate cable strands of the main cable in the anchor span. The performance evaluation of the main cable is conducted based on the collected health monitoring data: (1) the measured strand forces are used to derive the overall tension force of a main cable, which is further translated into load bearing capacity assessment using the concept of safety factor; and (2) the proposed technique can also evaluate the uniformity of tension forces from different cable strands. The assessment of uniformity of strand forces of a main cable offers critical information in terms of potential risks of partial damage and performance deterioration of the main cable. The results suggest the proposed low-cost monitoring system is an option to provide approximate estimation of tension forces of main cables for suspension bridges. With the long-term monitoring data, the proposed monitoring-based evaluation methods can further provide critical information to assess the safety and serviceability performance of main cables. PMID:28621743

Long-Term In-Service Monitoring and Performance Assessment of the Main Cables of Long-Span Suspension Bridges.

PubMed

Deng, Yang; Liu, Yang; Chen, Suren

2017-06-16

Despite the recent developments in structural health monitoring, there remain great challenges for accurately, conveniently, and economically assessing the in-service performance of the main cables for long-span suspension bridges. A long-term structural health monitoring technique is developed to measure the tension force with a conventional sensing technology and further provide the in-service performance assessment strategy of the main cable. The monitoring system adopts conventional vibrating strings transducers to monitor the tension forces of separate cable strands of the main cable in the anchor span. The performance evaluation of the main cable is conducted based on the collected health monitoring data: (1) the measured strand forces are used to derive the overall tension force of a main cable, which is further translated into load bearing capacity assessment using the concept of safety factor; and (2) the proposed technique can also evaluate the uniformity of tension forces from different cable strands. The assessment of uniformity of strand forces of a main cable offers critical information in terms of potential risks of partial damage and performance deterioration of the main cable. The results suggest the proposed low-cost monitoring system is an option to provide approximate estimation of tension forces of main cables for suspension bridges. With the long-term monitoring data, the proposed monitoring-based evaluation methods can further provide critical information to assess the safety and serviceability performance of main cables.

Measuring Michigan local and statewide transit levels of service.

DOT National Transportation Integrated Search

2014-09-01

The Michigan Department of Transportations (MDOT) Office of Passenger Transportation, in : conjunction with MDOTs Research Administration, worked with Cambridge Systematics and : Kimley-Horn and Associates to research performance measures for t...

Investigating emergency room service quality using lean manufacturing.

PubMed

Abdelhadi, Abdelhakim

2015-01-01

The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.

Western Cape Primary Care Assessment Tool (PCAT) study: Measuring primary care organisation and performance in the Western Cape Province, South Africa (2013)

PubMed Central

Sayed, Abdul-Rauf; le Grange, Cynthia; Bhagwan, Susheela; Manga, Nayna; Hellenberg, Derek

2016-01-01

Background Major health sector reform and the need for baseline measures of performance to determine impact. Aim Baseline audit of primary healthcare (PHC) performance. Setting Cape Town and Cape Winelands (rural) PHC facilities (PCFs) in Western Cape Province, South Africa. Method The South African cross-culturally validated ZA PCAT to audit PHC performance on 11 subdomains associated with improved health and reduced costs. Adult PCF users systematically sampled. All full-time doctors and nurse practitioners in PCFs sampled and all PCF managers in sub-districts sampled invited into the study. Results Data from 1432 users, 100 clinicians and 64 managers from 13 PCFs in 10 sub-districts analysed (figures show stakeholder percentages scoring subdomain performance ‘acceptable to good’). 11.5% users scored access ‘acceptable to good’; community orientation and comprehensive services provided 20.8% and 39.9%, respectively. Total PHC score for users 50.2%; for managers and practitioners 82.8% and 88.0%, respectively. Among practitioners access was lowest (33.3%); PHC team (98.0%) and comprehensive services available (100.0%) highest. Among managers, access (13.5%) and family centredness (45.6%) are lowest; PHC team (85.9%) and comprehensive services available (90.6%) highest. Managers scored access, family centredness and cultural competence significantly lower than practitioners. Users scored comprehensive services available, comprehensive services provided and community orientation significantly lower than practitioners and managers. Conclusion Gaps between users’ experience and providers’ assessments of PHC performance are identified. Features that need strengthening and alignment with best practice, provincial and national, and health policies are highlighted with implications for practitioner and manager training, health policy, and research. PMID:27247157

42 CFR 486.348 - Condition: Quality assessment and performance improvement (QAPI).

Code of Federal Regulations, 2010 CFR

2010-10-01

... improvement (QAPI). 486.348 Section 486.348 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Coverage: Organ Procurement Organizations Organ Procurement Organization Process Performance Measures § 486.348 Condition: Quality assessment and performance improvement (QAPI). The OPO must develop, implement...

45 CFR 305.33 - Determination of applicable percentages based on performance levels.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.33 Determination of applicable percentages based on performance levels. (a) A State's... performance levels. 305.33 Section 305.33 Public Welfare Regulations Relating to Public Welfare OFFICE OF...

49 CFR 393.52 - Brake performance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Brake performance. 393.52 Section 393.52... NECESSARY FOR SAFE OPERATION Brakes § 393.52 Brake performance. (a) Upon application of its service brakes... braking force is measured by a performance-based brake tester which meets the requirements of functional...

49 CFR 393.52 - Brake performance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Brake performance. 393.52 Section 393.52... NECESSARY FOR SAFE OPERATION Brakes § 393.52 Brake performance. (a) Upon application of its service brakes... braking force is measured by a performance-based brake tester which meets the requirements of functional...

49 CFR 393.52 - Brake performance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Brake performance. 393.52 Section 393.52... NECESSARY FOR SAFE OPERATION Brakes § 393.52 Brake performance. (a) Upon application of its service brakes... braking force is measured by a performance-based brake tester which meets the requirements of functional...

49 CFR 393.52 - Brake performance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Brake performance. 393.52 Section 393.52... NECESSARY FOR SAFE OPERATION Brakes § 393.52 Brake performance. (a) Upon application of its service brakes... braking force is measured by a performance-based brake tester which meets the requirements of functional...

49 CFR 393.52 - Brake performance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false Brake performance. 393.52 Section 393.52... NECESSARY FOR SAFE OPERATION Brakes § 393.52 Brake performance. (a) Upon application of its service brakes... braking force is measured by a performance-based brake tester which meets the requirements of functional...

Development and Evaluation of a Novel Survey Tool Assessing Inpatient Consult Service Performance.

PubMed

Miloslavsky, Eli M; Chang, Yuchiao

2017-12-01

Subspecialty consultation in inpatient medicine is increasing, and enhancing performance of consultation services may have a broad-reaching impact. Multisource feedback is an important tool in assessing competence and improving performance. A mechanism for primary team resident feedback on performance of consult services has not been described. We developed and evaluated an instrument designed to assess internal medicine (IM) subspecialty inpatient consult service performance. We hypothesized that the instrument would be feasible to administer and provide important information to fellowship directors. The instrument was administered in 2015 and 2016 at a single academic center. All IM residents were invited to evaluate 10 IM subspecialty consult services on 4 items and an overall satisfaction rating. The instrument allowed for free-text feedback to fellows. Program directors completed another survey assessing the impact of the consult service evaluation. A total of 113 residents responded (47 in 2015 and 66 in 2016, for a combined response rate of 35%). Each of the 4 items measured (communication, professionalism, teaching, and pushback) correlated significantly with the overall satisfaction rating in univariate and multivariate analyses. There were no differences in ratings across postgraduate year or year of administration. There was considerable variation in ratings among the services evaluated. The 7 program directors who provided feedback found the survey useful and made programmatic changes following evaluation implementation. A primary team resident evaluation of inpatient medicine subspecialty consult services is feasible, provides valuable information, and is associated with changes in consult service structure and curricula.

Efficiency of Health Care Production in Low-Resource Settings: A Monte-Carlo Simulation to Compare the Performance of Data Envelopment Analysis, Stochastic Distance Functions, and an Ensemble Model

PubMed Central

Giorgio, Laura Di; Flaxman, Abraham D.; Moses, Mark W.; Fullman, Nancy; Hanlon, Michael; Conner, Ruben O.; Wollum, Alexandra; Murray, Christopher J. L.

2016-01-01

Low-resource countries can greatly benefit from even small increases in efficiency of health service provision, supporting a strong case to measure and pursue efficiency improvement in low- and middle-income countries (LMICs). However, the knowledge base concerning efficiency measurement remains scarce for these contexts. This study shows that current estimation approaches may not be well suited to measure technical efficiency in LMICs and offers an alternative approach for efficiency measurement in these settings. We developed a simulation environment which reproduces the characteristics of health service production in LMICs, and evaluated the performance of Data Envelopment Analysis (DEA) and Stochastic Distance Function (SDF) for assessing efficiency. We found that an ensemble approach (ENS) combining efficiency estimates from a restricted version of DEA (rDEA) and restricted SDF (rSDF) is the preferable method across a range of scenarios. This is the first study to analyze efficiency measurement in a simulation setting for LMICs. Our findings aim to heighten the validity and reliability of efficiency analyses in LMICs, and thus inform policy dialogues about improving the efficiency of health service production in these settings. PMID:26812685

An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

DOE PAGES

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca; ...

2017-04-04

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

An end of service life assessment of PMMA lenses from veteran concentrator photovoltaic systems

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

Miller, David C.; Khonkar, Hussameldin I.; Herrero, Rebeca

The optical performance of poly(methyl methacrylate) lenses from veteran concentrator photovoltaic modules was examined after the end of their service life. Lenses from the Martin-Marietta and Intersol module designs were examined from the 'Solar Village' site near Riyadh, Saudi Arabia, as well as the Phoenix Sky Harbor airport, followed by the Arizona Public Service Solar Test and Research (APS-STaR) center in Tempe, Arizona. The various lens specimens were deployed for 20, 27, and 22 years, respectively. Optical characterizations included lens efficiency (Solar Simulator instrument), material transmittance and haze (of coupons cut from veteran lenses, then measured again after their facetedmore » back surface was polished, and then measured again after the incident front surface was polished), and direct transmittance (as a function of detector's acceptance angle, using the Very Low Angular Beam Spread ('VLABS') instrument). Lens efficiency measurements compared the central region to the entire lens, also using hot and cold mirror measurements to diagnose differences in performance. A series of subsequent characterizations was performed because a decrease in performance of greater than 10% was observed for some of the veteran lenses. The optimal focal distance of the lenses was quantified using the Solar Simulator, and then correlated to lens curvature using a recently developed measurement technique. Surface roughness was examined using atomic force microscopy and scanning electron microscopy. Facet geometry (tip and valley radius) was quantified on cross-sectioned specimens. As a result, molecular weight was compared between the incident and faceted surfaces of the lenses.« less

Gaining competitive advantage in personal dosimetry services through ISO 9001 certification.

PubMed

Noriah, M A

2007-01-01

This paper discusses the advantage of certification process in the quality assurance of individual dose monitoring in Malaysia. The demand by customers and the regulatory authority for a higher degree of quality service requires a switch in emphasis from a technically focused quality assurance program to a comprehensive quality management for service provision. Achieving the ISO 9001:2000 certification by an accredited third party demonstrates acceptable recognition and documents the fact that the methods used are capable of generating results that satisfy the performance criteria of the certification program. It also offers a proof of the commitment to quality and, as a benchmark, allows measurement of the progress for continual improvement of service performance.

Measure Guideline. Wood Window Repair, Rehabilitation, and Replacement

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

Baker, P.; Eng, P.

2012-12-01

This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

Measure Guideline: Window Repair, Rehabilitation, and Replacement

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

Baker, P.

2012-12-01

This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

26 CFR 801.5 - Employee satisfaction measures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 20 2011-04-01 2011-04-01 false Employee satisfaction measures. 801.5 Section 801.5 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INTERNAL REVENUE PRACTICE BALANCED SYSTEM FOR MEASURING ORGANIZATIONAL AND EMPLOYEE PERFORMANCE WITHIN THE INTERNAL...

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study

PubMed Central

Kikui, Miki; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-01-01

Abstract There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t‐test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t‐test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population. PMID:29744141

Does the utilization of dental services associate with masticatory performance in a Japanese urban population?: the Suita study.

PubMed

Kikui, Miki; Ono, Takahiro; Kida, Momoyo; Kosaka, Takayuki; Yamamoto, Masaaki; Yoshimuta, Yoko; Yasui, Sakae; Nokubi, Takashi; Maeda, Yoshinobu; Kokubo, Yoshihiro; Watanabe, Makoto; Miyamoto, Yoshihiro

2015-12-01

There are numerous reports on the relationship between regular utilization of dental care services and oral health, but most are based on questionnaires and subjective evaluation. Few have objectively evaluated masticatory performance and its relationship to utilization of dental care services. The purpose of this study was to identify the effect of regular utilization of dental services on masticatory performance. The subjects consisted of 1804 general residents of Suita City, Osaka Prefecture (760 men and 1044 women, mean age 66.5 ± 7.9 years). Regular utilization of dental services and oral hygiene habits (frequency of toothbrushing and use of interdental aids) was surveyed, and periodontal status, occlusal support, and masticatory performance were measured. Masticatory performance was evaluated by a chewing test using gummy jelly. The correlation between age, sex, regular dental utilization, oral hygiene habits, periodontal status or occlusal support, and masticatory performance was analyzed using Spearman's correlation test and t -test. In addition, multiple linear regression analysis was carried out to investigate the relationship of regular dental utilization with masticatory performance after controlling for other factors. Masticatory performance was significantly correlated to age when using Spearman's correlation test, and to regular dental utilization, periodontal status, or occlusal support with t -test. Multiple linear regression analysis showed that regular utilization of dental services was significantly related to masticatory performance even after adjusting for age, sex, oral hygiene habits, periodontal status, and occlusal support (standardized partial regression coefficient β  = 0.055). These findings suggested that the regular utilization of dental care services is an important factor influencing masticatory performance in a Japanese urban population.

NPS National Transit Inventory and Performance Report, 2014

DOT National Transportation Integrated Search

2015-09-09

This document summarizes key highlights and performance measures from the National Park Service (NPS) 2014 National Transit Inventory, and presents data for NPS transit systems system-wide. The document discusses statistics related to ridership, busi...

Indicators and Methods for Evaluating Economic, Ecosystem ...

EPA Pesticide Factsheets

The U.S. Human Well-being Index (HWBI) is a composite measure that incorporates economic, environmental, and societal well-being elements through the eight domains of connection to nature, cultural fulfillment, education, health, leisure time, living standards, safety and security, and social cohesion (USEPA 2012a; Smith et al. 2013). Twenty-eight services, represented by a collection of indicators and metrics, have been identified as influencing these domains of human well-being. By taking an inventory of stocks or measuring the results of a service, a relationship function can be derived to understand how changes in the provisioning of that service can influence the HWBI. An extensive review of existing services was performed to identify current services, indicators and metrics in use. This report describes the indicators and methods we have selected to evaluate the provisioning of economic, ecosystem, and social services related to human well-being. Provide metadata and methods for calculating services provisioning scores for HWBI modeling framework

Intelligent call admission control for multi-class services in mobile cellular networks

NASA Astrophysics Data System (ADS)

Ma, Yufeng; Hu, Xiulin; Zhang, Yunyu

2005-11-01

Scarcity of the spectrum resource and mobility of users make quality of service (QoS) provision a critical issue in mobile cellular networks. This paper presents a fuzzy call admission control scheme to meet the requirement of the QoS. A performance measure is formed as a weighted linear function of new call and handoff call blocking probabilities of each service class. Simulation compares the proposed fuzzy scheme with complete sharing and guard channel policies. Simulation results show that fuzzy scheme has a better robust performance in terms of average blocking criterion.

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... improves patient safety by using quality indicators or performance measures associated with improved health... incorporate quality indicator data, including patient care and other relevant data regarding services...

Research on the Establishment and Evaluation of End - to - End Service Quality Index System

NASA Astrophysics Data System (ADS)

Wei, Chen; Jing, Tao; Ji, Yutong

2018-01-01

From the perspective of power data networks, put forward the index system model to measure the quality of service, covering user experience, business performance, network capacity support, etc., and gives the establishment and use of each layer index in the model.

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

Kurnik, Charles W.; Stoughton, Kate M; Figueroa, Jorge

This measurement and verification (M&V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with outdoor irrigation efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M&V plan, and details the procedures to use to determine water savings.

Exploring emergency department 4-hour target performance and cancelled elective operations: a regression analysis of routinely collected and openly reported NHS trust data.

PubMed

Keogh, Brad; Culliford, David; Guerrero-Ludueña, Richard; Monks, Thomas

2018-05-24

To quantify the effect of intrahospital patient flow on emergency department (ED) performance targets and indicate if the expectations set by the National Health Service (NHS) England 5-year forward review are realistic in returning emergency services to previous performance levels. Linear regression analysis of routinely reported trust activity and performance data using a series of cross-sectional studies. NHS trusts in England submitting routine nationally reported measures to NHS England. 142 acute non-specialist trusts operating in England between 2012 and 2016. The primary outcome measures were proportion of 4-hour waiting time breaches and cancelled elective operations. Univariate and multivariate linear regression models were used to show relationships between the outcome measures and various measures of trust activity including empty day beds, empty night beds, day bed to night bed ratio, ED conversion ratio and delayed transfers of care. Univariate regression results using the outcome of 4-hour breaches showed clear relationships with empty night beds and ED conversion ratio between 2012 and 2016. The day bed to night bed ratio showed an increasing ability to explain variation in performance between 2015 and 2016. Delayed transfers of care showed little evidence of an association. Multivariate model results indicated that the ability of patient flow variables to explain 4-hour target performance had reduced between 2012 and 2016 (19% to 12%), and had increased in explaining cancelled elective operations (7% to 17%). The flow of patients through trusts is shown to influence ED performance; however, performance has become less explainable by intratrust patient flow between 2012 and 2016. Some commonly stated explanatory factors such as delayed transfers of care showed limited evidence of being related. The results indicate some of the measures proposed by NHS England to reduce pressure on EDs may not have the desired impact on returning services to previous performance levels. © 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.

75 FR 57989 - Exceptions from Periodic Reporting Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... requested semi-permanent exceptions to certain recently-adopted service performance measurement reporting... explore other measurement options or use of proxies for reporting purposes for the exceptions not granted... of a proxy as a substitute for a direct measurement. DATES: Request for waivers from the Postal...

Community Level Association between Home Health and Nursing Home Performance on Quality and Hospital 30-day Readmissions for Medicare Patients.

PubMed

Wang, Yun; Pandolfi, Michelle M; Fine, Jonathan; Metersky, Mark L; Wang, Changqin; Ho, Shih-Yieh; Galusha, Deron; Nuti, Sudhakar V; Murugiah, Karthik; Spenard, Ann; Elwell, Timothy; Krumholz, Harlan M

2016-11-01

We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17-0.34) and 0.60% (95% CI 0.33-0.83), respectively, in community-level risk-standardized readmission rates.

PHITS simulations of the Protective curtain experiment onboard the Service module of ISS: Comparison with absorbed doses measured with TLDs

NASA Astrophysics Data System (ADS)

Ploc, Ondřej; Sihver, Lembit; Kartashov, Dmitry; Shurshakov, Vyacheslav; Tolochek, Raisa

2013-12-01

"Protective curtain" was the physical experiment onboard the International Space Station (ISS) aimed on radiation measurement of the dose - reducing effect of the additional shielding made of hygienic water-soaked wipes and towels placed on the wall in the crew cabin of the Service module Zvezda. The measurements were performed with 12 detector packages composed of thermoluminescent detectors (TLDs) and plastic nuclear track detectors (PNTDs) placed at the Protective curtain, so that they created pairs of shielded and unshielded detectors.

Turf Conversion Measurement and Verification Protocol

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings as a result of water conservation measures (WCMs) in energy performance contracts associated with converting turfgrass or other water-intensive plantings to water-wise and sustainable landscapes. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

20 CFR 627.422 - Selection of service providers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... which provide training, such performance measures as retention in training, training completion, job... listed in paragraph (d) of this section; and may, if appropriate, be documented and described in the Job... ability to meet performance goals; (3) A satisfactory record of past performance (in job training, basic...

45 CFR 305.60 - Types and scope of Federal audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.60... more frequently if the State fails to meet performance standards and reliability of data requirements... used to process the data in calculating performance indicators under this part; (b) Also, OCSE will...

Hubble Space Telescope On-orbit NiH2 Battery Performance

NASA Technical Reports Server (NTRS)

Rao, Gopalakrishna M.; Krol, Stanley J., Jr.

2002-01-01

This paper summarizes the Hubble Space Telescope (HST) nickel-hydrogen (NiH2) battery performance from launch to the present time. Over the life of HST vehicle configuration, charge system degradation and failures together with thermal design limitations have had a significant effect on the capacity of the HST batteries. Changes made to the charge system configuration in order to protect against power system failures and to maintain battery thermal stability resulted in undercharging of the batteries. This undercharging resulted in decreased usable battery capacity as well as battery cell voltage/capacity divergence. This cell divergence was made evident during on-orbit battery capacity measurements by a relatively shallow slope of the discharge curve following the discharge knee. Early efforts to improve the battery performance have been successful. On-orbit capacity measurement data indicates increases in the usable battery capacity of all six batteries as well as improvements in the battery cell voltage/capacity divergence. Additional measures have been implemented to improve battery performance, however, failures within the HST Power Control Unit (PCU) have prevented verification of battery status. As this PCU fault prevents the execution of on-orbit capacity testing, the HST Project has based the battery capacity on trends, which utilizes previous on-orbit battery capacity test data, for science mission and servicing mission planning. The Servicing Mission 38 (SM-3B) in March 2002 replaced the faulty PCU. Following the servicing mission, on-orbit capacity test resumed. A summary of battery performance is reviewed since launch in this paper.

Performance Analysis of IIUM Wireless Campus Network

NASA Astrophysics Data System (ADS)

Abd Latif, Suhaimi; Masud, Mosharrof H.; Anwar, Farhat

2013-12-01

International Islamic University Malaysia (IIUM) is one of the leading universities in the world in terms of quality of education that has been achieved due to providing numerous facilities including wireless services to every enrolled student. The quality of this wireless service is controlled and monitored by Information Technology Division (ITD), an ISO standardized organization under the university. This paper aims to investigate the constraints of wireless campus network of IIUM. It evaluates the performance of the IIUM wireless campus network in terms of delay, throughput and jitter. QualNet 5.2 simulator tool has employed to measure these performances of IIUM wireless campus network. The observation from the simulation result could be one of the influencing factors in improving wireless services for ITD and further improvement.

Measuring the performance of transit relative to livability.

DOT National Transportation Integrated Search

2013-03-01

This project sought to understand the relationship between urban form, transit service characteristics, and ridership measured at the stop level. Most previous work in this area has looked at these issues separately, by either linking system performa...

Science Investigations Enabled by Magnetic Field Measurements on the Lunar Surface

NASA Astrophysics Data System (ADS)

Chi, P. J.; Russell, C. T.; Strangeway, R. J.; Farrell, W. M.; Garrick-Bethell, I.; Taylor, P.

2018-02-01

We present examples of the geophysical and heliophysics investigations that can be performed with magnetic field measurements on the lunar surface enabled by the support/servicing of lunar landers from the Deep Space Gateway.

[Policies and innovation in mental healthcare: limits to decoupling from the performance of the SUS].

PubMed

Ribeiro, José Mendes; Inglez-Dias, Aline

2011-12-01

We studied Brazilian policies on mental health with respect to normative, supply and demand and financing aspects. We concluded that the sustainability of innovations in psychiatric reform depends on enhanced financing and integration with primary care community services, on the overall performance of SUS and the reduction of autonomous and exclusive services in primary care. There is high and rising pressure in demand for services measured in DALY and the incidence of disease. The reduction observed in psychiatric beds was accompanied by the systemic reduction, though with selective reduction for psychiatric hospitalizations. CAPS services have institutional limits due to the model adopted of direct public administration and local government capacity. Secondary data available show that: (i) SUS has a virtual monopoly on general outpatient and hospital services; (ii) mental health specialists belong mostly to SUS; (iii) most mental health services are outpatient services; (iv) few CAPS have day-bed services available; and (v) there is reduced federal financing for these innovations.

Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance.

PubMed

Farquharson, Barbara; Allan, Julia; Johnston, Derek; Johnston, Marie; Choudhary, Carolyn; Jones, Martyn

2012-07-01

This paper is a report of a study, which assessed levels of stress amongst nurses working in a healthcare telephone-advice service. We explored whether stress related to performance, sickness absence, and intention to leave. Nurses report high levels of stress, as do call-centre workers. The emergence of telephone health advice services means many nurses now work in call-centres, doing work that differs markedly from traditional nursing roles. Stress associated with these roles could have implications for nurses, patients, and service provision. This paper reports cross-sectional survey results. The design of the overall study included longitudinal elements. A comprehensive study of stress was conducted amongst nurses working for a telephone-advice service in Scotland (2008-2010). All nurse-advisors were approached by letter and invited to participate. A total of 152 participants (33%) completed a questionnaire including General Health Questionnaire-12, Work Family Conflict Questionnaire, Job Satisfaction Scale and a measure of intention to leave the telephone-advice service and rated the perceived stress of 2 working shifts. Nurses' employers provided data on sickness absence and performance. Overall levels of psychological distress were similar to those found amongst Scottish women generally. In multiple regression, work-family conflict was identified as a significant predictor of job satisfaction and intention to leave, and significantly related to sickness absence. There were significant correlations between General Health Questionnaire scores and perceived stress of shifts and some performance measures. Work-family conflict is a significant predictor of job satisfaction, intention to leave, and sickness absence amongst telephone helpline nurses. Minimizing the impact of nurses' work on their home lives might reduce turnover and sickness absence. © 2012 Blackwell Publishing Ltd.

Network Quality of Service Monitoring for IP Telephony.

ERIC Educational Resources Information Center

Ghita, B. V.; Furnell, S. M.; Lines, B. M.; Le-Foll, D.; Ifeachor, E. C.

2001-01-01

Discusses the development of real-time applications on the Internet for telecommunications and presents a non-intrusive way of determining network performance parameters for voice packet flows within a voice over IP (Internet Protocol), or Internet telephony call. Considers measurement of quality of service and describes results of a preliminary…

Radio and Television Servicing. Intermediate Course.

ERIC Educational Resources Information Center

Campbell, Guy; And Others

Several intermediate performance objectives and corresponding criterion measures are listed for each of 32 terminal objectives for an intermediate (second year) radio/TV servicing course. This 1-year course (3 hours daily) was designed to provide the student with the basic skills and knowledges necessary for entry level employment in the Radio/TV…

42 CFR § 414.1340 - Data completeness criteria for the quality performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive... that meet the measure's denominator criteria, regardless of payer for MIPS payment year 2019. (2) At...

Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities.

PubMed

Schilling, Lisa; Chase, Alide; Kehrli, Sommer; Liu, Amy Y; Stiefel, Matt; Brentari, Ruth

2010-11-01

By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a Web-based data dashboard, "Big Q," which tracks the performance of each medical center and service area against external benchmarks and internal goals, was created. PLANNING FOR PI AND BENCHMARKING PERFORMANCE: In 2006, Kaiser Permanente national and regional continued planning the PI system, and in 2007, quality, medical group, operations, and information technology leaders benchmarked five high-performing organizations to identify capabilities required to achieve consistent best-in-class organizational performance. THE PI SYSTEM: The PI system addresses the six capabilities: leadership priority setting, a systems approach to improvement, measurement capability, a learning organization, improvement capacity, and a culture of improvement. PI "deep experts" (mentors) consult with national, regional, and local leaders, and more than 500 improvement advisors are trained to manage portfolios of 90-120 day improvement initiatives at medical centers. Between the second quarter of 2008 and the first quarter of 2009, performance across all Kaiser Permanente medical centers improved on the Big Q metrics. The lessons learned in implementing and sustaining PI as it becomes fully integrated into all levels of Kaiser Permanente can be generalized to other health care systems, hospitals, and other health care organizations.

PZEh-MO-8/Body Mass Measurement

NASA Image and Video Library

2009-06-30

ISS020-E-015853 (30 June 2009) --- Japan Aerospace Exploration Agency (JAXA) astronaut Koichi Wakata, Expedition 20 flight engineer, uses the IM mass measurement device to perform the PZEh-MO-8/Body Mass Measurement Russian biomedical routine assessments in the Zvezda Service Module of the International Space Station.

Miltipath measurements for land mobile satellite service using global positioning system signals

NASA Technical Reports Server (NTRS)

Lemmon, John J.

1988-01-01

A proposed multipath system for the land mobile satellite radio channel using the Global Positioning System (GPS) is presented. The measurement technique and equipment used to make multipath measurements on communications links are briefly described. The system configuration and performance specifications of the proposed measurement system are discussed.

Self-reported assistive technology outcomes and personal characteristics in college students with less-apparent disabilities.

PubMed

Malcolm, Matt P; Roll, Marla C

2017-11-20

The impact of assistive technology (AT) services for college students with less-apparent disabilities is under-reported. Using the Canadian Occupational Performance Measure (COPM), we assessed student Performance and Satisfaction ratings of common academic tasks at the start and end of a semester during which 105 student-clients with less-apparent disabilities received AT services. We examined if COPM scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student's follow-through with an AT service referral (n=231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n=187). COPM ratings significantly increased in all academic tasks (p<.001). Gender predicted initial Satisfaction (male ratings > female ratings; p=.01), and Performance changes (females were more likely to have a service-meaningful change; p=.02). Higher class-level predicted better follow-through with a referral for AT services (p=.006). Increasing class-level (p=.05) and higher initial studying (p<.006) and reading (p<.029) ratings predicted a lower likelihood for dropout. These findings demonstrate that college students with less-apparent disabilities experience substantial improvements in their self-ratings of academic performance and satisfaction following AT services. Gender, class-level, and initial self-perceived reading and studying abilities may influence if and how the student participates with AT services.

Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

PubMed

Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

2014-09-01

Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Development and evaluation of a predictive algorithm for telerobotic task complexity

NASA Technical Reports Server (NTRS)

Gernhardt, M. L.; Hunter, R. C.; Hedgecock, J. C.; Stephenson, A. G.

1993-01-01

There is a wide range of complexity in the various telerobotic servicing tasks performed in subsea, space, and hazardous material handling environments. Experience with telerobotic servicing has evolved into a knowledge base used to design tasks to be 'telerobot friendly.' This knowledge base generally resides in a small group of people. Written documentation and requirements are limited in conveying this knowledge base to serviceable equipment designers and are subject to misinterpretation. A mathematical model of task complexity based on measurable task parameters and telerobot performance characteristics would be a valuable tool to designers and operational planners. Oceaneering Space Systems and TRW have performed an independent research and development project to develop such a tool for telerobotic orbital replacement unit (ORU) exchange. This algorithm was developed to predict an ORU exchange degree of difficulty rating (based on the Cooper-Harper rating used to assess piloted operations). It is based on measurable parameters of the ORU, attachment receptacle and quantifiable telerobotic performance characteristics (e.g., link length, joint ranges, positional accuracy, tool lengths, number of cameras, and locations). The resulting algorithm can be used to predict task complexity as the ORU parameters, receptacle parameters, and telerobotic characteristics are varied.

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

Kurnik, Charles W.; Boyd, Brian; Stoughton, Kate M.

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings resulting from water conservation measures (WCMs) in energy performance contracts associated with cooling tower efficiency projects. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

Measuring the perceived quality of ophthalmology services in private organizations. A marketing perspective.

PubMed

Gheorghe, Iuliana Raluca; Gheorghe, Consuela-Mădălina; Purcărea, Victor Lorin

2018-01-01

Nowadays, the competition registered on the Romanian markets regarding the activity of private ophthalmology organizations has raised their interest in developing consumer-oriented strategies. The key factor that assures a differentiation as well as a competitive advantage is the service quality from a marketing perspective. From a marketing perspective, service quality is measured as a perceived discrepancy between the consumers' expectations and was actually performed in health care services. The most widely and validated measurement is the SERVQUAL scale. However, a variety of SERVQUAL scales have been applied in different health care environments without taking into consideration the specialty of the health care service. Thus, the objective of this paper was to measure the service quality in the Romanian ophthalmology private organizations using the SERVQUAL measurement, by identifying the SERVQUAL dimensions, which register the highest and the lowest gap scores. The instrument for data collection was the SERVQUAL self-administered questionnaire that consisted of 22 items measured on a 5-point Likert scale. The sample size encompassed 100 participants and the sampling technique was the snowball. The internal consistency, validity and the reliability of the SERVQUAL scale was determined by the Cronbach's alpha coefficients and factor analysis. The SERVQUAL questionnaire focused on 5 dimensions (tangibles, reliability, assurance, empathy and responsiveness) and each dimension, in its turn, was characterized by different items. The mean age of the participants was 49.52 years, with a mean income of 3031 Romanian Currency and the mean period of wearing eyeglasses was 5 years (±2). Further, there were 47% females and 53% males. The overall internal consistency of the SERVQUAL scale, as well as the dimensions' internal consistency were all above 0.7 and the factor analysis revealed that the items loaded properly on each dimension. Moreover, the gap scores of the SERVQUAL scale's dimensions pinpointed that the highest gap score was registered by the Tangibles dimension and the lowest gap score was registered by the Reliability dimension. Performing the ophthalmology service right the first time, contributes significantly to the improvement of the marketing effectiveness and the operating efficiency.

Measuring the perceived quality of ophthalmology services in private organizations. A marketing perspective

PubMed Central

Gheorghe, Iuliana Raluca; Gheorghe, Consuela-Mădălina; Purcărea, Victor Lorin

2018-01-01

Nowadays, the competition registered on the Romanian markets regarding the activity of private ophthalmology organizations has raised their interest in developing consumer-oriented strategies. The key factor that assures a differentiation as well as a competitive advantage is the service quality from a marketing perspective. Objectives: From a marketing perspective, service quality is measured as a perceived discrepancy between the consumers’ expectations and was actually performed in health care services. The most widely and validated measurement is the SERVQUAL scale. However, a variety of SERVQUAL scales have been applied in different health care environments without taking into consideration the specialty of the health care service. Thus, the objective of this paper was to measure the service quality in the Romanian ophthalmology private organizations using the SERVQUAL measurement, by identifying the SERVQUAL dimensions, which register the highest and the lowest gap scores. Materials and methods: The instrument for data collection was the SERVQUAL self-administered questionnaire that consisted of 22 items measured on a 5-point Likert scale. The sample size encompassed 100 participants and the sampling technique was the snowball. The internal consistency, validity and the reliability of the SERVQUAL scale was determined by the Cronbach’s alpha coefficients and factor analysis. The SERVQUAL questionnaire focused on 5 dimensions (tangibles, reliability, assurance, empathy and responsiveness) and each dimension, in its turn, was characterized by different items. Results: The mean age of the participants was 49.52 years, with a mean income of 3031 Romanian Currency and the mean period of wearing eyeglasses was 5 years (±2). Further, there were 47% females and 53% males. The overall internal consistency of the SERVQUAL scale, as well as the dimensions’ internal consistency were all above 0.7 and the factor analysis revealed that the items loaded properly on each dimension. Moreover, the gap scores of the SERVQUAL scale’s dimensions pinpointed that the highest gap score was registered by the Tangibles dimension and the lowest gap score was registered by the Reliability dimension. Conclusions: Performing the ophthalmology service right the first time, contributes significantly to the improvement of the marketing effectiveness and the operating efficiency. PMID:29796435

45 CFR 305.32 - Requirements applicable to calculations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.32... necessary to calculate performance for incentives and penalties for a fiscal year must be submitted to the... fiscal year. Only data submitted as of December 31st will be used to determine the State's performance...

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii) Preventative health. (iv) At... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... defined by CMS based on national Medicare fee-for-service rates, national MA quality measure rates, or a...

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2014 CFR

2014-10-01

... four domains: (i) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... a point scale for the measures. (2)(i) CMS will define the quality benchmarks using fee-for-service...

42 CFR 425.502 - Calculating the ACO quality performance score.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Patient/care giver experience. (ii) Care coordination/Patient safety. (iii) Preventative health. (iv) At... year. (1) For the first performance year of an ACO's agreement, CMS defines the quality performance... defined by CMS based on national Medicare fee-for-service rates, national MA quality measure rates, or a...

48 CFR 1609.7101-1 - Community-rated carrier incentive performance elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... incentive performance elements. 1609.7101-1 Section 1609.7101-1 Federal Acquisition Regulations System... performance elements. (a) Customer Service. This element is intended to assist OPM in achieving the goal of... and other measures as required contractually between OPM and the carrier. (This element will be...

48 CFR 1609.7101-1 - Community-rated carrier incentive performance elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... incentive performance elements. 1609.7101-1 Section 1609.7101-1 Federal Acquisition Regulations System... performance elements. (a) Customer Service. This element is intended to assist OPM in achieving the goal of... and other measures as required contractually between OPM and the carrier. (This element will be...

48 CFR 1609.7101-1 - Community-rated carrier incentive performance elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... incentive performance elements. 1609.7101-1 Section 1609.7101-1 Federal Acquisition Regulations System... performance elements. (a) Customer Service. This element is intended to assist OPM in achieving the goal of... and other measures as required contractually between OPM and the carrier. (This element will be...

42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... outcomes, patient safety, and quality of care. (2) Performance improvement activities must track adverse... patient safety by using quality indicators or performance measures associated with improved health... that includes care and services furnished in the ASC. (b) Standard: Program data. (1) The program must...

Rater Effects in Clinical Performance Ratings of Surgery Residents

ERIC Educational Resources Information Center

Iramaneerat, Cherdsak; Myford, Carol M.

2006-01-01

A multi-faceted Rasch measurement (MFRM) approach was used to analyze clinical performance ratings of 24 first-year residents in one surgery residency program in Thailand to investigate three types of rater effects: leniency, rater inconsistency, and restriction of range. Faculty from 14 surgical services rated the clinical performance of…

[Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

PubMed

Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

2015-10-01

The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

7 CFR 1755.404 - Fiber optic cable telecommunications plant measurements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... performed on each optical fiber within the cable. (2) Method of measurement. For single mode fibers, the end... on each optical fiber within the cable. (2) Method of measurement. For single mode fibers, the end-to...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE TELECOMMUNICATIONS POLICIES ON SPECIFICATIONS...

7 CFR 1755.404 - Fiber optic cable telecommunications plant measurements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... performed on each optical fiber within the cable. (2) Method of measurement. For single mode fibers, the end... on each optical fiber within the cable. (2) Method of measurement. For single mode fibers, the end-to...) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE TELECOMMUNICATIONS POLICIES ON SPECIFICATIONS...

The Use of In-Service Inspection Data in the Performance Measurement of Non-Destructive Inspections (Mise en oeuvre de donn es resultant de visites d’inspection en service pour l’evaluation des performances des visites d’inspection non destructives)

DTIC Science & Technology

2005-03-01

Significant numbers of in-service inspections are occurring but at present, there is no organized process whereby these data are collected and...Reliability under Field Conditions” was held in Brussels in May 1998. The processes under which this data could be collected must be defined and...Requirement 2-3 2.3 Impact on Existing Certification Issues 2-5 2.4 Risk Assessment and POD 2-5 Chapter 3 – Data Collection Process 3-1 3.1

A framework to measure the value of public health services.

PubMed

Jacobson, Peter D; Neumann, Peter J

2009-10-01

To develop a framework that public health practitioners could use to measure the value of public health services. Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers. Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected. The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services. Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability. We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.

Introducing care pathway commissioning to primary dental care: measuring performance.

PubMed

Harris, R; Bridgman, C; Ahmad, M; Bowes, L; Haley, R; Saleem, S; Singh, R; Taylor, S

2011-12-09

Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.

Championship management for healthcare organizations.

PubMed

Griffith, J R

2000-01-01

Stakeholders will put increasing pressure on integrated health systems (IHS) for measured performance, demanding data on quality and patient satisfaction, while simultaneously pressing for lower cost. The changes to Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) and the growing importance of the National Committee on Quality Assurance (NCQA) are simply forerunners of an intensifying trend. Quality of care in particular will face increasing scrutiny. Achieving competitive targets in these areas will also require measures addressing demand and worker satisfaction. "Balanced scorecard" approaches will allow IHS and their accountable work groups to track performance on several dimensions and establish integrated goals or targets. Those with consistently good scores will be labeled "champions." Champions will support the multidimensional measures with improved decision processes. About eight major processes will be central--governance/strategic management, clinical quality, clinical organization, financial planning, planning and marketing, information services, human resources, and plant services. It is possible to map these processes to the criteria of the Joint Commission, NCQA, and Malcolm Baldrige Quality Award. The processes themselves can be measured and common weaknesses identified and corrected. Champions share some common characteristics that seem to arise from the combination of processes and measures. Among these characteristics are service line orientation, extensive partnering with other organizations, and the possibility of outsourcing organizational components.

Organizational Attributes Associated With Medicare ACO Quality Performance.

PubMed

Zhu, Xi; Mueller, Keith; Huang, Huang; Ullrich, Fred; Vaughn, Thomas; MacKinney, A Clinton

2018-05-08

To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively. Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance. There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate. © 2018 National Rural Health Association.

A comparison of operational performance : Washington state ferries to ferry operators worldwide.

DOT National Transportation Integrated Search

2010-06-01

This project compares eight measures of performance related to transit service quality (e.g. trip reliability, on-time departures) and cost-efficiency (e.g. farebox recovery, subsidy per passenger) between Washington State Ferries (WSF) and 23 ferry ...

A balanced perspective: using nonfinancial measures to assess financial performance.

PubMed

Watkins, Ann L

2003-11-01

Assessments of hospitals' financial performance have traditionally been based exclusively on analysis of a concise set of key financial ratios. One study, however, demonstrates that analysis of a hospital's financial condition can be significantly enhanced with the addition of several nonfinancial measures, including case-mix adjusted admissions, case-mix adjusted admissions per full-time equivalent, and case-mix adjusted admissions per beds in service.

Identifying Shortcomings in the Measurement of Service Quality.

ERIC Educational Resources Information Center

Fogarty, Gerard; Catts, R.; Forlin, C.

2000-01-01

Studied the use of SERVPEFR the performance component of the Service Quality Scale (SERVQUAL) in 2 studies involving 113 and 212 customers of businesses in Australia and investigated a revised (extended) version of SERVPEFR with 122 customers. Results suggest that SERVPEFR items are too easy to rate highly, and that the revisions did not overcome…

Measuring Service Quality in a Nontraditional Institution Using Importance-Performance Gap Analysis

ERIC Educational Resources Information Center

Mugdh, Mrinal

2004-01-01

nd wants of these students, nontraditional colleges have adopted research strategies that take into account both student expectations as well as their perception of satisfaction to assess service quality at their institutions. As one of the model adult learner focused institutions, Empire State College used Noel-Levitz Adult Learner Inventory in…

Library Performance Measurement in the UK and Ireland

ERIC Educational Resources Information Center

Stanley, Tracey; Killick, Selena

2009-01-01

This survey was a joint initiative between Society of College, National, and University Libraries (SCONUL) and the Association of Research Libraries (ARL), that since 2004 has sponsored a program to assist libraries with the assessment of services that they offer their users and the processes that support those services. It was based on an ARL…

48 CFR 9904.415-50 - Techniques for application.

Code of Federal Regulations, 2014 CFR

2014-10-01

... service is performed for that part of the award attributable to such future service: (1) There is a... compensation award is to be satisfied by a future payment of money, other assets, or shares of stock of the contractor. (3) The amount of the future payment can be measured with reasonable accuracy. (4) The recipient...

48 CFR 9904.415-50 - Techniques for application.

Code of Federal Regulations, 2013 CFR

2013-10-01

... service is performed for that part of the award attributable to such future service: (1) There is a... compensation award is to be satisfied by a future payment of money, other assets, or shares of stock of the contractor. (3) The amount of the future payment can be measured with reasonable accuracy. (4) The recipient...

Public health case studies in diabetes prevention and control: innovation, partnerships, and funding.

PubMed

Davis, Mary V; Cannon, Margaret M; Reese, April; Lovette, Beth; Porterfield, Deborah S

2011-01-01

In 2006, we conducted case studies of 4 North Carolina local health departments (LHDs) that scored highly on an index of diabetes prevention and control performance, to explore characteristics that may serve as barriers or facilitators of diabetes prevention and control services. Case studies involving in-depth interviews were conducted at 4 LHDs. Sites were selected on the basis of 2 variables, known external funding for diabetes services and population size, that were associated with performance in diabetes prevention and control in a 2005 survey of all North Carolina LHDs. Fourteen interviews (individual and group) were conducted among 17 participants from the 4 LHDs. The main outcome measures were LHD characteristics that facilitate or hinder the performance of diabetes programs and services. Interviews revealed that all 4 high-performing LHDs had received some sort of funding from a source external to the LHD. Case study participants indicated that barriers to additional service delivery included low socioeconomic status of the population and lack of financial resources. Having a diabetes self-management education program that was recognized by the American Diabetes Association appeared to be a facilitator of diabetes services provision. Other facilitators were leadership and staff commitment, which appeared to facilitate the leveraging of partnerships and funding opportunities, leading to enhanced service delivery. The small number of LHDs participating in the study and the cross-sectional study design were limitations. Leadership, staff commitment, partnership leveraging, and funding appear to be associated with LHD performance in diabetes prevention and control services. These factors should be further studied in future public health systems and services research.

Measuring effective coverage of curative child health services in rural Burkina Faso: a cross-sectional study

PubMed Central

Koulidiati, Jean-Louis; Nesbitt, Robin C; Ouedraogo, Nobila; Hien, Hervé; Robyn, Paul Jacob; Compaoré, Philippe; Souares, Aurélia; Brenner, Stephan

2018-01-01

Objective To estimate both crude and effective curative health services coverage provided by rural health facilities to under 5-year-old (U5YO) children in Burkina Faso. Methods We surveyed 1298 child health providers and 1681 clinical cases across 494 primary-level health facilities, as well as 12 497 U5YO children across 7347households in the facilities’ catchment areas. Facilities were scored based on a set of indicators along three quality-of-care dimensions: management of common childhood diseases, management of severe childhood diseases and general service readiness. Linking service quality to service utilisation, we estimated both crude and effective coverage of U5YO children by these selected curative services. Results Measured performance quality among facilities was generally low with only 12.7% of facilities surveyed reaching our definition of high and 57.1% our definition of intermediate quality of care. The crude coverage was 69.5% while the effective coverages indicated that 5.3% and 44.6% of children reporting an illness episode received services of only high or high and intermediate quality, respectively. Conclusion Our study showed that the quality of U5YO child health services provided by primary-level health facilities in Burkina Faso was low, resulting in relatively ineffective population coverage. Poor adherence to clinical treatment guidelines combined with the lack of equipment and qualified clinical staff that performed U5YO consultations seemed to be contributors to the gap between crude and effective coverage. PMID:29858415

A study on M/G/1 retrial G - queue with two phases of service, immediate feedback and working vacations

NASA Astrophysics Data System (ADS)

Varalakshmi, M.; Chandrasekaran, V. M.; Saravanarajan, M. C.

2017-11-01

In this paper, we discuss about the steady state behaviour of M/G/1 retrial queueing system with two phases of services and immediate feedbacks under working vacation policy where the regular busy server is affected due to the arrival of negative customers. Upon arrival if the customer finds the server busy, breakdown or on working vacation it enters an orbit; otherwise the customer enters into the service area immediately. After service completion, the customer is allowed to make finite number of immediate feedback. The feedback service also consists of two phases. At the service completion epoch of a positive customer, if the orbit is empty the server goes for a working vacation. The server works at a lower service rate during working vacation (WV) period. Using the supplementary variable technique, we found out the steady state probability generating function for the system and in orbit. System performance measures and reliability measures are discussed. Finally, some numerical examples are presented to validate the analyticalresults.

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

Kurnik, Charles W.; Stoughton, Kate M.; Figueroa, Jorge

This measurement and verification (M and V) protocol provides procedures for energy service companies (ESCOs) and water efficiency service companies (WESCOs) to determine water savings as a result of water conservation measures (WCMs) in energy performance contracts associated with converting turfgrass or other water-intensive plantings to water-wise and sustainable landscapes. The water savings are determined by comparing the baseline water use to the water use after the WCM has been implemented. This protocol outlines the basic structure of the M and V plan, and details the procedures to use to determine water savings.

Doctors or technicians: assessing quality of medical education

PubMed Central

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059

Doctors or technicians: assessing quality of medical education.

PubMed

Hasan, Tayyab

2010-01-01

Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services.

PubMed

Stecher, Brian M; Camm, Frank; Damberg, Cheryl L; Hamilton, Laura S; Mullen, Kathleen J; Nelson, Christopher; Sorensen, Paul; Wachs, Martin; Yoh, Allison; Zellman, Gail L; Leuschner, Kristin J; Camm, Frank; Stecher, Brian M

2012-01-01

Performance-based accountability systems (PBASs), which link incentives to measured performance as a means of improving services to the public, have gained popularity. While PBASs can vary widely across sectors, they share three main components: goals, incentives, and measures. Research suggests that PBASs influence provider behaviors, but little is known about PBAS effectiveness at achieving performance goals or about government and agency experiences. This study examines nine PBASs that are drawn from five sectors: child care, education, health care, public health emergency preparedness, and transportation. In the right circumstances, a PBAS can be an effective strategy for improving service delivery. Optimum circumstances include having a widely shared goal, unambiguous observable measures, meaningful incentives for those with control over the relevant inputs and processes, few competing interests, and adequate resources to design, implement, and operate the PBAS. However, these conditions are rarely fully realized, so it is difficult to design and implement PBASs that are uniformly effective. PBASs represent a promising policy option for improving the quality of service-delivery activities in many contexts. The evidence supports continued experimentation with and adoption of this approach in appropriate circumstances. Even so, PBAS design and its prospects for success depend on the context in which it will operate. Also, ongoing system evaluation and monitoring are integral components of a PBAS; they inform refinements that improve system functioning over time. Empirical evidence of the effects of performance-based public management is scarce. This article also describes a framework used to evaluate a PBAS. Such a system identifies individuals or organizations that must change their behavior for the performance of an activity to improve, chooses an implicit or explicit incentive structure to motivate these organizations or individuals to change, and then chooses performance measures tailored to inform the incentive structure appropriately. The study focused on systems in the child care, education, health care, public health emergency preparedness, and transportation sectors, mainly in the United States. Analysts could use this framework to seek empirical information in other sectors and other parts of the world. Additional empirical information could help refine existing PBASs and, more broadly, improve decisions on where to initiate new PBASs, how to implement them, and then how to design, manage, and refine them over time.

77 FR 4654 - Senior Community Service Employment Program; Final Rule, Additional Indicator on Volunteer Work

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

... rule amends our regulations regarding Performance Accountability for title V of the Older Americans Act... on September 1, 2010. 75 FR 53786. Previously, an interim final rule (IFR) on performance measures... performance through regulation. OAA Sec. 513(b)(3). As established in the SCSEP Final Rule published September...

Benchmarking for the competitive marketplace.

PubMed

Clarke, R W; Sucher, T O

1999-07-01

One would get little argument these days regarding the importance of performance measurement in the health care industry. The traditional approach has been the straightforward use of measurable units such as financial comparisons and clinical indicators (e.g., length of stay). Also we in the health care industry have traditionally benchmarked our performance and strategies against those most like ourselves. Today's competitive market demands a more customer-focused set of performance measures that go beyond traditional approaches such as customer service. The most important task in today's environment is to study the customers' emerging priorities and adjust our business to meet those priorities.

Service models and realization of differentiated services networks

NASA Astrophysics Data System (ADS)

Elizondo, Antonio J.; Garcia Osma, Maria L.; Einsiedler, Hans J.; Roth, Rudolf; Smirnov, Michael I.; Bartoli, Maurizio; Castelli, Paolo; Varga, Balazs; Krampell, Magnus

2001-07-01

Internet Service Providers need to offer Quality of Service (QoS) to fulfil the requirements of applications of their customers. Moreover, in a competitive market environment costs must be low. The selected service model must be effective and low in complexity, but it should still provide high quality and service differentiation, that the current Internet is not yet capable to support. The Differentiated Services (DiffServ) Architecture has been proposed for enabling a range of different Classes of Service (CoS). In the EURESCOM project P1006 several European service providers co-operated to examine various aspects involved in the introduction of service differentiation using the DiffServ approach. The project explored a set of service models for Expedited Forwarding (EF) and Assured Forwarding (AF) and identified requirements for network nodes. Besides, we addressed also measurement issues, charging and accounting issues. Special attention has been devoted to requirements of elastic traffic that adapts its sending rate to congestion state and available bandwidth. QoS mechanisms must prove Transmission Control Protocol (TCP) friendliness. TCP performance degrades under multiple losses. Since RED based queue management may still cause multiple discards, a modified marking scheme called Capped Leaky Bucket is proposed to improve the performance of elastic applications.

Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative

PubMed Central

Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J; Dekker, Evelien; Hoff, Geir; Jover, Rodrigo; Suchanek, Stepan; Ferlitsch, Monika; Anderson, John; Roesch, Thomas; Hultcranz, Rolf; Racz, Istvan; Kuipers, Ernst J; Garborg, Kjetil; East, James E; Rupinski, Maciej; Seip, Birgitte; Bennett, Cathy; Senore, Carlo; Minozzi, Silvia; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Spada, Cristiano; Hassan, Cesare; Dinis-Ribeiro, Mario; Rutter, Matthew D

2017-01-01

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 rate of adequate bowel preparation (minimum standard 90%); 2 cecal intubation rate (minimum standard 90%); 3 adenoma detection rate (minimum standard 25%); 4 appropriate polypectomy technique (minimum standard 80%); 5 complication rate (minimum standard not set); 6 patient experience (minimum standard not set); 7 appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures. PMID:28507745

Responses to prospective payment by rural New Mexico hospitals.

PubMed

Smith, H L; Piland, N F; Phillipp, A M

1991-12-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.

Responses to prospective payment by rural New Mexico hospitals.

PubMed Central

Smith, H L; Piland, N F; Phillipp, A M

1991-01-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed. PMID:1743969

Evaluation of the Demand Response Performance of Electric Water Heaters

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

Mayhorn, Ebony T.; Widder, Sarah H.; Parker, Steven A.

2015-03-17

The purpose of this project is to verify or refute many of the concerns raised by utilities regarding the ability of large tank HPWHs to perform DR by measuring the performance of HPWHs compared to ERWHs in providing DR services. perform DR by measuring the performance of HPWHs compared to ERWHs in providing DR services. This project was divided into three phases. Phase 1 consisted of week-long laboratory experiments designed to demonstrate technical feasibility of individual large-tank HPWHs in providing DR services compared to large-tank ERWHs. In Phase 2, the individual behaviors of the water heaters were then extrapolated tomore » a population by first calibrating readily available water heater models developed in GridLAB-D simulation software to experimental results obtained in Phase 1. These models were used to simulate a population of water heaters and generate annual load profiles to assess the impacts on system-level power and residential load curves. Such population modeling allows for the inherent and permanent load reduction accomplished by the more efficient HPWHs to be considered, in addition to the temporal DR services the water heater can provide by switching ON or OFF as needed by utilities. The economic and emissions impacts of using large-tank water heaters in DR programs are then analyzed from the utility and consumer perspective, based on National Impacts Analysis in Phase 3. Phase 1 is discussed in this report. Details on Phases 2 and 3 can be found in the companion report (Cooke et al. 2014).« less

Research on the Complexity of Dual-Channel Supply Chain Model in Competitive Retailing Service Market

NASA Astrophysics Data System (ADS)

Ma, Junhai; Li, Ting; Ren, Wenbo

2017-06-01

This paper examines the optimal decisions of dual-channel game model considering the inputs of retailing service. We analyze how adjustment speed of service inputs affect the system complexity and market performance, and explore the stability of the equilibrium points by parameter basin diagrams. And chaos control is realized by variable feedback method. The numerical simulation shows that complex behavior would trigger the system to become unstable, such as double period bifurcation and chaos. We measure the performances of the model in different periods by analyzing the variation of average profit index. The theoretical results show that the percentage share of the demand and cross-service coefficients have important influence on the stability of the system and its feasible basin of attraction.

IT-based diagnostic instrumentation systems for personalized healthcare services.

PubMed

Chun, Honggu; Kang, Jaemin; Kim, Ki-Jung; Park, Kwang Suk; Kim, Hee Chan

2005-01-01

This paper describes recent research and development activities on the diagnostic instruments for personalized healthcare services in Seoul National University. Utilizing the state-of-the-art information technologies (IT), various diagnostic medical instruments have been integrated into a personal wearable device and a home telehealthcare system. We developed a wrist-worn integrated health monitoring device (WIHMD) which performs the measurements of non-invasive blood pressure (NIBP), pulse oximetry (SpO2), electrocardiogram (ECG), respiration rate, heart rate, and body surface temperature and the detection of falls to determine the onset of emergency situation. The WIHMD also analyzes the acquired bio-signals and transmits the resultant data to a healthcare service center through a commercial cellular phone. Two different kinds of IT-based blood glucometer have been developed using a cellular phone and PDA(personal digital assistant) as a main unit. A blood glucometer was also integrated within a wrist pressure measurement module which is interfaced with a cellular phone via Telecommunications Technology Association (TTA) standard in order to provide users with easiness in measuring and handling two important health parameters. Non-intrusive bio-signal measurement systems were developed for the ease of home use. One can measure his ECG on a bed while he is sleeping; measure his ECG, body temperature, bodyfat ratio and weight on a toilet seat; measure his ECG on a chair; and estimate the degree of activity by motion analysis using a camera. Another integrated diagnostic system for home telehealthcare services has been developed to include a 12 channels ECG, a pressure meter for NIBP, a blood glucometer, a bodyfat meter and a spirometer. It is an expert system to analyze the measured health data and based on the diagnostic result, the system provides an appropriate medical consultation. The measured data can be either stored on the system or transmitted to the central server through the internet. We have installed the developed systems on a model house for the performance evaluation and confirmed the possibility of the system as an effective tool for the personalized healthcare services.

Does quality influence utilization of primary health care? Evidence from Haiti.

PubMed

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

Measurement Program for Evaluation of Concrete Ties and Fastenings in Transit Track

DOT National Transportation Integrated Search

1979-03-01

This report outlines a measurement program to obtain data on the performance of standard tie designs and associated fastening systems under field service conditions. In addition, the program identifies limited data to be obtained from a wood tie trac...

Plant species and functional group combinations affect green roof ecosystem functions.

PubMed

Lundholm, Jeremy; Macivor, J Scott; Macdougall, Zachary; Ranalli, Melissa

2010-03-12

Green roofs perform ecosystem services such as summer roof temperature reduction and stormwater capture that directly contribute to lower building energy use and potential economic savings. These services are in turn related to ecosystem functions performed by the vegetation layer such as radiation reflection and transpiration, but little work has examined the role of plant species composition and diversity in improving these functions. We used a replicated modular extensive (shallow growing- medium) green roof system planted with monocultures or mixtures containing one, three or five life-forms, to quantify two ecosystem services: summer roof cooling and water capture. We also measured the related ecosystem properties/processes of albedo, evapotranspiration, and the mean and temporal variability of aboveground biomass over four months. Mixtures containing three or five life-form groups, simultaneously optimized several green roof ecosystem functions, outperforming monocultures and single life-form groups, but there was much variation in performance depending on which life-forms were present in the three life-form mixtures. Some mixtures outperformed the best monocultures for water capture, evapotranspiration, and an index combining both water capture and temperature reductions. Combinations of tall forbs, grasses and succulents simultaneously optimized a range of ecosystem performance measures, thus the main benefit of including all three groups was not to maximize any single process but to perform a variety of functions well. Ecosystem services from green roofs can be improved by planting certain life-form groups in combination, directly contributing to climate change mitigation and adaptation strategies. The strong performance by certain mixtures of life-forms, especially tall forbs, grasses and succulents, warrants further investigation into niche complementarity or facilitation as mechanisms governing biodiversity-ecosystem functioning relationships in green roof ecosystems.

Plant Species and Functional Group Combinations Affect Green Roof Ecosystem Functions

PubMed Central

Lundholm, Jeremy; MacIvor, J. Scott; MacDougall, Zachary; Ranalli, Melissa

2010-01-01

Background Green roofs perform ecosystem services such as summer roof temperature reduction and stormwater capture that directly contribute to lower building energy use and potential economic savings. These services are in turn related to ecosystem functions performed by the vegetation layer such as radiation reflection and transpiration, but little work has examined the role of plant species composition and diversity in improving these functions. Methodology/Principal Findings We used a replicated modular extensive (shallow growing- medium) green roof system planted with monocultures or mixtures containing one, three or five life-forms, to quantify two ecosystem services: summer roof cooling and water capture. We also measured the related ecosystem properties/processes of albedo, evapotranspiration, and the mean and temporal variability of aboveground biomass over four months. Mixtures containing three or five life-form groups, simultaneously optimized several green roof ecosystem functions, outperforming monocultures and single life-form groups, but there was much variation in performance depending on which life-forms were present in the three life-form mixtures. Some mixtures outperformed the best monocultures for water capture, evapotranspiration, and an index combining both water capture and temperature reductions. Combinations of tall forbs, grasses and succulents simultaneously optimized a range of ecosystem performance measures, thus the main benefit of including all three groups was not to maximize any single process but to perform a variety of functions well. Conclusions/Significance Ecosystem services from green roofs can be improved by planting certain life-form groups in combination, directly contributing to climate change mitigation and adaptation strategies. The strong performance by certain mixtures of life-forms, especially tall forbs, grasses and succulents, warrants further investigation into niche complementarity or facilitation as mechanisms governing biodiversity-ecosystem functioning relationships in green roof ecosystems. PMID:20300196

Around Marshall

NASA Image and Video Library

1998-08-04

Nurse performs tonometry examination, which measure the tension of the eyeball, during an employee's arnual physical examination given by MSFC Occupational Medicine Environmental Health Services under the Center Operations Directorate.

Empowerment at Pacific Gas & Electric.

ERIC Educational Resources Information Center

Kaufman, Steven B.

1991-01-01

Pacific Gas and Electric's employee involvement program aggressively focuses on customer service, performance measurement tied to management bonuses, and commitment to change in the organizational culture. (SK)

Cost (and Quality and Value) of Information Technology Support in Large Research Universities.

ERIC Educational Resources Information Center

Peebles, Christopher S.; Antolovic, Laurie

1999-01-01

Shows how financial and quality measures associated with the Balanced Scorecard (developed by Kaplan and Norton to measure organizational performance) can be applied to information technology (IT) user education and support in large research universities. Focuses on University Information Technology Services that has measured the quality of IT…

Payment for Environmental Services: Hypotheses and Evidence

PubMed Central

Alston, Lee J.; Andersson, Krister; Smith, Steven M.

2014-01-01

The use of payment for environmental services (PES) is not a new type of contract, but PES programs have become more in vogue because of the potential for sequestering carbon by paying to prevent deforestation and degradation of forestlands. We provide a framework utilizing transaction costs to hypothesize which services are more likely to be provided effectively. We then interpret the literature on PES programs to see the extent to which transaction costs vary as predicted across the type of service and to assess the performance of PES programs. As predicted, we find that transaction costs are the least for club goods like water and greatest for pure public goods like carbon reduction. Actual performance is difficult to measure and varies across the examples. More work and experimentation are needed to gain a better outlook on what elements support effective delivery of environmental services. PMID:25143798

Guidance and Navigation for Rendezvous and Proximity Operations with a Non-Cooperative Spacecraft at Geosynchronous Orbit

NASA Technical Reports Server (NTRS)

Barbee, Brent William; Carpenter, J. Russell; Heatwole, Scott; Markley, F. Landis; Moreau, Michael; Naasz, Bo J.; VanEepoel, John

2010-01-01

The feasibility and benefits of various spacecraft servicing concepts are currently being assessed, and all require that the servicer spacecraft perform rendezvous, proximity, and capture operations with the target spacecraft to be serviced. Many high-value spacecraft, which would be logical targets for servicing from an economic point of view, are located in geosynchronous orbit, a regime in which autonomous rendezvous and capture operations are not commonplace. Furthermore, existing GEO spacecraft were not designed to be serviced. Most do not have cooperative relative navigation sensors or docking features, and some servicing applications, such as de-orbiting of a non-functional spacecraft, entail rendezvous and capture with a spacecraft that may be non-functional or un-controlled. Several of these challenges have been explored via the design of a notional mission in which a nonfunctional satellite in geosynchronous orbit is captured by a servicer spacecraft and boosted into super-synchronous orbit for safe disposal. A strategy for autonomous rendezvous, proximity operations, and capture is developed, and the Orbit Determination Toolbox (ODTBX) is used to perform a relative navigation simulation to assess the feasibility of performing the rendezvous using a combination of angles-only and range measurements. Additionally, a method for designing efficient orbital rendezvous sequences for multiple target spacecraft is utilized to examine the capabilities of a servicer spacecraft to service multiple targets during the course of a single mission.

The development of a streamlined, coordinated and sustainable evaluation methodology for a diverse chronic disease management program.

PubMed

Berlowitz, David J; Graco, Marnie

2010-05-01

The Northern Alliance Hospital Admission Risk Program-Chronic Disease Management comprises 13 services delivering care to those with chronic disease and older people with complex care needs, who are frequent hospital users. To develop and implement a system-wide approach to the evaluation of this existing program. The Northern Clinical Research Centre audited all existing, routinely collected administrative data within the program and then met with each service to develop service specific outcome measures. The evaluators then developed and implemented a system-wide evaluation approach to measure performance in terms of: client profile; access and entry; service efficiency; client outcomes; and hospital demand. Data are collected electronically and more than 80% are derived from existing, administrative datasets, minimising staff and client burden. Additional data include client outcomes and a health related quality of life measure. The preliminary twelve month data suggest that clients have the equivalent of 'fair' or 'poor' self-reported health status (n = 862) and the average health utility scores are significantly (P < 0.05) worse than population control data. These analyses reveal, for the first time, that the Northern Alliance Hospital Admission Risk Program-Chronic Disease Management program is targeting appropriate clients. This methodology will enable many prospective assessments to be performed including; client outcome evaluation, service model comparisons, and cost-utility analyses. This evaluation approach demonstrates the feasibility of a highly coordinated 'whole of system' evaluation. Such an approach may ultimately contribute to the development of evidence-based policy.

A Data Specification for Software Project Performance Measures: Results of a Collaboration on Performance Measurement

DTIC Science & Technology

2008-07-01

cycle Evolution of a system, product, service, project or other human-made entity from conception through retirement [ ISO 12207 ]. Logical line of...012 [ ISO 1995] International Organization for Standardization. ISO /IEC 12207 :1995—Information technology— Software life cycle processes. http...definitions, authors were asked to use or align with already existing standards such as those available through ISO and IEEE when possible. Literature

Training Affects Variability in Training Performance both Within and Across Jobs

DTIC Science & Technology

2016-03-01

was measured by a verbal/ math composite derived from the US military enlistment test, the Armed Services Vocational Aptitude Battery. Training...performance was assessed by written tests of job-related knowledge content. Predictive validity of the verbal/ math composite ranged from .124 to .836...job over several years. Participants were 116,310 enlistees enrolled in 108 US Air Force training specialties. Aptitude was measured by a verbal/ math

Improving Aircraft Refueling Procedures at Naval Air Station Oceana

DTIC Science & Technology

2012-06-01

Station (NAS) Oceana, VA, using aircraft waiting time for fuel as a measure of performance. We develop a computer-assisted discrete-event simulation to...Station (NAS) Oceana, VA, using aircraft waiting time for fuel as a measure of performance. We develop a computer-assisted discrete-event simulation...server queue, with general interarrival and service time distributions gpm Gallons per minute JDK Java development kit M/M/1 Single-server queue

Performance Analysis of the NAS Y-MP Workload

NASA Technical Reports Server (NTRS)

Bergeron, Robert J.; Kutler, Paul (Technical Monitor)

1997-01-01

This paper describes the performance characteristics of the computational workloads on the NAS Cray Y-MP machines, a Y-MP 832 and later a Y-MP 8128. Hardware measurements indicated that the Y-MP workload performance matured over time, ultimately sustaining an average throughput of 0.8 GFLOPS and a vector operation fraction of 87%. The measurements also revealed an operation rate exceeding 1 per clock period, a well-balanced architecture featuring a strong utilization of vector functional units, and an efficient memory organization. Introduction of the larger memory 8128 increased throughput by allowing a more efficient utilization of CPUs. Throughput also depended on the metering of the batch queues; low-idle Saturday workloads required a buffer of small jobs to prevent memory starvation of the CPU. UNICOS required about 7% of total CPU time to service the 832 workloads; this overhead decreased to 5% for the 8128 workloads. While most of the system time went to service I/O requests, efficient scheduling prevented excessive idle due to I/O wait. System measurements disclosed no obvious bottlenecks in the response of the machine and UNICOS to the workloads. In most cases, Cray-provided software tools were- quite sufficient for measuring the performance of both the machine and operating, system.

School Competence and Fluent Academic Performance: Informing Assessment of Educational Outcomes in Survivors of Pediatric Medulloblastoma.

PubMed

Holland, Alice Ann; Hughes, Carroll W; Stavinoha, Peter L

2015-01-01

Academic difficulties are widely acknowledged but not adequately studied in survivors of pediatric medulloblastoma. Although most survivors require special education services and are significantly less likely than healthy peers to finish high school, measured academic skills are typically average. This study sought to identify potential factors associated with academic difficulties in this population and focused on school competence and fluent academic performance. Thirty-six patients (ages 7-18 years old) were recruited through the Departments of Neurosurgery and Neuro-Oncology at Children's Medical Center Dallas and Cook Children's Medical Center in Fort Worth, TX. Participants completed a neuropsychological screening battery including selected Woodcock-Johnson III Tests of Achievement subtests. Parents completed the Child Behavior Checklist. School competence was significantly correlated with measured academic skills and fluency. Basic academic skill development was broadly average, in contrast to significantly worse fluent academic performance. School competence may have utility as a measure estimating levels of educational success in this population. Additionally, academic difficulties experienced by childhood medulloblastoma survivors may be better captured by measuring deficits in fluent academic performance rather than skills. Identification of these potential factors associated with educational outcomes of pediatric medulloblastoma survivors has significant implications for research, clinical assessment, and academic services/interventions.

Hanford Radiological Protection Support Services Annual Report for 1998

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

DE Bihl; JA MacLellan; ML Johnson

1999-05-14

During calendar year (CY) 1998, the Pacific Northwest National Laboratory (PNNL) performed its customary radiological protection support services in support of the U.S. Department of Energy (DOE) Richland Operations OffIce (RL) and the Hanford contractors. These services included: 1) external dosimetry, 2) internal dosimetry, 3) in vivo measurements, 4) radiological records, 5) instrument calibra- tion and evaluation, and 6) calibration of radiation sources traceable to the National Institute of Standards and Technology (MST). The services were provided under a number of projects as summarized here.

45 CFR 305.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.1 Definitions. The definitions found in § 301.1 of this... fiscal year means the sum of the State's performance level percentages (determined in accordance with...

Community Level Association between Home Health and Nursing Home Performance on Quality and Hospital 30-day Readmissions for Medicare Patients

PubMed Central

Wang, Yun; Pandolfi, Michelle M.; Fine, Jonathan; Metersky, Mark L.; Wang, Changqin; Ho, Shih-Yieh; Galusha, Deron; Nuti, Sudhakar V.; Murugiah, Karthik; Spenard, Ann; Elwell, Timothy; Krumholz, Harlan M.

2016-01-01

We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17–0.34) and 0.60% (95% CI 0.33–0.83), respectively, in community-level risk-standardized readmission rates. PMID:27974869

Early Performance in Medicaid Accountable Care Organizations: A Comparison of Oregon and Colorado

PubMed Central

McConnell, K. John; Renfro, Stephanie; Chan, Benjamin K.S.; Meath, Thomas H.A.; Mendelson, Aaron; Cohen, Deborah; Waxmonsky, Jeanette; McCarty, Dennis; Wallace, Neal; Lindrooth, Richard C.

2017-01-01

Importance A variety of state Medicaid reforms are underway, but the relative performance of different approaches is unclear. Objective To compare performance in Oregon’s and Colorado’s Medicaid Accountable Care Organization (ACO) models. Design, Setting, and Participants Oregon initiated its Medicaid transformation in 2012, supported by a $1.9 billion federal investment, moving the majority of Medicaid enrollees into sixteen Coordinated Care Organizations (CCOs), which managed care within a global budget. Colorado initiated its Medicaid Accountable Care Collaborative (ACC) in 2011, creating seven Regional Care Collaborative Organizations that received funding to coordinate care with providers and connect Medicaid enrollees with community services. We analyzed data spanning July 1, 2010 through December 31, 2014, (18 months pre-intervention and 24 months post intervention, treating 2012 as a transition year) for 452,371 Oregon and 330,511 Colorado Medicaid enrollees, assessing changes in outcomes using difference-in-differences analyses. Exposures Both states emphasized a regional focus, primary care homes, and care coordination. Oregon’s CCO model was more comprehensive in its reform goals and in the imposition of downside financial risk. Main Outcomes and Measures Performance on claims-based measures of standardized expenditures and utilization for selected services, access, preventable hospitalizations, and appropriateness of care. Results Standardized expenditures for selected services declined in both states over the 2010–2014 time period, but these decreases were not significantly different between the two states. Oregon’s model was associated with reductions in emergency department visits (−6.28 per 1000 beneficiary months, 95% CI −10.51 to −2.05) and primary care visits (−15.09 visits per 1000 beneficiary months, 95% CI −26.57 to −3.61), improvements in acute preventable hospital admissions, three out of four measures of access, and one out of four measures of appropriateness of care. Conclusions and Relevance Two years into implementation, Oregon and Colorado’s Medicaid ACO models exhibited similar performance on standardized expenditures for selected services. Oregon’s model, marked by a large federal investment and movement to global budgets, was associated with improvements in some measures of utilization, access and quality, but Colorado’s model paralleled Oregon on a number of other metrics. PMID:28192568

Development of a new quality fair access best value performance indicator (BVPI) for recycling services.

PubMed

Harder, M K; Stantzos, N; Woodard, R; Read, A

2008-01-01

Recycling schemes are being used worldwide to reduce the impact of municipal waste. Those using public funds are usually obliged to set performance indicators by which the standards of such schemes can be measured. In the UK, a set of statutory Best Value Performance Indicators (BVPI) must be reported annually, such as the Quality of Fair Access, which monitors the public's access to recycling facilities within 1000 m (known as BVPI 91). This work shows that BVPI 91, and performance indicators like it, quantify only very basic recycling services. A much more sensitive performance indicator is developed in this paper, labelled as the Maximum Practicable Recycling Rate Provision (MPRRP) achievable by a local authority. It indicates the percentage of local waste that could be reasonably recycled using the services provided, calculated on the basis of the average composition of the local waste, the local population coverage for collection of any materials, and nationally provided information stating how much of each material stream is generally suitable (practical) for recycling. Evidence for the usefulness of this new quantity is presented. Although this paper refers a particular performance indicator in the UK, its findings are applicable to all urban areas worldwide needing to monitor recycling service. Furthermore, the MPRRP could be used for planning purposes, and for determining the level of performance of an existing service, by comparing its predicted recycling rate to that actually obtained. Further work is now being carried out on this.

Railroads and the Environment : Estimation of Fuel Consumption in Rail Transportation : Volume 3. Comparison of Computer Simulations with Field Measurements

DOT National Transportation Integrated Search

1978-09-01

This report documents comparisons between extensive rail freight service measurements (previously presented in Volume II) and simulations of the same operations using a sophisticated train performance calculator computer program. The comparisons cove...

Noguchi uses BMMD in SM

NASA Image and Video Library

2010-05-26

ISS023-E-052104 (26 May 2010) --- Japan Aerospace Exploration Agency (JAXA) astronaut Soichi Noguchi, Expedition 23 flight engineer, uses the IM mass measurement device to perform the PZEh-MO-8/Body Mass Measurement Russian biomedical routine assessments in the Zvezda Service Module of the International Space Station.

Contract management in USA hospitals: service duplication and access within local markets.

PubMed

Carey, Kathleen; Dor, Avi

2008-08-01

This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.

PERFORMANCE MEASUREMENT IN TRIBAL HOME VISITING: CHALLENGES AND OPPORTUNITIES.

PubMed

Morales, Julie R; Ferron, Cathy; Whitmore, Corrie; Reifel, Nancy; Geary, Erin; Anderson, Cyndi; Mcdaniel, Judy

2018-05-01

Over the last several decades, performance measurement has become an increasingly prevalent requirement among human services agencies for demonstrating program progress and achieving outcomes. In the Tribal Maternal, Infant, and Early Childhood Home Visiting Program (Tribal MIECHV), performance measurement was one of the central components of the Administration for Children and Families' cooperative agreements to tribes, urban Indian organizations, and tribal organizations. Since the inception of the Tribal MIECHV Program in 2010, the benchmark requirement was intended to be a mechanism to systematically monitor program progress and performance toward improving the quality of home-visiting programs that serve vulnerable American Indian or Alaska Native families. In this article, we examine performance measurement in the context of Tribal MIECHV, providing an overview of performance measurement, the Tribal MIECHV requirement, and how grantees experienced the requirement; we describe the existing literature on performance measurement challenges and benefits, and the specific challenges and advantages experienced by tribal grantees; and provide recommendations for performance measurement in tribal home-visiting contexts based on grantees' own experiences. This article contributes to the literature by examining performance measurement challenges and opportunities in the context of tribal communities, and provides recommendations that may inform future policy on performance measurement design and implementation in tribal communities. © 2018 Michigan Association for Infant Mental Health.

Sources and performance criteria of uncertainty of reference measurement procedures.

PubMed

Mosca, Andrea; Paleari, Renata

2018-05-29

This article wants to focus on the today available Reference Measurement Procedures (RMPs) for the determination of various analytes in Laboratory Medicine and the possible tools to evaluate their performance in the laboratories who are currently using them. A brief review on the RMPs has been performed by investigating the Joint Committee for Traceability in Laboratory Medicine (JCTLM) database. In order to evaluate their performances, we have checked the organization of three international ring trials, i.e. those regularly performed by the IFCC External Quality assessment scheme for Reference Laboratories in Laboratory Medicine (RELA), by the Center for Disease Control and Prevention (CDC) cholesterol network and by the IFCC Network for HbA 1c . Several RMPs are available through the JCTLM database, but the best way to collect information about the RMPs and their uncertainties is to look at the reference measurement service providers (RMS). This part of the database and the background on how to listed in the database is very helpful for the assessment of expanded uncertainty (MU) and performance in general of RMPs. Worldwide, 17 RMS are listed in the database, and for most of the measurands more than one RMS is able to run the relative RMPs, with similar expanded uncertainties. As an example, for a-amylase, 4 SP offer their services with MU between 1.6 and 3.3%. In other cases (such as total cholesterol, the U may span over a broader range, i.e. from 0.02 to 3.6%). With regard to the performance evaluation, the approach is often heterogenous, and it is difficult to compare the performance of laboratories running the same RMP for the same measurand if involved in more than one EQAS. The reference measurement services have been created to help laboratory professionals and manufacturers to implement the correct metrological traceability, and the JCTLM database is the only correct way to retrieve all the necessary important information to this end. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

45 CFR 305.0 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.0 Scope. This part implements the incentive system...

Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors. Research Brief

ERIC Educational Resources Information Center

Leuschner, Kristin J.

2010-01-01

During the past two decades, performance-based accountability systems (PBASs), which link financial or other incentives to measured performance as a means of improving services, have gained popularity among policymakers. Although PBASs can vary widely across sectors, they share three main components: goals (i.e., one or more long-term outcomes to…

Strategic performance management: development of a performance measurement system at the Mayo Clinic.

PubMed

Curtright, J W; Stolp-Smith, S C; Edell, E S

2000-01-01

Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

School bus’s level of service in Malang City

NASA Astrophysics Data System (ADS)

Hariyani, S.

2017-06-01

School Bus began operated on the 12th of January 2015. Provision of school buses is expected to reduce not only the use of vehicles by students, but it is also to reduce the number of traffic jams. Malang school bus facilities provided by the Department of Transport in cooperation with the Department of Education to serve students in elementary school, junior and senior high schools. After the service running two years, based on the preliminary observation not all students are interested in using the school bus. The research objective was to measure the school bus’s level service. The method to measure school bus’s level of service was used Importance Performance analysis (IPA). The results showed that through IPA, it can be concluded that school bus’s level of service in Malang City have been able to serve students/customers with the mean of degree suitability (Tki) is 111. Meanwhile it must be observed and get more attention to improve by government, attributes which is lies in the first quadrant or concentrate here (attribute Adequate space, Seating capacity, Availability trash can, Passenger facility down in points, The availability of information boards in each bus stop, Availability public telephone in each bus stop, and Availability CCTV in each bus), in order to increase its performance.

Quality and equity of care in U.S. hospitals.

PubMed

Trivedi, Amal N; Nsa, Wato; Hausmann, Leslie R M; Lee, Jonathan S; Ma, Allen; Bratzler, Dale W; Mor, Maria K; Baus, Kristie; Larbi, Fiona; Fine, Michael J

2014-12-11

Nearly every U.S. hospital publicly reports its performance on quality measures for patients who are hospitalized for acute myocardial infarction, heart failure, or pneumonia. Because performance rates are not reported according to race or ethnic group, it is unclear whether improvements in equity of care have accompanied aggregate improvements in health care quality over time. We assessed performance rates for quality measures covering three conditions (six measures for acute myocardial infarction, four for heart failure, and seven for pneumonia). These rates, adjusted for patient- and hospital-level covariates, were compared among non-Hispanic white, non-Hispanic black, and Hispanic patients who received care between 2005 and 2010 in acute care hospitals throughout the United States. Adjusted performance rates for the 17 quality measures improved by 3.4 to 57.6 percentage points between 2005 and 2010 for white, black, and Hispanic adults (P<0.001 for all comparisons). In 2005, as compared with adjusted performance rates for white patients, adjusted performance rates were more than 5 percentage points lower for black patients on 3 measures (range of differences, 12.3 to 14.2) and for Hispanic patients on 6 measures (5.6 to 14.5). Gaps decreased significantly on all 9 of these measures between 2005 and 2010, with adjusted changes for differences between white patients and black patients ranging from -8.5 to -11.8 percentage points and from -6.2 to -15.1 percentage points for differences between white patients and Hispanic patients. Decreasing differences according to race or ethnic group were attributable to more equitable care for white patients and minority patients treated in the same hospital, as well as to greater performance improvements among hospitals that disproportionately serve minority patients. Improved performance on quality measures for white, black, and Hispanic adults hospitalized for acute myocardial infarction, heart failure, or pneumonia was accompanied by increased racial and ethnic equity in performance rates both within and among U.S. hospitals. (Funded by the Centers for Medicare and Medicaid Services and the Veterans Affairs Health Services Research and Development Career Development Program.).

Performance Measurement of Location Enabled e-Government Processes: A Use Case on Traffic Safety Monitoring

NASA Astrophysics Data System (ADS)

Vandenbroucke, D.; Vancauwenberghe, G.

2016-12-01

The European Union Location Framework (EULF), as part of the Interoperable Solutions for European Public Administrations (ISA) Programme of the EU (EC DG DIGIT), aims to enhance the interactions between governments, businesses and citizens by embedding location information into e-Government processes. The challenge remains to find scientific sound and at the same time practicable approaches to estimate or measure the impact of location enablement of e-Government processes on the performance of the processes. A method has been defined to estimate process performance in terms of variables describing the efficiency, effectiveness, as well as the quality of the output of the work processes. A series of use cases have been identified, corresponding to existing e-Government work processes in which location information could bring added value. In a first step, the processes are described by means of BPMN (Business Process Model and Notation) to better understand the process steps, the actors involved, the spatial data flows, as well as the required input and the generated output. In a second step the processes are assessed in terms of the (sub-optimal) use of location information and the potential enhancement of the process by better integrating location information and services. The process performance is measured ex ante (before using location enabled e-Government services) and ex-post (after the integration of such services) in order to estimate and measure the impact of location information. The paper describes the method for performance measurement and highlights how the method is applied to one use case, i.e. the process of traffic safety monitoring. The use case is analysed and assessed in terms of location enablement and its potential impact on process performance. The results of applying the methodology on the use case revealed that performance is highly impacted by factors such as the way location information is collected, managed and shared throughout the process, and the degree to which spatial data are harmonized. The work led also to the formulation of some recommendations to enrich the BPMN standard with additional methods for annotating processes, and to the proposal of the development of some tools for automatic process performance. In that context some planned future work is highlighted as well.

Data Collection Manual for Academic and Research Library Network Statistics and Performance Measures.

ERIC Educational Resources Information Center

Shim, Wonsik "Jeff"; McClure, Charles R.; Fraser, Bruce T.; Bertot, John Carlo

This manual provides a beginning approach for research libraries to better describe the use and users of their networked services. The manual also aims to increase the visibility and importance of developing such statistics and measures. Specific objectives are: to identify selected key statistics and measures that can describe use and users of…

45 CFR 305.35 - Reinvestment.

Code of Federal Regulations, 2010 CFR

2010-10-01

...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.35 Reinvestment. (a) A State must expend the full...

JT9D engine diagnostics. Task 2: Feasibility study of measuring in-service flight loads. [747 aircraft performance

NASA Technical Reports Server (NTRS)

Kafka, P. G.; Skibo, M. A.; White, J. L.

1977-01-01

The feasibility of measuring JT9D propulsion system flight inertia loads on a 747 airplane is studied. Flight loads background is discussed including the current status of 747/JT9D loads knowledge. An instrumentation and test plan is formulated for an airline-owned in-service airplane and the Boeing-owned RA001 test airplane. Technical and cost comparisons are made between these two options. An overall technical feasibility evaluation is made and a cost summary presented. Conclusions and recommendations are presented in regard to using existing inertia loads data versus conducting a flight test to measure inertia loads.

View of FE Stott using the BMMD in the SM

NASA Image and Video Library

2009-10-12

ISS021-E-014503 (12 Oct. 2009) --- NASA astronaut Nicole Stott, Expedition 21 flight engineer, uses the IM mass measurement device to perform the PZEh-MO-8/Body Mass Measurement Russian biomedical routine assessments in the Zvezda Service Module of the International Space Station.

Determining and Communicating the Value of the Special Library.

ERIC Educational Resources Information Center

Matthews, Joseph R.

2003-01-01

Discusses performance measures for libraries that will indicate the goodness of the library and its services. Highlights include a general evaluation model that includes input, process, output, and outcome measures; balanced scorecard approach that includes financial perspectives; focusing on strategy; strategies for change; user criteria for…

Implementation of electronic medical records

PubMed Central

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

Organizational characteristics, financial performance measures, and funding sources of faith based organizations.

PubMed

Lampkin, Lynne; Raghavan, Kamala

2008-01-01

This study examined the impact of organizational characteristics and financial performance measures of faith based organizations (FBOS) in Pennsylvania and Ohio on the decisions of the funding sources. Organizational characteristics of size, age, and type of service, and financial performance measures such as expense, liquidity, and solvency ratios were gathered from the data on IRS form 990 for 97 FBOS for the period of 1995 to 2004. The study found that the 1996 Charitable Choice provisions and the 2001 Office of Faith-Based and Community Initiatives have led to increased government funding for FBOS. The results showed that government funding of FBOS is affected positively by age of the FBO, and negatively by its size. For smaller FBOS, savings ratio had a negative relationship to government funding and a positive relationship to direct public support. For social service FBOS government funding was positively affected by age and negatively affected by size and debt ratio, while days-cash-on-hand had a negative impact on direct public support. All of the above relationships were statistically significant.

Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard.

PubMed

Chan, Grace J; Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

2010-09-01

After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons.

Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

PubMed

Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

2008-01-01

The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

Quality and price--impact on patient satisfaction.

PubMed

Pantouvakis, Angelos; Bouranta, Nancy

2014-01-01

The purpose of this paper is to synthesize existing quality-measurement models and applies them to healthcare by combining a Nordic service-quality with an American service performance model. Results are based on a questionnaire survey of 1,298 respondents. Service quality dimensions were derived and related to satisfaction by employing a multinomial logistic model, which allows prediction and service improvement. Qualitative and empirical evidence indicates that customer satisfaction and service quality are multi-dimensional constructs, whose quality components, together with convenience and cost, influence the customer's overall satisfaction. The proposed model identifies important quality and satisfaction issues. It also enables transitions between different responses in different studies to be compared.

Quality of service routing in the differentiated services framework

NASA Astrophysics Data System (ADS)

Oliveira, Marilia C.; Melo, Bruno; Quadros, Goncalo; Monteiro, Edmundo

2001-02-01

In this paper we present a quality of service routing strategy for network where traffic differentiation follows the class-based paradigm, as in the Differentiated Services framework. This routing strategy is based on a metric of quality of service. This metric represents the impact that delay and losses verified at each router in the network have in application performance. Based on this metric, it is selected a path for each class according to the class sensitivity to delay and losses. The distribution of the metric is triggered by a relative criterion with two thresholds, and the values advertised are the moving average of the last values measured.

Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

PubMed

Kim, S; McLeod, J H; Williams, C; Hepler, N

2000-01-01

The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured by fourteen measurement units, tapping into the dimensions of staff resources and community assets. Staff resources are, in turn, operationalized in terms of staff size, staff certification status, staff turnover rate, and the accreditation status of a provider agency. Community assets are operationalized by the number of community centers accessible to the funded agency, number of formalized teams or antidrug coalitions active in the catchment area, and other social/human services providers with whom the prevention agency has formalized networks. The totality of process output from all sources of program activities is reduced to eighteen classes of measures. These are operationalized by thirty-three summary measures. Some of these include: total count of events facilitated; total number of clients served; average number of clients served per event; clients served by single and multiple program sessions; classification of target population in terms of the severity of risk as defined by the Institute of Medicine; age groups and race/ethnicity of clients served; number of program participants retained by recurring programs; number of clients who have completed the program; penetration rates to the target population; client attrition rates; average referral rates per provider per time interval; referral success rates; and so on. All process output measures specified in the Platform are derived from two broad classes of events classified as either products or services. The collectivity of these measures is expected to present a cost-effective, parsimonious, yet comprehensive picture of the entire spectrum of the process output, i.e., "what came out of the program as program activities". For the measurement of performance outcomes, two types of data are incorporated into the Platform: outcome data from individuals and the behavior (or performance) of social indicators from aggregated data bases. Individual data are used to evaluate the outcome of substance abuse programs

Launch commit criteria performance trending analysis, phase 1, revision A. SRM and QA mission services

NASA Technical Reports Server (NTRS)

1989-01-01

An assessment of quantitative methods and measures for measuring launch commit criteria (LCC) performance measurement trends is made. A statistical performance trending analysis pilot study was processed and compared to STS-26 mission data. This study used four selected shuttle measurement types (solid rocket booster, external tank, space shuttle main engine, and range safety switch safe and arm device) from the five missions prior to mission 51-L. After obtaining raw data coordinates, each set of measurements was processed to obtain statistical confidence bounds and mean data profiles for each of the selected measurement types. STS-26 measurements were compared to the statistical data base profiles to verify the statistical capability of assessing occurrences of data trend anomalies and abnormal time-varying operational conditions associated with data amplitude and phase shifts.

Evaluation of family-centred practices in the early intervention programmes for infants and young children in Singapore with Measure of Processes of Care for Service Providers and Measure of Beliefs about Participation in Family-Centred Service.

PubMed

Tang, H N; Chong, W H; Goh, W; Chan, W P; Choo, S

2012-01-01

The primary purpose of this study was to report on an evaluation of the perceptions and beliefs of service providers towards family-centred practices in 11 early intervention programmes for infants and young children in Singapore. The Measure of Processes of Care for Service Providers (MPOC-SP) and Measure of Beliefs about Participation in Family-Centred Service (MBP-FCS) were administered to 213 service providers made up of teachers, therapists, psychologists and social workers providing centre-based therapy to children with special needs who were below the age of 6 years. Exploratory factor analyses were performed with both scales. Nineteen of the 27 MPOC-SP items were retained and supported the original four-factor structure model. The exploratory factor analyses on MBP-FCS provided a less satisfactory outcome. Fourteen of the 28 items were retained and these loaded onto four factors. The two factors relating to Beliefs about benefits of FCS and Beliefs about the absence of negative outcomes from FCS failed to emerge as separate factors. Further multiple regressions indicated that more direct work with families and positive self-efficacy in implementing FCS contributed significantly to explaining service providers' positive perception towards family-centred practice in service delivery. This is the first time MPOC-SP and MBP-FCS were administered to a population in an Asian context. While MBP-FCS would benefit from further development work on its construct, MPOC-SP offered important insights into service providers' perspectives about family-centred practices that would have useful implications for professional and service development. © 2011 Blackwell Publishing Ltd.

Services of the CDRH X-ray calibration laboratory and their traceability to National Standards

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

Cerra, F.; Heaton, H.T.

The X-ray Calibration Laboratory (XCL) of the Center for Devices and Radiological Health (CDRH) provides calibration services for the Food and Drug Administration (FDA). The instruments calibrated are used by FDA and contract state inspectors to verify compliance with federal x-ray performance standards and for national surveys of x-ray trends. In order to provide traceability of measurements, the CDRH XCL is accredited by the National Voluntary Laboratory Accreditation Program (NVLAP) for reference, diagnostic, and x-ray survey instrument calibrations. In addition to these accredited services, the CDRH XCL also calibrates non-invasive kVp meters in single- and three-phase x-ray beams, and thermoluminescentmore » dosimeter (TLD) chips used to measure CT beam profiles. The poster illustrates these services and shows the traceability links back to the National Standards.« less

A Research on Performance Measurement Based on Economic Valued-Added Comprehensive Scorecard

NASA Astrophysics Data System (ADS)

Chen, Qin; Zhang, Xiaomei

With the development of economic, the traditional performance mainly rely on financial indicators could not satisfy the need of work. In order to make the performance measurement taking the best services for business goals, this paper proposed Economic Valued-Added Comprehensive Scorecard based on research of shortages and advantages of EVA and BSC .We used Analytic Hierarchy Process to build matrix to solve the weighting of EVA Comprehensive Scorecard. At last we could find the most influence factors for enterprise value forming the weighting.

Explaining the Intention to Use Technology among Pre-Service Teachers: A Multi-Group Analysis of the Unified Theory of Acceptance and Use of Technology

ERIC Educational Resources Information Center

Teo, Timothy; Noyes, Jan

2014-01-01

Pre-service teachers' self-reported intentions to use information technology were studied. Two hundred and sixty-four participants completed a survey questionnaire measuring their responses to four constructs (performance expectancy, effort expectancy, social influence and facilitating conditions) derived from the Unified Theory of Acceptance and…

Employee assistance programs in the new millennium.

PubMed

Masi, Dale A

2005-01-01

This article presents an overall view of Employee Assistance Programs (EAPs). Beginning with the history, this article describes various models and essential ingredients of EAPs. It then discusses current trends including integration with Work/Life, web-based services, EAP accreditation, and the growth of international programs. Several issues are discussed including the need for licensing done nationally rather than by states and the effect the lack of substance abuse and brief counseling education has had on the delivery of EAP services. Future directions for EAPs emphasize the importance of quality assurance and the development of performance measurements, performance guarantees, and outcome measurements. The formation of the Alliance for Employee Assistance Advancement, an organization of organizations, completes the description and shows a new direction for EAPs in the next millennium.

Optimal service using Matlab - simulink controlled Queuing system at call centers

NASA Astrophysics Data System (ADS)

Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.

2018-04-01

This paper presents graphical integrated model based academic research on telephone call centres. This paper introduces an important feature of impatient customers and abandonments in the queue system. However the modern call centre is a complex socio-technical system. Queuing theory has now become a suitable application in the telecom industry to provide better online services. Through this Matlab-simulink multi queuing structured models provide better solutions in complex situations at call centres. Service performance measures analyzed at optimal level through Simulink queuing model.

An Investigation into the Use of 3G Mobile Communications to Provide Telehealth Services in Rural KwaZulu-Natal

PubMed Central

Mars, Maurice

2015-01-01

Abstract Background: We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. Materials and Methods: We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. Results: We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. Conclusions: We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable communication is essential and use of store and forward for mobile applications. PMID:24926731

An investigation into the use of 3G mobile communications to provide telehealth services in rural KwaZulu-Natal.

PubMed

Clarke, Malcolm; Mars, Maurice

2015-02-01

We investigated the use of third-generation (3G) mobile communications to provide telehealth services in remote health clinics in rural KwaZulu-Natal, South Africa. We specified a minimal set of services as our use case that would be representative of typical activity and to provide a baseline for analysis of network performance. Services included database access to manage chronic disease, local support and management of patients (to reduce unnecessary travel to the hospital), emergency care (up to 8 h for an ambulance to arrive), e-mail, access to up-to-date information (Web), and teleclinics. We made site measurements at a representative set of health clinics to determine the type of coverage (general packet radio service [GPRS]/3G), its capabilities to support videoconferencing (H323 and Skype™ [Microsoft, Redmond, WA]) and audio (Skype), and throughput for transmission control protocol (TCP) to gain a measure of application performance. We found that none of the remote health clinics had 3G service. The GPRS service provided typical upload speed of 44 kilobits per second (Kbps) and download speed of 64 Kbps. This was not sufficient to support any form of videoconferencing. We also observed that GPRS had significant round trip time (RTT), in some cases in excess of 750 ms, and this led to slow start-up for TCP applications. We found audio was always so broken as to be unusable and further observed that many applications such as Web access would fail under conditions of very high RTT. We found some health clinics were so remote that they had no mobile service. 3G, where available, had measured upload speed of 331 Kbps and download speed of 446 Kbps and supported videoconferencing and audio at all sites, but we frequently experienced 3G changing to GPRS. We conclude that mobile communications currently provide insufficient coverage and capability to provide reliable clinical services and would advocate dedicated wireless services where reliable communication is essential and use of store and forward for mobile applications.

Performance standards for pass-fail determinations in the national air traffic flight service station training program.

DOT National Transportation Integrated Search

1979-07-01

This report describes and documents Pass-Fail procedures for the new FSS Training Program. New types of measures and sets of norms are used to create standards of performance that students must meet to become eligible for acceptance into the operatio...

Diesel Mechanics. Performance Objectives. Intermediate Course.

ERIC Educational Resources Information Center

Tidwell, Joseph

Several intermediate performance objectives and corresponding criterion measures are listed for each of six terminal objectives for an intermediate diesel mechanics course (two semesters, 3 hours daily) designed for high school students who upon completion would be ready for an on-the-job training experience in diesel service and repair. Through…

Analysis of bulk arrival queueing system with batch size dependent service and working vacation

NASA Astrophysics Data System (ADS)

Niranjan, S. P.; Indhira, K.; Chandrasekaran, V. M.

2018-04-01

This paper concentrates on single server bulk arrival queue system with batch size dependent service and working vacation. The server provides service in two service modes depending upon the queue length. The server provides single service if the queue length is at least `a'. On the other hand the server provides fixed batch service if the queue length is at least `k' (k > a). Batch service is provided with some fixed batch size `k'. After completion of service if the queue length is less than `a' then the server leaves for working vacation. During working vacation customers are served with lower service rate than the regular service rate. Service during working vacation also contains two service modes. For the proposed model probability generating function of the queue length at an arbitrary time will be obtained by using supplementary variable technique. Some performance measures will also be presented with suitable numerical illustrations.

Clinical Quality Performance in U.S. Health Centers

PubMed Central

Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

2012-01-01

Objective To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. Data Sources National data from the 2009 Uniform Data System. Data Collection/Extraction Methods Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Study Design Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Principal Findings Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Conclusions Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. PMID:22594465

Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative.

PubMed

Myers, B; Petersen Williams, P; Johnson, K; Govender, R; Manderscheid, R; Koch, J R

2017-01-30

A performance measurement system - the Service Quality Measures (SQM) initiative - has been developed to monitor the quality of South Africa (SA)'s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63). In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df)=3.70), p=0.015), awareness (r=0.78, p<0.0001), leadership support (r=0.70, p<0.0001), resources (r=0.65, p<0.0001), openness to change (r=0.372, p=0.001), and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE) 0.08, t=4.4, p<0.0001) and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001) were significantly associated with readiness to adopt this system. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.

A Comparative Study of 11 Local Health Department Organizational Networks

PubMed Central

Merrill, Jacqueline; Keeling, Jonathan W.; Carley, Kathleen M.

2013-01-01

Context Although the nation’s local health departments (LHDs) share a common mission, variability in administrative structures is a barrier to identifying common, optimal management strategies. There is a gap in understanding what unifying features LHDs share as organizations that could be leveraged systematically for achieving high performance. Objective To explore sources of commonality and variability in a range of LHDs by comparing intraorganizational networks. Intervention We used organizational network analysis to document relationships between employees, tasks, knowledge, and resources within LHDs, which may exist regardless of formal administrative structure. Setting A national sample of 11 LHDs from seven states that differed in size, geographic location, and governance. Participants Relational network data were collected via an on-line survey of all employees in 11 LHDs. A total of 1 062 out of 1 239 employees responded (84% response rate). Outcome Measures Network measurements were compared using coefficient of variation. Measurements were correlated with scores from the National Public Health Performance Assessment and with LHD demographics. Rankings of tasks, knowledge, and resources were correlated across pairs of LHDs. Results We found that 11 LHDs exhibited compound organizational structures in which centralized hierarchies were coupled with distributed networks at the point of service. Local health departments were distinguished from random networks by a pattern of high centralization and clustering. Network measurements were positively associated with performance for 3 of 10 essential services (r > 0.65). Patterns in the measurements suggest how LHDs adapt to the population served. Conclusions Shared network patterns across LHDs suggest where common organizational management strategies are feasible. This evidence supports national efforts to promote uniform standards for service delivery to diverse populations. PMID:20445462

Measuring the Performance of Document Supply Systems.

ERIC Educational Resources Information Center

Line, Maurice B.

Produced by Unesco as part of its program designed to help member states develop national information systems, including libraries, information services, and archives, this manual is a guide to document supply measurement techniques that are applicable to a wide range of countries. The first of seven chapters considers the objectives, nature, and…

Serviceable pavement marking retroreflectivity levels : technical report.

DOT National Transportation Integrated Search

2009-03-01

This research addressed an array of issues related to measuring pavement markings retroreflectivity, factors : related to pavement marking performance, subjective evaluation process, best practices for using mobile : retroreflectometers, sampling pav...

A comparative study of 11 local health department organizational networks.

PubMed

Merrill, Jacqueline; Keeling, Jonathan W; Carley, Kathleen M

2010-01-01

Although the nation's local health departments (LHDs) share a common mission, variability in administrative structures is a barrier to identifying common, optimal management strategies. There is a gap in understanding what unifying features LHDs share as organizations that could be leveraged systematically for achieving high performance. To explore sources of commonality and variability in a range of LHDs by comparing intraorganizational networks. We used organizational network analysis to document relationships between employees, tasks, knowledge, and resources within LHDs, which may exist regardless of formal administrative structure. A national sample of 11 LHDs from seven states that differed in size, geographic location, and governance. Relational network data were collected via an on-line survey of all employees in 11 LHDs. A total of 1062 out of 1239 employees responded (84% response rate). Network measurements were compared using coefficient of variation. Measurements were correlated with scores from the National Public Health Performance Assessment and with LHD demographics. Rankings of tasks, knowledge, and resources were correlated across pairs of LHDs. We found that 11 LHDs exhibited compound organizational structures in which centralized hierarchies were coupled with distributed networks at the point of service. Local health departments were distinguished from random networks by a pattern of high centralization and clustering. Network measurements were positively associated with performance for 3 of 10 essential services (r > 0.65). Patterns in the measurements suggest how LHDs adapt to the population served. Shared network patterns across LHDs suggest where common organizational management strategies are feasible. This evidence supports national efforts to promote uniform standards for service delivery to diverse populations.

Improving trends in gender disparities in the Department of Veterans Affairs: 2008-2013.

PubMed

Whitehead, Alison M; Czarnogorski, Maggie; Wright, Steve M; Hayes, Patricia M; Haskell, Sally G

2014-09-01

Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women's health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures.

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries

PubMed Central

2013-01-01

Background Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Methods Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Results Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. Conclusion In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning, having a metric that captures the impact of a range of diverse services and allows comparisons will be increasingly important. However, standardizing reporting will be essential to make such comparisons useful. While not widespread, errors in self-reported data appear to have included social marketing distribution data in social franchising reporting, requiring clearer data collection and reporting guidelines. Differences noted above must be interpreted cautiously as a result. PMID:23902679

Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries.

PubMed

Montagu, Dominic; Ngamkitpaiboon, Lek; Duvall, Susan; Ratcliffe, Amy

2013-01-01

Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact. Country-specific and service-specific, DALYs averted enables impact comparisons between programs operating in different contexts. This study explores the use of DALYs averted as a social franchise performance metric. Using data collected by the Social Franchising Compendia in 2010 and 2011, we compared franchise performance, analyzing by region and program area. Coefficients produced by Population Services International converted each franchise's service delivery data into DALYs averted. For the 32 networks with two years of data corresponding to these metrics, a paired t-test compared all metrics. Finally, to test data reporting quality, we compared services provided to patient volume. Social franchising programs grew considerably from 2010 to 2011, measured by services provided (215%), patient volume (31%), and impact (couple-years of protection (CYPs): 86% and DALYs averted: 519%), but not by the total number of outlets. Non-family planning services increased by 857%, with diversification centered in Asia and Africa. However, paired t-test comparisons showed no significant increase within the networks, whether categorized as family planning or non-family planning. The ratio of services provided to patient visits yielded considerable range, with one network reporting a ratio of 16,000:1. In theory, the DALYs averted metric is a more robust and comprehensive metric for social franchising than current program measures. As social franchising spreads beyond family planning, having a metric that captures the impact of a range of diverse services and allows comparisons will be increasingly important. However, standardizing reporting will be essential to make such comparisons useful. While not widespread, errors in self-reported data appear to have included social marketing distribution data in social franchising reporting, requiring clearer data collection and reporting guidelines. Differences noted above must be interpreted cautiously as a result.

Determining hospital performance based on rank ordering: is it appropriate?

PubMed

Anderson, Judy; Hackman, Mark; Burnich, Jeff; Gurgiolo, Thomas R

2007-01-01

An increasing number of "pay for performance" initiatives for hospitals and physicians ascribe performance by ranking hospitals or physicians on quality of care measures. Payment is subsequently based on where a hospital or physician ranks among peers. This study examines the variability of ranking hospitals on quality of care measures and its impact on comparing hospital performance. Variability in the ranks of 3 quality of care measures was examined: discharge instruction for congestive heart failure, use of beta-blockers at discharge for heart attack, and timing of initial antibiotic therapy within 4 hours of admission to the hospital for pneumonia. The data are available on the Centers for Medicare and Medicaid Services Web site as part of the Hospital Quality Alliance project. We found that considerable uncertainty exists in ranking of hospitals on these measures, which calls into question the use of rank ordering as a determinant of performance.

Do the clinical competencies of musculoskeletal outpatient physiotherapists improve after they have participated in a bespoke in-service education programme designed around individual and service continuing professional development needs?

PubMed

Banks, Kevin; Meaburn, Anthony; Phelan, Elaine

2013-01-01

To determine whether the clinical competencies of musculoskeletal outpatient physiotherapists improve if they participate in an annual in-service education programme designed around clinical practice needs. A within-subject, without-control, experimental, pre-test post-test study. Clinical and educational facilities of Doncaster and Bassetlaw Hospitals NHS Foundation Trust and locality-based outpatient facilities. Participants were 37 specialist musculoskeletal outpatient physiotherapists (band 6 and 7), working for Doncaster and Bassetlaw Hospitals NHS Foundation Trust. Participants completed three separate modules of in-service education through an academic year, based on learning outcomes identified from observation and performance rating of their clinical competencies. Each module lasted 7 hours, with supporting clinical assistance sessions and self-directed learning time. The primary outcome measure was a (participant) performance rating (from novice to expert) of 20 clinical competencies scored by experienced clinical educators before and after completion of the in-service education programme. A secondary, qualitative outcome measure (a purpose-made, semi-structured questionnaire) given after the programme explored participants' experiences and perceptions of the in-service education programme. Seven competencies were identified as the focus of the programme because their performance ratings were the lowest. All seven of these competencies improved following the programme. Communication scores improved by 6%, clinical reasoning by 4%, functional analysis of movement by 6%, use of research in practice by 4%, and critical appraisal of evidence by 4.6%. Performance of structural differentiation and the range of manual handling skills demonstrated were the only competencies to show a statistically significant improvement of 14.6% and 12%, respectively (p≤0.025(. Thematic analysis of the questionnaires revealed that 96% of respondents felt that their practice had changed positively over the year because of the programme. Providing a structured and bespoke in-service education programme over an academic year may help to improve the rating of clinical competencies and give participants the perception that their clinical practice has changed because of the programme.

Agility assessment using fuzzy logic approach: a case of healthcare dispensary.

PubMed

Suresh, M; Patri, Rojalin

2017-06-09

Agile concepts are not only beneficial for manufacturing sector but also for service sector such as healthcare. However, assessment of agility has been predominantly done in manufacturing enterprises. This study demonstrates a means to measure agility of a healthcare organization by assessing agility of a university dispensary. Its contribution to the knowledge base is twofold. First, it proposes a means to measure the agility of a healthcare organization and second, it identifies the attributes that prevent agile performance and outlines the suggestive measure to enhance its agile capabilities. A case study approach has been adopted and fuzzy logic has been employed to measure the agility of the case dispensary. At first, the measures of assessment which include four enablers, fifteen criteria and forty-five attributes have been identified from the literature and rated by the experts indicating the importance of the measures in the assessment. Then, the case dispensary has been assessed on those measures by collecting observed performance rating from decision makers. At last, Fuzzy logic has been applied on the performance rating data to analyze and interpret the agile capability of the dispensary. The findings suggest that transparent information flow, adequate salary and bonuses for caregivers, reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are the attributes that weakens agile capability of the University dispensary. The current agility of the dispensary was found to be 'Agile' which is average in relation to the agility labels. Attributes such as transparent information flow, adequate salary and bonuses for caregivers, elimination of reading error in medical descriptions, in house/nearby pathology laboratory services, technical up-gradation of dispensary equipments and facilities, minimization of patient throughput time and adequate training programme for safety practices are extremely crucial for enhancing agile capability of a healthcare organization.

Network survivability performance

NASA Astrophysics Data System (ADS)

1993-11-01

This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia

PubMed Central

Teklehaimanot, Hailay D.; Teklehaimanot, Awash; Tedella, Aregawi A.; Abdella, Mustofa

2016-01-01

In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. PMID:26928842

Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia.

PubMed

Teklehaimanot, Hailay D; Teklehaimanot, Awash; Tedella, Aregawi A; Abdella, Mustofa

2016-05-04

In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. © The American Society of Tropical Medicine and Hygiene.

Performance evaluation of a health insurance in Nigeria using optimal resource use: health care providers perspectives

PubMed Central

2014-01-01

Background Performance measures are often neglected during the transition period of national health insurance scheme implementation in many low and middle income countries. These measurements evaluate the extent to which various aspects of the schemes meet their key objectives. This study assesses the implementation of a health insurance scheme using optimal resource use domains and examines possible factors that influence each domain, according to providers’ perspectives. Methods A retrospective, cross-sectional survey was done between August and December 2010 in Kaduna state, and 466 health care provider personnel were interviewed. Optimal-resource-use was defined in four domains: provider payment mechanism (capitation and fee-for-service payment methods), benefit package, administrative efficiency, and active monitoring mechanism. Logistic regression analysis was used to identify provider factors that may influence each domain. Results In the provider payment mechanism domain, capitation payment method (95%) performed better than fee-for-service payment method (62%). Benefit package domain performed strongly (97%), while active monitoring mechanism performed weakly (37%). In the administrative efficiency domain, both promptness of referral system (80%) and prompt arrival of funds (93%) performed well. At the individual level, providers with fewer enrolees encountered difficulties with reimbursement. Other factors significantly influenced each of the optimal-resource-use domains. Conclusions Fee-for-service payment method and claims review, in the provider payment and active monitoring mechanisms, respectively, performed weakly according to the providers’ (at individual-level) perspectives. A short-fall on the supply-side of health insurance could lead to a direct or indirect adverse effect on the demand-side of the scheme. Capitation payment per enrolees should be revised to conform to economic circumstances. Performance indicators and providers’ characteristics and experiences associated with resource use can assist policy makers to monitor and evaluate health insurance implementation. PMID:24628889

Development of a cloud-based application for the Fracture Liaison Service model of care.

PubMed

Holzmueller, C G; Karp, S; Zeldow, D; Lee, D B; Thompson, D A

2016-02-01

The aims of this study are to develop a cloud-based application of the Fracture Liaison Service for practitioners to coordinate the care of osteoporotic patients after suffering primary fractures and provide a performance feedback portal for practitioners to determine quality of care. The application provides continuity of care, improved patient outcomes, and reduced medical costs. The purpose of this study is to describe the content development and functionality of a cloud-based application to broadly deploy the Fracture Liaison Service (FLS) to coordinate post-fracture care for osteoporotic patients. The Bone Health Collaborative developed the FLS application in 2013 to support practitioners' access to information and management of patients and provide a feedback portal for practitioners to track their performance in providing quality care. A five-step protocol (identify, inform, initiate, investigate, and iterate) organized osteoporotic post-fracture care-related tasks and timelines for the application. A range of descriptive data about the patient, their medical condition, therapies and care, and current providers can be collected. Seven quality of care measures from the National Quality Forum, The Joint Commission, and the Centers for Medicare and Medicaid Services can be tracked through the application. There are five functional areas including home, tasks, measures, improvement, and data. The home, tasks, and data pages are used to enter patient information and coordinate care using the five-step protocol. Measures and improvement pages are used to enter quality measures and provide practitioners with continuous performance feedback. The application resides within a portal, running on a multitenant, private cloud-based Avedis enterprise registry platform. All data are encrypted in transit and users access the application using a password from any common web browser. The application could spread the FLS model of care across the US health care system, provide continuity of care, effectively manage osteoporotic patients, improve outcomes, and reduce medical costs.

Preventing re-entry to foster care.

PubMed

Carnochan, Sarah; Rizik-Baer, Daniel; Austin, Michael J

2013-01-01

Re-entry to foster care generally refers to circumstances in which children who have been discharged from foster care to be reunified with their family of origin, adopted, or provided kinship guardianship are returned to foster care. In the context of the federal performance measurement system, re-entry refers specifically to a return to foster care following an unsuccessful reunification. The federal Children and Family Services Review measures re-entry to foster care with a single indicator, called the permanency of reunification indicator, one of four indicators comprising the reunification composite measure. This review focuses on research related to the re-entry indicator, including the characteristics of children, caregivers and families, as well as case and child welfare services that are associated with a higher or lower risk of re-entry to foster care. Promising post-reunification services designed to prevent re-entry to foster care are described.

The role of non-financial performance measures in predicting hospital financial performance: the case of for-profit system hospitals.

PubMed

Vélez-González, Heltie; Pradhan, Rohit; Weech-Maldonado, Robert

2011-01-01

Non-financial measures have found increasing acceptance in the business world--however, their application in the health care industry remains limited. The purpose of this article is to understand the influence of non-financial measures (efficiency, productivity, and quality) on the financial performance of for-profit system hospitals. The sample consists of 499 for-profit system hospitals in the United States from 1999 to 2002. Data analyzed include the American Hospital Association's Annual Survey, Medicare Cost Reports, Joint Commission's quality scores, and the Centers for Medicare & Medicaid Services' Hospital Case Mix Index. Dependent variables consist of financial measures (operating and total margins), while independent variables include measures of efficiency, productivity, and quality. Our results suggest the influence of non-financial performance measures on financial performance; occupancy rate positively influences financial performance while greater labor intensity may have negative implications for financial performance. In addition, we show that quality positively influences financial performance thereby offering a potential business case for quality. This result has important managerial and policy implications as it may incentivize capital and human resource investments required to improve hospital quality of care.

An Explanatory Model of Self-Service on the Internet

NASA Astrophysics Data System (ADS)

Oliver, Dave; Livermore, Celia Romm; Farag, Neveen Awad

This chapter describes research that identifies and classifies the dimensions of self-service activity enabled through the Internet. Self-service is effected by organizations providing ways and means whereby customers perform tasks related to the procurement of goods and services. We describe how an instrument used to measure Internet-based self-service was developed, validated and applied. The results from applying the instrument to a large number of Web sites, covering a range of industries, countries and cultures, are analyzed and discussed. The study presents a model in which type of industry, level of technological development, income and cultural factors are proposed as explanatory variables for Web-based self-service. We conclude with an assessment of this program of research’s achievements so far.

More quality measures versus measuring what matters: a call for balance and parsimony

PubMed Central

Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-01-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs. PMID:22893696

More quality measures versus measuring what matters: a call for balance and parsimony.

PubMed

Meyer, Gregg S; Nelson, Eugene C; Pryor, David B; James, Brent; Swensen, Stephen J; Kaplan, Gary S; Weissberg, Jed I; Bisognano, Maureen; Yates, Gary R; Hunt, Gordon C

2012-11-01

External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.

Physical Examination to Marshall Space Flight Center (MSFC) Employees

NASA Technical Reports Server (NTRS)

1998-01-01

Nurse performs tonometry examination, which measure the tension of the eyeball, during an employee's arnual physical examination given by MSFC Occupational Medicine Environmental Health Services under the Center Operations Directorate.

75 FR 49942 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

..., performance measurement, and improvement of SAMHSA administrative and management services; (3) provides...) coordinates and manages General Accounting Office (GAO) and Office of Inspector General (OIG) reviews of the...

Using fuzzy gap analysis to measure service quality of medical tourism in Taiwan.

PubMed

Ho, Li-Hsing; Feng, Shu-Yun; Yen, Tieh-Min

2015-01-01

The purpose of this paper is intended to create a model to measure quality of service, using fuzzy linguistics to analyze the quality of service of medical tourism in Taiwan so as to find the direction for improvement of service quality in medical tourism. The study developed fuzzy questionnaires based on the characteristics of medical tourism quality of service in Taiwan. Questionnaires were delivered and recovered from February to April 2014, using random sampling according to the proportion of medical tourism companies in each region, and 150 effective samples were obtained. The critical quality of service level is found through the fuzzy gap analysis using questionnaires examining expectations and perceptions of customers, as the direction for continuous improvement. From the study, the primary five critical service items that improve the quality of service for medical tourism in Taiwan include, in order: the capability of the service provider to provide committed medical tourism services reliably and accurately, facility service providers in conjunction with the services provided, the cordial and polite attitude of the service provider eliciting a sense of trust from the customer, professional ability of medical (nursing) personnel in hospital and reliability of service provider. The contribution of this study is to create a fuzzy gap analysis to assess the performance of medical tourism service quality, identify key quality characteristics and provide a direction for improvement and development for medical tourism service quality in Taiwan.

Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

PubMed Central

Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert

2010-01-01

BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic “health coach” — a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coach’s influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 21–64) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available to authorized users. PMID:20556533

Establishing Key Performance Indicators [KPIs] and Their Importance for the Surgical Management of Inflammatory Bowel Disease-Results From a Pan-European, Delphi Consensus Study.

PubMed

Morar, Pritesh S; Hollingshead, James; Bemelman, Willem; Sevdalis, Nick; Pinkney, Thomas; Wilson, Graeme; Dunlop, Malcolm; Davies, R Justin; Guy, Richard; Fearnhead, Nicola; Brown, Steven; Warusavitarne, Janindra; Edwards, Cathryn; Faiz, Omar

2017-10-27

Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus. Items were ranked on a Likert scale from 1 [not important] to 5 [very important]. Consensus was defined when the inter quartile range was ≤ 1, and items with a median score > 3 were considered for inclusion. A panel of 21 experts [14 surgeons and 7 gastroenterologists] was recruited. Consensus was achieved on procedure-specific KPIs for ileocaecal and perianal surgery for Crohn's disease, [N = 10] with themes relating to morbidity [N = 7], multidisciplinary input [N = 2], and quality of life [N = 1]; and for subtotal colectomy, proctocolectomy and ileoanal pouch surgery for ulcerative colitis [N = 11], with themes relating to mortality [N = 2], morbidity [N = 8], and service provision [N = 1]. Consensus was also achieved for measures of the quality of IBD surgical service provision and quality assurance in IBD surgery. This study has provided measurable KPIs for the provision of surgical services in IBD. These indicators cover IBD surgery in general, the governance and structures of the surgical services, and separate indicators for specific subareas of surgery. Monitoring of IBD services with these KPIs may reduce variation across services and improve quality. Copyright © 2017 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

Comparing the performance of residential fire sprinklers with other life-safety technologies.

PubMed

Butry, David T

2012-09-01

Residential fire sprinklers have long proven themselves as life-safety technologies to the fire service community. Yet, about 1% of all one- and two-family dwelling fires occur in homes protected by sprinklers. It has been argued that measured sprinkler performance has ignored factors confounding the relationship between sprinkler use and performance. In this analysis, sprinkler performance is measured by comparing 'like' structure fires, while conditioning on smoke detection technology and neighborhood housing and socioeconomic conditions, using propensity score matching. Results show that residential fire sprinklers protect occupant and firefighter health and safety, and are comparable to other life-safety technologies. Published by Elsevier Ltd.

Diesel Mechanics. Performance Objectives. Basic Course.

ERIC Educational Resources Information Center

Tidwell, Joseph

Several intermediate performance objectives and corresponding criterion measures are listed for each of 12 terminal objectives for a basic diesel mechanics course. The course is designed as a two-semester (2 hour daily) course for 10th graders interested in being diesel service and repair mechanics; it would serve as the first year of a 3-year…

20 CFR 669.500 - What performance measures and standards apply to the NFJP?

Code of Federal Regulations, 2011 CFR

2011-04-01

... youth programs, described in 20 CFR part 666. The levels of performance for the farmworker indicators will be established in a negotiation between the Department and the grantee. The levels must take into account the characteristics of the population to be served and the economic conditions in the service area...

Performance Measurement for Substance Abuse Treatment Services. Integrated Evaluation Methods. Revised.

ERIC Educational Resources Information Center

Harwood, Henrick; Bazron, Barbara; Fountain, Douglas

This paper presents state-of-the-art models addressing issues related to coordination of treatment and evaluation activities, and integration of clinical, performance, and evaluation information. Specifically, this concept paper contains a discussion of the need for and types of cost analyses for CSAT treatment evaluation and knowledge-generating…

Validating Student Satisfaction Related to Persistence, Academic Performance, Retention and Career Advancement within ODL Perspectives

ERIC Educational Resources Information Center

Sembiring, Maximus Gorky

2015-01-01

Student satisfaction associated with persistence, academic performance, retention, and its relations to career advancement were examined. It was aimed at measuring service quality (Servqual) dimensions as a foundation of satisfaction and how, in what comportments, they were interrelated. The study was conducted under explanatory-design. Data was…

Proposed Performance Standards for Comprehensive Support Services and Vocational Equity Grants.

ERIC Educational Resources Information Center

Lewis, Morgan V.

Activities to develop proposed performance standards and measures for programs receiving funds authorized by the Carl D. Perkins Vocational and Applied Technology Education Act are described in this report. Two sections of the act are considered: Section 221 authorizes programs for single parents, displaced homemakers, and single pregnant women;…

Designing for resilience

NASA Astrophysics Data System (ADS)

Dwivedi, Anurag

2014-06-01

The motivation for this work comes from a desire to improve resilience of mission critical cyber enabled systems including those used in critical infrastructure domains such as cyber, power, water, fuel, financial, healthcare, agriculture, and manufacturing. Resilience can be defined as the ability of a system to persistently meet its performance requirements despite the occurrence of adverse events. Characterizing the resilience of a system requires a clear definition of the performance requirements of the system of interest and an ability to quantify the impact on performance by the adverse events of concern. A quantitative characterization of system resilience allows the resilience requirements to be included in the system design criteria. Resilience requirements of a system are derived from the service level agreements (SLAs), measures of effectiveness (MOEs), and measures of performance (MOPs) of the services or missions supported by the system. This paper describes a methodology for designing resilient systems. The components of the methodology include resilience characterization for threat models associated with various exposure modes, requirements mapping, subsystem ranking based on criticality, and selective implementation of mitigations to improve system resilience to a desired level.

Paying for Performance to Improve the Delivery and Uptake of Family Planning in Low and Middle Income Countries: A Systematic Review.

PubMed

Blacklock, Claire; MacPepple, Ekelechi; Kunutsor, Setor; Witter, Sophie

2016-12-01

Paying for performance is a strategy to meet the unmet need for family planning in low and middle income countries; however, rigorous evidence on effectiveness is lacking. Scientific databases and grey literature were searched from 1994 to May 2016. Thirteen studies were included. Payments were linked to units of targeted services, usually modified by quality indicators. Ancillary components and payment indicators differed between studies. Results were mixed for family planning outcome measures. Paying for performance was associated with improved modern family planning use in one study, and increased user and coverage rates in two more. Paying for performance with conditional cash transfers increased family planning use in another. One study found increased use in the upper wealth group only. However, eight studies reported no impact on modern family planning use or prevalence. Secondary outcomes of equity, financial risk protection, satisfaction, quality, and service organization were mixed. Available evidence is inconclusive and limited by the scarcity of studies and by variation in intervention, study design, and outcome measures. Further studies are warranted. © 2016 The Population Council, Inc.

Complication Rates, Hospital Size, and Bias in the CMS Hospital-Acquired Condition Reduction Program.

PubMed

Koenig, Lane; Soltoff, Samuel A; Demiralp, Berna; Demehin, Akinluwa A; Foster, Nancy E; Steinberg, Caroline Rossi; Vaz, Christopher; Wetzel, Scott; Xu, Susan

In 2016, Medicare's Hospital-Acquired Condition Reduction Program (HAC-RP) will reduce hospital payments by $364 million. Although observers have questioned the validity of certain HAC-RP measures, less attention has been paid to the determination of low-performing hospitals (bottom quartile) and the assignment of penalties. This study investigated possible bias in the HAC-RP by simulating hospitals' likelihood of being in the worst-performing quartile for 8 patient safety measures, assuming identical expected complication rates across hospitals. Simulated likelihood of being a poor performer varied with hospital size. This relationship depended on the measure's complication rate. For 3 of 8 measures examined, the equal-quality simulation identified poor performers similarly to empirical data (c-statistic approximately 0.7 or higher) and explained most of the variation in empirical performance by size (Efron's R 2 > 0.85). The Centers for Medicare & Medicaid Services could address potential bias in the HAC-RP by stratifying by hospital size or using a broader "all-harm" measure.

Evaluation of mammography equipment performance, dose and image quality in five Latin American countries

NASA Astrophysics Data System (ADS)

Brandan, M.-E.; Ruiz-Trejo, C.; Caspani, C. E. M.; Fleitas, I.; de-la-Mora, R.; Miranda, A. A.; Plazas, M.-C.; Betancourt, C.-M.; Borras, C.

2001-10-01

Under the auspices of PAHO/WHO, a multicentric investigation is carried out in five Latin American countries. Its aim is to correlate quality indicators of radiology services with the accuracy of the radiological interpretation as determined by a panel of radiology experts. We present preliminary results from mammographic imaging facilities. Evaluation of the equipment performance and dose measurements in 21 mammographic units show that, on the average, 75% of the units comply with recommendations issued by various organizations. An independent evaluation of the quality of the clinical images show strong variations among the different radiological services.

A measurement-based performability model for a multiprocessor system

NASA Technical Reports Server (NTRS)

Ilsueh, M. C.; Iyer, Ravi K.; Trivedi, K. S.

1987-01-01

A measurement-based performability model based on real error-data collected on a multiprocessor system is described. Model development from the raw errror-data to the estimation of cumulative reward is described. Both normal and failure behavior of the system are characterized. The measured data show that the holding times in key operational and failure states are not simple exponential and that semi-Markov process is necessary to model the system behavior. A reward function, based on the service rate and the error rate in each state, is then defined in order to estimate the performability of the system and to depict the cost of different failure types and recovery procedures.

Measuring NO, NO2, CO2 and O3 with low-cost sensors

NASA Astrophysics Data System (ADS)

Müller, Michael; Graf, Peter; Hüglin, Christoph

2017-04-01

Inexpensive sensors measuring ambient gas concentrations can be integrated in sensor units forming dense sensor networks. The utilized sensors have to be sufficiently accurate as the value of such networks directly depends on the information they provide. Thus, thorough testing of sensors before bringing them into service and the application of effective strategies for performance monitoring and adjustments during service are key elements for operating the low-cost sensors that are currently available on the market. We integrated several types of low-cost sensors into sensor units (Alphasense NO2 B4/B42F/B43F, Alphasense NO B4, SensAir CO2 LP8, Aeroqual O3 SM50), run them in the field next to instruments of air quality monitoring stations and performed tests in the laboratory. The poster summarizes our findings regarding the achieved sensor accuracy, methods to improve sensor performance as well as strategies to monitor the current state of the sensor (drifts, sensitivity) within a sensor network.

Opportunities for Improved Management Efficiency of the Head Start Program: Performance Evaluation and High Risk Determination.

ERIC Educational Resources Information Center

Gall, Mary Sheila

This report provides results of a review of the methodology used by the Office of Human Development Services (HDS) to measure Head Start performance and to control high risk Head Start agencies. The review was performed at HDS headquarters and regional locations nationwide. The review was based on a sample of 200 Head Start agencies and focused on…

[Integrated Quality Management System (IQMS): a model for improving the quality of reproductive health care in rural Kenya].

PubMed

Herrler, Claudia; Bramesfeld, Anke; Brodowski, Marc; Prytherch, Helen; Marx, Irmgard; Nafula, Maureen; Richter-Aairijoki, Heide; Musyoka, Lucy; Marx, Michael; Szecsenyi, Joachim

2015-01-01

To develop a model aiming to improve the quality of services for reproductive health care in rural Kenya and designed to measure the quality of reproductive health services in such a way that allows these services to identify measures for improving their performance. The Integrated Quality Management System (IQMS) was developed on the basis of a pre-existing and validated model for quality promotion, namely the European Practice Assessment (EPA). The methodology for quality assessment and feedback of assessment results to the service teams was adopted from the EPA model. Quality assessment methodology included data assessment through staff, patient surveys and service visitation. Quality is assessed by indicators, and so indicators had to be developed that were appropriate for assessing reproductive health care in rural Kenya. A search of the Kenyan and international literature was conducted to identify potential indicators. These were then rated for their relevance and clarity by a panel of Kenyan experts. 260 indicators were rated as relevant and assigned to 29 quality dimensions and 5 domains. The implementation of IQMS in ten facilities showed that IQMS is a feasible model for assessing the quality of reproductive health services in rural Kenya. IQMS enables these services to identify quality improvement targets and necessary improvement measures. Both strengths and limitations of IQMS will be discussed. Copyright © 2015. Published by Elsevier GmbH.

76 FR 9052 - Comment Request for Information Collection for the Unemployment Insurance (UI) Facilitation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... effectiveness and public accountability by focusing on program results, service quality, and customer satisfaction. Outcome Goal 1.3 in the Department's fiscal year (FY) 2011--2016 Strategic Plan--Help workers who... Measures The UI reemployment GPRA and UI Performs measures are defined as the percentage of all UI...

Building brand equity and customer loyalty

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

Pokorny, G.

Customer satisfaction and customer loyalty are two different concepts, not merely two different phrases measuring a single consumer attitude. Utilities having identical customer satisfaction ratings based on performance in areas like power reliability, pricing, and quality of service differ dramatically in their levels of customer loyalty. As competitive markets establish themselves, discrepancies in customer loyalty will have profound impacts on each utility`s prospects for market retention, profitability, and ultimately, shareholder value. Meeting pre-existing consumer needs, wants and preferences is the foundation of any utility strategy for building customer loyalty and market retention. Utilities meet their underlying customer expectations by performingmore » well in three discrete areas: product, customer service programs, and customer service transactions. Brand equity is an intervening variable standing between performance and the loyalty a utility desires. It is the totality of customer perceptions about the unique extra value the utility provides above and beyond its basic product, customer service programs and customer service transactions; it is the tangible, palpable reality of a branded utility that exists in the minds of consumers. By learning to manage their brand equity as well as they manage their brand performance, utilities gain control over all the major elements in the value-creation process that creates customer loyalty. By integrating brand performance and brand equity, electric utility companies can truly become in their customers` eyes a brand - a unique, very special, value-added energy services provider that can ask for and deserve a premium price in the marketplace.« less

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures

PubMed Central

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-01-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. PMID:26803655

Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures.

PubMed

Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

2016-02-01

Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of performance suggest that efficiency may be achieved without sacrificing quality. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

Effect of Total Quality Management on the Quality and Productivity of Human Resources

NASA Astrophysics Data System (ADS)

Siregar, I.; Nasution, A. A.; Sari, R. M.

2017-03-01

Human resources is the main factor in improving company performance not only in industrial products but also services. Therefore, all of the organization performers involved must work together to achieve product quality services expected by consumers. Educational institutions are the service industries which are educators and instructor involved in it. Quality of product and services produced depends on the education organization performers. This study did a survey of instructors in public and private universities in North Sumatra to obtain the factors that affect quality of human resources and productivity of human resources. Human resources quality is viewed by the elements of TQM. TQM elements that are discussed in this study are leadership, communication, training and education, support structure, measurement and reward and recognition. The results of this study showed a correlation numbers across the exogenous variables on endogenous variables relationships tend to be strong and be positive. In addition, elements of TQM are discussed except the support structure which has a direct influence on the quality of human resources. Variable leadership, reward and recognition and quality of human resources have a significant effect on productivity.

The ESRD Quality Incentive Program—Can We Bridge the Chasm?

PubMed Central

Weiner, Daniel

2017-01-01

The ESRD Quality Incentive Program (QIP) is the first mandatory federal pay for performance program launched on January 1, 2012. The QIP is tied to the ESRD prospective payment system and mandated by the Medicare Improvements for Patients and Providers Act of 2008, which directed the Centers for Medicare and Medicaid Services to expand the payment bundle for renal dialysis services and legislated that payment be tied to quality measures. The QIP links 2% of the payment that a dialysis facility receives for Medicare patients on dialysis to the facility’s performance on quality of care measures. Quality measures are evaluated annually for inclusion on the basis of importance, validity, and performance gap. Other quality assessment programs overlap with the QIP; all have substantial effects on provision of care as clinicians, patients, regulators, and dialysis organizations scramble to keep up with the frequent release of wide-ranging regulations. In this review, we provide an overview of quality assessment and quality measures, focusing on the ESRD QIP, its effect on care, and its potential future directions. We conclude that a patient-centered, individualized, and parsimonious approach to quality assessment needs to be maintained to allow the nephrology community to further bridge the quality chasm in dialysis care. PMID:28298324

A system for comparison of boring parameters of mini-HDD machines

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

Gunsaulis, F.R.

A system has been developed to accurately evaluate changes in performance of a mini-horizontal directional drilling (HDD) system in the backreaming/pullback portion of a bore as the parameters influencing the backream are changed. Parameters incorporated in the study include spindle rotation rate, rate of pull, fluid flow rate, and backreamer design. The boring system is able to run at variable, operator-determined rates of spindle rotation and pullback speed utilizing electronic feedback controls for regulation. Spindle torque and pullback force are continuously measured and recorded giving an indication of the performance of the unit. A method has also been developed tomore » measure the pull load on the installed service line to determine the effect of the boring parameters on the service line. Variability of soil along the bore path is measured and quantified using a soil sampling system developed for the study. Sample results obtained with the system are included in the report. 2 refs., 5 figs., 2 tabs.« less

Association Between Hospital Performance on Patient Safety and 30-Day Mortality and Unplanned Readmission for Medicare Fee-for-Service Patients With Acute Myocardial Infarction.

PubMed

Wang, Yun; Eldridge, Noel; Metersky, Mark L; Sonnenfeld, Nancy; Fine, Jonathan M; Pandolfi, Michelle M; Eckenrode, Sheila; Bakullari, Anila; Galusha, Deron H; Jaser, Lisa; Verzier, Nancy R; Nuti, Sudhakar V; Hunt, David; Normand, Sharon-Lise T; Krumholz, Harlan M

2016-07-12

Little is known regarding the relationship between hospital performance on adverse event rates and hospital performance on 30-day mortality and unplanned readmission rates for Medicare fee-for-service patients hospitalized for acute myocardial infarction (AMI). Using 2009-2013 medical record-abstracted patient safety data from the Agency for Healthcare Research and Quality's Medicare Patient Safety Monitoring System and hospital mortality and readmission data from the Centers for Medicare & Medicaid Services, we fitted a mixed-effects model, adjusting for hospital characteristics, to evaluate whether hospital performance on patient safety, as measured by the hospital-specific risk-standardized occurrence rate of 21 common adverse event measures for which patients were at risk, is associated with hospital-specific 30-day all-cause risk-standardized mortality and unplanned readmission rates for Medicare patients with AMI. The unit of analysis was at the hospital level. The final sample included 793 acute care hospitals that treated 30 or more Medicare patients hospitalized for AMI and had 40 or more adverse events for which patients were at risk. The occurrence rate of adverse events for which patients were at risk was 3.8%. A 1% point change in the risk-standardized occurrence rate of adverse events was associated with average changes in the same direction of 4.86% points (95% CI, 0.79-8.94) and 3.44% points (95% CI, 0.19-6.68) for the risk-standardized mortality and unplanned readmission rates, respectively. For Medicare fee-for-service patients discharged with AMI, hospitals with poorer patient safety performance were also more likely to have poorer performance on 30-day all-cause mortality and on unplanned readmissions. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Development and Psychometric Testing of a Novel Food Service Satisfaction Questionnaire for Food Service Staff of Aged Care Homes.

PubMed

Miller, M; Hamilton, J; Scupham, R; Matwiejczyk, L; Prichard, I; Farrer, O; Yaxley, A

2018-01-01

Food service staff are integral to delivery of quality food in aged care homes yet measurement of their satisfaction is unable to be performed due to an absence of a valid and reliable questionnaire. The aim of this study was to develop and perform psychometric testing for a new Food Service Satisfaction Questionnaire developed in Australia specifically for use by food service staff working in residential aged care homes (Flinders FSSQFSAC). A mixed methods design utilizing both a qualitative (in-depth interviews, focus groups) and a quantitative approach (cross sectional survey) was used. Content validity was determined from focus groups and interviews with food service staff currently working in aged care homes, related questionnaires from the literature and consultation with an expert panel. The questionnaire was tested for construct validity and internal consistency using data from food service staff currently working in aged care homes that responded to an electronic invitation circulated to Australian aged care homes using a national database of email addresses. Construct validity was tested via principle components analysis and internal consistency through Cronbach's alpha. Temporal stability of the questionnaire was determined from food service staff undertaking the Flinders FSSQFSAC on two occasions, two weeks apart, and analysed using Pearson's correlations. Content validity for the Flinders FSSQFSAC was established from a panel of experts and stakeholders. Principle components analysis revealed food service staff satisfaction was represented by 61-items divided into eight domains: job satisfaction (α=0.832), food quality (α=0.871), staff training (α=0.922), consultation (α=0.840), eating environment (α=0.777), reliability (α=0.695), family expectations (α=0.781) and resident relationships (α=0.429), establishing construct validity in all domains, and internal consistency in all (α>0.5) except for "resident relationships" (α=0.429). Test-retest reliability coefficients ranged from 0.276 to 0.826 dependent on domain, with test-retest reliability established in seven domains at r>0.4; an exception was "reliability" at r=0.276. The newly developed Flinders FSSQFSAC has acceptable validity and reliability and thereby the potential to measure satisfaction of food service staff working in residential aged care homes, identify areas for strategic change, measure improvements and in turn, improve the satisfaction and quality of life of both food service staff and residents of aged care homes.

Performance of the measures of processes of care for adults and service providers in rehabilitation settings.

PubMed

Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

2015-01-01

In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). A validation study. In-patient rehabilitation facilities. MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71-0.88 for health care professionals, 0.82-0.90 for patients, and 0.87-0.94 for family members), as well as moderate to good correlations between domains (0.40-0.78 for health care professionals and 0.52-0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

Promoting prevention with economic arguments – The case of Finnish occupational health services

PubMed Central

Kankaanpää, Eila; Suhonen, Aki; Valtonen, Hannu

2008-01-01

Background Both social and ethical arguments have been used to support preventive occupational health services (OHS). During the 1990s it became more common to support political argumentation for occupational health and safety by converting the consequences of ill health at work into monetary units. In addition, OHS has been promoted as a profitable investment for companies, and this aspect has been used by OHS providers in their marketing. Our intention was to study whether preventive occupational health services positively influence a company's economic performance. Methods We combined the financial statements provided by Statistics Finland and employers' reimbursement applications for occupational health services (OHS) costs to the Social Insurance Institution. The data covered the years 1997, 1999 and 2001 and over 6000 companies. We applied linear regression analysis to assess whether preventive OHS had had a positive influence on the companies' economic performance after two or four years. Results Resources invested in preventive OHS were not positively related to a company's economic performance. In fact, the total cost of preventive OHS per turnover was negatively correlated to economic performance. Conclusion Even if OHS has no effect on the economic performance of companies, it may have other effects more specific to OHS. Therefore, we recommend that the evaluation of prevention in OHS should move towards outcome measures, such as sickness absence, disability pension and productivity, when applicable, both in occupational health service research and in practice at workplaces. PMID:18430218

A balanced scorecard for health services in Afghanistan.

PubMed

Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert

2007-02-01

The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

Improving health services to displaced persons in Aceh, Indonesia: a balanced scorecard

PubMed Central

Parco, Kristin B; Sihombing, Melva E; Tredwell, Susan P; O'Rourke, Edward J

2010-01-01

Abstract Problem After the Indian Ocean tsunami in December 2004, the International Organization for Migration constructed temporary health clinics to provide medical services to survivors living in temporary accommodation centres throughout Aceh, Indonesia. Limited resources, inadequate supervision, staff turnover and lack of a health information system made it challenging to provide quality primary health services. Approach A balanced scorecard was developed and implemented in collaboration with local health clinic staff and district health officials. Performance targets were identified. Staff collected data from clinics and accommodation centres to develop 30 simple performance measures. These measures were monitored periodically and discussed at meetings with stakeholders to guide the development of health interventions. Local setting Two years after the tsunami, 34 000 displaced persons continued to receive services from temporary health clinics in two districts of Aceh province. From March to December 2007, the scorecard was implemented in seven temporary health clinics. Relevant changes Interventions stimulated and tracked by the scorecard showed measurable improvements in preventive medicine, child health, capacity building of clinic staff and availability of essential drugs. By enhancing communication, the scorecard also led to qualitative benefits. Lessons learnt The balanced scorecard is a practical tool to focus attention and resources to facilitate improvement in disaster rehabilitation settings where health information infrastructure is poor. Introducing a mechanism for rapid improvement fostered communication between nongovernmental organizations, district health officials, clinic health workers and displaced persons. PMID:20865077

Measuring patients' satisfaction with pharmaceutical services at a public hospital in Qatar.

PubMed

Khudair, Imran Fahmi; Raza, Syed Asif

2013-01-01

The aim of this paper is to study pharmacy service impact on patient satisfaction and to determine what factors saliently link with pharmaceutical service performance at Hamad General Hospital. A patient satisfaction questionnaire was designed using the literature and consultation with Hamad General Hospital medical experts. The questionnaire contained 22 items that focused on five influencing factors: promptness; attitude; supply; location; medication education; and respondent demographic aspects. A total of 220 respondents completed the questionnaire. An exploratory factor analysis was used to group items and a structural equation model was developed to test causality between five factors along with their influence on patient satisfaction. The study establishes statistical evidence that patient satisfaction is positively influenced by service promptness, pharmacist attitude, medication counseling, pharmacy location and waiting area. Several socio-demographic characteristics have statistically different effect on satisfaction, notably: gender; marital status; health status; age; educational level; and ethnicity. However, medication supply did not influence patient satisfaction. Pharmaceutical services are recognized as an essential healthcare-system component. Their impact on customer satisfaction has been investigated in many countries; however, there is no such study in Qatar. The findings identify pharmaceutical service performance indicators and provide guidelines to improve Qatari pharmaceutical services.

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

Not Available

This report summarizes lessons learned to date by the transit industry regarding four major types of strategic initiatives aimed to improving productivity or cost-effectiveness of public-transit services. Successful policies to reduce absenteeism are recorded; most combine incentives for improved attendance and disciplinary measures for unsatisfactory performance. Part-time labor is examined as a means to reduce labor costs. Competitive selection of bus service providers--examines the productivity and cost-effectiveness implications of increased service competition. The fourth strategy concerns the better targeting of supply to demand. The final chapter in the report addresses how the suggested actions might be implemented.

Medicare Accountable Care Organizations of Diverse Structures Achieve Comparable Quality and Cost Performance.

PubMed

Comfort, Leeann N; Shortell, Stephen M; Rodriguez, Hector P; Colla, Carrie H

2018-01-31

To examine whether an empirically derived taxonomy of Accountable Care Organizations (ACOs) is associated with quality and spending performance among patients of ACOs in the Medicare Shared Savings Program (MSSP). Three waves of the National Survey of ACOs and corresponding publicly available Centers for Medicare & Medicaid Services performance data for NSACO respondents participating in the MSSP (N = 204); SK&A Office Based Physicians Database from QuintilesIMS. We compare the performance of three ACO types (physician-led, integrated, and hybrid) for three domains: quality, spending, and likelihood of achieving savings. Sources of performance variation within and between ACO types are compared for each performance measure. There is greater heterogeneity within ACO types than between ACO types. There were no consistent differences in quality by ACO type, nor were there differences in likelihood of achieving savings or overall spending per-person-year. There was evidence for higher spending on physician services for physician-led ACOs. ACOs of diverse structures perform comparably on core MSSP quality and spending measures. CMS should maintain its flexibility and continue to support participation of diverse ACOs. Future research to identify modifiable organizational factors that account for performance variation within ACO types may provide insight as to how best to improve ACO performance based on organizational structure and ownership. © Health Research and Educational Trust.

NERC Policy 10: Measurement of two generation and load balancing IOS

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

Spicer, P.J.; Galow, G.G.

1999-11-01

Policy 10 will describe specific standards and metrics for most of the reliability functions described in the Interconnected Operations Services Working Group (IOS WG) report. The purpose of this paper is to discuss, in detail, the proposed metrics for two generation and load balancing IOSs: Regulation; Load Following. For purposes of this paper, metrics include both measurement and performance evaluation. The measurement methods discussed are included in the current draft of the proposed Policy 10. The performance evaluation method discussed is offered by the authors for consideration by the IOS ITF (Implementation Task Force) for inclusion into Policy 10.

Advanced ISDN satellite designs and experiments

NASA Technical Reports Server (NTRS)

Pepin, Gerard R.

1992-01-01

The research performed by GTE Government Systems and the University of Colorado in support of the NASA Satellite Communications Applications Research (SCAR) Program is summarized. Two levels of research were undertaken. The first dealt with providing interim services Integrated Services Digital Network (ISDN) satellite (ISIS) capabilities that accented basic rate ISDN with a ground control similar to that of the Advanced Communications Technology Satellite (ACTS). The ISIS Network Model development represents satellite systems like the ACTS orbiting switch. The ultimate aim is to move these ACTS ground control functions on-board the next generation of ISDN communications satellite to provide full-service ISDN satellite (FSIS) capabilities. The technical and operational parameters for the advanced ISDN communications satellite design are obtainable from the simulation of ISIS and FSIS engineering software models of the major subsystems of the ISDN communications satellite architecture. Discrete event simulation experiments would generate data for analysis against NASA SCAR performance measure and the data obtained from the ISDN satellite terminal adapter hardware (ISTA) experiments, also developed in the program. The Basic and Option 1 phases of the program are also described and include the following: literature search, traffic mode, network model, scenario specifications, performance measures definitions, hardware experiment design, hardware experiment development, simulator design, and simulator development.

Is Donor Service Area Market Competition Associated With Organ Procurement Organization Performance?

PubMed

Adler, Joel T; Yeh, Heidi; Markmann, James F; Axelrod, David A

2016-06-01

Organ procurement organizations (OPOs) are currently evaluated on donation rates and number of organs per donor. However, there is significant variability in market characteristics which affect transplant programs' donor organ acceptance practices and OPOs' ability to successfully place higher risk organs. The impact of transplant market characteristics on OPO performance metrics has not been evaluated. The OPO performance measures were correlated annually with the Herfindahl Hirschman Index, a standard measure of market competition for centers within the OPO donor service areas from 2003 to 2011. More competitive donor service areas were associated with increased number of donors (P = 0.01) and eligible deaths (P < 0.001). Market competition was associated with increased use of high Donor Risk Index for kidney (P = 0.03) and liver (P = 0.01) allografts. The OPOs with increased competition in liver transplant also were noted to have a higher donor conversion rate (P < 0.001), more donors per million population (P < 0.001), and a higher utilization rate for liver allografts (P = 0.007). These data suggest that proposals to increase district size to increase competition among transplant programs could result in improved organ utilization over time by incentivizing the use of marginal donor organs and increasing access to transplantation.

Improving Trends in Gender Disparities in the Department of Veterans Affairs: 2008–2013

PubMed Central

Czarnogorski, Maggie; Wright, Steve M.; Hayes, Patricia M.; Haskell, Sally G.

2014-01-01

Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women’s health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures. PMID:25100416

Reinforcement Learning Performance and Risk for Psychosis in Youth.

PubMed

Waltz, James A; Demro, Caroline; Schiffman, Jason; Thompson, Elizabeth; Kline, Emily; Reeves, Gloria; Xu, Ziye; Gold, James

2015-12-01

Early identification efforts for psychosis have thus far yielded many more individuals "at risk" than actually develop psychotic illness. Here, we test whether measures of reinforcement learning (RL), known to be impaired in chronic schizophrenia, are related to the severity of clinical risk symptoms. Because of the reliance of RL on dopamine-rich frontostriatal systems and evidence of dopamine system dysfunction in the psychosis prodrome, RL measures are of specific interest in this clinical population. The current study examines relationships between psychosis risk symptoms and RL task performance in a sample of adolescents and young adults (n = 70) receiving mental health services. We observed significant correlations between multiple measures of RL performance and measures of both positive and negative symptoms. These results suggest that RL measures may provide a psychosis risk signal in treatment-seeking youth. Further research is necessary to understand the potential predictive role of RL measures for conversion to psychosis.

Quality indicators for family support services and their relationship to organizational social context.

PubMed

Olin, S Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E

2014-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs-those targeting the program and staff-were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed.

Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

PubMed Central

Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

2013-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

PubMed

Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

2014-01-01

Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.

Patient satisfaction in Dental Healthcare Centers.

PubMed

Ali, Dena A

2016-01-01

This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists' performance, followed by the dental assistants' services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R (2)) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required.

Local Geographic Variation of Public Services Inequality: Does the Neighborhood Scale Matter?

PubMed Central

Wei, Chunzhu; Cabrera-Barona, Pablo; Blaschke, Thomas

2016-01-01

This study aims to explore the effect of the neighborhood scale when estimating public services inequality based on the aggregation of social, environmental, and health-related indicators. Inequality analyses were carried out at three neighborhood scales: the original census blocks and two aggregated neighborhood units generated by the spatial “k”luster analysis by the tree edge removal (SKATER) algorithm and the self-organizing map (SOM) algorithm. Then, we combined a set of health-related public services indicators with the geographically weighted principal components analyses (GWPCA) and the principal components analyses (PCA) to measure the public services inequality across all multi-scale neighborhood units. Finally, a statistical test was applied to evaluate the scale effects in inequality measurements by combining all available field survey data. We chose Quito as the case study area. All of the aggregated neighborhood units performed better than the original census blocks in terms of the social indicators extracted from a field survey. The SKATER and SOM algorithms can help to define the neighborhoods in inequality analyses. Moreover, GWPCA performs better than PCA in multivariate spatial inequality estimation. Understanding the scale effects is essential to sustain a social neighborhood organization, which, in turn, positively affects social determinants of public health and public quality of life. PMID:27706072

[Geriatric institutions, between ambulatory and hospital care: patients' description and performance assessment].

PubMed

Eggli, Yves; Schaller, Philippe; Baudoin, Florence

2015-01-01

To describe patients admitted to a geriatric institution, providing short-term hospitalizations in the context of ambulatory care in the canton of Geneva. To measure the performances of thisstructure in terms of quality ofcare and costs. Data related to the clinical,functioning and participation profiles of the first 100 patients were collected. Data related to effects (readmission, deaths, satisfaction, complications), services and resources were also documented over an 8-month period to measure various quality and costindicators. Observed values were systematically compared to expected values, adjustedfor case mix. Explicit criteria were proposed to focus on the suitable patients, excluding situations in which other structures were considered to be more appropriate. The specificity of this intermediate structure was to immediately organize, upon discharge, outpatient services at home. The low rate of potentially avoidable readmissions, the high patient satisfaction scores, the absence of premature death and the low number of iatrogenic complications suggest that medical and nursing care delivered reflect a good quality of services. The cost was significantly lower than expected, after adjusting for case mix. The pilot experience showed that a short-stay hospitalization unit was feasible with acceptable security conditions. The attending physician's knowledge of the patients allowed this system tofocus on essential issues without proposing inappropriate services.

Patient satisfaction in Dental Healthcare Centers

PubMed Central

Ali, Dena A.

2016-01-01

Objectives: This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Materials and Methods: Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. Results: The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists’ performance, followed by the dental assistants’ services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R2) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Conclusion: Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required. PMID:27403045

A multistate examination of partnership activity among local public health systems using the National Public Health Performance Standards.

PubMed

Barnes, Priscilla A; Curtis, Amy B; Hall-Downey, Laura; Moonesinghe, Ramal

2012-01-01

This study examines whether partnership-related measures in the second version of the National Public Health Performance Standards (NPHPS) are useful in evaluating level of activity as well as identifying latent constructs that exist among local public health systems (LPHSs). In a sample of 110 LPHSs, descriptive analysis was conducted to determine frequency and percentage of 18 partnership-related NPHPS measures. Principal components factor analysis was conducted to identify unobserved characteristics that promote effective partnerships among LPHSs. Results revealed that 13 of the 18 measures were most frequently reported at the minimal-moderate level (conducted 1%-49% of the time). Coordination of personal health and social services to optimize access (74.6%) was the most frequently reported measure at minimal-moderate levels. Optimal levels (conducted >75% of the time) were reported most frequently in 2 activities: participation in emergency preparedness coalitions and local health departments ensuring service provision by working with state health departments (67% and 61% of respondents, respectively) and the least optimally reported activity was review partnership effectiveness (4% of respondents). Factor analysis revealed categories of partnership-related measures in 4 domains: resources and activities contributing to relationship building, evaluating community leadership activities, research, and state and local linkages to support public health activities. System-oriented public health assessments may have questions that serve as proxy measures to examine levels of interorganizational partnerships. Several measures from the NPHPS were useful in establishing a national baseline of minimal and optimal activity levels as well as identifying factors to enhance the delivery of the 10 essential public health services among organizations and individuals in public health systems.

Identifying an outcome measure to assess the impact of Mobility Dogs.

PubMed

Mudge, Suzie; Rewi, Dallas; Channon, Alexis

2017-01-01

Mobility Dogs® trains dogs to work with people with physical disabilities to increase independence, confidence, self-esteem and participation. Mobility Dogs® seeks to critically evaluate and improve its services as it grows. This study aimed to identify and implement a standardised outcome measure into practice at Mobility Dogs®. Based on the Consolidated Framework for Implementation Research and guided by a steering group of key stakeholders, a three-phase approach was developed to identify and assess an outcome measure. The steering group highlighted the organisation's specific needs, selected participation as the assessment domain and identified core utility requirements of the measure. A comprehensive review of evidence was undertaken to identify and rank potential measures according to the specified needs. Of the seven participation outcome measures that met inclusion criteria, the three highest ranked measures were critically evaluated by the steering group to determine suitability against the organisation's needs. The Impact on Participation and Autonomy (IPA) was selected for implementation into practice at Mobility Dogs®. Use of the IPA is an important first step for Mobility Dogs® to test the benefits of trained service dogs. This process could be replicated by other service dog organisations to identify outcome measures to assess their own services. Implications for Rehabilitation Service dogs (such as Mobility Dogs® in New Zealand) assist people living with physical impairments by performing tasks, however there is limited evidence on outcomes. The process for selecting an appropriate outcome measure for Mobility Dogs® involving partnership between Mobility Dogs® personnel and academics was an effective way to steer the project by determining important properties of the measure, before a search of the literature was undertaken. While the IPA was selected as the most appropriate outcome measure for use at Mobility Dogs®, it was the process that is valuable to replicate if other organisations wish to select an outcome measure for use in their own practice.

[Methodology for the comprehensive evaluation of the quality of performance of activities of medical and social experts].

PubMed

Moskalenko, V F; Gorban', Ie M; Marunich, V V; Ipatov, A V; Sergiieni, O V

2001-01-01

The paper scientifically substantiates methodology, approaches, criteria, and control indices for assessment of activities of establishments of medical-and-social performance. Most indices for efficiency and certain indices for week points in the work of establishments of the service depend on interaction thereof with curative- and prophylactic institutions; the best results with the problem of prevention of disability and rehabilitation of invalids are supposed to be achieved through collaborative efforts. Other criteria and intermediate indices having an effect on the quality of activities reflect the resource- and trained personnel supplies of establishments of the service, amount of work, organizational measures designed to raise the quality of medical-and-social expert performance.

Reproductive health services in Malawi: an evaluation of a quality improvement intervention.

PubMed

Rawlins, Barbara J; Kim, Young-Mi; Rozario, Aleisha M; Bazant, Eva; Rashidi, Tambudzai; Bandazi, Sheila N; Kachale, Fannie; Sanghvi, Harshad; Noh, Jin Won

2013-01-01

this study was to evaluate the impact of a quality improvement initiative in Malawi on reproductive health service quality and related outcomes. (1) post-only quasi-experimental design comparing observed service quality at intervention and comparison health facilities, and (2) a time-series analysis of service statistics. sixteen of Malawi's 23 district hospitals, half of which had implemented the Performance and Quality Improvement (PQI) intervention for reproductive health at the time of the study. a total of 98 reproductive health-care providers (mostly nurse-midwives) and 139 patients seeking family planning (FP), antenatal care (ANC), labour and delivery (L&D), or postnatal care (PNC) services. health facility teams implemented a performance and quality improvement (PQI) intervention over a 3-year period. Following an external observational assessment of service quality at baseline, facility teams analysed performance gaps, designed and implemented interventions to address weaknesses, and conducted quarterly internal assessments to assess progress. Facilities qualified for national recognition by complying with at least 80% of reproductive health clinical standards during an external verification assessment. key measures include facility readiness to provide quality care, observed health-care provider adherence to clinical performance standards during service delivery, and trends in service utilisation. intervention facilities were more likely than comparison facilities to have the needed infrastructure, equipment, supplies, and systems in place to offer reproductive health services. Observed quality of care was significantly higher at intervention than comparison facilities for PNC and FP. Compared with other providers, those at intervention facilities scored significantly higher on client assessment and diagnosis in three service areas, on clinical management and procedures in two service areas, and on counselling in one service area. Service statistics suggest that the PQI intervention increased the number of Caesarean sections, but showed no impact on other indicators of service utilisation and skilled care. the PQI intervention showed a positive impact on the quality of reproductive health services. The effects of the intervention on service utilisation had likely not yet been fully realized, since none of the facilities had achieved national recognition before the evaluation. Staff turnover needs to be reduced to maximise the effectiveness of the intervention. the PQI intervention evaluated here offers an effective way to improve the quality of health services in low-resource settings and should continue to be scaled up in Malawi. Copyright © 2011 Elsevier Ltd. All rights reserved.

Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

PubMed Central

Pennington, S J; McClelland, D B; Murphy, W G

1993-01-01

One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians. PMID:10132458

Surface Warfare Junior Officer Retention: Background and First Sea Tour Factors as Predictors of Continuance Beyond Obligated Services.

DTIC Science & Technology

1983-01-01

to perinnt items" kIcluded In the 4-silswmlre ops scales constucoted from respose to certain ltemr, and a measure id actua coninuance. Hypo#eized...commitment, and continuance will be positively associated with self -reports of performance (fitness reports) during the pre- MSR period. Performance, in turn

The Physical Activities Survey of Police Officers in New Jersey. Final Report.

ERIC Educational Resources Information Center

Goldstein, Leo S.

A survey of the physical activities of police officers in New Jersey was conducted to collect information about the kinds of physical activities they perform, their present health status, the measures they take to maintain good physical condition, and their appraisal of the present civil service physical performance test battery. Another purpose…

Military Aptitude Testing: The Past Fifty Years

DTIC Science & Technology

1993-06-01

61 Relationship Between the STP and the Joint-Service Program ............. 64 CHAPTER 4 NORMING AND SCALING MILITARY SELECTION...34* Identify the skills and knowledge that underlie performance in an occupational area. "* Develop experimental tests that may predict performance in...and nuclear technicians.) "* Construct experimental tests that measure the skills , knowledge, and aptitudes needed for success in that occupational

Wake-up call leads to organizational transformation.

PubMed

Paslidis, Nick J

2008-01-01

We've all heard the buzzwords--organizational transformation, corporate compliance, culture change, transparency. We may tire of the jargon, but as pressure continues to mount, organizations--particularly those viewed as performing public service--are being forced to rethink old habits, find truly measurable ways to evaluate performance, and become more accountable in every aspect of their operations.

The quality, safety and governance of telephone triage and advice services - an overview of evidence from systematic reviews.

PubMed

Lake, Rebecca; Georgiou, Andrew; Li, Julie; Li, Ling; Byrne, Mary; Robinson, Maureen; Westbrook, Johanna I

2017-08-30

Telephone triage and advice services (TTAS) are increasingly being implemented around the world. These services allow people to speak to a nurse or general practitioner over the telephone and receive assessment and healthcare advice. There is an existing body of research on the topic of TTAS, however the diffuseness of the evidence base makes it difficult to identify key lessons that are consistent across the literature. Systematic reviews represent the highest level of evidence synthesis. We aimed to undertake an overview of such reviews to determine the scope, consistency and generalisability of findings in relation to the governance, safety and quality of TTAS. We searched PubMed, MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library for English language systematic reviews focused on key governance, quality and safety findings related to telephone based triage and advice services, published since 1990. The search was undertaken by three researchers who reached consensus on all included systematic reviews. An appraisal of the methodological quality of the systematic reviews was independently undertaken by two researchers using A Measurement Tool to Assess Systematic Reviews. Ten systematic reviews from a potential 291 results were selected for inclusion. TTAS was examined either alone, or as part of a primary care service model or intervention designed to improve primary care. Evidence of TTAS performance was reported across nine key indicators - access, appropriateness, compliance, patient satisfaction, cost, safety, health service utilisation, physician workload and clinical outcomes. Patient satisfaction with TTAS was generally high and there is some consistency of evidence of the ability of TTAS to reduce clinical workload. Measures of the safety of TTAS tended to show that there is no major difference between TTAS and traditional care. Taken as a whole, current evidence does not provide definitive answers to questions about the quality of care provided, access and equity of the service, its costs and outcomes. The available evidence also suggests that there are many interactional factors (e.g., relationship with other health service providers) which can impact on measures of performance, and also affect the external validity of the research findings.

From service provision to function based performance - perspectives on public health systems from the USA and Israel

PubMed Central

2012-01-01

If public health agencies are to fulfill their overall mission, they need to have defined measurable targets and should structure services to reach these targets, rather than offer a combination of ill-targeted programs. In order to do this, it is essential that there be a clear definition of what public health should do- a definition that does not ebb and flow based upon the prevailing political winds, but rather is based upon professional standards and measurements. The establishment of the Essential Public Health Services framework in the U.S.A. was a major move in that direction, and the model, or revisions of the model, have been adopted beyond the borders of the U.S. This article reviews the U.S. public health system, the needs and processes which brought about the development of the 10 Essential Public Health Services (EPHS), and historical and contemporary applications of the model. It highlights the value of establishing a common delineation of public health activities such as those contained in the EPHS, and explores the validity of using the same process in other countries through a discussion of the development in Israel of a similar model, the 10 Public Health Essential Functions (PHEF), that describes the activities of Israel’s public health system. The use of the same process and framework to develop similar yet distinct frameworks suggests that the process has wide applicability, and may be beneficial to any public health system. Once a model is developed, it can be used to measure public health performance and improve the quality of services delivered through the development of standards and measures based upon the model, which could, ultimately, improve the health of the communities that depend upon public health agencies to protect their well-being. PMID:23181452

Improving student satisfaction of Andalas University Dormitory through Service Quality and Importance Performance Analysis

NASA Astrophysics Data System (ADS)

Putri, Nilda Tri; Anggraini, Larisa

2018-03-01

Residential satisfaction of university dormitories serve as one of the significant aspects in the framework of sustainability in higher education. This research investigated the quality of dormitory services in Andalas University Dormitory based on student’s satisfaction. According to management residential, the enrollment of residential student has increased gradually in Andalas University. In 2016, capacity of residential student is 1686, but only 1081 students can stay at dormitory because some rooms in bad condition. There are a lot of problems and complaints regarding dormitory’s service quality i.e water problems, leaky rooms and bathrooms, cleanliness and inadequate facilities in residential college. In addition, there are 20% of last year student’s residential check out before the time of contract runs out. The aim of this research are understanding the level of GAP exists between expectation and perception students’ residential in the content of service quality and evaluating the improvement priority services using Importance Performance Analysis. This study is measuring service quality by using Responsiveness, Assurance, Empathy, Reliability and Tangible dimension. A negative GAP indicates that the actual services are than what was expected and the GAP is highlighted area for improvement. Based on IPA, management should improve this following dimension services : responsiveness, tangible and assurance dimension.

Sustainable business models: systematic approach toward successful ambulatory care pharmacy practice.

PubMed

Sachdev, Gloria

2014-08-15

This article discusses considerations for making ambulatory care pharmacist services at least cost neutral and, ideally, generate a margin that allows for service expansion. The four pillars of business sustainability are leadership, staffing, information technology, and compensation. A key facet of leadership in ambulatory care pharmacy practice is creating and expressing a clear vision for pharmacists' services. Staffing considerations include establishing training needs, maximizing efficiencies, and minimizing costs. Information technology is essential for efficiency in patient care delivery and outcomes assessment. The three domains of compensation are cost savings, pay for performance, and revenue generation. The following eight steps for designing and implementing an ambulatory care pharmacist service are discussed: (1) prepare a needs assessment, (2) analyze existing strengths, weaknesses, opportunities, and threats, (3) analyze service gaps and feasibility, (4) consider financial opportunities, (5) consider stakeholders' interests, (6) develop a business plan, (7) implement the service, and (8) measure outcomes. Potential future changes in national healthcare policy (such as pharmacist provider status and expanded pay for performance) could enhance the opportunities for sustainable ambulatory care pharmacy practice. The key challenges facing ambulatory care pharmacists are developing sustainable business models, determining which services yield a positive return on investment, and demanding payment for value-added services. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The home health care routing and scheduling problem with interdependent services.

PubMed

Mankowska, Dorota Slawa; Meisel, Frank; Bierwirth, Christian

2014-03-01

This paper presents a model for the daily planning of health care services carried out at patients' homes by staff members of a home care company. The planning takes into account individual service requirements of the patients, individual qualifications of the staff and possible interdependencies between different service operations. Interdependencies of services can include, for example, a temporal separation of two services as is required if drugs have to be administered a certain time before providing a meal. Other services like handling a disabled patient may require two staff members working together at a patient's home. The time preferences of patients are included in terms of given time windows. In this paper, we propose a planning approach for the described problem, which can be used for optimizing economical and service oriented measures of performance. A mathematical model formulation is proposed together with a powerful heuristic based on a sophisticated solution representation.

Using Generalizability Theory as a Framework for Informing Measurement Issues in Middle School Settings

ERIC Educational Resources Information Center

Ing, Marsha; Shih, Jeffrey C.

2013-01-01

There are situations within middle school settings where measurements of students and teachers are used for high-stakes decisions. For example, student performance is used as an indicator of teacher quality or determines student eligibility for particular types of support services. Given the high-stakes nature of these types of assessments,…

Measuring urban forestry performance and demographic associations in Massachusetts, USA

Treesearch

David Rines; Brian Kane; David B. Kittredge; H. Dennis P. Ryan; Brett Butler

2011-01-01

The United States Forest Service measures successful management of the urban forest by the number of communities that have achieved some or all of four parameters described by the Community Accomplishment Reporting System. The four parameters address whether a community has: (1) a management plan, (2) professional staff, (3) urban forestry ordinances/policies, and (4)...

The impact of assistive technology services in post-secondary education for students with disabilities: Intervention outcomes, use-profiles, and user-experiences.

PubMed

Malcolm, Matthew P; Roll, Marla C

2017-01-01

The outcomes of assistive technology (AT) support services for post-secondary education students with disabilities are under-reported, and little is known about use-profiles and user experiences when AT interventions are applied to this rapidly growing population. We examined AT service outcomes related to performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure [COPM]), as well as how students with disabilities use and experience AT and AT services (employing an AT-use survey). Three-hundred fifty-three students with disabilities completed the AT-use survey, with a subset of these (n = 216) also participating with pre-post AT intervention COPM assessment. COPM performance and satisfaction ratings significantly increased from pre- to post-AT intervention in all academic task categories (reading, writing, note-taking, test-taking, and studying; p < 0.001). The AT-use survey most notably revealed these students preferred face-to-face training, used their AT at least 3 days per week, used AT in a variety of environments, felt AT positively impacted their academic success, and believed they would continue using AT post-graduation. The study findings contribute to evidence-base for AT services with a hope we may improve AT services to best meet the changing needs of the growing number of college students with disabilities.

The Impact of Comprehensive School Nursing Services on Students' Academic Performance.

PubMed

Kocoglu, Deniz; Emiroglu, Oya Nuran

2017-03-01

Introduction: School nursing services should be evaluated through health and academic outcomes of students; however, it is observed that the number of studies in this field is limited. The aim of this study is to evaluate the impact of comprehensive school nursing services provided to 4th grade primary school students on academic performance of students. Methods: The quasi-experimental study was conducted with 31 students attending a randomly selected school in economic disadvantaged area in Turky. Correlation analysis, repeated measures analyses of variance, multiple regression analysis were used to analyze the data with SPSS software. Results: At the end of school nursing practices, an increase was occurred in students' academic achievement grades whereas a decrease was occurred in absenteeism and academic procrastination behaviors. Whilst it was determined that nursing interventions including treatment/ procedure and surveillance was associated to the decrease of absenteeism, it also was discovered that the change in the health status of the student after nursing interventions was related to the increase of the academic achievement grade and the decrease of the academic procrastination behavior score. Conclusion: In this study, the conclusion that comprehensive school nursing services contributed positively to the academic performance of students has been reached. In addition, it can be suggested that effective school nursing services should include services such as acute-chronic disease treatment, first aid, health screening, health improvement-protection, health education, guidance and counseling and case management.

Implementation of New Reactivity Measurement System and New Reactor Noise Analysis Equipment in a VVER-440 Nuclear Power Plant

NASA Astrophysics Data System (ADS)

Vegh, János; Kiss, Sándor; Lipcsei, Sándor; Horvath, Csaba; Pos, István; Kiss, Gábor

2010-10-01

The paper deals with two recently developed, high-precision nuclear measurement systems installed at the VVER-440 units of the Hungarian Paks NPP. Both developments were motivated by the reactor power increase to 108%, and by the planned plant service time extension. The first part describes the RMR start-up reactivity measurement system with advanced services. High-precision picoampere meters were installed at each reactor unit and measured ionization chamber current signals are handled by a portable computer providing data acquisition and online reactivity calculation service. Detailed offline evaluation and analysis of reactor start-up measurements can be performed on the portable unit, too. The second part of the paper describes a new reactor noise diagnostics system using state-of-the-art data acquisition hardware and signal processing methods. Details of the new reactor noise measurement evaluation software are also outlined. Noise diagnostics at Paks NPP is a standard tool for core anomaly detection and for long-term noise trend monitoring. Regular application of these systems is illustrated by real plant data, e.g., results of standard reactivity measurements during a reactor startup session are given. Noise applications are also illustrated by real plant measurements; results of core anomaly detection are presented.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries

PubMed Central

Sapkota, Vishnu Prasad; Supakankunti, Siripen

2015-01-01

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results. Consequently, policy decisions are uncertain. Even the most of evidence were produced by using data from high income countries. Conflicting results were produced particularly due to differences in methods of measuring performance. Recently a management approach has been developed to measure the hospital performance. This approach to measure the hospital performance is very useful from policy perspective to improve health system from cost-effective way in low and middle income countries. Measuring hospital performance through management approach has some basic characteristics such as scoring management practices through double blind survey, measuring hospital outputs using various indicators, estimating the relationship between management practices and outputs of the hospitals. This approach has been successfully applied to developed countries; however, some revisions are required without violating the fundamental principle of this approach to replicate in low- and middle-income countries. The process has been clearly defined and applied to Nepal. As the results of this, the approach produced expected results. The paper contributes to improve the approach to measure hospital performance. PMID:26617448

Are carrots, corn and cattle really provided by Nature- If not ...

EPA Pesticide Factsheets

People harbor different perspectives regarding the aspects of agroecosystems or cultivated lands that are or could be considered ecosystem services. The first issues that need to be addressed in this regard are to define agro-ecosystem services and to establish their potential purpose (or use) to human beneficiaries. This early decision provides the foundation for what ecosystem services are, who uses them, and if or how they can be quantified. An important point to consider is that agricultural activities, while performed in and on environments provided by nature, are characterized by human labor and capital originating in the human economy. There are inherent reasons to quantify (i.e., measure) ecosystem services in a relatively standard way across landscapes and even within political units, such as counties or nations. Standard approaches to defining and measuring can underpin a multitude of accounting activities such as assigning value to them using either monetary or non-monetary approaches. The ecosystem services community could benefit by applying an ecosystem services definition that embodies from where in the environment the “service” originates and, equally as important, the user or beneficiary of this service. If we focus on the subset of ecosystem services which are Final Ecosystem Goods and Services by adopting the definition of Final Ecosystem Goods and Services (or FEGS), “components of nature, directly enjoyed, consumed or used to yi

Process and outcome measures of quality of care at the diabetes outpatient clinic, University College Hospital, Ibadan.

PubMed

Adeleye, J O; Kuti, M A

2017-02-01

The study aims to assess the quality of care provided at a diabetes outpatient clinic of a tertiary hospital in Nigeria using quality indicators approved by the National Diabetes Quality Improvement Alliance (NDQIA). The medical records of patients who had visited the clinic at least two times within a 12 months period preceding the index visit were reviewed during a 5 month period. Process measure indicators, approved by the NDQIA (evaluating the functioning of the clinic) and outcome measures, published by the American Diabetes Association, (evaluating the health status of the attending patients) were retrieved from the medical records. The 332 records reviewed showed that the most consistently performed process measures were blood pressure and weight measurement (>90%). Foot examination was done infrequently (10.5%). Less than 50% had at least an annual low-density lipoprotein cholesterol (LDL-C) and hemoglobin A1c testing done. The mean (standard deviation) HbA1C (%), LDL-C (mg/dL) systolic blood pressure (SBP) (mmHg), and diastolic blood pressure (DBP) (mmHg) were 7.6 (2.0), 107.3 (31.5), 134.3 (20.8), 79.5 (11.0), respectively. HbA1C >8.0%, LDL-C >130 mg/dL, SBP >130 mmHg, and DBP >90 mmHg) were observed in 34.8%, 21.1%, 40.4%, and 23.8%, respectively. Although the organization of the outpatient services allowed for good performance with regards to "free" services such as blood pressure and weight measurement, it performed suboptimally for foot examinations. Performance indicators that required payment were consistently underperformed. Regular assessment of the quality of care may help in the identification of opportunities for improvement in the organization and delivery of care.

Quality pharmacy services and key performance indicators in Polish NICUs: a Delphi approach.

PubMed

Krzyżaniak, Natalia; Pawłowska, Iga; Bajorek, Beata

2018-03-31

Background Currently, there is no literature describing what a quality level of practice entails in Polish neonatal intensive care units (NICUs), nor are there any means of currently measuring the quality of pharmaceutical care provided to NICU patients. Objective To identify a set of essential pharmacist roles and pharmacy-relevant key performance indicators (KPI's) suitable for Polish neonatal intensive units (NICUs). Setting Polish hospital pharmacies and NICUs. Method Using a modified Delphi technique, potential KPI's structured along Donabedian's domains as well as pharmacy services were presented to an expert panel of stakeholders. Two online, consecutive Delphi rounds, were completed by panellists between August and September 2017. Main outcome measure To identify the minimum level of pharmacy services that should be consistently provided to NICU patients. Results A total of 16 panellists contributed to the expert panel. Overall, consensus of 75% was reached for 23 indicators and for 28 roles. When considering pharmacy services for the NICU, the experts were found to highly value traditional pharmacy roles, such as dispensing and extemporaneous compounding, however, they were still eager for roles in the other domains, such as educational and clinical services, to be listed as essential for NICU practice. Panellists were found to positively value the list of indicators presented, and excluded only 9 out of the total list. Conclusion There is a need for future research to establish a minimum standard of practice for Polish pharmacists to encourage the progression and standardisation of hospital pharmacy services to meet the level of practice seen in NICUs worldwide.

Expert opinions and scientific evidence for colonoscopy key performance indicators.

PubMed

Rees, Colin J; Bevan, Roisin; Zimmermann-Fraedrich, Katharina; Rutter, Matthew D; Rex, Douglas; Dekker, Evelien; Ponchon, Thierry; Bretthauer, Michael; Regula, Jaroslaw; Saunders, Brian; Hassan, Cesare; Bourke, Michael J; Rösch, Thomas

2016-12-01

Colonoscopy is a widely performed procedure with procedural volumes increasing annually throughout the world. Many procedures are now performed as part of colorectal cancer screening programmes. Colonoscopy should be of high quality and measures of this quality should be evidence based. New UK key performance indicators and quality assurance standards have been developed by a working group with consensus agreement on each standard reached. This paper reviews the scientific basis for each of the quality measures published in the UK standards. 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/.

Implementation of Web 2.0 services in academic, medical and research libraries: a scoping review.

PubMed

Gardois, Paolo; Colombi, Nicoletta; Grillo, Gaetano; Villanacci, Maria C

2012-06-01

Academic, medical and research libraries frequently implement Web 2.0 services for users. Several reports notwithstanding, characteristics and effectiveness of services are unclear. To find out: the Web 2.0 services implemented by medical, academic and research libraries; study designs, measures and types of data used in included articles to evaluate effectiveness; whether the identified body of literature is amenable to a systematic review of results. Scoping review mapping the literature on the topic. Searches were performed in 19 databases. research articles in English, Italian, German, French and Spanish (publication date ≥ 2006) about Web 2.0 services for final users implemented by academic, medical and research libraries. Reviewers' agreement was measured by Cohen's kappa. From a data set of 6461 articles, 255 (4%) were coded and analysed. Conferencing/chat/instant messaging, blogging, podcasts, social networking, wikis and aggregators were frequently examined. Services were mainly targeted at general academic users of English-speaking countries. Data prohibit a reliable estimate of the relative frequency of implemented Web 2.0 services. Case studies were the prevalent design. Most articles evaluated different outcomes using diverse assessment methodologies. A systematic review is recommended to assess the effectiveness of such services. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

The Use of Data Analytics to Build an Australian Context-Sensitive Health Informatics Framework for Consumer-Directed Community Aged Care.

PubMed

Georgiou, Andrew; Jorgensen, Mikaela; Siette, Joyce; Westbrook, Johanna I

2017-01-01

The challenge of providing services that meet the growing needs of an ageing population is one confronted by communities across Australia and internationally. The aim of this study was to: a) undertake semi-structured interviews and focus groups across a sample of service and technical staff to identify the interconnection between communication, information, work practices and performance; and b) carry out a comprehensive review of existing data sources to identify the data linkages required to identify and monitor performance across different dimensions of the quality of aged care spectrum. The results from this study provided empirical evidence of the interconnection between communication, information, work practices and performance; and highlighted numerous potential data linkages which can be used to monitor performance across different dimensions of aged care. These included: the uptake and utilisation of community care services, community aged care client interactions and transitions (with hospitals and other health care providers), and quality of life measures (e.g., health and safety status, symptoms of depression and anxiety, social integration and mortality rates).

Thermographic Inspections And The Residential Conservation Service Program (RCS)

NASA Astrophysics Data System (ADS)

Ward, Ronald J.

1983-03-01

Rhode Islanders Saving Energy (RISE) is a non-profit corporation founded in 1977 to provide Rhode Island residents with a variety of energy conservation services. Since January of 1981, it has been performing energy audits in compliance with the Department of Energy's (DOE) Residential Conservation Service Program (RCS). One aspect of the RCS program is the performance of inspections on energy conservation activities completed according to RCS installation guidelines. This paper will describe both the use and results of thermographic inspections within the RISE program. The primary objective of these inspections has been to assure the quality of the building envelope after completion of retrofit measures. Thermal anamolies have been detected that vary in size, location and probable cause. Approximately 37% of all jobs performed through RISE in conjunction with the RCS program have required remedial work as a result of problems that were identi-fied during the thermographic inspection. This percentage was much higher when infra-red inspections were conducted on "Non-RCS" retrofits. Statistics will be presented that provide an interesting insight on the quality of retrofit work when performed in associa-tion with a constant inspection process.

Developing a performance measurement framework and indicators for community health service facilities in urban China.

PubMed

Wong, Sabrina T; Yin, Delu; Bhattacharyya, Onil; Wang, Bin; Liu, Liqun; Chen, Bowen

2010-11-18

China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC.

Developing a Performance Measurement Framework and Indicators for Community Health Service Facilities in Urban China

PubMed Central

2010-01-01

Background China has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report on the development of the China results-based Logic Model for Community Health Facilities and Stations (CHS) and a set of relevant PHC indicators intended to measure CHS priorities. Methods We adapted the PHC Results Based Logic Model developed in Canada and current work conducted in the community health system in China to create the China CHS Logic Model framework. We used a staged approach by first constructing the framework and indicators and then validating their content through an interactive process involving policy analysis, critical review of relevant literature and multiple stakeholder consultation. Results The China CHS Logic Model includes inputs, activities, outputs and outcomes with a total of 287 detailed performance indicators. In these indicators, 31 indicators measure inputs, 64 measure activities, 105 measure outputs, and 87 measure immediate (n = 65), intermediate (n = 15), or final (n = 7) outcomes. Conclusion A Logic Model framework can be useful in planning, implementation, analysis and evaluation of PHC at a system and service level. The development and content validation of the China CHS Logic Model and subsequent indicators provides a means for stronger accountability and a clearer sense of overall direction and purpose needed to renew and strengthen the PHC system in China. Moreover, this work will be useful in moving towards developing a PHC information system and performance measurement across districts in urban China, and guiding the pursuit of quality in PHC. PMID:21087516

76 FR 48822 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

... improved student performance on standardized measures of math and literacy achievement (Pearson, Sawyer... skills in context: Testing the value of enhanced math learning in CTE (Final study). St. Paul, Minnesota...

Radical Learning Technology Happening Now.

ERIC Educational Resources Information Center

Adkins, Sam S.

2003-01-01

Enterprise application integration products are changing the landscape of learning technology, content, and services. Although products are marketed as processes to measure performance indicators, this is just the beginning of a strategy to integrate learning with other enterprise processes. (JOW)

A Simulation Model for Measuring Customer Satisfaction through Employee Satisfaction

NASA Astrophysics Data System (ADS)

Zondiros, Dimitris; Konstantopoulos, Nikolaos; Tomaras, Petros

2007-12-01

Customer satisfaction is defined as a measure of how a firm's product or service performs compared to customer's expectations. It has long been a subject of research due to its importance for measuring marketing and business performance. A lot of models have been developed for its measurement. This paper propose a simulation model using employee satisfaction as one of the most important factors leading to customer satisfaction (the others being expectations and disconfirmation of expectations). Data obtained from a two-year survey in customers of banks in Greece were used. The application of three approaches regarding employee satisfaction resulted in greater customer satisfaction when there is serious effort to keep employees satisfied.

Investigation of enablers of knowledge transfer in the medical industry.

PubMed

Tuan, Han-Wen

2008-01-01

This paper presents a research model for investigating the relationship between organisational enablers and the Knowledge Transfer (KT) Performance (KTP) in the medical industry. The enablers include leadership, organisational culture, Information Technology (IT) and individual performance measurement, and KTP is determined by individual capability, organisational capability and product/service innovation. This paper chose professional medical personnel as the research subject to determine whether or not these enablers affect KT. The findings show that only leadership directly affects the KTP, with IT also impacting both organisational capability and product/service innovation. The implications of these findings are discussed based on interviews with experts and practitioners.

Technique for finding and identifying filters that cut off OTDR lights in front of ONU from a central office

NASA Astrophysics Data System (ADS)

Takaya, Masaaki; Honda, Hiroyasu; Narita, Yoshihiro; Yamamoto, Fumihiko; Arakawa, Koji

2006-04-01

We report on a newly developed in-service measurement technique that can be used from a central office to find and identify any filter in front of an ONU on an optical fiber access network. Using this system, in-service tests can be performed because the test lights are modulated at a high frequency. Moreover, by using the equipment we developed, this confirmation operation can be performed continuously and automatically with existing automatic fiber testing systems. The developed technique is effective for constructing a fiber line testing system with an optical time domain reflectometer.

Integration mechanisms and hospital efficiency in integrated health care delivery systems.

PubMed

Wan, Thomas T H; Lin, Blossom Yen-Ju; Ma, Allen

2002-04-01

This study analyzes integration mechanisms that affect system performances measured by indicators of efficiency in integrated delivery systems (IDSs) in the United States. The research question is, do integration mechanisms improve IDSs' efficiency in hospital care? American Hospital Association's Annual Survey (1998) and Dorenfest's Survey on Information Systems in Integrated Healthcare Delivery Systems (1998) were used to conduct the study, using IDS as the unit of analysis. A covariance structure equation model of the effects of system integration mechanisms on IDS performance was formulated and validated by an empirical examination of IDSs. The study sample includes 973 hospital-based integrated health care delivery systems operating in the United States, carried in the list of Dorenfests Survey on Information Systems in Integrated Health care Delivery Systems. The measurement indicators of system integration mechanisms are categorized into six related domains: informatic integration, case management, hybrid physician-hospital integration, forward integration, backward integration, and high tech medical services. The multivariate analysis reveals that integration mechanisms in system operation are positively correlated and positively affect IDSs' efficiency. The six domains of integration mechanisms account for 58.9% of the total variance in hospital performance. The service differentiation strategy such as having more high tech medical services have much stronger influences on efficiency than other integration mechanisms do. The beneficial effects of integration mechanisms have been realized in IDS performance. High efficiency in hospital care can be achieved by employing proper integration strategies in operations.

Organizational determinants of efficiency and effectiveness in mental health partial care programs.

PubMed Central

Schinnar, A P; Kamis-Gould, E; Delucia, N; Rothbard, A B

1990-01-01

The use of partial care as a treatment modality for mentally ill patients, particularly the chronically mentally ill, has greatly increased. However, research into what constitutes a "good" program has been scant. This article reports on an evaluation study of staff productivity, cost efficiency, and service effectiveness of adult partial care programs carried out in New Jersey in fiscal year 1984/1985. Five program performance indexes are developed based on comparisons of multiple measures of resources, service activities, and client outcomes. These are used to test various hypotheses regarding the effect of organizational and fiscal variables on partial care program efficiency and effectiveness. The four issues explored are: auspices, organizational complexity, service mix, and fiscal control by the state. These were found to explain about half of the variance in program performance. In addition, partial care programs demonstrating midlevel performance with regard to productivity and efficiency were observed to be the most effective, implying a possible optimal level of efficiency at which effectiveness is maximized. PMID:2113046

Cross-Cultural Perspectives of Service Quality and Risk in Air Transportation

NASA Technical Reports Server (NTRS)

Cunningham, Lawrence F.; Young, Clifford E.; Lee, Moonkyu

2002-01-01

This study compares US and Korean customers in terms of their perceptions of airline service quality based on SERVPERF and industry-based measures, as well as their perceptions of risks involved in the airline choice. SERVPERF is a set of multi-dimensional measures of customer evaluations of service quality. The results indicate that: (1) US passengers are generally more satisfied with their airline service than Korean customers on most of the SERVPERF dimensions; (2) Koreans are generally more satisfied with the bumping procedures whereas US participants feel more satisfied with the airline's baggage handling, operations/safety, and connections; and (3) US participants perceive higher levels of performance and financial risks whereas Koreans feel greater social risk in choosing an airline. This study also examines the SERVPERF, industry-based measure, and perceived risk in predicting customer satisfaction with, and intention to repatronize the airline. The results suggest that US customers consider service reliability, in-flight comfort, and connections as the key factors determining satisfaction with airline service whereas Korean passengers generally regard reliability, assurance, and risk factors as predictors of satisfaction. The determining factors of customer intention to repatronize the airline are reliability and empathy for US, and reliability and overall risk for Korean customers. The study demonstrates the applicability of SERVPERF as a cross-cultural tool and indicates the importance of perceived risk in cross-cultural studies.

Variations in the service quality of medical practices.

PubMed

Ly, Dan P; Glied, Sherry A

2013-11-01

To examine regional variation in the service quality of physician practices and to assess the association of this variation with the supply and organization of physicians. Secondary analyses of the Community Tracking Study (CTS) household and physician surveys. A total of 40,339 individuals who had seen a primary care physician because of an illness or injury and 17,345 generalist physicians across 4 survey time periods in 60 CTS sites were included. Service quality measures used were lag between making an appointment and seeing a physician, and wait time at the physician's office. Our supply measure was the physician-to-population ratio. Our organizational measure was the percentage of physicians in group practices. Multivariate regressions were performed to examine the relationship between service quality and the supply and organization of physicians. There was substantial variation in the service quality of physician visits across the country. For example, in 2003, the average wait time to see a doctor was 16 minutes in Milwaukee but more than 41 minutes in Miami; the average appointment lag for a sick visit in 2003 was 1.2 days in west-central Alabama but almost 6 days in Northwestern Washington. Service quality was not associated with the primary care physician-to-population ratio and had varying associations with the organization of practices. Cross-site variation in service quality of care in primary care has been large, persistent, and associated with the organization of practices. Areas with higher primary care physician-to-population ratios had longer, not shorter, appointment lags.

Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

PubMed

Jones, G T

2000-02-01

Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision.

Importance-performance analysis of dental satisfaction among three ethnic groups in malaysia.

PubMed

Dewi, Fellani Danasra; Gundavarapu, Kalyan C; Cugati, Navaneetha

2013-01-01

To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service. This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test. Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians. The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.

A New Strategic Direction for the AAHSLD Annual Statistics: Planning, Service Roles, Performance Measures, and Management Information Systems for Academic Health Science Libraries: Final Report for Phase I.

ERIC Educational Resources Information Center

McClure, Charles R.; And Others

This report presents a summary of activities, findings, and recommendations from Phase I of a project to improve the effectiveness of academic health science libraries and their provision of information services. The objectives for Phase I of the project are given: (1) to identify academic health science library requirements in the areas of…

Evaluating the impact of the reconfiguration of gynaecology services at a University Hospital NHS trust in the United Kingdom.

PubMed

Choo, Teck; Deb, Shilpa; Wilkins, Joanne; Atiomo, William

2014-09-24

The project aim was to investigate the impact of reconfiguring gynaecology services on the key performance indicators of a University Hospital NHS Trust in the UK. The reconfiguration involved the centralisation of elective gynaecology on one hospital site and emergency gynaecology on the other. Data measuring outcomes of the Trust's performance indicators (clinical outcomes, patient experience, staff satisfaction, teaching/training, research/development and value for money) were collected. Two time periods, 12 months before and after the reconfiguration in March 2011, were compared for all outcome measures except patient experience. Retrospective data from the hospitals audit department on clinical activity/outcomes and emergency gynaecology patient's feedback questionnaires were analysed. Staff satisfaction, teaching/training and research/development were measured through an online survey of gynaecology consultants. Post reconfiguration, the total number of admissions reduced by 6% (6,867 vs 6,446). There was a 14% increase in elective theatre sessions available (902.29 vs 1030.57) and an 84% increase in elective theatre sessions cancelled (44.43 vs 81.71). However, the average number of elective operations performed during each theatre session remained similar (2.63 vs 2.5). There was a significant increase in medical devices related clinical incidents (2 vs 11). With patient experience, there was a significant reduction in patient's overall length of stay on the emergency gynaecology ward and waiting times for investigations. For staff satisfaction, Consultants were significantly more dissatisfied with workload (3.45 vs 2.85) and standards of care (3.75 vs 2.93). With research and development, consultants remained dissatisfied with time/funding/opportunities for research. No significant impact on undergraduate/postgraduate teaching was found. No financial data on gynaecology was provided for the assessment of value for money. Reconfiguration of gynaecology services at this Trust may have resulted in a reduction in gynaecological activity and increased cancellation of elective operations but did not significantly reduce the number of elective operations performed. Although consultants expressed increased dissatisfaction with standards of clinical care, clinical incident reports did not significantly increase apart from medical devices incidents. Patient experience of emergency gynaecology services was improved. This manuscript provides a framework for similar exercises evaluating the impact of service redesign in the NHS.

Building and measuring a high performance network architecture

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

Kramer, William T.C.; Toole, Timothy; Fisher, Chuck

2001-04-20

Once a year, the SC conferences present a unique opportunity to create and build one of the most complex and highest performance networks in the world. At SC2000, large-scale and complex local and wide area networking connections were demonstrated, including large-scale distributed applications running on different architectures. This project was designed to use the unique opportunity presented at SC2000 to create a testbed network environment and then use that network to demonstrate and evaluate high performance computational and communication applications. This testbed was designed to incorporate many interoperable systems and services and was designed for measurement from the very beginning.more » The end results were key insights into how to use novel, high performance networking technologies and to accumulate measurements that will give insights into the networks of the future.« less

Measuring primary care practice performance within an integrated delivery system: a case study.

PubMed

Stewart, Louis J; Greisler, David

2002-01-01

This article examines the use of an integrated performance measurement system to plan and control primary care service delivery within an integrated delivery system. We review a growing body of literature that focuses on the development and implementation of management reporting systems among healthcare providers. Our study extends the existing literature by examining the use of performance information generated by an integrated performance measurement system within a healthcare organization. We conduct our examination through a case study of the WMG Primary Care Medicine Group, the primary care medical group practice of WellSpan Health System. WellSpan Health System is an integrated delivery system that serves south central Pennsylvania and northern Maryland. Our study examines the linkage between WellSpan Health's strategic objectives and its primary care medicine group's integrated performance measurement system. The conceptual design of this integrated performance measurement system combines financial metrics with practice management and clinical operating metrics to provide a more complete picture of medical group performance. Our findings demonstrate that WellSpan Health was able to achieve superior financial results despite a weak linkage between its integrated performance measurement system and its strategic objectives. WellSpan Health achieved this objective for its primary care medicine group by linking clinical performance information to physician compensation and reporting practice management performance through the use of statistical process charts. They found that the combined mechanisms of integrated performance measurement and statistical process control charts improved organizational learning and communications between organizational stakeholders.

Benchmarking routine psychological services: a discussion of challenges and methods.

PubMed

Delgadillo, Jaime; McMillan, Dean; Leach, Chris; Lucock, Mike; Gilbody, Simon; Wood, Nick

2014-01-01

Policy developments in recent years have led to important changes in the level of access to evidence-based psychological treatments. Several methods have been used to investigate the effectiveness of these treatments in routine care, with different approaches to outcome definition and data analysis. To present a review of challenges and methods for the evaluation of evidence-based treatments delivered in routine mental healthcare. This is followed by a case example of a benchmarking method applied in primary care. High, average and poor performance benchmarks were calculated through a meta-analysis of published data from services working under the Improving Access to Psychological Therapies (IAPT) Programme in England. Pre-post treatment effect sizes (ES) and confidence intervals were estimated to illustrate a benchmarking method enabling services to evaluate routine clinical outcomes. High, average and poor performance ES for routine IAPT services were estimated to be 0.91, 0.73 and 0.46 for depression (using PHQ-9) and 1.02, 0.78 and 0.52 for anxiety (using GAD-7). Data from one specific IAPT service exemplify how to evaluate and contextualize routine clinical performance against these benchmarks. The main contribution of this report is to summarize key recommendations for the selection of an adequate set of psychometric measures, the operational definition of outcomes, and the statistical evaluation of clinical performance. A benchmarking method is also presented, which may enable a robust evaluation of clinical performance against national benchmarks. Some limitations concerned significant heterogeneity among data sources, and wide variations in ES and data completeness.

Quality measurement and benchmarking of HPV vaccination services: a new approach.

PubMed

Maurici, Massimo; Paulon, Luca; Campolongo, Alessandra; Meleleo, Cristina; Carlino, Cristiana; Giordani, Alessandro; Perrelli, Fabrizio; Sgricia, Stefano; Ferrante, Maurizio; Franco, Elisabetta

2014-01-01

A new measurement process based upon a well-defined mathematical model was applied to evaluate the quality of human papillomavirus (HPV) vaccination centers in 3 of 12 Local Health Units (ASLs) within the Lazio Region of Italy. The quality aspects considered for evaluation were communicational efficiency, organizational efficiency and comfort. The overall maximum achievable value was 86.10%, while the HPV vaccination quality scores for ASL1, ASL2 and ASL3 were 73.07%, 71.08%, and 67.21%, respectively. With this new approach it is possible to represent the probabilistic reasoning of a stakeholder who evaluates the quality of a healthcare provider. All ASLs had margins for improvements and optimal quality results can be assessed in terms of better performance conditions, confirming the relationship between the resulting quality scores and HPV vaccination coverage. The measurement process was structured into three steps and involved four stakeholder categories: doctors, nurses, parents and vaccinated women. In Step 1, questionnaires were administered to collect different stakeholders' points of view (i.e., subjective data) that were elaborated to obtain the best and worst performance conditions when delivering a healthcare service. Step 2 of the process involved the gathering of performance data during the service delivery (i.e., objective data collection). Step 3 of the process involved the elaboration of all data: subjective data from step 1 are used to define a "standard" to test objective data from step 2. This entire process led to the creation of a set of scorecards. Benchmarking is presented as a result of the probabilistic meaning of the evaluated scores.

Data Envelopment Analysis (DEA) Model in Operation Management

NASA Astrophysics Data System (ADS)

Malik, Meilisa; Efendi, Syahril; Zarlis, Muhammad

2018-01-01

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

Service quality from the perspective of myocardial infarction patients.

PubMed

Gholipour, Kamal; Tabrizi, Jafar Sadegh; Azimzadeh, Solmaz; Ghafari, Samad; Iezadi, Shabnam

2018-04-01

Service quality (SQ) generally refers to the nonclinical aspects of health services and primarily focuses on the relationship between the care provider and the customers, and the environment in which care services are delivered. The aim of this study was to assess the SQ provided for myocardial infarction (MI) from the patients' perspective. A cross-sectional study was conducted with 164 patients with MI at the Tabriz Shahid Madani cardiology clinic. Study participants were selected using convenience sampling. SQ was measured using a validated Comprehensive Quality Measurement in Healthcare SQ questionnaire. The reliability was confirmed based on Cronbach's alpha coefficient (α=0.81). SQ was calculated using the formula SQ=10- (importance × performance), based on the importance and performance of non-health-related aspects from the customers' perspective. Importance scores ranged from 1 to 10 and performance was scored between 0 and 1. Of 164 participants, about 75% were men and almost 44% were between 51 and 65 years of age. From the customers' perspective, the total SQ score was 6.80 (0-10 scale), and the individual scores for all SQ aspects were below an acceptable level. Confidentiality, dignity and continuity were given the highest scores, while availability of support groups had the lowest score. The study findings revealed an opportunity to improve SQ. Patient and provider participation in quality improvement activities could be an effective strategy to improve the aspects of health care quality that were most important to the customers and those with low scores, such as availability of support groups.

Payment Reform

PubMed Central

Schneider, Eric C.; Hussey, Peter S.; Schnyer, Christopher

2011-01-01

Abstract Insurers and purchasers of health care in the United States are on the verge of potentially revolutionary changes in the approaches they use to pay for health care. Recently, purchasers and insurers have been experimenting with payment approaches that include incentives to improve quality and reduce the use of unnecessary and costly services. The Patient Protection and Affordable Care Act of 2010 is likely to accelerate payment reform based on performance measurement. This article provides details of the results of a technical report that catalogues nearly 100 implemented and proposed payment reform programs, classifies each of these programs into one of 11 payment reform models, and identifies the performance measurement needs associated with each model. A synthesis of the results suggests near-term priorities for performance measure development and identifies pertinent challenges related to the use of performance measures as a basis for payment reform. The report is also intended to create a shared framework for analysis of future performance measurement opportunities. This report is intended for the many stakeholders tasked with outlining a national quality strategy in the wake of health care reform legislation. PMID:28083159

How different is cancer control across Canada? Comparing performance indicators for prevention, screening, diagnosis, and treatment.

PubMed

Rahal, R; Chadder, J; DeCaria, K; Lockwood, G; Bryant, H

2017-04-01

Meaningful performance measures are an important part of the toolkit for health system improvement. The Canadian Partnership Against Cancer has been reporting on pan-Canadian cancer system performance indicators since 2009-work that has led to the availability of standardized measures that can help to shed light on the extent of variation and opportunities for quality improvement across the country. Those measures include a core set of system indicators ranging from prevention and screening, through diagnosis and treatment, to survivorship and end-of-life care. Key indicators were calculated and graphed, showing the range from worst to best result for the provinces and territories included in the data. There were often significant differences in cancer system performance between provinces and territories. For example, smoking prevalence rates ranged from 14% to 62%. The 90th percentile wait times from an abnormal breast screen to resolution (without biopsy) ranged from 4 weeks to 8 weeks. The percentage of breast cancer resections that used breast-conserving surgery rather than mastectomy ranged from 38% to 75%. Clinical trial participation rates for adults ranged from 0.2% to 6.6%. Variations in performance indicators between Canadian jurisdictions suggest potential differences in the planning and delivery of cancer control services and in clinical practice patterns and patient outcomes. Understanding sources of variation can help to identify opportunities for improvements in the quality and outcomes of cancer control service delivery in each province and territory.

Market-Based Adult Lifelong Learning Performance Measures for Public Libraries Serving Lower Income and Majority-Minority Markets. Final Performance Report. September 1, 1996-August 31, 1999.

ERIC Educational Resources Information Center

Koontz, Christine; Jue, Dean K.; Lance, Keith Curry

This document is the final performance report for a Field Initiated Studies (FIS) project that addressed the need for a better assessment of public library services for adult lifelong learning in majority-minority and lower income library market areas. After stating the major educational problem addressed by the FIS project, the report lists the…

Balanced scorecard as a framework for driving performance in managed care organizations.

PubMed

Sahney, V K

1998-01-01

Managed care organizations in a highly competitive environment constantly face the pressure of improving their financial performance. At the same time, customers of the organization expect the organization to deliver high-quality outcomes and improve customer service. Payers expect the organization to develop innovative new products to meet their needs. This article presents an approach called "Balanced Scorecard" for measurement, development of strategy, and performance improvement in a managed care organization.

Enhanced Positioning Algorithm of ARPS for Improving Accuracy and Expanding Service Coverage

PubMed Central

Lee, Kyuman; Baek, Hoki; Lim, Jaesung

2016-01-01

The airborne relay-based positioning system (ARPS), which employs the relaying of navigation signals, was proposed as an alternative positioning system. However, the ARPS has limitations, such as relatively large vertical error and service restrictions, because firstly, the user position is estimated based on airborne relays that are located in one direction, and secondly, the positioning is processed using only relayed navigation signals. In this paper, we propose an enhanced positioning algorithm to improve the performance of the ARPS. The main idea of the enhanced algorithm is the adaptable use of either virtual or direct measurements of reference stations in the calculation process based on the structural features of the ARPS. Unlike the existing two-step algorithm for airborne relay and user positioning, the enhanced algorithm is divided into two cases based on whether the required number of navigation signals for user positioning is met. In the first case, where the number of signals is greater than four, the user first estimates the positions of the airborne relays and its own initial position. Then, the user position is re-estimated by integrating a virtual measurement of a reference station that is calculated using the initial estimated user position and known reference positions. To prevent performance degradation, the re-estimation is performed after determining its requirement through comparing the expected position errors. If the navigation signals are insufficient, such as when the user is outside of airborne relay coverage, the user position is estimated by additionally using direct signal measurements of the reference stations in place of absent relayed signals. The simulation results demonstrate that a higher accuracy level can be achieved because the user position is estimated based on the measurements of airborne relays and a ground station. Furthermore, the service coverage is expanded by using direct measurements of reference stations for user positioning. PMID:27529252

Enhanced Positioning Algorithm of ARPS for Improving Accuracy and Expanding Service Coverage.

PubMed

Lee, Kyuman; Baek, Hoki; Lim, Jaesung

2016-08-12

The airborne relay-based positioning system (ARPS), which employs the relaying of navigation signals, was proposed as an alternative positioning system. However, the ARPS has limitations, such as relatively large vertical error and service restrictions, because firstly, the user position is estimated based on airborne relays that are located in one direction, and secondly, the positioning is processed using only relayed navigation signals. In this paper, we propose an enhanced positioning algorithm to improve the performance of the ARPS. The main idea of the enhanced algorithm is the adaptable use of either virtual or direct measurements of reference stations in the calculation process based on the structural features of the ARPS. Unlike the existing two-step algorithm for airborne relay and user positioning, the enhanced algorithm is divided into two cases based on whether the required number of navigation signals for user positioning is met. In the first case, where the number of signals is greater than four, the user first estimates the positions of the airborne relays and its own initial position. Then, the user position is re-estimated by integrating a virtual measurement of a reference station that is calculated using the initial estimated user position and known reference positions. To prevent performance degradation, the re-estimation is performed after determining its requirement through comparing the expected position errors. If the navigation signals are insufficient, such as when the user is outside of airborne relay coverage, the user position is estimated by additionally using direct signal measurements of the reference stations in place of absent relayed signals. The simulation results demonstrate that a higher accuracy level can be achieved because the user position is estimated based on the measurements of airborne relays and a ground station. Furthermore, the service coverage is expanded by using direct measurements of reference stations for user positioning.