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Quality Measurements (quality + measurement)
Selected AbstractsQuality Measurement and Contract Design: Lessons from the North American Sugarbeet IndustryCANADIAN JOURNAL OF AGRICULTURAL ECONOMICS, Issue 2 2004Brent Hueth This paper examines contracts used in the North American sugarbeet industry. Though quite similar in many respects, the contracts we study vary across processing firms in the set of quality measures used to condition contract payments to growers. This is somewhat surprising, given the homogeneous nature of the processors' finished product (refined sugar). It seems unlikely that processors differ significantly in how they value the various attributes of a sugarbeet, and such a difference is perhaps the most natural reason to expect variation in the structure of quality incentives across processors. Previous attempts to explain the observed variation in sugarbeet contracts have focused on differences in organizational form across firms. In this paper, we provide an alternative explanation that relies on variation across production regions in growers' ability to control the relevant measures of sugarbeet quality. Les auteurs se penchent sur les contrats utilisés dans l'industrie nord-américaine de la betterave sucrière. Bien qu'ils se ressemblent à maints égards, les contrats examinés varient d'un transformateur à l'autre quant au jeu de paramètres servant àévaluer la qualité du produit et à déterminer les sommes qu'on versera au producteur. La chose est surprenante étant donné le caractère homogène du produit fini (sucre raffiné). Il est peu probable que les transformateurs recourent à des méthodes fort différentes pour évaluer les paramètres de la betterave. Or, ce facteur constituerait normalement la raison la plus plausible pour expliquer la variation des incitatifs auxquels recourent les transformateurs Antérieurement, on a tenté d'expliquer les écarts relevés dans les contrats par les différences dans l'organisation des entreprises. L'article que voici propose une autre explication s'appuyant sur la compétence variable des producteurs à respecter les critères de qualité de la betterave sucrière selon la région. [source] The Clinical Value Compass: Achieving Benchmarking and Quality Improvement in Aged CareAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2000Michael Woodward Quality measurement and benchmarking in aged care presents several challenges. A model which addresses this by linking four dimensions of outcomes has been developed - the Clinical Value Compass (CVC). A CVC was developed for stroke rehabilitation and measured across four sites. The CVC was well accepted by the treatment teams and proved practical to measure. The results revealed differences in practices and client groups that led to a closer analysis of processes and subsequent changes in these processes. Remeasuring of the CVC is required to demonstrate improved outcomes arising from these process changes. [source] Healthcare in a land called PeoplePower: nothing about me without meHEALTH EXPECTATIONS, Issue 3 2001Tom Delbanco MD In a 5-day retreat at a Salzburg Seminar attended by 64 individuals from 29 countries, teams of health professionals, patient advocates, artists, reporters and social scientists adopted the guiding principle of ,nothing about me without me' and created the country of PeoplePower. Designed to shift health care from ,biomedicine' to ,infomedicine', patients and health workers throughout PeoplePower join in informed, shared decision-making and governance. Drawing, where possible, on computer-based guidance and communication technologies, patients and clinicians contribute actively to the patient record, transcripts of clinical encounters are shared, and patient education occurs primarily in the home, school and community-based organizations. Patients and clinicians jointly develop individual ,quality contracts', serving as building blocks for quality measurement and improvement systems that aggregate data, while reflecting unique attributes of individual patients and clinicians. Patients donate process and outcome data to national data banks that fuel epidemiological research and evidence-based improvement systems. In PeoplePower hospitals, constant patient and employee feedback informs quality improvement work teams of patients and health professionals. Volunteers work actively in all units, patient rooms are information centres that transform their shape and decor as needs and individual preferences dictate, and arts and humanities programmes nourish the spirit. In the community, from the earliest school days the citizenry works with health professionals to adopt responsible health behaviours. Communities join in selecting and educating health professionals and barter systems improve access to care. Finally, lay individuals partner with professionals on all local, regional and national governmental and private health agencies. [source] Measuring the Quality of Diabetes Care Using Administrative Data: Is There Bias?HEALTH SERVICES RESEARCH, Issue 6p1 2003Nancy L. Keating Objectives. Health care organizations often measure processes of care using only administrative data. We assessed whether measuring processes of diabetes care using administrative data without medical record data is likely to underdetect compliance with accepted standards for certain groups of patients. Data Sources/Study Setting. Assessment of quality indicators during 1998 using administrative and medical records data for a cohort of 1,335 diabetic patients enrolled in three Minnesota health plans. Study Design. Cross-sectional retrospective study assessing hemoglobin A1c testing, LDL cholesterol testing, and retinopathy screening from the two data sources. Analyses examined whether patient or clinic characteristics were associated with underdetection of quality indicators when administrative data were not supplemented with medical record data. Data Collection/Extraction Methods. The health plans provided administrative data, and trained abstractors collected medical records data. Principal Findings. Quality indicators that would be identified if administrative data were supplemented with medical records data are often not identified using administrative data alone. In adjusted analyses, older patients were more likely to have hemoglobin A1c testing underdetected in administrative data (compared to patients <45 years, OR 2.95, 95 percent CI 1.09 to 7.96 for patients 65 to 74 years, and OR 4.20, 95 percent CI 1.81 to 9.77 for patients 75 years and older). Black patients were more likely than white patients to have retinopathy screening underdetected using administrative data (2.57, 95 percent CI 1.16 to 5.70). Patients in different health plans also differed in the likelihood of having quality indicators underdetected. Conclusions. Diabetes quality indicators may be underdetected more frequently for elderly and black patients and the physicians, clinics, and plans who care for such patients when quality measurement is based on administrative data alone. This suggests that providers who care for such patients may be disproportionately affected by public release of such data or by its use in determining the magnitude of financial incentives. [source] Does Pediatric Patient-Centeredness Affect Family Trust?JOURNAL FOR HEALTHCARE QUALITY, Issue 3 2010Stephen J. Aragon Abstract: Despite its recognition as a key dimension of healthcare quality, it is often unclear what exactly patient-centeredness means. A generally accepted measurement model of patient-centeredness is still nonexistent, current operational definitions lack sufficient specificity to inform providers how it relates to outcomes, and the influence of patient-centeredness on pediatric patients and families has not been quantified. This study demonstrates that patient-centeredness is a measurable ability of pediatricians that increases family trust. As an ability, it is teachable. The study offers an evidence-based model for future research with specific implications for quality measurement and improvement in the outpatient pediatrician's office. [source] Hospital quality measurement, Perplexing for professionals, let alone for patientsJOURNAL OF HOSPITAL MEDICINE, Issue 3 2007Kevin J. O'Leary MD [source] The role of guidelines in quality improvement for cancer surgeryJOURNAL OF SURGICAL ONCOLOGY, Issue 8 2009FRCPC, George P. Browman MD Abstract In February 2008, Cancer Surgery Alberta hosted a conference on surgical outcomes and quality. The objective here is to review the interactions between quality/outcomes and guidelines, highlighting surgeons' roles. Potential interactions between quality measurement and guidelines are discussed. We analyzed data from practitioner surveys about guidelines to determine surgeons' participation compared with other specialists. The response rate of surgeons in both community-based and academic practices to guideline development surveys was equivalent to other cancer disciplines. J. Surg. Oncol. 2009;99:467,469. © 2009 Wiley-Liss, Inc. [source] Continuing education meets the learning organization: The challenge of a systems approach to patient safetyTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2000John M. Eisenberg MD Director Abstract Since the release of the report of the Institute of Medicine on medical errors and patient safety in November 1999, health policy makers and health care leaders in several nations have sought solutions that will improve the safety of health care. This attention to patient safety has highlighted the importance of a learning approach and a systems approach to quality measurement and improvement. Balanced with the need for public disclosure of performance, confidential reporting with feedback is one of the prime ways that nations such as the United States, Canada, the United Kingdom, and Australia have approached this challenge. In the United States, the Quality Interagency Coordination Task Force has convened federal agencies that are involved in health care quality improvement for a coordinated initiative. Based on an investment in a strong research foundation in health care quality measurement and improvement, there are eight key lessons for continuing education if it is to parlay the interest in patient safety into enhanced continuing education and quality improvement in learning health care systems. The themes for these lessons are (1) informatics for information, (2) guidelines as learning tools, (3) learning from opinion leaders, (4) learning from the patient, (5) decision support systems, (6) the team learning together, (7) learning organizations, and (8) just-in-time and point-of-care delivery. [source] Statistical Metrics for Quality Assessment of High-Density Tiling Array DataBIOMETRICS, Issue 2 2010Hui Tang Summary High-density tiling arrays are designed to blanket an entire genomic region of interest using tiled oligonucleotides at very high resolution and are widely used in various biological applications. Experiments are usually conducted in multiple stages, in which unwanted technical variations may be introduced. As tiling arrays become more popular and are adopted by many research labs, it is pressing to develop quality control tools as was done for expression microarrays. We propose a set of statistical quality metrics analogous to those in expression microarrays with application to tiling array data. We also develop a method to estimate the significance level of an observed quality measurement using randomization tests. These methods have been applied to multiple real data sets, including three independent ChIP-chip experiments and one transcriptom mapping study, and they have successfully identified good quality chips as well as outliers in each study. [source] Using Patient Care Quality Measures to Assess Educational OutcomesACADEMIC EMERGENCY MEDICINE, Issue 5 2007Susan R. Swing PhD ObjectivesTo report the results of a project designed to develop and implement a prototype methodology for identifying candidate patient care quality measures for potential use in assessing the outcomes and effectiveness of graduate medical education in emergency medicine. MethodsA workgroup composed of experts in emergency medicine residency education and patient care quality measurement was convened. Workgroup members performed a modified Delphi process that included iterative review of potential measures; individual expert rating of the measures on four dimensions, including measures quality of care and educational effectiveness; development of consensus on measures to be retained; external stakeholder rating of measures followed by a final workgroup review; and a post hoc stratification of measures. The workgroup completed a structured exercise to examine the linkage of patient care process and outcome measures to educational effectiveness. ResultsThe workgroup selected 62 measures for inclusion in its final set, including 43 measures for 21 clinical conditions, eight medication measures, seven measures for procedures, and four measures for department efficiency. Twenty-six measures met the more stringent criteria applied post hoc to further stratify and prioritize measures for development. Nineteen of these measures received high ratings from 75% of the workgroup and external stakeholder raters on importance for care in the ED, measures quality of care, and measures educational effectiveness; the majority of the raters considered these indicators feasible to measure. The workgroup utilized a simple framework for exploring the relationship of residency program educational activities, competencies from the six Accreditation Council for Graduate Medical Education general competency domains, patient care quality measures, and external factors that could intervene to affect care quality. ConclusionsNumerous patient care quality measures have potential for use in assessing the educational effectiveness and performance of graduate medical education programs in emergency medicine. The measures identified in this report can be used as a starter set for further development, implementation, and study. Implementation of the measures, especially for high-stakes use, will require resolution of significant measurement issues. [source] Constrained multivariate trend analysis applied to water quality variablesENVIRONMETRICS, Issue 1 2002D. M. Cooper Abstract Constrained multivariate regression analysis is used to model trends and seasonal effects in time series measurements of water quality variables. The constraint used ensures that when identifying trends the scientifically important charge balance of model-fitted concentrations is maintained, while accounting for between variable dependencies. The analysis is a special case of linear reduction of dimensionality which preserves the integrity of a subset of the original variables, while allowing the remainder to be identified as linear combinations of this subset. The technique is applied to water quality measurements made at the outflow from Loch Grannoch, an acid-sensitive loch in Scotland. A reduction in marine ion concentrations is observed in water samples collected four times a year over the period 1988,2000. This is identified with long term variability in the marine component in rainfall. Separation of the non-marine component of the solute load shows a reduction in non-marine sulphate and calcium concentrations, and an increase in the non-marine sodium concentration. There is no significant change in either alkalinity or acid neutralizing capacity over the period. The reduction in non-marine sulphate is consistent with reductions in atmospheric inputs of sulphate. However, the reduction in sulphate has not been accompanied by a reduction in the acidity of water samples from Loch Grannoch, but with a reduction in calcium concentration and an apparent increase in organic acids, as evidenced by increased dissolved organic carbon concentrations, with possible increases in nitrate and non-marine sodium concentrations. Copyright © 2002 John Wiley & Sons, Ltd. [source] A review of current developments in process and quality control for injection moldingADVANCES IN POLYMER TECHNOLOGY, Issue 3 2005Zhongbao Chen Abstract Injection molding is one of the most versatile and important manufacturing processes capable of mass-producing complicated plastic parts in net shape with excellent dimensional tolerance. Injection molding process and quality control has been an active research area for many years, as part quality and yield requirements become more stringent. This paper reviews the state-of-the-art research and development in injection molding control. It organizes prior studies into four categories, namely, process setup, machine control, process control, and quality control, and presents the distinction and connection of these different levels of control. This paper further reviews and compares the typical variables, models, and control methods that have been proposed and employed for those control tasks. Strictly speaking, real online quality control without human intervention has yet to be realized, primarily due to the lack of transducers for online, real time quality response measurement, and a robust model that correlates the control variables with quantitative quality measurements. Based on the research progress to date, this paper suggests that the different levels of control tasks have to be integrated into a multilevel quality control system, and that the quality sensor and the process and quality model are the two most important areas for further advancement in injection molding control. © 2005 Wiley Periodicals, Inc. Adv Polym Techn 24: 165,182, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20046 [source] Measuring patient assessments of the quality of outpatient care: a systematic reviewJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2008Tiina Säilä MNSc Abstract Rationale, aims and objectives, The aim of the study was to answer three questions: first, what methods have been used to measure patient assessments of the quality of care? Second, how do outpatients rate their care? And third, what needs to be taken into account in measuring patient assessments of the quality of care? Methods, Systematic review of the literature. Electronic searches were conducted on Medline, CINAHL and the Cochrane Database of Systematic Reviews. To be included, articles were to deal with patients' assessments of health care in ambulatory units for somatic adult patients. They were to have been published between January 2000 and May 2005, written in English, Swedish or Finnish with an English abstract, and the research was to have been conducted in Europe. The search terms used were: ambulatory care, ambulatory care facilities, outpatient, outpatients, patient satisfaction and quality of health care. The articles were screened by two independent reviewers in three phases. Results, Thirty-five articles were included. The quality of care was measured using both quantitative and qualitative methods. Only a few studies relied on the single criterion of patient satisfaction for quality measurements. It is easy to identify common sources of dissatisfaction in different studies. Sources of satisfaction are more closely dependent on the target population, the context and research design. Conclusion, Patient satisfaction is widely used as one indicator among others in assessing the quality of outpatient care. However, there is no single, universally accepted method for measuring this. [source] Monitoring of batch processes through state-space modelsAICHE JOURNAL, Issue 6 2004Jay H. Lee Abstract The development of a state-space framework for monitoring batch processes that can complement the existing multivariate monitoring methods is presented. A subspace identification method will be used to extract the dynamic and batch-to-batch trends of the process and quality variables from historical operation data in the form of a "lifted" state-space stochastic model. A simple monitoring procedure can be formed around the state and residuals of the model using appropriate scalar statistical metrics. The proposed state-space monitoring framework complements the existing multivariate methods like the multi-way PCA method, in that it allows us to build a more complete statistical representation of batch operations and use it with incoming measurements for early detection of not only large, abrupt changes but also subtle changes. In particular, it is shown to be effective for detecting changes in the batch-to-batch correlation structure, slow drifts, and mean shifts. Such information can be useful in adapting the prediction model for batch-to-batch control. The framework allows for the use of on-line process measurements and/or off-line quality measurements. When both types of measurements are used in model building, one can also use the model to predict the quality variables based on incoming on-line measurements and quality measurements of previous batches. © 2004 American Institute of Chemical Engineers AIChE J, 50: 1198,1210, 2004 [source] Prymnesium parvum: The Norwegian Experience,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 1 2010Torbjørn M. Johnsen Johnsen, Torbjørn M., Wenche Eikrem, Christine D. Olseng, Knut E. Tollefsen, and Vilhelm Bjerknes, 2010. Prymnesium parvum: The Norwegian Experience. Journal of the American Water Resources Association (JAWRA) 46(1):6-13. DOI: 10.1111/j.1752-1688.2009.00386.x Abstract:, In Norwegian waters, Prymnesium parvum has been reported from Oslofjorden in the south to Spitzbergen in the north. However, blooms of P. parvum have only been reported from the Sandsfjorden system in Ryfylke, Western Norway where the salinity of the permanent brackish layer (2-5 m) typically is in the range of 4-7 psu during the summer months. The first bloom on record occurred in 1989, and it killed 750 metric tons of caged salmon and trout which was a significant economic loss to the fish farming industry. Toxic blooms occurred as well in subsequent years and the number of fish farms in the area decreased considerably as did the occurrence of P. parvum. In 2005, fish farming was reintroduced to the area and again, in 2007 a toxic bloom of P. parvum killed 135 metric tons of caged fish. The Norwegian Institute for Water Research has, in collaboration with "Erfjord Stamfisk" fish farm, set up a monitoring program that includes light microscopy cell counts of Prymnesium, water quality measurements, and observation of the caged fish. A submergible fish net was mounted over the fish pens and during the toxic outbreak of P. parvum in July-August 2007, which was as previous years confined to the upper brackish water layer, the fish nets were lowered to 10 m depths below the surface and fish feeding was temporarily stopped. Despite substantial weight loss, the fish survived the toxic bloom and the economic loss was minimal. Monitoring of P. parvum bloom dynamics in 2007 revealed that populations were initially dominated by the nonmotile forms which were gradually replaced by the flagellated forms. Toxicity was observed when the flagellated cells dominated populations in the summer. Chrysochromulina, solitary small Chaetoceros species, and small centric diatoms co-existed with P. parvum during the monitoring period (June-October). [source] Seasonal patterns of sucrose concentration in relation to other quality parameters of sugar beet (Beta vulgaris L.)JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 1 2006Christine Kenter Abstract The chemical composition of sugar beet is the most important parameter affecting its processing. Sugar factories require beet with high concentrations of sucrose and low concentrations of melassigenic substances to maximise the amount of extractable sugar. In order to plan the processing campaign, forecasts of root and sugar yield by prediction models are possible but there are no means to predict the technical quality of the beet. In the present study, the seasonal development and physiological relationships of different parameters of sugar beet quality were analysed. In order to estimate possibilities for quality forecasts, the concentrations of beet quality variables in October were correlated with corresponding quality measurements in late summer and to weather variables during the growing season by linear regressions. In 2000 and 2001, 27 field trials were conducted on commercial farm fields in all sugar beet growing areas in Germany. From June to October, sequential samples were taken every 4 weeks and the concentrations of sucrose, potassium, sodium, total soluble nitrogen, ,-amino nitrogen, nitrate, betaine, reducing sugars and marc in the beet were determined. The sucrose concentration increased progressively until the final harvest date in autumn, whereas the concentrations of the melassigenic substances decreased markedly until late summer and remained fairly constant as the season progressed. Marc concentration was the most stable of the parameters analysed. The sucrose concentration was positively correlated with the concentrations of dry matter, betaine and marc, but negatively with nitrate concentration and leaf yield throughout the season. The correlation between the concentrations of sucrose and nitrogenous compounds measured in summer and their final concentrations in autumn was rather weak. However, it was close for potassium, sodium and marc and a satisfactory prediction of their final concentrations was possible by the end of August. Based on weather data, beet quality was not predictable. Therefore, it seems to be difficult to integrate beet quality parameters into prediction models. Copyright © 2005 Society of Chemical Industry [source] Renovation of a "sick building": The challenge of attaining the confidence of occupantsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009Marjaana Lahtinen PhD (Psychology) Abstract Background This case study focused on the renovation of a building with severe mold and HVAC problems. The users did not trust the success of the planned remedies, and the situation became conflict-prone. The aims of the study were to improve communication and cooperation between experts participating in the renovation process and the future users of the building and monitor the success of the remedies. Methods An intervention was implemented with the aim of making the renovation easily understood by the future users of the building and preventing the escalation of unnecessary concern among them. The follow-up methods comprised a questionnaire study, technical inspections, quality measurements of the indoor air, structural follow-up measurements, and interviews of key persons. Results The renovation itself seems to have been successful, and the model to improve communication and cooperation appears to be a promising one. The confidence of the future users was attained, and the relocation took place as planned. Conclusions In order to succeed in the renovation of a "sick building," both technical expertise and investment in information and communication are needed. Am. J. Ind. Med. 52:438,445, 2009. © 2009 Wiley-Liss, Inc. [source] Polymorphisms in eggshell organic matrix genes are associated with eggshell quality measurements in pedigree Rhode Island Red hensANIMAL GENETICS, Issue 1 2009I. C. Dunn Summary Novel and traditional eggshell quality measurements were made from up to 2000 commercial pedigree hens for a candidate gene association analysis with organic eggshell matrix genes: ovocleidin-116, osteopontin (SPP1), ovocalyxin-32 (RARRES1), ovotransferrin (LTF), ovalbumin and ovocalyxin-36, as well as key genes in the maintenance and function of the shell gland [estrogen receptor (ESR1) and carbonic anhydrase II (CAII)]. Associations were found for (i) ovalbumin with breaking strength and shell thickness; (ii) ovocleidin-116 with elastic modulus, shell thickness and egg shape; (iii) RARRES1 with mammillary layer thickness; (iv) ESR1 with dynamic stiffness; (v) SPP1 with fracture toughness and (vi) CAII with egg shape. The marker effects are as large as 17% of trait standard deviations and could be used to improve eggshell quality. [source] | ||||||||||||||||