Concept Of Continuous Quality Improvement Research Articles

Research on safety management of student apartments under the continuous improvement concept of CQI

This article explores how to effectively enhance the prevention and response capabilities of student apartment emergencies based on the concept of CQI (Continuous Quality Improvement). The article first elaborates on thetypes and characteristics of emergencies, and then formulates targeted preventive measures, and constructs an early warning system and emergency response mechanism. Through data analysis to support decision-making, continuous improvement and evaluation of security management were ultimately achieved. This study provides a new perspective and practical path for counselors in the management of student apartment safety in the new era.

Experience in the development and use of simulators for professional training of specialists in the electric power industry

Issues of development of simulators for training and testing of electrical engineers and students of electrical engineering specialties were considered. They are based on modern knowledge in the field of electricity. The main characteristics of simulators and requirements for their computer support are given. The developments implement a new method of practical training and testing of electrical engineers and can be used at all stages of electrical engineer training. The considered simulators are based on a combination of practical and theoretical knowledge of the electric power industry. The purpose of the developments is to activate and increase the efficiency of the educational process due to the introduction of new learning technologies. The technical capabilities of the software implement both individual and team work of students and electric power personnel. It was noted that in recent years, two professional simulators, implemented in the form of two laboratory workshops, have been developed and implemented in the educational process at the department of electrical energy transmission of National technical university “Kharkiv polytechnic institute”. The first helps students study the main provisions of the Normative Documentation in the power industry, the second – the rules and sequence of operational switching in electrical networks. In addition, experts determine the high efficiency of training systems based on precedent-analytical models. The exercise program according to the plan-do-check-act cycle is considered. Its basis is the well-known concept of continuous quality improvement “Plan-Do-Check-Act” (Deming's cycle). For the electric power industry, a plan-do-check-act cycle approach can consist of cyclical planning of activities, implementation of planned actions, verification of results obtained and correction of non-conformance to expectations. The precedent-scenario method of constructing a training system based on the software platform of the training system based on the plan-do-check-act scenario is presented in detail.

The Role of Electronic Feedback Loops in the Continuous Quality Improvement of Thyroid Nodule and Thyroid Cancer Care

Physicians strive to achieve and society demands that the delivery of health care undergo continuous quality improvement. In 2001, the Institute of Medicine's report, Crossing the Quality Chasm: A New Health System for the 21st Century, underscored the importance of improving the standards of care of our health care system and emphasized the goal of delivering personalized care for each patient ( 1. Insitute of Medicine Committee on Quality of Health Care in America Crossing the quality chasm: a new health system for the 21st century. National Academies Press, Washington, DC2001 Google Scholar ). In response to this report, the National Learning Consortium (NLC) was established as a “virtual and evolving body of knowledge and resources designed to support health care providers and IT professionals collaborating to achieving this end” ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). The NLC's strategy focused on “continuous quality improvement” (CQI), which emphasized the need to improve patient-specific quality of care through enhanced efficiency of data sharing between involved physicians as well as via electronic feedback loops as a mechanism to encourage continual self-assessment ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). Vital to this initiative was the adoption and use of electronic health record (EHR) systems, designed to efficiently record health data and facilitate the sharing of this health-related information between individual clinicians and their patients ( 2. Continuous quality improvement (CQI) strategies to optimize your practice. National Learning Consortium; 2013. Google Scholar ). While the concept of CQI can be broadly applied to health care, this model can also be employed to improve the quality of care of specific disease processes. Not only does enhancing quality of care lead to an improvement in patient outcomes, it also enhances patient safety and facilitates cost-effective utilization of precious health care resources. By establishing a culture as well as a mechanism for self-assessment, the development of feedback loops of patient information is vital to improve physician performance through continuous self-monitored modification and fine-tuning of diagnostic and therapeutic interventions. Ultimately, the goal of this initiative is to eliminate the current clinical silos of specialties that serve as barriers to clinical information sharing.

Design and implementation of the Americas Hernia Society Quality Collaborative (AHSQC): improving value in hernia care.

Wide variation in care and costs exists regarding the management of abdominal wall hernias, with unproven benefit for many therapies. This work establishes a specialty society-based solution to improve the quality and value of care delivered to hernia patients during routine clinical management on a national scale. The Americas Hernia Society Quality Task Force was charged by the Americas Hernia Society leadership to develop an initiative that utilizes the concepts of continuous quality improvement (CQI). A disease-based registry was created to collect information for CQI incorporating real-time outcome reporting, patient reported outcomes, stakeholder engagement, and collaborative learning methods to form a comprehensive quality improvement effort. The Americas Hernia Society Quality Collaborative (AHSQC) was formed with the mission to provide health care professionals real-time information for maximizing value in hernia care. The initial disease areas selected for CQI were incisional and parastomal hernias with ten priorities encompassing the spectrum of care. A prospective registry was created with real-time analytic feedback to surgeons. A data assurance process was implemented to ensure maximal data quality and completeness. Four collaborative meetings per year were established to meet the goals of the AHSQC. As of the fourth quarter 2014, the AHSQC includes nearly 2377 patients at 38 institutions with 82 participating surgeons. The AHSQC has been established as a quality improvement initiative utilizing concepts of CQI. This ongoing effort will continually refine its scope and goals based on stakeholder input to improve care delivered to hernia patients.

Introducing a legal mandate for basic medical education accreditation in Korea.

Introducing a legal mandate for basic medical education accreditation in Korea.

New Medical Education System: Implementation of Informatic Technology and Holistic Approach Concept

Sir, the recent report on “Quality Assessment of Medical Education at Faculty of Medicine of Sarajevo University” is very interesting (1). It is interesting that the new system seems to be challenging and can result in satisfaction of the students and outcome. Indeed, the continuous assessment of the medical education and curriculum is needed. This is according to the concept of continuous quality improvement. The updating of the necessary content (knowledge) as well as new education, teaching, techniques must be the fundamental concepts. Of interest, Masic I (1) raised the importance of medical student satisfaction assessment which is usually forgotten issue. In fact, medical student can be the “client” of the Faculty and the satisfaction survey should be regularly done. However, education is not the business. Sometimes, the interpretation of satisfaction of the students has to be carefully done. Some regulations and standards must be kept. As a new medical education system, to promote the new knowledge and skill via using new tools including to the informatic technology can be helpful. The holistic approach is required.

Moving beyond guidelines to ensure high-quality cancer care in the United States.

Moving beyond guidelines to ensure high-quality cancer care in the United States.

Online Weld Quality Benchmarking and Assurance during the Mass-Production Resistance Spot Welding Process

Nowadays online quality estimation for the resistance spot welding (RSW) has benefited a lot from monitoring the electrode displacement caused by nugget thermal expansion. Based on these emerging monitoring techniques a new approach is proposed to classify the weld quality and assure the quality for mass-produced weld group, which enables the continuous quality improvement concept during the welding process. A causal models are built with the offline trained Bayesian Belief Networks (BBN). It is a weld quality assessment net reveals the dependency of the weld quality on the features displayed by the displacement curve, which can be used for overdesigning the safety welds or as the probabilistic forecasting model for online weld quality assessment. The experimental results show that the proposed approach is valid and feasible to predict the weld quality and assure the overall quality for weld group in real applications.

The Value Proposition: Using a Cost Improvement Map to Improve Value for Patients with Nonsyndromic, Isolated Cleft Palate

As health care costs rise exponentially in the United States, increasing emphasis is being placed on measuring value, which incorporates both quality and costs. Although the concept of continuous quality improvement has taken a firm foothold in health care, techniques for measuring and continuously improving costs at the patient or system level are lacking. A retrospective, microcosting analysis mapped detailed medical costs over 18 months for 25 patients with nonsyndromic, isolated cleft palate to illustrate the concept of a continuous cost improvement map in a complex, multidisciplinary condition. Care for patients with nonsyndromic, isolated cleft palate was mapped to three timelines based on diagnostic subtype. Patients with Robin sequence requiring early surgical intervention for airway or feeding management (n = 4) had median costs that were triple those of Robin patients managed conservatively (n = 5) ($87,841 versus $27,864, respectively) as compared with patients without Robin sequence (n = 16) ($15,698). Inpatient services accounted for 85 to 95 percent of all costs, which were driven by the operating room, intensive care unit, and inpatient ward. More detailed analysis of each cost driver is reported. The cost improvement map provides a counterpart to the quality improvement map to illustrate how costs may be incorporated into value improvement efforts for complex, multidisciplinary conditions. The transparency and level of detail provided by this methodology are critical for internal improvement efforts and offer valuable insight for health care managers and policy makers, whose decisions should be based on accurate, patient-centered data.

Medical error in surgery

I read the recent report on human error in hernia surgery with a great interest [1]. Hope et al. [1] concluded that “Surgical technique improves with increased experience with abdominal closures; however, residents at all levels have the physical ability to adequately perform this task.” I would like to share some ideas on the topic of error in medicine. The questions are “What is the best way to prevent error?” and “Can the error be reduced by experience?” Indeed, reducing the error in surgery and any other kinds of medicine is the aim of the continuous quality improvement (CQI) process. It might seem that training can help decrease the error. However, this does not mean that the error does not exist in the case of an experienced and qualiWed setting [2]. Continuous repetitive sessions to promote awareness on medical error might be a useful solution according to the CQI concept.

A method for teaching continuous quality improvement to student pharmacists through a practical application project

Objective To provide future pharmacists with the skills and knowledge they need to use the continuous quality improvement (CQI) process to solve problems in a variety of practice settings. Material and methods At the University of Pittsburgh School of Pharmacy, the theory of CQI is presented to third-year pharmacy students in two lectures, followed by a practicum assignment. Student groups select a pharmacy, medical, or other identified problem and devise a solution through application of CQI principles. A member of each group presents the completed project to the class and a panel of CQI experts who judge project quality. Practice innovation Students apply learned CQI principles through a problem-based practicum assignment in which they create a plan to solve a real health care or non–health care problem. Main outcome measure Student learning was assessed through the project presentation and examination questions. A voluntary formative evaluation examined student attitudes toward the CQI module, applicability of CQI to pharmacy practice, and the most effective strategy for learning CQI concepts. Results Mean scores for presentations were 93%, reflecting a high level of ability to apply CQI principles. In the formative evaluation, 80% of students reported that lectures were informative or necessary; however, all responding students reported learning more through practicum experience as opposed to the lecture alone. Ninety-seven percent of students were able to provide examples of CQI opportunities in their career interest area. Conclusion This structured learning opportunity teaches students a systematic approach to identifying and solving system problems by applying CQI principles.

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and American Dietetic Association (ADA): Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Nutrition Support

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and American Dietetic Association (ADA): Standards of Practice and Standards of Professional Performance for Registered Dietitians (Generalist, Specialty, and Advanced) in Nutrition Support

Shaping the Future: Maintenance of Board Certification and Quality Care

This review is a summary of a presentation at the 2005 Intersociety Conference on training for the future of radiology. Certification by all 24 boards of the American Board of Medical Specialties, including the American Board of Radiology (ABR), has changed significantly. All primary and subspecialty certificates issued by the ABR are currently limited to 10 years, and diplomates of the board must maintain their certification by completing the ABR's maintenance of certification (MOC) program. The program consists of 4 components (professional standing, lifelong learning and self-assessment, cognitive expertise, and practice performance) and 6 competencies (medical knowledge, patient care, interpersonal skill, professionalism, practice-based learning and self-improvement, and systems-based practice) that are the key elements to be incorporated within the concepts of continuous quality improvement. The result, over time, is intended to have a major impact in the quality of patient care in terms of outcomes and best practices. How adults learn in the environment of expanding knowledge and the electronic distribution of content is a substantive question requiring research, data, and change. We must seize the opportunity to explore adult learning and the process of MOC. Time-limited certification and MOC can become catalysts for future training requirements, for the design of training pathways, and for certification methodologies. Shaping the future is a noble task requiring leadership, vision, patience throughout change, and creativity.

Continuous quality improvement using a practice improvement model

PurposeCape and Barkham's practice improvement model (PIM) describes how healthcare systems can be designed to facilitate the usage of self‐generated clinical outcomes in the delivery of subsequent interventions. This article aims to describe the application of the PIM in the implementation of group‐based cognitive‐behavioural therapy, for clients referred from Primary Care with anxiety disorders.Design/methodology/approachThe groups were evaluated using and pre‐ and post‐intervention design using a variety of validated measures of psychological functioning as part of a wider audit and evaluation system. The conclusions drawn from the audit and evaluation system, in the form of PIMs, were fed‐back into the design of successive groups in the attempt to increase subsequent effectiveness. Group 1 had no PIM applied, group 2 had a single PIM applied and group 3 had two PIMs applied.FindingsThe introduction of the single PIM for group 2 increased the effectiveness of clinical outcomes, while for group 3, the introduction of two PIMs increased effectiveness again in comparison to group 1, but not in comparison to group 2.Practice implicationsThe results indicate that the active use of feedback of outcomes from interventions conducted can be utilised to design and then evaluate the application of resultant PIMs. This represents attempts to introduce and operationalise the concept of continuous quality improvement in the delivery of a clinical service.Originality/valueThe evaluation of PIMs is in its practical and methodological infancy and this initiative represents the first attempt to utilise PIMs in the design of Primary Care psychological services.

P ERFORMANCE M EASUREMENTS IN E MERGENCY M EDICAL S ERVICES

With the strong encouragement of leading health care agencies, business principles are being implemented throughout health care, including emergency medical services (EMS). The reason is simple—quality of care can be enhanced by incorporating the management concepts of continuous quality improvement (CQI). The CQI process couples carefully identified, measurable performance indicators with information systems to monitor, analyze, and trend data. Benchmarking outcomes with other EMS systems allows the identification of “best practices” and the evolution of standards. Emergency medical services professionals must actively participate with the broader health care community in creating performance measurements to ensure that high-quality care is delivered consistently.

Community-based health improvement: lessons from the Learning for Action Institute, Simmons College.

The Learning for Action Institute at the Graduate School for Health Studies, Simmons College, uses continuous quality improvement concepts and methods to help community-based groups to make positive change. Eight core concepts are the basis for creating sustainable improvements, developing new models for community capacity, and building and disseminating knowledge of what has been learned. These concepts are: clarify the aim, form the right team, target improvement efforts, use data, listen to the customer, use tools and methods, conduct improvement and learning cycles, and make improvements. Two community-based projects are used to illustrate the concepts.

E FFECTS OF A C ONTINUOUS Q UALITY I MPROVEMENT P ROGRAM ON H ELICOPTER L IFTOFF T IMES

Background. The continuous quality improvement (CQI) process addresses concerns from a systems approach, employing committees of employees rather than selected management personnel to identify and solve problems, improve patient care and efficiency, and enhance customer satisfaction. Little is known about the effects of the CQI process on an aeromedical program. Objectives. To create a CQI program within an aeromedical program and to investigate its effect on helicopter liftoff times for scene responses. Methods. A CQI program was established at a busy aeromedical service that completed 897 missions in the previous year. A concern identified by the CQI committee was delays in helicopter liftoff time after receipt of mission requests for scene responses. Each component necessary for liftoff (dispatch, pilot weather check, and crew response) was identified, time limits were set for each, new procedures were developed, and all staff received training on the new procedures. Computer tracking of each of the identified component times allowed comparison of data pre and post procedure implementation of the CQI-developed procedures. Results. After CQI changes in procedures were implemented, there were a total of 30 delays out of 323 calls (9% of liftoffs for on-scene flights). This represents a 6% reduction in total delays. The largest drop in component times was observed in crew response (2.6%). An unanticipated 10% drop in response times for interhospital liftoffs also occurred, presumably due to heightened awareness of the service to response times in general. Conclusions. These findings suggest that employing a program utilizing CQI concepts can shorten helicopter liftoff times and improve response times in aeromedical programs.

A novel quality assurance method in a university teaching paediatric radiology department.

Primary diagnostic equipment in a paediatric radiology department must perform at optimal levels at all times. The Children's Hospital Radiology Department in Winnipeg, Canada, has developed an impartial means of reporting radiographic image quality. The main objectives of this study programme were two-fold. First, to monitor diagnostic X-ray equipment performance, and second, to improve the resultant image quality as a means of implementing the fundamental concepts of continuous quality improvement. Reading radiologists completed a quality assurance (QA) card when they identified a radiographic image quality problem. The cards were subsequently collected by the clinical instructor who then informed, in confidence, the radiographers of the written comments or concerns. QA cards have been conspicuously installed in the paediatric radiology reading room since the middle of 1993. Since its inception, equipment malfunction has been monitored and indicators for improving image quality developed. This component of the QA programme has shown itself to be a successful means of communicating with radiographers in maintaining superior image quality.

Basic tools to integration in management and continuous quality improvement: protocols and procedures

In order to support interested colleagues with the concepts of Continuous Quality Improvement (CQI) and Clinical Standards for Nephrology Practice, a package of education support has been set up. We enhance the use of procedures, protocols, working plans, guidelines and nursing care plans as instruments of organisational integration. For the nursing care of renal patients in HD and PD we believe that all the procedures and protocols (P&P) above could have an important impact in the renal nursing practice. We propose that group members run a programme which is presented and implemented as a modular package including, theoretical knowledge, setting up working groups involved in literature revision, evaluation of defined P&P after a period of implementation, final implementation & periodic evaluation.

Delivering effective health care through teamwork: the role of pharmaceutical care management.

In recent years, there has been significant interest in the application of continuous quality improvement (CQI) and total quality management (TQM), and patient-focused care (PFC) in health care organisations around the globe. The hospital industry has substantially embraced the concepts of CQI and TQM with the belief that these concepts and programmes will lead to an improvement in both the quality and efficiency with which health services are delivered. The objective of this article is to achieve better outcomes in health care services with fewer resources by studying the implementation of patient-focused care in the health care provision context and particularly in the area of pharmaceutical care management as an integrated process in the delivery of health care in a hospital setting. The changes in health care provision have in many instances meant that the provision of pharmaceutical services needed re-assessing.