Continuous Improvement Techniques Research Articles

Leaning on leadership? Understanding how a lean implementation impacts hospital workers’ performance

This study examines the extent to which a Lean implementation impacts hospital work unit performance. It also explores the extent to which willingness to change and role clarity explain these relationships. The longitudinal data for this study were collected from a Lean implementation study conducted in a Dutch hospital and then analyzed using structural equation modelling. The results reveal that the practice of Lean Leadership behaviour positively affects performance, both directly and indirectly through role clarity. However, other Lean practices, involvement in continuous improvement and Lean techniques, did not enhance hospital performance. The inconsistent findings concerning Lean’s soft practices suggest that major events (the COVID-19 pandemic in this case) can influence the implementation of Lean and the subsequent outcomes, potentially obstructing sustainable results. The novelty of this study is in its multi-wave design to evaluate the long-term effects of Lean and line managers’ leadership behaviour in a hospital context. Furthermore, it enhances our understanding of the mechanisms explaining the relationship between Lean and its outcomes in healthcare.

Enhancing data quality through comprehensive governance: Methodologies, tools, and continuous improvement techniques

Enhancing data quality through comprehensive governance: Methodologies, tools, and continuous improvement techniques

Application of Kaizen Philosophy in Business Process Improvement in the Automotive Industry

This paper presents the application of the Kaizen philosophy in business process improvement in the automotive industry in the Republic of North Macedonia using methods and techniques for continuous improvement. The purpose of this paper is to indicate the benefit from the application of the methods and techniques from the adoption of the Kaizen philosophy and the Rational (Lean) production which are actually applied by the companies. Through the implementation of the tools, the processes, efficiency, effectiveness, and quality of the products are significantly improved, and thеrefore the companies become more competitive in the market.

Climate Change Impact on Water Resources using Hydrological Modelling

In order to understand the effects of continuous improvement techniques on water resources initiatives, process efficiency, equipment downtime, and hydrological modelling, this study synthesizes empirical data to examine the synchronized efficacy of these tactics. The results show that staff efficiency has increased, with an overall improvement of 10% and a significant 15% uptick in the Production division. Lean Water resources reduced waste by 12%, Six Sigma Implementation reduced defects by 18%, Predictive Maintenance reduced equipment downtime by 20%, and Supply Chain Optimization improved logistical efficiency by 10%; all of these initiatives demonstrated substantial positive outcomes as a result of continuous improvement. The efficacy of the techniques on reducing operational interruptions is shown by the equipment downtime log analysis, which shows a 25% decrease in downtime hours ascribed to Predictive Maintenance. Reductions of 15% in cycle times and 12% in defect rates are two examples of the impressive gains seen in process efficiency indicators. A complete optimization of water resources operations is shown by the cumulative percentage changes across projects and processes, which highlight the transforming power of strategic interventions. This research offers a path for businesses to create better productivity, resilience, and operational excellence by providing empirical insights into the interwoven symphony of continuous improvement.

Analyze vehicular flow at the intersection, Fernando Baeza avenues and Chuvíscar River, applying work sampling

It is an innovative work to carry out this analysis of vehicular flow that will be very useful for the city of Delicias Chihuahua, this town is relatively young and lacks road engineering (traffic lights) in some specific points, given the demographic growth of the neighborhoods on the outskirts, this avenue has been a key point to vent the vehicular flow to the different neighborhoods. The continuous improvement technique was applied, which is work sampling, according to ILO establishes that Work sampling is a technique to determine, through statistical analysis and random observations, the percentage of appearance of a certain activity. It will be necessary to continuously observe each of the points in the area and record the moment, at a previously selected time in the same period of time, but at different random times provided by the work sampling. For this investigation, the general objective is: identify the vehicular flow at the intersection of Fernando Baeza and Río Chuvíscar avenues in Ciudad Delicias, Chihuahua. The contribution of this study will benefit more than 79,907 vehicles that are registered in the vehicle registry of the Revenue Collection Office (2022) in the town and in this way apply continuous improvement for the benefit of citizens, identifying the hours of more vehicle capacity and consequently take advantage of cutting-edge technology, and build a road engineering focused on traffic lights for the benefit of its entire population.

Continuous improvement of the assembly process of an automotive part applying lean manufacturing tools

The object of research: The analysis of the entire assembly process of any automotive part is of utmost importance, given that optimizing any indicator such as time, cost, labor, materials, among others, will allow increasing the productivity and efficiency of the companies.
 Investigated problem: analyze how to reduce cycle time in the assembly process of an automotive part that is sold to Ford, this with the purpose of reducing costs and delivery times by making use of industrial engineering tools, specifically techniques related to lean manufacturing.
 The main scientific results: the assembly process of the upper B Post of the F-CX727 platform was optimized, through continuous improvement tools, improving indicators such as the reduction of cycle time and the cost of the product sold to the customer.
 The scope of practical application of the research results: auto parts companies specialized in the manufacturing of products for the automotive industry require the application of continuous improvement tools necessary to balance assembly lines and make incremental improvements in an organization.
 Innovative technological product: The use of soft techniques and methodologies allows a company to be flexible in its assembly system, this allows it to generate value in its processes as well as the control and reduction of key efficiency indicators.
 Scope of the innovative technological product: the scope of the research work is basically to present the development of continuous improvement techniques for an assembly product made in an auto parts industry in Mexico with the purpose of optimizing the process.

Kaizen-mindfulness a twin continuous improvement approach at workplace: A qualitative exploratory study

PurposeWorld Health Organizations (WHO) (2023) states that governments and employers have a responsibility to uphold that right by providing work that simultaneously prevents workers from experiencing excessive stress and mental health risks. The business environment continues to produce a lot of stress on workers, which includes internal pressures to achieve results and employees suffer the consequences. Some companies have turned to mindfulness as a technique that helps mitigate these consequences and have joined Kaizen as a process improvement technique in the work environment. Therefore, this study has a research purpose: “to comprehend the possible linkage between Kaizen philosophy from an individual perspective, with Mindfulness ZEN Buddhism technique to understand the individual benefit (well-being) of each employee in organizations.” The answer to this represents the research gap in this article. The research questions governing this study are as follows: RQ1: Does Mindfulness is used as Kaizen technique of personal-individual improvement in 21st-century organizations? RQ2: What elements and characteristics of Kaizen and mindfulness can be found working together? And RQ3: Which qualitative impact of mindfulness and Kaizen in the workplace outcome (well-being, performance of the job (process)) and relationships with other employees)?Design/methodology/approachThis research used a qualitative approach due to the recent phenomenon studied. In a certain way, it was used a mixed-method (combination of qualitative data – web search secondary data analysis and qualitative research-Convergence Model). First, it was done an intensive web search with the aim to identify companies' corporate mindfulness programs, along with companies which have applied mindfulness and Kaizen programs. It was identified a group of big companies with global and international presence (“famous” for their products and services) in diverse industrial and service sectors, country of origin and business locations; with the purpose of getting a holistic vision of all organizations which have practice Kaizen and mindfulness. Therefore, this study explored secondary data related to both practices, analyzing reports or briefings published in management magazines and official WEB pages and/or business magazines.FindingsAs a result of the triangulation of the data with its secondary data convergence model and qualitative research, a theoretical framework was reached that shows the benefits of the two combined twin techniques of Kaizen and mindfulness. The worker experiences a path that goes from concentrating on the execution of their processes, following their operating standards (Standardize, Do, Check, Act [SDCA] cycle), going through the evolution to continuous improvement or Plan-Do-Check-Act (PDCA) cycle, experiencing work with concentration-awareness and reducing your daily stress, maintaining high sensitivity to the work process and your environment and finally, discovering an essential life purpose. Finally, worker experiences benefit when there is wide application of both with the SDCA and PDCA cycles such as high motivation, constant learning from your mistakes, day-to-day learning and the Munen Musso (not using the mind).Research limitations/implicationsThe main limitation is the qualitative methodological bias and secondary data research. In addition, to have a theoretical sample. However, the richness of the data helps to overcome this limitation. On the other hand, the qualitative research interviews are for a certain geographical area, therefore, the results cannot be generalized.Practical implicationsThe results of this research can shed light on operations managers in the use of techniques for continuous improvement and improvement of people's quality of life, such as mindfulness. In Mexico, they are beginning to be used jointly (twin techniques) to comply with Regulation 035 of psychosocial risk, the researchers are sure that in other countries it will be used in the same way to comply with regulations. However, the research findings show the benefits that can be provided to workers in organizations by applying Kaizen and Mindfulness together.Originality/valueTo the best of the authors’ knowledge, according to the literature review, this is the first article that explores the relationship between Kaizen and Mindfulness as twin techniques that help improve the individual quality of life of employees in organizations.

Enhancing Construction Project Workflow Reliability through Observe–Plan–Do–Check–React Cycle: A Bridge Project Case Study

This research aims to determine the appropriate level of effort required for each step of the Observe–Plan–Do–Check–React (OPDCA) cycle to improve the workflow reliability of a construction project. Empirical data on detailed weekly meeting minutes over 18 weeks and the planned and actual starting and finish times of 475 activities were collected from a bridge construction case project. The information theory approach was utilized to measure the information gained from discussions pertaining to the OPDCA cycle during weekly planning meetings. Cooperative game theory and the Shapley notation of fairness were used to compute the contribution of each OPDCA step to workflow reliability. Results showed that “Observe”, “Plan”, “Do”, “Check”, and “reAct”, contributed 18%, 23%, 23%, 24%, and 12% to observed variations in workflow reliability measured by the percent plan complete (PPC). Also, findings revealed that synergy exists between the “Check” step and other steps in the OPDCA cycle. The methodology developed in this paper has potential implications for engineering managers. The method can be generalized to help project managers find the balance between planning and control efforts to improve workflow. It also provides proven techniques for continuous improvement during project execution to facilitate project success. Furthermore, at the organizational level, the developed method can help higher-level managers make informed investment decisions for employees’ training and development to improve performance in future projects.

Using Fuzzy TOPSIS and Balanced Scorecard for Kaizen Evaluation

Abstract Background Kaizen is a very important continuous improvement technique; however, measuring kaizen results/benefits have not been clearly and comprehensively addressed by the literature. Objectives This paper aims to propose a kaizen measuring system by integrating a Balanced Scorecard (BSC) and a Fuzzy Technique for Order Performance by Similarity to Ideal Solution (Fuzzy TOPSIS). Methods/Approach Three research instruments were distributed to kaizen experts to allocate kaizen benefits into the four BSC perspectives. The best measures of kaizen benefits were determined by employing the Fuzzy TOPSIS technique. Results The results present a kaizen performance evaluation system where the benefits were allocated into the four BSC perspectives, and the best measure for each kaizen benefit was chosen using fuzzy TOPSIS. Conclusions The research contributes to the literature by proposing a kaizen measurement system that will pair each benefit of using kaizen with BSC perspectives and measures, thus expanding the advantages of adopting kaizen to any sector or industry.

Establishment of Nurse Case Manager Role in a Pediatric Orthopedic Team.

Incorporating a nurse case manager (NCM) directly into a pediatric orthopedic department was implemented to address gaps in processes that had previously led to common delays in discharge planning. The orthopedic NCM works within an interdisciplinary team and provides guidance and support for both elective and emergent pediatric admissions. Applying continuous improvement techniques, the NCM role included the review of existing processes and determination of root causes of delays. This article describes some of the unique challenges and new processes included in the NCM role in the pediatric orthopedic setting, several solutions created and implemented to address identified delays, and statistical results of anticipatory discharge planning. An NCM role was initiated in the orthopedic department at a quaternary-level freestanding pediatric hospital. After interdisciplinary planning and implementation, the NCM role was established within the orthopedic department to facilitate timely, efficient, safe, and sustained discharges of patients. Success was realized through decreased denials and decreased number of avoidable inpatient days. Once rapport was established and streamlined work was developed, a retrospective review of length of stay was conducted to compare time periods prior to and after embedding this position. Changes in discharge planning processes positively affected the average length of stay for patients managed by the NCM. Cost savings are found in decreased avoidable inpatient days, decreased number of denials of inpatient medical necessity, and improved progression of care, which resulted in timely transitions and discharges. The effects of a consignment process and web-based ordering of durable medical equipment were also evaluated. Although this process in and of itself did not seem to impact length of stay, it did foster an improvement in team satisfaction around discharge readiness. Pediatric orthopedic service teams benefit from the role of the NCM when there is interdisciplinary involvement and a focus on streamlining processes from preadmission through transition of care. Further study in a concurrent design will shed light on other factors that impact length of stay, such as specific diagnoses and medical complexity. Average length of stay is an effective metric for services with a high percentage of elective admissions but may not be as dependable for teams that do not have prescribed lengths of stay. Study with a specific focus around those factors that impact both team and family satisfaction is also indicated.

The impact of applying the target cost and continuous improvement (Kaizen) on achieving the sustainable competitive advantage of Palestinian industrial companies

PurposeThis study aims to examine the impact of implementing target costing and continuous improvement techniques in industrial companies operating in southern Palestine on achieving sustainable competitive advantage (SCA). The study mainly assesses the level of application of these techniques by Palestinian industrial companies (PICs). Furthermore, it evaluates the extent to which the integration of these two methods can impact SCA, by producing cost-effective and innovative products that meet customer demands and needs, while simultaneously achieving continuous development of the company and an SCA.Design/methodology/approachA descriptive analytical approach was used to study the target costing and continuous improvement techniques employed by industrial companies in southern Palestine. A questionnaire was administered to 415 companies in the southern West Bank to collect data on the application of target cost and continuous improvement and their impact on SCA, measured through market share, differentiation and cost reduction. Control variables, such as company age, size (measured by the number of employees) and industrial sector classification were also included in the study model.FindingsThe findings of the study revealed that the PICs apply target costing and continuous improvement at a high level. Furthermore, all dimensions of achieving SCA were found to be achieved at a high level, with market share being the most prominent. The study also found that the integration of the target costing and continuous improvement had a positive impact on achieving SCA in the PICs. However, the study found no impact on company size, age or industrial sector on achieving a competitive advantage in terms of market share or other results.Research limitations/implicationsThe current study was limited to the application of strategic management methods to companies within the industrial sector only. This may constitute a limitation because it neglected other sectors. Likely, another limitation was the difficulty of obtaining the quantitative numbers needed for some quantitative variables that pertain to that type of industrial companies, which are mostly family companies that could not be regulated by the local companies' law to disclose their financial statement.Practical implicationsIf industrial companies have ambitions to reduce production costs from the planning and design stage to set the target selling price. It is based on the understanding and awareness of customers' desires while maintaining the quality of products according to the best methods of improvement and innovation; therefore, this can be achieved by using the target costing and the continuous improvement techniques through reviewing the current study and its results.Social implicationsThe current study sought to link two methods, simultaneously and complementary, with each other of the strategic methods of managerial accounting, which helps the companies to offer their best to attract customers, develop the product or service and maintain their continuity in a changing labor market that enables it to achieve sustainable and competitive advantage.Originality/valueThis study is unique in that it explores the impact of the integration of target costing or continuous improvement techniques (Kaizen) on achieving SCA in Palestine industrial companies. While previous studies have examined either target costing or continuous improvement techniques separately, this study enhances the integration of these two methods to achieve SCA.

‘Lean Dancing’: How Involvement in Continuous Improvement and Lean Techniques Relate to Hospital Performance and Workers’ Wellbeing through Autonomy

This study examines Lean—conceptualized as Involvement in Continuous Improvement and Lean Techniques—in hospitals. Specifically, we aim to determine the extent to which hospital workers’ perceptions of Lean are related to perceptions of their performance and wellbeing, and to what extent these relationships are explained by autonomy. Our data (n = 754) come from a Lean implementation study in a Dutch hospital, and are analysed using structural equation modelling. First, our results indicate that Involvement in Continuous Improvement positively relates to hospital workers’ perceptions of several dimensions of hospital performance (quality, service, efficiency, and predictability) and their own wellbeing (burnout and engagement)—a mutual benefit for both employer and employees. However, we also show that the Lean Techniques do not significantly relate to wellbeing. Second, our study reveals that it is essential to distinguish between responsible autonomy and choice autonomy, as we found differing mediating effects. Based on these findings, we recommend HR executives to move away from approaches that focus on happy few and to move away from approaches that focus on techniques.

The Use of the Continuous Improvement Technique (Kaizen) in Egyptian Hotels' (An Exploratory Study on a Sample of Five-star Hotels in Giza Governorate)

The Use of the Continuous Improvement Technique (Kaizen) in Egyptian Hotels' (An Exploratory Study on a Sample of Five-star Hotels in Giza Governorate)

INFLUENCE OF TOTAL QUALITY MANAGEMENT ON PERFORMANCE OF CATHOLIC PRIVATE SECONDARY SCHOOLS ON NYAHURURU DIOCESE, KENYA

Purpose: This research sought to investigate the influence of TQM style on the performance of four, Catholic Private Secondary Schools (CPSC) within the diocese. The research objectives were; To determine the extent to which benchmarking aspect of TQM is assisting in the development of CPSS in CDN; To ascertain the extent to which Continuous Improvement technique of TQM is assisting in improving academic performance in CPSS in CDN; To establish the challenges faced by managers in the implementation of TQM in CPSS in CDN; To assess ways of enhancing the implementation of TQM in CPSS in CDN. 
 Methodology: Concurrent, qualitative and quantitative, methods of data collection and analysis were employed. A total of four CDN secondary schools participated in the study. The target population was 64 teachers, 4 managers, 4 principals. The sample size of teachers was 54 (84%), 4 (100%) managers and 4(100%) principals. Cross-sectional survey was used to collect both qualitative and quantitative data using an interview guide and a questionnaire. Qualitative data were summarized into main thematic areas while the quantitative data were analyzed using descriptive statistical method such as frequency and percentages with the aid SPSS version 23.0. Tables and pie charts were used for presentation and interpretation of the data. Research ethics were upheld throughout the study. 
 Results: The research established that Benchmarking is not implemented and the Continuous Improvement aspect is not well implemented in the Schools. The study recommended that schools should implement the TQM elements; Continuous Improvement and Benchmarking to improve performance and enhance the growth of the schools. It was evident that lack of resources was one of the major problems in TQM implementation. 
 Unique Contribution to Theory, Policy, and Practice: The study recommended the prioritization of resources to enable the scarce resources to be used for improvement of schools’ growth and enhancement of the performance. These findings will be useful to policy makers, parents, county governments and in as well as adding knowledge to academia in education related studies. It will be of great benefit to the CDN in enhancement of growth and development of its schools.

Interconception Care and Safe Sleep: Adapting the IMPLICIT Toolkit for Pediatrics.

A woman's health in the interconception period has an impact on birth outcomes. Pediatric visits offer a unique opportunity to provide interconception care (ICC). Our aim was to screen and provide interconception and safe sleep screening, counseling, and interventions for 50% of caregivers of children <2 years of age in a pediatric medical setting. Two pediatric clinics implemented the March of Dimes' Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques (IMPLICIT) toolkit, in addition to standardized safe sleep assessments. A quality improvement learning collaborative was formed with a local "infant mortality champion" leading quality improvement efforts. Monthly webinars with the clinic teams reviewed project successes and challenges. Framework for Reporting Adaptations and Modifications was used to document adaptations. For each individual IMPLICIT domain, clinics screened and provided needed interventions for ICC and safe sleep in >50% of eligible encounters. Over the course of the quality improvement learning collaborative, the number of caregivers screened for at least 4 of the 5 IMPLICIT domains increased from 0% to 95%. To successfully implement the IMPLICIT toolkit in pediatrics, adaptations were made to the existing model, which had previously been used in family medicine clinics. Pediatricians should consider providing ICC as an innovative way to impact infant mortality rates in their community. Framework for Reporting Adaptations and Modifications can be used to systematically describe the adaptations needed to improve the fit of IMPLICIT in the pediatric clinic, understand the process of change and potential application to local context.

Factorial Analysis of the Critical Success Factors of Continuous Improvement (CI) Techniques in the Companies from Sohar Industrial Estate, Oman

Purpose: The research objectives were to analyze the role of continuous improvement (CI) techniques in manufacturing in Oman in the CI process and to investigate the crucial factors of CI and the application techniques of CI that have been implemented by the manufacturing companies during the CI process. Design/methodology/approach: A survey questionnaire was developed with the baseline of CI practices used by manufacturing companies in Oman and a convenient sampling method was used to collect the data. 146 completely filled-in questionnaires were collected from 75 manufacturing units out of the entire Public Establishment database. The data was tabulated, compiled. The robustness was tested along with the ranking tests and the factor analysis using SPSS and AMOS. Findings: The results reveal that the Omani manufacturing companies using structured CI programs had lesser product recalls, leading to increased overall sales, decrease in processing time. Further, it is also revealed that the CI culture and Employee Performance Measurement and Review are instrumental in translating into company savings. Research limitations/implications: This research was limited to Sohar Industrial estate only. As there are nine industrial estates in Oman, the research can be undertaken to study the CI practices adoption in all the other industrial estates as well. Social implications: Countries from all over the world are facing numerous challenges due to COVID-19. The paper will help the manufacturing companies in decision making towards the process improvement. Originality/Value: There are not many studies on continuous improvement practices within the Omani manufacturing industry and this paper examines the status of CI implementation in manufacturing companies in Oman.

Application of Industrial Engineering Techniques for Continuous Improvement in Plastic Industry

Abstract: Industrial engineering is a specified field of engineering that deals with the design, improvement, and installation of integrated systems such as of people, materials, and energy in industry. Industrial engineers use specialized knowledge and skills in the mathematical, physical and social sciences, together with the principles and methods of engineering analysis and design, to specify, predict, and evaluate the results obtained from systems and processes. As the present condition of the company is capable to some extent, but it is not sufficient as it looks. But it also faces some problems due to some improper arrangement like no proper storage system, proper material handling component, improper layout and improper arrangement of working tools. So to overcome these problems in the company, industrial engineering and its techniques can be used. By applying industrial engineering and its techniques there is improvement in companies existing situation and it helps to improve productivity and profit of the company. Problems identified in the company Atharva Moulds Pvt. Ltd. are storage department problem, company layout, material handling problem, 5s and safety issues. This problems are sort by using various engineering techniques such as, 5s, layout improvement, material handling, maintenance, safety, etc tools and productivity is improved. Keywords: Industrial Engineering, Productivity, Engineering Techniques,

Influence of Total Quality Management on Performance of Catholic Private Secondary Schools on Nyahururu Diocese, Kenya

Purpose: This research sought to investigate the influence of TQM style on the performance of four, Catholic Private Secondary Schools (CPSC) within the diocese. The research objectives were; To determine the extent to which benchmarking aspect of TQM is assisting in the development of CPSS in CDN; To ascertain the extent to which Continuous Improvement technique of TQM is assisting in improving academic performance in CPSS in CDN; To establish the challenges faced by managers in the implementation of TQM in CPSS in CDN; To assess ways of enhancing the implementation of TQM in CPSS in CDN.Methodology: Concurrent, qualitative and quantitative, methods of data collection and analysis were employed. A total of four CDN secondary schools participated in the study. The target population was 64 teachers, 4 managers, 4 principals. The sample size of teachers was 54 (84%), 4 (100%) managers and 4(100%) principals. Cross-sectional survey was used to collect both qualitative and quantitative data using an interview guide and a questionnaire. Qualitative data were summarized into main thematic areas while the quantitative data were analyzed using descriptive statistical method such as frequency and percentages with the aid SPSS version 23.0. Tables and pie charts were used for presentation and interpretation of the data. Research ethics were upheld throughout the study.Findings: The research established that Benchmarking is not implemented and the Continuous Improvement aspect is not well implemented in the Schools. The study recommended that schools should implement the TQM elements; Continuous Improvement and Benchmarking to improve performance and enhance the growth of the schools. It was evident that lack of resources was one of the major problems in TQM implementation.Unique contribution to theory, policy, and practice: The study recommended the prioritization of resources to enable the scarce resources to be used for improvement of schools’ growth and enhancement of the performance. These findings will be useful to policy makers, parents, county governments and in as well as adding knowledge to academia in education related studies. It will be of great benefit to the CDN in enhancement of growth and development of its schools.

Continuous improvement strategy- lifeblood of organizations

Continuous improvement strategy results improved productivity, better quality, lesser breakdowns, reduced costs, motivating working conditions, reliable deliveries, improved safety and enhanced morale of the employees. Total Quality Management has advocated this strategy for the survival of any of the organizations in the market. The existing processes turn to be a bit more efficient and effective due to continuous improvements. These more efficient and effective processes take the processes and the products to higher levels of quality leading to the customer satisfaction resulting in company survival. An attempt has been made in this paper to present the concept through the literature survey and also different sophisticated continuous improvement techniques recommended by several researchers and managers in the area of Continuous improvement are summarized here for all those who are interested in carrying research in this area, managers and others concerned with improvement. Certainly the research paper will be beneficial for them as it presents the overview of the strategy and the different application tools established by manufacturing organizations globally

Interventions to Increase Multivitamin Use Among Women in the Interconception Period: An IMPLICIT Network Study.

Each year, 3% of infants in the Unites States (US) are born with congenital anomalies, including 3000 with neural tube defects. Multivitamins (MVIs) including folic acid reduce the incidence of these birth defects. Most women do not take recommended levels of folic acid prior to conception or during the interconception period. The Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) ICC model was implemented to screen mothers who attend well child visits (WCVs) for their children aged 0-24months. Mothers were queried for maternal behavioral risks known to affect pregnancy including multivitamin use and use of family planning methods to enhance birth spacing. When appropriate, interventions targeted at those at risk behaviors are offered. A mixed effects logistic regression model was used to calculate the odds ratio (OR) of behavior change in MVI use among mothers who reported not using MVIs. 37.7% of mothers reported not using MVIs at WCVs. 64.0% of mothers received an intervention to improve MVI use in this model. Mothers who received an intervention were more likely to report taking an MVI at the subsequent WCV if they received advice to take MVIs (OR 1.64) or directly received MVI samples (OR 3.09). Dedicated maternal counseling during pediatric WCVs is an opportunity to influence behavioral change in women at risk of becoming pregnant. Direct provision of MVIs increases the odds that women will report taking them at a higher rate than provider advice or no counseling at all.