Corrective Action Plan Research Articles

PBIS Implementation Fidelity and Student Outcomes in an Urban School District

The purpose of our study was to examine Positive Behavior Interventions and Supports (PBIS) implementation fidelity and student outcomes for secondary schools in a large, urban school district placed under a corrective action plan due to disproportionate suspension practices for students of color. Drawing upon data over a four-year period on PBIS implementation fidelity, discipline referrals, suspensions, and standardized test scores, we employed repeated measures analysis of variance (ANOVA) and revealed improved outcomes in the first year, but improvements did not continue over time. Additionally, academic outcomes did not show any significant increases. The study concludes with implications for policy, practice, and future research.

The introduction of lean production principles at OJSC “Velikonovgorodsky Myasnoy Dvor”

The concept of “Lean Production” is one of the most promising directions for the development of modern processing industries. In addition to the development of equipment and technologies, in terms of ensuring the quality and competitiveness of enterprises, we must not forget about the main factor for encouraging development and stable work – human resources. It is the competent management work with specialists that promotes the optimization of technological processes, reduces production costs, and promptly solves emerging problem situations with the development and implementation of a corrective action plan. The article considers the introduction of the lean system at one of the largest processing enterprises in the North-Western region of Russia – OJSC “Velikonogorodsky Myasnoy Dvor”, Veliky Novgorod. The company started implementing this concept only recently – in 2019 and has not yet managed to get significant financial results. At the moment, the company’s specialists are at the initial stages of the lean production system implementation - the types of losses that occur at the enterprise have already been identified, and measures to eliminate these losses have been worked out. During the new system’s implementation period, it was found that the proposals for a technical improvement received by the management from ordinary employees of the enterprise are difficult to implement in the production process, as this complex task requires quite a lot of time. Only 18% of all proposals for a technical improvement were put into production throughout the concept implementation period. However, even such a small number of implemented ideas brought the company significant economic profit, which makes it possible to call the lean system introduction at processing enterprises a promising task.

CORRECTIONAL STRATEGY AND TACTICS OF EQUILIBRIUM DISORDERS OVERCOMING OF PRESCHOOLERS

The article describes planning system features of corrective actions for the balance function formation in preschool children with musculoskeletal system disorders. The analysis of the existing planning approaches of physical education and physical rehabilitation is made: the insufficiency of the substantiated scientific methodological bases in planning of corrective actions for balance function improvement in preschool children with musculoskeletal system disorders is found out. The general principles of adaptive physical education planning of preschoolers with musculoskeletal disorders are considered. On this basis, a method of step-by-step planning of equilibrium function purposeful formation was developed, which reflects the logic of five channels stimulating of the postural aplomb system and takes into account the peculiarities of postural deficit in each case. Conclusions present the algorithm of corrective actions planning system, which improves balance function of the specified children category. Research prospects of effective ways of postural deficit overcoming of preschool children with musculoskeletal system disorders are briefly marked.

Cleanliness Is Everyone's Business – a Multi-disciplinary Approach to Improving Environmental Cleanliness in an Acute Care Medical Center

Background According to the Centers for Disease Control and Prevention, environmental cleanliness is a significant mitigating factor for healthcare associated infections and disease transmission. The purpose of this performance improvement (PI) initiative was to improve hospital cleanliness, using a multi-disciplinary approach, following a regulatory visit that revealed several opportunities for improvement. Methods The setting was a 397 bed, acute-care medical center. The project focused on inpatient units representing the highest risk to patient safety. A 90% benchmark was established as a measure of success following process implementations and remediation efforts. The goal was to improve cleanliness as measured and reflected through compliance audits focused on regulatory findings. A multi-disciplinary approach was used to address the findings. Once a corrective action plan was implemented, action items were established. These included rounding on inpatient units by Infection Prevention (IP) and leaders from environmental services (EVS), nursing, facilities, medical equipment, and supply chain to establish cleaning expectations; formulating a riskstratification matrix tool to assess damaged IV poles for a phased replacement strategy; creating an audit tool to assess compliance; formulating a cleanliness campaign; and establishing a cleaning responsibility grid and procedural policy. Point-prevalence audits were conducted over 8 weeks and sustained through hospital-wide quarterly audits to assess compliance and track success. Findings were disseminated to unit leaders and placed into an online tracking system that required timely follow-up. Results Initial compliance improved from 63% to 100% over the course of 8 weeks. Sustained quarterly audit compliance rates averaged 92% over a 4 quarter period. The hospital's annual accreditation survey resulted in 0 non-conformities related to cleanliness, with the previous year's non-conformity resolved. Conclusions This PI initiative found that by engaging a multi-disciplinary team, hospital cleanliness can be improved and sustained through a culture of shared responsibility and accountability. According to the Centers for Disease Control and Prevention, environmental cleanliness is a significant mitigating factor for healthcare associated infections and disease transmission. The purpose of this performance improvement (PI) initiative was to improve hospital cleanliness, using a multi-disciplinary approach, following a regulatory visit that revealed several opportunities for improvement. The setting was a 397 bed, acute-care medical center. The project focused on inpatient units representing the highest risk to patient safety. A 90% benchmark was established as a measure of success following process implementations and remediation efforts. The goal was to improve cleanliness as measured and reflected through compliance audits focused on regulatory findings. A multi-disciplinary approach was used to address the findings. Once a corrective action plan was implemented, action items were established. These included rounding on inpatient units by Infection Prevention (IP) and leaders from environmental services (EVS), nursing, facilities, medical equipment, and supply chain to establish cleaning expectations; formulating a riskstratification matrix tool to assess damaged IV poles for a phased replacement strategy; creating an audit tool to assess compliance; formulating a cleanliness campaign; and establishing a cleaning responsibility grid and procedural policy. Point-prevalence audits were conducted over 8 weeks and sustained through hospital-wide quarterly audits to assess compliance and track success. Findings were disseminated to unit leaders and placed into an online tracking system that required timely follow-up. Initial compliance improved from 63% to 100% over the course of 8 weeks. Sustained quarterly audit compliance rates averaged 92% over a 4 quarter period. The hospital's annual accreditation survey resulted in 0 non-conformities related to cleanliness, with the previous year's non-conformity resolved. This PI initiative found that by engaging a multi-disciplinary team, hospital cleanliness can be improved and sustained through a culture of shared responsibility and accountability.

A Roadmap to Success – One Workgroup's Approach to Improving Internal Hand Hygiene Compliance in an Acute Care Medical Center

Background According to the Centers for Disease Control and Prevention, hand hygiene (HH) is the number one way to prevent transmission of infection. The purpose of this performance improvement (PI) project was to improve internal hand hygiene compliance, monitored via the revamped observational compliance program. Methods The setting was a 397 bed, acute-care medical center. All inpatient departments and roles were monitored for compliance. The goal was to improve the hospital's internal HH compliance by rebuilding the observation program and regularly implementing initiatives to raise awareness for HH throughout the year. A target of 90% was used as a measure of success. A corrective action plan was utilized within a multi-disciplinary workgroup to establish action items and track progress. Due to a failing observation tool, a new phone application was developed leveraging available hospital technology. An interactive data-stratification dashboard was developed that auto-configured observation data, providing a standard method for reporting. New volunteers (unit-based and travelers) were selected, trained, competencied, and incentivized to participate. Additional initiatives included: targeted in-person education, a coaching catchphrase contest, fun-fact sharing at team huddles, HH technique posters distributed, stickers distributed for appropriately performing HH, a behavioral survey was created to understand barriers and opportunities, and a HH technique blacklight assessment activity was conducted. The data was continuously monitored to track and trend internal compliance rates. Results Internal compliance improved from 57% to 90% between the months of March 2019 (program go-live) and October 2019. The total number of observations was 5145, averaging over 500 per month. Additionally, role based data was now available for targeted education purposes and report card sharing. Conclusions This PI project found that by engaging a multi-disciplinary team, reestablishing a compliance observation program, leveraging innovative technology, and involving hospital leadership, internal HH compliance rates can be improved. According to the Centers for Disease Control and Prevention, hand hygiene (HH) is the number one way to prevent transmission of infection. The purpose of this performance improvement (PI) project was to improve internal hand hygiene compliance, monitored via the revamped observational compliance program. The setting was a 397 bed, acute-care medical center. All inpatient departments and roles were monitored for compliance. The goal was to improve the hospital's internal HH compliance by rebuilding the observation program and regularly implementing initiatives to raise awareness for HH throughout the year. A target of 90% was used as a measure of success. A corrective action plan was utilized within a multi-disciplinary workgroup to establish action items and track progress. Due to a failing observation tool, a new phone application was developed leveraging available hospital technology. An interactive data-stratification dashboard was developed that auto-configured observation data, providing a standard method for reporting. New volunteers (unit-based and travelers) were selected, trained, competencied, and incentivized to participate. Additional initiatives included: targeted in-person education, a coaching catchphrase contest, fun-fact sharing at team huddles, HH technique posters distributed, stickers distributed for appropriately performing HH, a behavioral survey was created to understand barriers and opportunities, and a HH technique blacklight assessment activity was conducted. The data was continuously monitored to track and trend internal compliance rates. Internal compliance improved from 57% to 90% between the months of March 2019 (program go-live) and October 2019. The total number of observations was 5145, averaging over 500 per month. Additionally, role based data was now available for targeted education purposes and report card sharing. This PI project found that by engaging a multi-disciplinary team, reestablishing a compliance observation program, leveraging innovative technology, and involving hospital leadership, internal HH compliance rates can be improved.

ANSI/ASSP Z9.14-2020 Testing and Performance-Verification Methodologies for Biosafety Level 3 (BSL-3) and Animal Biosafety Level 3 (ABSL-3) Ventilation Systems.

The American National Standards Institute has approved the revised standard ANSI/ASSP Z9.14-2020, "Testing and Performance-Verification Methodologies for Biosafety Level 3 (BSL-3) and Animal Biosafety Level 3 (ABSL-3) Ventilation Systems"; the revision was published on March 31, 2020. ANSI/ASSP Z9.14-2020 focuses on performance verification of engineering controls related specifically to ventilation system features of BSL-3/ABSL-3 facilities. The revised standard has been enhanced to include new definitions; new guidance for developing corrective action plans and performing verification of conformance to regulations, appendices, risk assessment matrices, and checklists dedicated to performing a facility risk assessment; and numerous updates to the original content.

Using the risk-based approach to curb modern slavery in the supply chain

PurposeThis paper aims to critically examine the modern slavery statements of Anglo American Plc. and Marks and Spencer Group Plc. to determine the level of effectiveness of the risk assessment and risk mitigation measures of both companies and provide recommendations on how the risk assessment and risk mitigation measures of both companies could be strengthened.Design/methodology/approachThe analysis took the form of a desk study, which analysed various documents and reports such as the UK Modern Slavery Act 2015, the UK Modern Slavery Act 2015 (Transparency in Supply Chains) Regulations 2015, the UK Guidance issued under Section 54(9) of the Modern Slavery Act 2015, the 2018 Global Slavery Index, funded by Forrest’s Walk Free Foundation, the Anglo American Plc. Modern Slavery Statement of 2017/18, the Marks and Spencer Modern Slavery Statement of 2017/18, the Financial Action Task Force Guidance on the Risk Based Approach to Combating Money Laundering and Terrorist Financing (High Level Principles and Procedures) 2007, the Financial Action Task Force International Standards On Combating Money Laundering and the Financing of Terrorism and Proliferation (The FATF Recommendations) 2012, the Australia Anti-Money Laundering and Counter-Terrorism Financing Rules Instrument 2007 (No. 1) (as amended), the Financial Transactions and Reports Analysis Centre of Canada Guidance on the risk-based approach to combatting money laundering and terrorist financing 2017 and the Central Bank of Nigeria (Anti-Money Laundering and Combating the Financing of Terrorism in Banks and Other Financial Institutions in Nigeria) Regulations, 2013.FindingsThis paper determined that the standard due diligence measures and the enhanced due diligence measures of Anglo American Plc. are not effective enough to identify/assess the risk(s) of modern slavery in the supply chains reason being that Anglo American Plc. does not use diverse methods/methodologies for her due diligence programme. This paper, however, determined that the standard due diligence measures and the enhanced due diligence measures of Marks and Spencer Group Plc. are effective enough to identify/assess the risk(s) of modern slavery in the supply chains because Marks and Spencer adopts diverse methods/methodologies for her due diligence programme. This paper also determined that both Anglo American Plc. and Marks and Spencer Group Plc. adopt diverse methods for the monitoring of their corrective action plans which are designed to mitigate the modern slavery risk(s) associated with high-risk suppliers. For example, Anglo American Plc. monitors anti-modern slavery compliance with the use of both internal Anglo American teams and third-party auditors to ensure that the identified issues are adequately addressed.Research limitations/implicationsThis paper focuses on Section 54 of the UK Modern Slavery Act 2015 and the Modern Slavery Statements of Anglo American Plc. and Marks and Spencer Group Plc for the year 2017/18.Originality/valueSeveral articles have been published on this topic. Among them, is an article by Stefan Gold, Alexander Trautrims and Zoe Trodd titled “Modern slavery challenges to supply chain management”, Supply Chain Management: An International Journal, Vol. 20 Issue: 5, pp.485-494 and an article by Stephen John New titled “Modern slavery and the supply chain: the limits of corporate social responsibility?”, Supply Chain Management: An International Journal, Vol. 20 Issue: 6, pp.697-707. The article by Stefan Gold, Alexander Trautrims and Zoe Trodd drew attention to the challenges modern slavery poses to supply chain management. Although the article briefly talked about the risk-based approach to monitoring supply chains for slavery, it did not discuss about the due diligence measures that UK firms are required to apply during risk identification and risk assessment, and the risk mitigation measures that will address the risk(s) that have been identified. The article by Stephen John New examines legal attempts to encourage supply chain transparency and the use of corporate social responsibility methods. Though the article mentions the UK Modern Slavery Act 2015, more attention was paid to the California Transparency in Supply Chains Act [S.B. 657], State of California, 2010), enacted in 2011 and in effect from 2012. The article analysed the California Act without critically discussing the risk assessment procedures for UK companies. In addition to discussing the different stages of the risk assessment/risk management process, this paper will examine the modern slavery statements of Anglo American Plc. and Marks and Spencer Group Plc. This paper will provide recommendations on how the risk assessment/risk mitigation measures of both companies could be strengthened. This is the only paper to adopt this kind of approach. The analysis/recommendations in this paper will help UK companies to design effective due diligence procedures for their supply chain.

From Failure to Excellence: A Capa Plan for Improving CIBMTR Data Submission

Topic Significance & Study Purpose/Background/Rationale Transplant centers that maintain membership in the Center for International Blood & Marrow Transplantation Research (CIMBTR) are required to submit clinical treatment and patient outcome data. To ensure data integrity, the CIMBTR performs audits of submitted data. The audit benchmark is to have a data reporting error rate that is less than or equal to three percent (≤3%) on Transplant Essential Data (TED) and other selected forms. Adverse consequences are instituted if repeated audit failures occur. Audits at our center in 2007, 2011, and 2015 all exceeded the CIMBTR benchmark (>3%). Corrective action plans were implemented after each audit; however, they were not fully completed or successful. Methods, Intervention, & Analysis After the third audit failure in 2015, a systemic review of the data reporting process was performed by the BMT Clinical Nurse Specialist, Research Nurse and Data Manager. Deficiencies were identified in numerous areas: inadequate staffing for data management, lack of ongoing training/development of the data manager, lack of retention of critical documents in the shadow charts, infrequent consultation with content experts, poor design of physical space for storage, and conversion from a paper-based medical records system to an electronic medical record (EMR). A comprehensive corrective action/preventive action plan (CAPA) was implemented to improve the data reporting process and decrease the error reporting rate. The following actions influenced a reduction in errors: structured shadow charts; additional data management support, expansive training of a new data manager, robust internal audit process, and re-commitment by medical staff as content experts for disease-based and GVHD reporting. Findings & Interpretation Internal audits demonstrated improvement over the next three years. A formal audit by CIMBTR in 2019 demonstrated an overall audit error rate of less than one percent ( Discussion & Implications We found the focused use of TED form instructions, extensive auditing and real time audit feedback to be beneficial. The key factor of success for improvement in the data reporting process and subsequent decreased error rate was collaborative work of multiple team members from multiple disciplines within the transplant program.

Using the Risk-Based Approach To Curb Modern Slavery in the Supply Chain: The Anglo American and Marks and Spencer Example

PURPOSE – This paper critically examines the modern slavery statements of Anglo American Plc. and Marks and Spencer Group Plc., to determine the level of effectiveness of the risk assessment and risk mitigation measures of both companies, and to provide recommendations on how the risk assessment and risk mitigation measures of both companies could be strengthened. DESIGN/METHODOLOGY/APPROACH – The analysis took the form of a desk study, which analyzed various documents and reports such as the UK Slavery Act 2015, the UK Slavery Act 2015 (Transparency in Supply Chains) Regulations 2015, the UK Guidance issued under section 54(9) of the Slavery Act 2015, the 2018 Global Slavery Index, funded by Forrest’s Walk Free Foundation, the Anglo American Plc. Slavery Statement of 2017/18, the Marks and Spencer Slavery Statement of 2017/18, the Financial Action Task Force Guidance on the Risk Based Approach to Combating Money Laundering and Terrorist Financing (High Level Principles and Procedures) 2007; the Financial Action Task Force International Standards On Combating Money Laundering and the Financing of Terrorism and Proliferation, (The FATF Recommendations) 2012; the Australia Anti-Money Laundering and Counter-Terrorism Financing Rules Instrument 2007 (No. 1) (as amended); the Financial Transactions and Reports Analysis Centre of Canada Guidance on the risk-based approach to combatting money laundering and terrorist financing 2017; and the Central Bank of Nigeria (Anti-Money Laundering and Combating the Financing of Terrorism in Banks and Other Financial Institutions in Nigeria) Regulations, 2013. FINDINGS – This paper determined that the standard due diligence measures and the enhanced due diligence measures of Anglo American Plc. are not effective enough to identify/assess the risk(s) of modern slavery in the supply chains reason being that Anglo American Plc. does not employ diverse methods/methodologies for her due diligence programme. This paper however determined that the standard due diligence measures and the enhanced due diligence measures of Marks and Spencer Group Plc. are effective enough to identify/assess the risk(s) of modern slavery in the supply chains since Marks and Spencer adopts diverse methods/methodologies for her due diligence programme. This paper also determined that both Anglo American Plc. and Marks and Spencer Group Plc. adopt diverse methods for the monitoring of their corrective action plans which are designed to mitigate the modern slavery risk(s) associated with high-risk suppliers. For example, Anglo American Plc. monitors anti-modern slavery compliance with the use of both internal Anglo American teams and third-party auditors to ensure that the identified issues are adequately addressed. RESEARCH LIMITATIONS – This paper focuses on Section 54 of the UK Slavery Act 2015, and the Slavery Statements of Anglo American Plc. and Marks and Spencer Group Plc for the year 2017/18. ORIGINALITY/VALUE – Several articles have been published on this topic. Among them, is an article by Stefan Gold, Alexander Trautrims and Zoe Trodd titled Modern slavery challenges to supply chain management, Supply Chain Management: An International Journal, Vol. 20 Issue: 5, pp.485-494 and an article by Stephen John New titled Modern slavery and the supply chain: the limits of corporate social responsibility?, Supply Chain Management: An International Journal, Vol. 20 Issue: 6, pp.697-707. The Article by Stefan Gold, Alexander Trautrims and Zoe Trodd drew attention to the challenges modern slavery poses to supply chain management. Although the Article briefly talked about the risk-based approach to monitoring supply chains for slavery, it did not discuss about the due diligence measures that UK firms are required to apply during risk identification and risk assessment, and the risk mitigation measures that will address the risk(s) that have been identified. The Article by Stephen John New examines legal attempts to encourage supply chain transparency and the use of corporate social responsibility (CSR) methods. Though the Article mentions the UK Slavery Act 2015, more attention was paid to the California Transparency in Supply Chains Act [S.B. 657], State of California, 2010), enacted in 2011 and in effect from 2012. The Article analysed the California Act without critically discussing the risk assessment procedures for UK Companies. In addition to discussing the different stages of the risk assessment/risk management process, this Article will examine the modern slavery statements of Anglo American Plc. and Marks and Spencer Group Plc. This Article will provide recommendations on how the risk assessment/risk mitigation measures of both companies could be strengthened. This is the only article to adopt this kind of approach. The analysis/recommendations in this Article will help UK Companies to design effective due diligence procedures for their supply chain.

Successful Reduction of Blood Culture Contamination in an Emergency Department by Monitoring and Feedback

Background:Blood Culture (BC) contamination is a common problem in the Emergency Department (ED) and is associated with prolonged length of patient stay and excess costs.Objective:The study aimed to investigate the impact of monthly monitoring and feedback of BC results on contamination rates.Methods:Data from a previous study showed that the contamination rate in the ED consistently exceeded the recommended level. This triggered an ad hoc Quality Improvement team to develop and implement a corrective action plan. In 2017, BC contamination rates were reported to the ED on a monthly basis. In response to this, ED staff conducted intensified educational workshops, followed by private counselling and competency assessment of nurses who collected contaminated BCs.Results:A total of 12 educational workshops were conducted in February and March, 2017. The intervention resulted in >60% reduction in the contamination rate, from 8.6% baseline level to less than 3%. Of the 2660 BC sets drawn in 2017 from 1318 patients, 128 (4.8%) were contaminated, accounting for 39.5% of the total number of positive cultures. Sixty percent of the contaminated BCs grew Coagulase-negativeStaphylococcusspecies; other contaminants includedCorynebacteriumspp.,Micrococcusspp.,Propionibacteriumspp.,viridansStreptococcus, andNeisseriaspp.Conclusion:Continuous monitoring and feedback of contamination rates reduced BC contamination.

Comparison Between 1-D and 3-D Geoelectric Field Methods to Calculate Geomagnetically Induced Currents: A Case Study

Severe Geomagnetic Disturbances (GMD) pose a threat to the reliability of the United States bulk electrical power system. The NERC reliability standard TPL-007 requires transmission planners to assess potential problems in their service territories due to Geomagnetically Induced Currents (GIC) including transformer thermal assessment. If the assessment indicates a vulnerability, the standard requires the development of a corrective action plan to resolve potential issues. GIC calculation accuracy is critical to the assessment. In this paper, the impact of various geoelectric field calculation methods on the accuracy of calculated GIC is evaluated by comparing with observations for a geomagnetic storm that occurred on 07–08 September, 2017. The GIC calculation is carried out for a fairly large-scale power system model and the comparison with observation indicates that better results are achieved using magnetotelluric transfer functions that incorporate the effects of 3-D earth conductivity. The results also indicate an improvement in the comparisons when the transfer-function derived E-fields are interpolated between the original survey site locations.

Dynamic condition monitoring method based on dimensionality reduction techniques for data-limited industrial environments

In recent years, the integration of intelligent condition monitoring systems has become crucial for the Operation and Maintenance in the industry. Condition-based maintenance strategies allow the identification of the current health status of industrial assets. Consequently, downtimes and maintenance costs are reduced by the efficient planning of corrective actions and the early detection of costly damages. However, the implementation of data-based monitoring techniques is often hampered by two main difficulties: Firstly, the lack of understanding of the monitored equipment; and secondly, the lack of data related to failures and their evolution, which is one of the major obstacles for the implementation.This article proposes a method based on the use of dimensionality reduction (DR) techniques to perform real-time monitoring of the state of the machine. The performance of the approach is studied with four different DR techniques: PCA, LDA, Relief, and Autoencoders. The algorithms are tested in a simulation of various asset lifetimes in which they determine when the assets are working under abnormal conditions. Next, the results of the simulation are evaluated under a specifically designed evaluation criterion based on three key performance indicators; cost, interpretability, and effectiveness. In this way, a common situation in industrial field applications is imitated, where the information is gathered in real-time and there is not enough prior knowledge of the machine nor data about its degradation or failures.

Reliability design and case study of the domestic compressor subjected to repetitive internal stresses

To improve the lifetime of mechanical system such as compressor, parametric accelerated life testing (ALT) as a reliability methodology is suggested. It consists of (1) a parametric ALT plan based on BX lifetime, (2) load analysis for accelerated lifetime test, (3) a tailored series of parametric ALTs with action plans, and (4) evaluation of the final compressor design to ensure the targeted BX lifetime is satisfied. As a test case, failed reciprocating compressors of French-door refrigerators returned from the field were studied. Disassembling the compressors revealed that the suction reed valve had fractured. In the first ALT, the failed samples from the field were reproduced. The root cause of the failures came from the sharp edges of the valve plate and an overlap between the suction reed valve and the valve plate. Corrective actions included modifying the valve plate in the compressor system to increase the trepan size and adding a ball peening process to eliminate sharp edges on the valve plate. There were no problems during the second ALT. After these parametric ALTs with corrective action plans were conducted, the modified compressor was expected to achieve lifetime of B1 life 10 years.

Integration of Publicly Reported Center Outcomes into Standards and Accreditation: The FACT Model.

The rapid evolution of blood and marrow transplantation (BMT), coupled with diverse outcomes associated with heterogeneous groups of patients, led to the formation of 2 important organizations early in the development of the field: the Center for International Blood and Marrow Transplant Research (CIBMTR) and the Foundation for the Accreditation of Cellular Therapy (FACT). These organizations have addressed 2 of the 9 elements identified by the National Quality Strategy (NQS) for achieving better health care, more affordable care, and healthy people and communities: a registry that promotes improvement of care and accreditation based on quality standards. More recently, a federally mandated database in the United States addresses the third element of the NQS: public reporting of treatment results. Here we describe the current process by which FACT incorporates patient outcomes reported by the CIBMTR into standards for accreditation, the requirements for accredited programs with performance below expected outcomes to maintain accreditation, and preliminary findings of an assessment of corrective action plans intended to improve outcomes.

Culture-dependent diversity profiling of spoilage yeasts species by PCR-RFLP comparative analysis.

Spoilage caused by yeasts is a constant, widespread problem in the beverage industry that can result in major economic losses. Fruit juices provide an environment that allows the proliferation of yeast. Some factories in South Africa are not equipped with laboratory facilities to identify spoilage yeasts and outsourcing becomes a prolonged process which obstructs corrective action planning. This study aimed to establish yeast diversity and apply a rapid method for preliminary identification of spoilage yeasts associated with a small-scale fruit juice bottling factory. Yeast population in the factory was determined by isolation from the production environment, process equipment and spoiled products. PCR-RFLP analysis targeting the 5.8S-ITS region and D1/D2 sequencing was used for identification. A total of 207 yeasts belonging to 10 different genera (Candida, Lodderomyces, Wickerhamomyces, Yarrowia, Zygosaccharomyces, Zygoascus, Cryptococcus, Filobasidium, Rhodotorula/Cystobasidium and Trichosporon) were isolated and identified from the production environment and processing equipment. Candida intermedia, C. parapsilosis and Lodderomyces elongisporus were widely distributed in the factory. Zygosaccharomyces bailii, Z. bisporus, Zygoascus hellenicus and Saccharomyces cerevisiae were isolated from the spoiled products. The data provided a yeast control panel that was used successfully to identify unknown yeasts in spoiled products from this factory using polymerase chain reaction-restriction length polymorphism (PCR-RFLP) comparative analysis.

Using the Trauma Quality Improvement Program Metrics Data to Enhance Clinical Practice.

The American College of Surgeons Trauma Quality Improvement Program (TQIP) provides trauma centers with hospital-specific performance data and the ability to compare their performance data with that of similar hospitals nationwide. Utilizing the TQIP data and drill down feature can lead to changes in clinical practice and improved care. The purpose of this article is to provide a guide that demonstrates how using the TQIP hospital-specific data can improve outcomes. We recommend 4 separate categories by which data and reports should be evaluated: processes of care, quality of care, data coding, and data mapping. We discuss these categories using 4 targeted examples. Utilizing our guidelines, trauma programs participating in the TQIP should be able to (1) identify trends and focus on outliers in their institutional data, (2) create processes and implement practice improvements, and (3) evaluate the results of their corrective action plan. This topic may be of special interest to those involved in the management of programs or systems-level policies as reduction in costs and improving quality are program drivers.

Framework for trajectory‐based probabilistic security assessment of power systems

Transmission system operators prepare against threats to system security through preventive actions and the planning of corrective actions. Required actions are determined by performing security analyses according to some reliability management approach and criterion. Probabilistic approaches have been proposed as an alternative to the deterministic N − 1 approach, by using a probabilistically filtered contingency list. This study begins by formally defining system trajectories, as a means of connecting the initiating contingency to the system response, corrective control, and restoration activities. A system trajectory considers the realisation of exogenous variables, as well as a sequence of contingencies and the subsequent system response and control behaviours. Using this definition, it is argued that the system trajectory should be modelled until service and component outages are resolved, rather than only modelling its reaction to the initiating contingency. The authors then propose some simplifying assumptions to achieve a scalable approach to probabilistic real-time security assessment. To support this argument, contingency-based and trajectory-based probabilistic security assessments are compared in terms of their residual risk (the risk associated with future system trajectories that are not modelled). This comparison shows that security assessments based on trajectories allow for previously implicit assumptions on modelling accuracy to be made explicit.

Implementation of Lean techniques for Sustainable workflow process in Indian motor manufacturing unit

The process of material movement in the motor factory while transference of raw material from the supplier to stock un-ergonomically designed while loading and unloading using a heavy corrugated box. There is a need for improving the process for a sustainable materials movement and minimizing the material handling wastage. This research study uses a lean principle of manufacturing that is well accepted such as chalk circle exercise (seven mudas of lean principles), by analyzing the spaghetti diagram that minimizes wastes process. To minimize the usage of the corrugated box and deforestation sustainable metallic returnable pallets is ergonomically designed for the material handling. The findings from this research, a reduction of material handling time from 67 hours to 30.1hours per annum was achieved, with physical movement from 152 kms to 117 kms per annum and solid waste from 464 kg to zero. As this research is action research with the corrective action plan and by developing a sustainable returnable packaging that reduced the lean waste in the handling of raw materials at motor manufacturing. The implication of this study is reducing the corrugated packaging material from getting wasted every time by enhancing the material handling productivity and movement of material efficiently with an eco-environmentally friendly product.

Pengelolaan Sampah Rumah Tangga pada Masyarakat Tepi Sungai dan Faktor yang Mempengaruhinya

Littering was recognized as an important cause of environmental pollution and was related to health problems. Banjarmasin city has been achieved the predicate of Adipura in 2015, but in reality there were still many drainage that clogged because of the pile of garbage, especially in the river. Management and disposal of household waste was an important issue in the city of Banjarmasin. The purpose of this study was to identify socioeconomic and demographic factors related to family members’ knowledge, practice, and behavior related to household waste management and produce corrective action plans. This study uses cross-sectional design. The study population is eople in the city of Banjarmasin who live on the edge of the river and meet the sample inclusion and exclusion criteria. Sampling was done using multistage random sampling method. Binary logistic regression was used for data analysis. We found that education level, household income, and sex were independently linked to littering. We also found that communities have unsafe knowledge, practices, and behaviors in relation to waste management. This study concludes that promotion of environmental information and public education on proper waste disposal needs to be done to improve the health and safety of the community environment

Drone na Auditoria Ambiental: Potencialidades e Aplicações

Remotely Aircrafts (RA), popularly known as Drones, are capable tools to generate highly accurate remote sensing products with a great potential perspective for use in the Environmental Audit process, performing previously exclusive tasks of manned aircrafts. However, because it is a relatively recent technology, it is justified the need to consider the applicability of its use in environmental studies. The purpose of this article is to evaluate the potentialities and applications of Drones in the Environmental Audit process, as well is present a methodology for data acquisition and identification of environmental impacts, listing the conformities and nonconformities of the audited enterprise, giving subsidy for an effective planning of actions to minimize impacts. Orthomosaics generated by the Drone in this studied case was used to carry out a compliance audit, based on the applicable legislation and regulations, being a fundamental tool to verify the real situation of the mining company through the legislation in force in the country, giving support to the implementation of corrective actions of detected nonconformities. In view of the obtained results it was possible to conclude that Drone presented promising quickly and low cost data, proving to be an important tool in environmental audits, providing necessary information to carry out an effective planning and implementation of corrective actions of detected non-adjustments, considering the principle of reparability of environmental damage, which obliges the polluter and the predator to recover and/or indemnify the damages caused.