Effective Continuous Quality Improvement Research Articles

Analysis of program outcomes attainment for diploma in civil engineering at Universiti Teknologi MARA Pahang

Analysis of program outcomes involves the assessment of the learning objectives based on cognitive, psychomotor, and affective domains and their attainment is measured using both direct and indirect approaches. This study aims to assess the program outcomes attainment for the civil engineering diploma program at Universiti Teknologi MARA Pahang. The program outcomes attainment in this study was obtained from two categories of students based on cohort 20174 using the Plan ID 6541, namely i) 257 graduated on-time students and ii) 365 overall students including extended students. The attainments were analyzed quantitatively using key performance indicators for each program outcome and program performance indicators for the overall attainment of program outcomes. Based on the key performance indicator, the results reveal that nine program outcomes are indicated as excellent while three program outcomes are indicated as good. Meanwhile, based on the program performance indicator, this cohort is indicated as well performed where 9 out of 12 program outcomes recorded above 70% average attainment. Various effective continuous quality improvement (CQI) program can be identified by the school’s committee based on these findings to further enhance the program outcomes attainment.

Effective and Efficient Implementation of OBE Framework within Constrained Pakistani Environment to Attain Desired Learning Outcomes

Outcome-based-education (OBE) is an educational theory that bases each part of an educational system around goals (outcomes). Pakistan Engineering Council (PEC) introduced the OBE in Pakistani engineering higher-education-institutions (HEIs),from 2018, in the replacement of previously followed Syllabus& Curriculum based education system. Key to success of OBE System is its continuous-quality-improvement (CQI) mechanism. The CQI mechanism design should be based on accurate assessment process and flawless evaluation of OBE System parameters; otherwise the OBE System’s benefits cannot be achieved. However, some HEIs have not devised an effective CQI mechanism and they still using classical procedures and academic tools in implementation of the OBE Framework, which cannot give desired results from the new System. This paper presents that; instead of presently employed loose-control, a modified stringent control strategy for academic activity and employment of latest technology, can make the CQI mechanism, more effective and efficient. This paper therefore presents a two-fold contribution. At first, the implementation problems of the OBE System are critically analyzed. Secondly, few modifications in the existing approaches have been introduced to achieve the desired results from the recently adopted OBE system.

A Conceptual Model for Effective Quality Management of Online and Blended Learning

Institutions considering online and blended learning (OBL) face the challenge of strategically adopting OBL to develop, implement, monitor, assess and improve the quality of programmes and courses. The principles of continuous quality improvement (CQI) allow this challenge to be addressed. Effective CQI management implies that quality assurance and quality improvement follow and inform each other as part of a continuous cycle. Scholars report however, that quality management of OBL usually focuses on assurance. The purpose of this paper is to provide a state of the art approach for effective CQI management which allows practitioners to achieve coherence between quality assurance and improvement of OBL. In this conceptual paper we link and integrate work across fields to address the challenge of achieving coherence between quality assurance and improvement. We discuss research in the context of CQI that uncovers features of OBL that prevent practitioners from achieving coherence. The conceptual model for effective CQI of OBL integrates data based decision‑making. The conceptual model provides a foundation for research on the effectiveness of this CQI management approach in the context of OBL. The quality management approach supports practitioners during the entire CQI‑cycle to foster dialogue and consultation between all stakeholders in the institution in order to strategically develop assess and improve the quality of OBL programmes and courses. The originality of the model lies in making explicit data‑based decision making as a driver for effective CQI management in the context of OBL.

ABET Accreditation During and After COVID19 - Navigating the Digital Age.

Engineering accreditation agencies and governmental educational bodies worldwide require programs to evaluate specific learning outcomes information for attainment of student learning and establish accountability. Ranking and accreditation have resulted in programs adopting shortcut approaches to collate cohort information with minimally acceptable rigor for Continuous Quality Improvement (CQI). With tens of thousands of engineering programs seeking accreditation, qualifying program evaluations that are based on reliable and accurate cohort outcomes is becoming increasingly complex and is high stakes. Manual data collection processes and vague performance criteria assimilate inaccurate or insufficient learning outcomes information that cannot be used for effective CQI. Additionally, due to the COVID19 global pandemic, many accreditation bodies have cancelled onsite visits and either deferred or announced virtual audit visits for upcoming accreditation cycles. In this study, we examine a novel meta-framework to qualify state of the art digital Integrated Quality Management Systems for three engineering programs seeking accreditation. The digital quality systems utilize authentic OBE frameworks and assessment methodology to automate collection, evaluation and reporting of precision CQI data. A novel Remote Evaluator Module that enables successful virtual ABET accreditation audits is presented. A theory based mixed methods approach is applied for evaluations. Detailed results and discussions show how various phases of the meta-framework help to qualify the context, construct, causal links, processes, technology, data collection and outcomes of comprehensive CQI efforts. Key stakeholders such as accreditation agencies and universities can adopt this multi-dimensional approach for employing a holistic meta-framework to achieve accurate and credible remote accreditation of engineering programs.

Syphilis testing performance in Aboriginal primary health care: exploring impact of continuous quality improvement over time.

Data from 110 primary healthcare clinics participating in two or more continuous quality improvement (CQI) cycles in preventive care, which included syphilis testing performance (STP) for Aboriginal and Torres Strait Islander people aged between 15 and 54 years, were used to examine whether the number of audit cycles including syphilis testing was associated over time with STP improvement at clinic level in this specific measure of public health importance. The number of cycles per clinic ranged from two to nine (mode 3). As shown by medical record audit at entry to CQI, only 42 (38%) clinics had tested or approached 50% or more of their eligible clients for syphilis in the prior 24 months. Using mixed effects logistic regression, it was found that the odds of a clinic's STP relative to its first cycle increased only modestly. Counterintuitively, clinics undertaking the most preventive health CQI cycles tended to have the lowest STP throughout. Participation in a general preventive care CQI tool was insufficient to achieve and sustain high rates of STP for Aboriginal and Torres Strait Islander people required for public health benefit. Improving STP requires dedicated effort and greater understanding of barriers to effective CQI within and beyond clinic control.

Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services.

BackgroundManagement of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia.MethodsRetrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. Main outcome measures: diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI.ResultsA total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change.ConclusionsWell-designed health care delivery and CQI systems, with a strong sense of ownership over diabetes management led to increased service delivery rates and improved clinical outcome measures in ACCHSs. Locally run CQI processes may be more responsive to individual health services and more sustainable than externally driven systems.

Effective continuous quality improvement and primary percutaneous coronary intervention

Effective continuous quality improvement and primary percutaneous coronary intervention

CONTROLLED TRIAL OF ADVANCE CARE PLANNING IN NURSING HOMES IN AUSTRALIA

This article makes the case that many nursing home programs labeled as continuous quality improvement (CQI) efforts do not use trademark methods that have made CQI so effective in other settings. Confusion about the distinction between quality assurance and quality improvement is one barrier to implementing effective CQI programs in nursing homes. Another is that federal regulations and reporting systems prompt nursing homes to focus on outcomes as opposed to care processes. 1 Nursing Home Compare. Medicare: The official US government site for people with Medicare web site 2002. Available at: http://www.medicare.gov/NHCOmpare/home.asp. Accessed August 2006. Google Scholar Indeed, data available about care process quality in nursing homes are useful only for regulatory compliance and, perhaps, quality assurance activities designed to avoid survey deficiencies. A radical change in how care processes are documented is needed if CQI is to become a reality in nursing homes, rather than an empty program label. This article discusses how care processes related to daily care provision can be efficiently measured and the data used in CQI programs. It focuses especially on daily care processes implemented by nurse aides because of their paramount importance for enhancing quality of care and life and because research suggests that consumers view this care as both important and problematic.

Developing a CQI Program in a Family Medicine Department

Efforts to implement continuous quality improvement (CQI) principles in ambulatory or primary care settings still lag behind efforts in the hospital setting. Many physicians view the concept of CQI with unconcealed skepticism; the process of ambulatory care is very different from that of hospital-based care; and the data necessary to guide CQI efforts are often either missing or inaccurate in the outpatient setting. Since fall 1995, the Department of Family Medicine (DFM) at the University of Michigan (Ann Arbor), including approximately 35 faculty members at seven family practice sites, has been engaged in CQI projects. The CQI committee had a six-month deadline to lay out a plan for educating all faculty and staff in the importance of the CQI approach to problems; design methods for all faculty and staff to buy in to the concepts; and develop a plan to address basic clinical CQI activities, administrative systems change and work environment improvement, and larger ad hoc projects in clinical care, educational programs, and research programs. CQI activities were incorporated into the routine monthly business agendas at each clinical site, each of which had a functioning local committee and had begun development of at least one CQI project. Cost cutting has further moved CQI from the sideline to center stage in the DFM's activities. An effective CQI program can be a major asset in the current competitive health care market, but designing and implementing an outpatient CQI program is a difficult and complex process. Three major problems--the ongoing resistance to change, the slow pace of adding CQI projects to already overburdened work schedules, and the need to conduct the program with ever-decreasing resources available-persist.

An effective continuous quality improvement approach to the prevention of ventilator-associated pneumonia

In 1989, our medical center used continuous quality improvement concepts in the creation of a Nosocomial Pneumonia Prevention Team whose aim was to significantly reduce nosocomial ventilator-associated pneumonia. The team included representatives from nursing, respiratory therapy, pulmonary medicine, internal medicine, anesthesiology, education and training, and infection control. Because the majority of mechanically ventilated patients were located in the intensive care unit, this unit became the focus of the prevention efforts. Team meetings were held regularly, with all representatives brainstorming barriers, possible interventions, methods of outcome measurement, and frequency of evaluation. Policies and procedures were reviewed, surveillance was increased, handwashing practices were surveyed, periodic feedback to staff was begun, and an educational program was developed and presented. During 1990, we observed a 57% reduction in ventilator-associated pneumonia from the baseline years, 1987 and 1988. Statistical comparison of proportions by z test indicated a p value less than 0.05. Fifteen cases of nosocomial ventilator-associated pneumonia were prevented and a cost saving of $105,000 was realized. Performance of traditional surveillance for outliers, coupled with literature-based thresholds, can lead to tolerance of inordinately high endemic rates. Infection control programs can significantly reduce endemic rates of nosocomial ventilator-associated pneumonia through continuous quality improvement methods and multidisciplinary interventions, with standard infection control procedures used for improvement.