Quality Assurance Framework Research Articles

Development of a framework for quality assurance of off-site manufactured building components: A case study of the New Zealand housing sector

A shortage of housing is a prominent issue across the globe. Traditional on-site construction methods seem too inefficient to meet the increasing housing demand. As a solution, many countries, including the United States, Germany, Singapore, Japan, Hong Kong and Australia, have introduced off-site manufacturing methods to increase the housing supply. Different from the traditional way of on-site construction, off-site manufacturing is a technique that involves manufacturing building components in a controlled environment. Despite strong government support and industry attempts to increase off-site manufacturing, the current building consenting and inspection processes in New Zealand have significant quality-related issues. Therefore, this study aimed to identify the gaps in current quality assurance processes used in off-site manufacturing and recommend a framework in order to gain credibility and the acceptance of the construction market. The study collected qualitative data from industry experts (e.g., developers, architects, engineers, project managers, quantity surveyors, head contractors and council officers) who had significant experience in current quality assurance regimes in New Zealand prefabrication construction. The key themes for designing the proposed framework were generated using content analysis of the primary data collected from semi-structured interviews with industry experts. The study has found that standardisation in off-shore products regarding the New Zealand Building Code remains the biggest challenge in the consenting process. Quality assurance and inspection test plans are the developer’s responsibility and are typically provided by third-party inspectors. In this post-Covid-19 world-building, consent authorities rely heavily on third-party inspection companies that apply more rigorous auditing. Essentially, the most important parts of quality assurance are to have an experienced team and to adopt a holistic approach by engaging stakeholders early in the design stage. The stakeholders should consider recommendations for mandatory after-service insurance to ensure end-customer interests are protected. The findings of this study can contribute to the early engagement of different stakeholders to ensure overseas manufacturing of building components meets New Zealand quality standards. It is expected that the new quality assurance framework would help to promote off-site manufacturing for the New Zealand housing sector.

Review of data quality assessment frameworks experiences around Europe

Abstract In the first phase of its work, WP6 has explored and synthesized existing knowledge and experiences on data quality assurance frameworks (DQAFs) in the context of cross-border sharing of federated secondary use health data. Our aim was to identify good practices within this area and develop a first set of corresponding recommendations. The recommendations reflect the synthesis of results from three parallel lines of work, each utilizing a different methodology: a) thematic workshops and partner meetings, b) analysis of existing data-sharing initiatives, and c) a scoping literature review. Our analysis of literature and existing health data initiatives suggest that currently deployed DQAFs cannot as such serve as platforms or models for an EHDS-wide data quality solution. There is an agreement in principle, that reliability, relevance, timeliness, coherence, coverage and completeness should be incorporated in a DQAF as measurable dimensions of data quality. We aim towards a working definition of data quality, which will be able to reflect the reality of the data, as well as its fitness for purpose from the perspective of potential users. • We recommend focusing efforts on transparency at the level of data holder institutions across Member States in relation to adoption of regular audits, a well-developed DQAF and clear procedures with regard to processing the data. • In the medium to longer-term EHDS nodes could promote and support the development of a benchmarking process, which will assist data managers and data holder institutions with alignment against a Europe-wide approach to measuring data quality within and across Member States.

Review of interoperability standards as data quality supporting elements

Abstract WP6 has approached the target of supporting trustworthy secondary use of health and health care data through two operational objectives: developing the EHDS data quality assurance framework for real-world health data and developing the EHDS secondary use Semantic Interoperability Framework. For the latter objective, several interoperability standards were identified in accordance with the EHDS2 data life cycle and user's journey approach, hence focusing on data discoverability (at data source and variable levels), communication support across nodes and on development of common data models. Selection was based on active participation of WP6 leaders in various pertinent workshops and interactive activities, both in the framework of TEHDAS (Stakeholder and Project Forum meetings) as well as other relevant initiatives (e.g. the PHIRI project). Input was also sought from Commission representatives and EU-level regulatory authorities. In a first step, standards were catalogued based of features such as typology of interest, utility and application domains. In the next phase we organised virtual semi-structured interviews with key representatives of over 20 standards (incl. HL7, SNOMED, CDISC, DCAT, OMOP etc.). The focus of the interviews targeted experiences in standards’ actual use, challenges in their implementation, issues of maintenance and sustainability, as well as undergoing collaborations and developments. Sessions were recorded and subsequently the transcripts of discussion extracted automatically. The process of analysing interview materials is presently ongoing, using an adapted version of the Common Assessment Method for Standards and Specifications (CAMSS) v.4.0.0. toolkit. Interim results will be discussed within the Joint Action meeting activities in June 2022, to produce a version for wider stakeholder dialogue later in the fall. Results and recommendations generated through this process will also be presented for discussion with the workshop audience.

Efficacy and safety in ketamine-guided prehospital analgesia for abdominal pain.

Abdominal pain is a common reason for presentation in the emergency department and for calling emergency medical services. The complexity of abdominal pain also influences the analgesia strategy. However, there are almost no data on the use of ketamine for abdominal pain. This study aims to analyze the safety and efficacy of using ketamine as an analgesic for abdominal pain. In a retrospective analysis of prehospital patient data within the framework of quality assurance, all cases with ketamine administered by paramedics as analgesia for abdominal pain were analyzed in terms of pain reduction and patient safety and also compared with other analgesic drugs including fentanyl, morphine, and metamizole. From 01/01/2018 to 11/24/2021, 129 datasets were analyzed. The mean patient age was 50 ± 19years (19-90years), with 47.3% (n = 61) women. The application of fentanyl was documented as a monotherapy in 10.9% (n = 14), morphine in 2.3% (n = 3), metamizole in 34.1% (n = 44), and ketamine in 52.7% (n = 68) of cases. The pain relief of fentanyl, metamizole, and ketamine differed significantly from each other (p < 0.001), with fentanyl and ketamine being comparable. Looking at the quality assurance definition of successful analgesia (pain on handover NRS < 5 or pain reduction ≥ 2 points), successful analgesia was shown in 92.9% (n = 13) of cases for fentanyl, in 65.9% (n = 44) for metamizole, and 92.6% (n = 68) for ketamine (p < 0.001). Adverse events were not observed in patients treated with ketamine. Analgesia is an important goal in the treatment of patients with abdominal pain. With ketamine, analgesia comparable to fentanyl can be achieved. Ketamine appears to be a safe and effective option for the treatment of patients with abdominal pain in emergency medicine.Trial registration number DRKS00027343, date of registration: 09.12.2021, retrospectively registered.

An Assessment of the Internal Quality Assurance Mechanisms at the Open University of Tanzania

The purpose of this study was to assess the status of Quality Assurance systems at the Open University of Tanzania (OUT) as well as give recommendations for improvement. The study employed the exploratory sequential mixed methods design that had three phases. The study sample comprised of one senior staff from the Quality Assurance directorate and 12 Heads of departments. Data was collected through an interview and a questionnaire. Qualitative data was analysed thematically while quantitative data was analysed descriptively using frequencies and mean. The study established that OUT had put in place an elaborate Quality Assurance (QA) framework with a directorate of QA headed by a director under the office of the Vice Chancellor. The university also had an IQA policy document as well as a QA handbook. The QA directorate had embraced the use of ICT as it employed online tools for monitoring various activities in the institution. The university also carried out a Self-Assessment every five years. However, the IQA at the university was faced by the following challenges: inadequate funding, understaffing of the IQA directorate, negative attitude by university staff towards QA staff, lack of involvement of HoDs in planning QA activities amongst others. The study recommends the following: the university should adequately staff and fund the QA directorate; the QA directorate should develop its activities in a participatory manner; and the QA directorate should increase sensitization of the university community on QA policies and issues.

Higher education quality assurance: the case of the United States

The purpose of this article is to provide an overview and critique of higher education quality assurance in the context of the United States (US), reviewing the US model in terms of its history, characteristics, problems and controversies, in an effort to extract lessons that are applicable to other countries, including Brazil. The study examines topics such as institutional rankings, student learning assessment, the role of government in the university accreditation process and the challenge of assuring the quality of for-profit institutions. The article concludes with a list of recommendations extracted from the US experience that could conceivably contribute to the improvement of quality assurance frameworks in other parts of the world.

Garantia de qualidade do ensino superior: o caso dos Estados Unidos

The purpose of this article is to provide an overview and critique of higher education quality assurance in the context of the United States (US), reviewing the US model in terms of its history, characteristics, problems and controversies, in an effort to extract lessons that are applicable to other countries, including Brazil. The study examines topics such as institutional rankings, student learning assessment, the role of government in the university accreditation process and the challenge of assuring the quality of for-profit institutions. The article concludes with a list of recommendations extracted from the US experience that could conceivably contribute to the improvement of quality assurance frameworks in other parts of the world.

A statistical quality assurance framework for the United Nations

A statistical quality assurance framework for the United Nations

How the “lessons learned” from emergency remote teaching can enrich European higher education in the post-COVID-19 era

More than 2.5 years after the outbreak of the COVID-19 pandemic and the lessons learned from the implementation of emergency remote teaching in (European) higher education, this essay reflects on how universities, governments, and policy makers can re-imagine higher education in the post-COVID-19 era. It envisions universities as inclusive, student-centered, and accessible organizations capable of meeting diverse learning needs through technology-enhanced high-quality academic programs. This can be achieved through wide-scale uptake of blended learning in higher education; capacity building for stakeholders on online/blended learning; consideration of the unique needs of its stakeholders; and a holistic quality assurance framework. The author’s proposal is evolving, and its elements can be adjusted to the strategic priorities and characteristics of each institution.

A Cloud-based Framework for Quality Assurance and Enhancement as a Service (QAEaaS) for Universities with Blended Learning Approach

The dynamic and multi-dimensional quality assurance process for Saudi higher education institutes under the National Commission for Academic Accreditation and Assessment (NCAAA) demands an integrated framework for management and support of internal quality reviews and evidence-based self -studies in a cost-effective way. Due to cross-institutional involvement, quality assurance compliance with NCAAA standards is even more challenging for institutes offering courses with blended learning paradigm in multiple campuses. This papers proposes a Cloud-based framework to realize Quality Assurance and Enhancement as a Service (QAEaaS) to facilitate the internal quality reviews by providing efficient data management and effective communication for different stakeholders. Architecture of the proposed framework is described with respective features to cope with the identified quality assurance challenges and issues faced by the Saudi higher education institutes.

Measuring and controlling medical record abstraction (MRA) error rates in an observational study

BackgroundStudies have shown that data collection by medical record abstraction (MRA) is a significant source of error in clinical research studies relying on secondary use data. Yet, the quality of data collected using MRA is seldom assessed. We employed a novel, theory-based framework for data quality assurance and quality control of MRA. The objective of this work is to determine the potential impact of formalized MRA training and continuous quality control (QC) processes on data quality over time.MethodsWe conducted a retrospective analysis of QC data collected during a cross-sectional medical record review of mother-infant dyads with Neonatal Opioid Withdrawal Syndrome. A confidence interval approach was used to calculate crude (Wald’s method) and adjusted (generalized estimating equation) error rates over time. We calculated error rates using the number of errors divided by total fields (“all-field” error rate) and populated fields (“populated-field” error rate) as the denominators, to provide both an optimistic and a conservative measurement, respectively.ResultsOn average, the ACT NOW CE Study maintained an error rate between 1% (optimistic) and 3% (conservative). Additionally, we observed a decrease of 0.51 percentage points with each additional QC Event conducted.ConclusionsFormalized MRA training and continuous QC resulted in lower error rates than have been found in previous literature and a decrease in error rates over time. This study newly demonstrates the importance of continuous process controls for MRA within the context of a multi-site clinical research study.

Translating knowledge into practice for communication skills training for health care professionals

Despite the evidence that person-centred communication underpins all that we do in our interactions with patients, caregivers and team members, the knowledge about the implementation of systematic communication skills training is still in its infancy. This position paper describes some of the main contextual facilitators for translating knowledge about communication skills training for health care professionals (HCP) and recommends ways to guide practical implementation. Based on the literature that has been published over the last two decades, it seems evident that communication skills training programs should be underpinned by clinician self-reflection, be experiential, and focused on behaviour change and implementation of new skills into practice. The programs should be delivered by trainers possessing an understanding of communication micro skills, the skills and confidence to observe interactions, and coach learners through the rehearsal of alternative approaches. Communication skills programs should be flexible to adapt to individual learners, local needs, and circumstances. Interventions should not be limited to the empowerment of individual HCP but should be a part of the organisational quality assurance framework, e.g., by including communication skills in clinical audits.Implementation science frameworks may provide tools to align programs to the context and to address the determinants important for a sustained implementation process. Programs need to be embedded as ‘core business’, otherwise the culture change will be elusive and sustainability under threat if they are only dependent on provisional funding.

Performance evaluation of a multinational data platform for critical care in Asia

Background: The value of medical registries strongly depends on the quality of the data collected. This must be objectively measured before large clinical databases can be promoted for observational research, quality improvement, and clinical trials. We aimed to evaluate the quality of a multinational intensive care unit (ICU) network of registries of critically ill patients established in seven Asian low- and middle-income countries (LMICs). Methods: The Critical Care Asia federated registry platform enables ICUs to collect clinical, outcome and process data for aggregate and unit-level analysis. The evaluation used the standardised criteria of the Directory of Clinical Databases (DoCDat) and a framework for data quality assurance in medical registries. Six reviewers assessed structure, coverage, reliability and validity of the ICU registry data. Case mix and process measures on patient episodes from June to December 2020 were analysed. Results: Data on 20,507 consecutive patient episodes from 97 ICUs in Afghanistan, Bangladesh, India, Malaysia, Nepal, Pakistan and Vietnam were included. The quality level achieved according to the ten prespecified DoCDat criteria was high (average score 3.4 out of 4) as was the structural and organizational performance -- comparable to ICU registries in high-income countries. Identified strengths were types of variables included, reliability of coding, data completeness and validation. Potential improvements included extension of national coverage,optimization of recruitment completeness validation in all centers and the use of interobserver reliability checks. Conclusions: The Critical Care Asia platform evaluates well using standardised frameworks for data quality and equally to registries in resource-rich settings.

Blended Teaching in Tertiary Education: Framework for Building the Capacity of HEI for Paradigm Shift

The study determined the learners’ preparedness and acceptability of blended learning in the higher education educational landscape. The study was quantitative in nature and used a survey that was delivered by a purposive sampling of respondents. The findings demonstrated a high level of satisfaction among learners in the overall characteristics of blended learning. The results also revealed a very high approval rate for the adoption of blended teaching pedagogy. The findings provide a better understanding of the importance of technology in the classroom will aid educators and policymakers in formulating methods to expand the quality assurance framework to include blended learning approaches as well as improve the government’s mobilization in the procurement of ICT resources for every classroom. Keywords: Blended Teaching-Learning, Education 4.0, Fourth Industrial Revolution

Recognition of prior learning: implications for quality assurance in higher education

PurposeA diverse range of initiatives in relation to the recognition of prior learning (RPL) have been introduced in higher education systems over the past 20 years. This paper aims to explore the implementation of RPL initiatives, in an Irish context, and the implications for quality assurance in higher education.Design/methodology/approachA qualitative approach is adopted, to provide an enhanced understanding of the impact of RPL initiatives. Data is presented from interviews with key stakeholders: six academics, six coordinators and six learners who availed of RPL.FindingsThe introduction of RPL requires higher education institutions to adopt new approaches to the design and delivery of their programmes and also to review and revise quality assurance frameworks. This paper presents key insights across five over-arching themes (ambitions and outcomes; caution and suspicion; in the classroom; assessment and examinations; and life after university).Originality/valueThe introduction of RPL evokes a mixed reaction from stakeholders, and there is a range of differing experiences, leading to differences in attitudes and unintended impacts. This study provides insights both at an individual and institutional levels using experiential learning theory.

Machine learning-based detection of aberrant deep learning segmentations of target and organs at risk for prostate radiotherapy using a secondary segmentation algorithm

Objective. The output of a deep learning (DL) auto-segmentation application should be reviewed, corrected if needed and approved before being used clinically. This verification procedure is labour-intensive, time-consuming and user-dependent, which potentially leads to significant errors with impact on the overall treatment quality. Additionally, when the time needed to correct auto-segmentations approaches the time to delineate target and organs at risk from scratch, the usability of the DL model can be questioned. Therefore, an automated quality assurance framework was developed with the aim to detect in advance aberrant auto-segmentations. Approach. Five organs (prostate, bladder, anorectum, femoral head left and right) were auto-delineated on CT acquisitions for 48 prostate patients by an in-house trained primary DL model. An experienced radiation oncologist assessed the correctness of the model output and categorised the auto-segmentations into two classes whether minor or major adaptations were needed. Subsequently, an independent, secondary DL model was implemented to delineate the same structures as the primary model. Quantitative comparison metrics were calculated using both models’ segmentations and used as input features for a machine learning classification model to predict the output quality of the primary model. Main results. For every organ, the approach of independent validation by the secondary model was able to detect primary auto-segmentations that needed major adaptation with high sensitivity (recall = 1) based on the calculated quantitative metrics. The surface DSC and APL were found to be the most indicated parameters in comparison to standard quantitative metrics for the time needed to adapt auto-segmentations. Significance. This proposed method includes a proof of concept for the use of an independent DL segmentation model in combination with a ML classifier to improve time saving during QA of auto-segmentations. The integration of such system into current automatic segmentation pipelines can increase the efficiency of the radiotherapy contouring workflow.

An integrated quality assurance and assessment framework for matchmaking seniors needs with AAL solutions

An integrated quality assurance and assessment framework for matchmaking seniors needs with AAL solutions

Living donor hepatectomy in medium volume liver transplant centre has comparable outcomes to high volume centres: validation of donabedian quality assurance framework.

Given the complexity of living donor hepatectomy, it is expected that high hospital volume will better outcomes. This study aims to evaluate post-operative outcomes for living donor hepatectomy in a medium volume liver transplant centre and compare to outcomes in high volume centres. Also, it serves as a validation tool for framework of structure-process-outcome model for safe living donor hepatectomy program. 204 donors who underwent donor hepatectomy between June 1996 to September 2019 were reviewed retrospectively and compared to outcomes in high volume centres. At 6 months, overall donor morbidity rate was 20/204 (9.8%). Wound complications were most common at 5/204 (2.5%). Majority of complications were either Clavien grade 1 or 2 and only 3 donors had Clavien grade 3 complications. There was zero donor mortality. Our centre's donor morbidity rate of 9.8% is the one of the lowest reported in the published literature. With increased experience, stringent donor selection and enhanced perioperative care by a multi-disciplinary team, outcomes in a medium volume centre can match the outcomes reported in high volume centres. The framework for quality in terms of structure, process and outcomes is presented which can be adopted for developing programs.

Do European quality assurance frameworks support integration of transformative learning for sustainable development in higher education?

PurposeA transition toward sustainable development requires engagement of university students in transformative learning. Therefore, quality frameworks and processes should support deep approaches to sustainable development in higher education. Research and initiatives that connect sustainable development, higher education and quality assurance (QA) are lacking. This study aims to explore to what extent quality assurance agencies in Europe support transformative learning for sustainable development in their frameworks.Design/methodology/approachThe authors conducted a qualitative analysis of national QA frameworks in the European Higher Education Area (EHEA) to assess whether they support transformative learning for sustainable development. First, frequency analysis was undertaken; second, a blended coding approach was used to investigate whether and how transformative learning for sustainable development is addressed.FindingsOverall, the authors found little support for transformative learning for sustainable development in most QA frameworks. One exception is the framework of the United Kingdom, which includes a specific guide on education for sustainable development wherein transformative learning is prominently mentioned. To a lesser extent, some support exists in the frameworks of Estonia, Holy See, Romania, Sweden, Switzerland and Ukraine. Although the transformative learning for sustainable development approach is not explicitly mentioned in most QA frameworks, many of them contain opportunities to highlight it. France and The Netherlands offer guidelines and criteria for acquiring a sustainable development label, while Andorra suggests including the sustainable development goals in institutional quality assessment.Originality/valueThe research provides the first map of how countries within the EHEA support transformative learning for sustainable development in national QA systems.

Agile methodology in higher education quality assurance system for SDGs 4, 8 and 9 achievement: national experience

This paper is focused on considering agile methodology as an instrument to use in education quality assurance. We propose the Scrum method applicable for education quality assurance based on adapted Manifesto for Agile Education Quality Assurance and twelve principles behind it. The Scrum procedure is described and roles are distributed for two real-life cases of external and internal educational program quality evaluation. We illustrate that proposed Scrum procedure perfectly fits existing practices and can be used to enhance both external and internal quality assurance processes in higher education. We consider achievement of SDG 4 targets through proposed methodology as the necessary step to take in achieving SDGs 8 and 9. It is concluded that stakeholders feedback about their satisfaction by economic and innovative factors should be included in each sprint review procedure in proposed Scrum methodology. We discuss SDG 4 achieving within multilayered DIKW+DM hierarchy as a framework for education quality assurance that allow to join information processing, knowledge acquisition and corresponding decision-making algorithm.