Identify Performance Gaps Research Articles

Plywood Proficiency: Navigating Quality Assurance in Manufacturing

Proficiency testing (PT) plays a vital role in the plywood manufacturing industry, acting as a quality assurance tool to maintain high standards in product consistency and reliability. This study evaluates the effectiveness of PT in identifying and addressing quality issues within plywood production, focusing on three main objectives: assessing PT’s role in uncovering quality problems, analyzing root causes, and proposing targeted solutions for process improvement. The research involved eight laboratories evaluating the Modulus of Rupture (MoR) and Modulus of Elasticity (MoE) of plywood samples, with results statistically analyzed to measure inter-laboratory consistency and identify performance gaps. To ensure reliable testing, the PT samples were prepared in line with IS 303:1989 standards, emphasizing homogeneity and stability. Statistical analyses revealed variability among laboratories, highlighting areas for improvement in material handling and testing protocols. The study found that PT is instrumental for the industry, not only in identifying discrepancies but also in fostering a culture of continuous quality enhancement. Recommendations for improvement include refining the adhesive application, optimizing pressing parameters, ensuring accurate layer alignment, and implementing thorough end-of-line inspections. Quality control measures such as random sampling, supplier audits, and traceability systems are also recommended to maintain consistency. The study advocates for comprehensive employee training and cross-functional collaboration across production, quality assurance, and R&D teams to enhance overall product quality. By addressing critical process variables and leveraging PT as a benchmarking tool, plywood manufacturers can meet regulatory standards and customer expectations. This research underscores the importance of PT in delivering actionable insights for improving product quality and reliability, ultimately supporting the industry’s growth and commitment to safe, high-quality plywood products.

INFLUENCE OF CAPABILITIES FOR RESOURCE MOBILIZATION ON THE PERFORMANCE OF THE LOCAL AUTHORITIES IN ZAMBIA

This study examined the influence of resource mobilization capabilities on the performance of local authorities in Zambia, addressing a decade-long performance challenge despite various government interventions. Using a correlational research design with a sample of 736 employees from 116 local authorities, the study tested the hypothesis that there is no statistically significant influence of resource mobilization capabilities on the financial performance of local authorities. Data collected through a structured questionnaire and analyzed using multiple linear regression revealed a significant positive relationship between capabilities for resource mobilization and local authorities' performance (B = 0.272, t = 6.516, p < .001), with the model explaining 63.7% of the performance variance. While local authorities demonstrated strengths in developing annual work plans, they struggled to provide all required public services. The study concludes that resource mobilization capabilities significantly influence local authorities' performance in Zambia and recommends enhancing resource mobilization strategies, improving service delivery capabilities, promoting knowledge sharing among local authorities, investing in technology-enabled systems for revenue collection and management, and implementing standardized performance management practices to address the identified performance gaps and improve overall public service delivery.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0745/a.php" alt="Hit counter" /></p>

Ensuring Quality and Consistency in OPC-53 Cement Testing: A Comprehensive Proficiency Testing Evaluation

The proficiency testing (PT) program is a critical part of quality assurance in laboratories, especially within industries like construction where cement testing is essential. This study provides a comprehensive evaluation of the fifth PT scheme for Ordinary Portland Cement (OPC) grade 53, conducted by the Nodal Laboratory. The key parameters assessed in this program were standard consistency, compressive strength, and soundness using the Le-Chatelier method. Twenty-four laboratories participated, and their performance was analyzed using advanced statistical methods, adhering to ISO 17043:2010 and ISO 13528:2015 standards. The results showed that most laboratories performed satisfactorily, with only one outlier identified in the soundness test. This paper covers all aspects of the PT program, from sample preparation to the distribution of materials, as well as the homogeneity and stability tests conducted on the samples. Statistical evaluation was carried out using Z-scores, which allowed the laboratories to be ranked according to their performance in each parameter. This method highlights discrepancies and provides a clear framework for participating laboratories to improve their testing procedures. Proficiency testing is essential for maintaining high standards in laboratory performance. It helps standardize testing methods across multiple laboratories, ensuring that OPC-53 cement meets strict quality and performance specifications. The program enables laboratories to identify performance gaps and take corrective actions, ensuring the reliability and accuracy of results. Participation in PT programs is a step toward continuous improvement, keeping laboratories aligned with international standards, ultimately benefiting the broader construction industry by ensuring the structural integrity of buildings and infrastructure. This study underscores the importance of regular PT participation. It not only provides a benchmark for laboratory performance but also ensures compliance with ISO standards. This fosters the consistent quality of cement used in large-scale construction, reducing the risk of structural failures and contributing to long-term safety and durability. The findings demonstrate the positive impact of PT programs on overall testing accuracy and laboratory reliability, emphasizing their role in advancing best practices in the construction industry.

A system readiness approach to support the packaging and scaling of innovation bundles for farming systems transformation

CONTEXTA newly established ‘systemic approach to technology packaging’ for improved scaling has emerged in the literature. This approach suggests that core transformative innovations can be scaled more effectively through scaling readiness, which helps identify complementary innovations that support and facilitate the scalability of the core innovation. Since these packaging approaches start with single core innovations, we propose that they can benefit from the broader literature on sustainable agricultural systems transformation and readiness. OBJECTIVEThe objective of this paper is to advocate for a more comprehensive packaging of innovations for sustainable agricultural system transformations by better understanding gaps in the agricultural system – and its capacity for change. This approach provides a stronger rationale for the selection of relevant innovations to be packaged together. We introduce the concept of agricultural ‘system readiness’ as a possible framework for guiding such bundles. METHODSThe paper begins with a comprehensive literature review that identifies the current gaps in tools and methods to guide system transformation. It also focuses on the specific literature on innovation packaging for scaling, and builds on the gaps of existing approaches as a rationale for introducing the concept of system readiness (mostly used in infrastructure engineering), and adapting it to agricultural science. We also use illustrative hypothetical examples from mixed crop-livestock systems in the drylands to show how two approaches – ‘packaging for scaling’ and ‘packaging for transformation’ – can lead to different innovation packages. RESULTS AND CONCLUSIONSThe concept of system readiness is introduced, defined and advocated. We show that it can help identify performance gaps in agricultural systems and guide better planning for system strengthening and integration. We conclude with possible complementarities between the two approaches of scaling and system readiness. SIGNIFICANCEThe agricultural system readiness approach, as outlined in this paper, would be particularly beneficial for agricultural research-for-development, as well as other agricultural investment programs that seek to identify strategies for fostering sustainable transition in farming systems. Such programs would typically entail complexity-aware theories of change that focus on stimulating sustainable transformation pathways related to key target areas, such as agroecology, sustainable intensification, and system integration (e.g., crop-livestock integration and integrated pest management). The system readiness approach can support such programs through the identification, prioritization, targeting, and empowerment of the most significant (and transformative) system components by identifying respective innovations to be packaged.

Suočavanje s izazovima u vezi s ocjenjivanjem zelene gradnje prema LEED-u u Turskoj

This study examined the effectiveness of the LEED green building rating system and identified performance gaps in developing countries using Türkiye as a case study. The analysis of 134 LEED Platinum V4-certified buildings in Turkiye revealed discrepancies in high-priority sites, site evaluation, building product definition and optimisation, and low-emission material credits compared with other countries. Variations in energy, atmosphere, and indoor environmental quality criteria were also noted within LEED Platinum-certified buildings in Turkiye. The study concludes that while LEED is widely embraced, local standards and contextual factors must be considered when implementing these programs.

Assessing Sustainability Performance at Farm Level in the Kingdom of Bahrain

Crop production in Bahrain is facing many challenges that may undermine farm's sustainability. Farmers are an important player and assessing farm’s sustainability to identify performance gaps is essential. This study aims to measures farm sustainability in Bahrain using Response-Inducing Sustainability Evaluation (RISE) tool accompanied by field visit observations. The assessment was carried out on 29 farms and applied on 8 themes. The study contributed by configuring RISE's regional data to match Bahrain's conditions through the adjustment of some evaluation functions. The application of RISE showed that the average score of the 29 farms was (63 points) which indicates the requirement of additional improvement. Farms fared well in five themes (quality of life, water use, working conditions, soil use, and farm management). Whereas it performed low in three themes (Material Use, Biodiversity & Economic viability). Quality of life theme received the highest score (76 points), while biodiversity was the lowest (34 points). RISE application was successful; however, land tenure needs to be considered to improve local sustainability. Despite the presence of lands that are classified as agriculture but unexploited, it is suggested to encourage landowners exploiting the lands or rent them out to other farmers. In addition, the development of good agricultural practises guidelines is vital.

Promoting TVET excellence in Palestine: a case study of WBL in secondary vocational schools

ABSTRACT Reporting findings from action research in Secondary Vocational Schools (SVSs) in Palestine contributes to our understanding of the five criteria that underpin excellence in Work-Based Learning (WBL) This paper presents a new model for promoting WBL performance for SVSs in Palestine by focusing on five key indicators derived from previous research analysis and findings for the researcher of this paper, the European Foundation for Quality Management (EFQM) and the Quality, Cost and Delivery (QCD) model. This paper addresses the question of how to promote WBL in SVSs in Palestine? In-depth interviews with 52 school personnel and 85 students from three SVSs in Palestine were conducted. A five-question descriptive questionnaire was administered to all respondents to assess the five key performance indicators to identify performance gaps. Analysis of the responses provides an understanding of the causes of the gaps and helps provide explanations to develop an action plan to improve performance.

Addressing challenges in LEED green building ratings in Türkiye

This study examined the effectiveness of the LEED green building rating system and identified performance gaps in developing countries using Türkiye as a case study. The analysis of 134 LEED Platinum V4-certified buildings in Turkiye revealed discrepancies in high-priority sites, site evaluation, building product definition and optimisation, and low-emission material credits compared with other countries. Variations in energy, atmosphere, and indoor environmental quality criteria were also noted within LEED Platinum-certified buildings in Turkiye. The study concludes that while LEED is widely embraced, local standards and contextual factors must be considered when implementing these programs.

Patient Safety Indicators at an Academic Veterans Affairs Hospital: Addressing Dual Goals of Clinical Care and Validity

Hospital-acquired complications add to patient morbidity and mortality, costs, length of stay, and negative patient experience. Patient Safety Indicators (PSIs) are a validated and widely used metric to evaluate hospital administrative data on preventing these events. Although many studies have addressed PSI validity, few have aimed to reduce PSI through clinical care. The authors aimed to reduce PSI events by addressing both validity and clinical care. Frontline clinicians used a deep dive template to provide input on all PSI cases, which were then reviewed by a PSI task force to identify performance gaps. After analyzing the frequency of gaps and cost-vs.-impact of potential solutions, five interventions were implemented to address the three most common, highly weighted PSIs: pressure ulcers, postoperative venous thromboembolism (VTE), and postoperative sepsis. Clinical care interventions included increasing patient mobility by creating a specialized mobility technician position, skin care audits to prevent pressure ulcers, and increasing use of pharmacologic VTE prophylaxis. Administrative interventions addressed improving clinician-coding concordance for sepsis and increasing documentation of comorbidities. After interventions, the number of PSI events for composite PSI, VTE, and sepsis decreased by 41.3% (p = 0.039), 85.2% (p = 0.0091), and 51.5% (p = 0.063), respectively, relative to the preintervention period. Pressure ulcers increased by 33.3% (p = 0.0091). Hospital complications cause substantial burden to hospitals, patients, and caregivers. Addressing administrative and clinical factors with targeted interventions led to reduction in composite PSI. Further efforts are needed locally to reduce the pressure ulcer PSI.

Integrated post-occupancy evaluation and intervention that achieve real-world zero-carbon buildings

Many building standards are available worldwide to support sustainable building design. However, most of them only define compliance before occupancy, overlooking the real building usage and its implications for meeting zero-carbon targets. This research proposes a systematic post-occupancy evaluation and intervention (POEI) protocol to analyse real building performance and support cost-effective and zero-carbon upgrading. The novelty lies in integrating novel diagnostic data science techniques to identify performance gaps, advanced physics-driven energy modelling iteratively calibrated with POE data to disaggregate energy use by end-use, and cost-optimal intervention analysis. The POEI protocol has been validated in a university building. The results demonstrated the POEI benefits for the cost-optimal upgrading of in-use building assets based on real needs. By optimising control, reducing demand, increasing efficiency, and implementing renewables, the building can reach the nearly zero-carbon building target with a payback period of 13 years and a 23 % lower life-cycle cost compared to the baseline scenario. Building energy management interventions were identified as the most important actions to reduce the performance gap, reducing energy consumption by 20 % and carbon emissions by 24 %. The results also highlight the critical role of Information and Communication Technologies (ICT), which may represent up to 49 % of energy use in the future zero-carbon building scenario if overlooked.

Pizzaluv-Math: Analysis of Learning Media Needs to Make It Easy for Students to Learn the Limits of Trigonometric Functions

One of the teacher's pedagogical skills is using media for learning purposes, such as creating and disseminating learning materials through media. The purpose of this study is to analyze the necessity of Pizzaluv means in the learning model of the Base Learning project on the limits of trigonometric functions with the Pizzaluv high school math task by testing the possibility of modelling the habit Students' familiarity with using media, therefore, requires an alternative learning material to help students learn math. The research methodology included the needs analysis (Analysis) steps of the ADDIE (Analysis, Design, Development, Implementation, Evaluation) development methodology. The needs analysis includes Identifying performance gaps, Developing instructional goals, Identifying student characteristics, Identifying required resources, Determining appropriate learning strategies, Preparing training plans, and Managing programs/projects. The results of this need analysis form the basis for implementing a Pizzaluv problem. The resulting Pizzaluv is a fun and appropriate math Pizzaluv for the independent learning theme

The Role of Specialty Certification in Career-Long Competence.

Across the medical profession there is broad acceptance of the critical role of continuing medical education (CME) in enabling physicians to adapt to both new information and evolving expectations within the profession. In the presence of widespread participation in CME, some have attempted to question, discredit, or marginalize the role of ongoing lifelong assessment of physician knowledge and skills through specialty continuing certification, advocating instead for a participatory standard based only on engagement with CME. This essay outlines the limitations of physician self-evaluation and clarifies the need for external assessments. Certification boards' role is to set specialty-specific standards for competence, assess to those standards, and assure the public that certified physicians are adequately maintaining their skills and abilities; doing so credibly necessarily requires, in part, independent assessments of physician competence. In these contexts, the specialty boards are taking approaches to identify performance gaps and leverage intrinsic motivation to facilitate physician engagement in targeted learning. Specialty board continuing certification plays a unique role, distinct from and complementary to the CME enterprise. Calls to eliminate continuing certification requirements beyond self-directed CME are contradictory to the evidence and fail the profession and the public.

PENERAPAN METODE BUSINESS MODEL CANVAS DAN PETA EMPATI PADA USAHA MIKRO KECIL DAN MENENGAH (UMKM) KEBAB DURIAN UCOK

The research explores the development of a business model for UMKM Kebab Durian Ucok using business model canvas analysis, empathy maps, and gap analysis. As an MSME, Kebab Durian Ucok plays an important role in the national economy. Understanding the business model, customer needs, and identifying performance gaps is critical to Kebab Durian Ucok's continued growth and competitiveness.The study begins by providing an overview of the challenges faced by Kebab Durian Ucok as MSMEs in the food industry and emphasizing the importance of strategic planning in business. This study provides an overview and relevance of business model canvas analysis, empathy maps, and gap analysis of business competition.The research framework begins with digging up internal information related to the initial description of the strategy and business model that will produce a value proposition, then an analysis of customer insights with an empathy map is carried out to obtain information from the external side that will produce a customer value proposition, from these results a gap analysis is carried out. The gap is then used as material for evaluating the improvement of the strategy using the new business model canvas.The results obtained are in the form of nine block elements of the UMKM Kebab Durian Ucok canvas business model, the needs and desires of customers consisting of product taste, price suitability, product variety, fresh durian content, texture, and service, as well as the gap between the value proposition and the customer's value proposition. The gap is in the aspects of product attractiveness, information reach, price suitability, and service. The recommended business model strategy is the addition of value proposition, key activities, channels, and key partners element blocks.

Benchmarking as a Measure of Competitiveness in North Macedonia

Benchmarking is crucial in positioning companies on the market and achieving high financial results. Nowadays, processes, products, services and globally all segments of a business are subject to constant changes. Hence, keeping up with the activities and changes of competitors is of paramount importance. This work explores the benchmarking concept and its importance in keeping up with competition. Given the lack in existing literature, this paper contributes with an unswerving comprehension of benchmarking practices in North Macedonia, while providing foundation and directions for professionals. By using random sampling, we collect survey data from managers in North Macedonia and explore the openness to learning, implementation of changes and realistic goal setting of the subject entities. We conclude that most of the companies that took part in this research use benchmarking. Our empirical findings indicate that competitive benchmarking as well as realistic goal setting by identifying performance gaps are largely adopted practices in the Macedonian entities. We also establish that benchmarking is not a prerequisite for learning in the surveyed organizations. Nonetheless, the proportion of adopters is expected to increase as managers become more familiar with the concept of benchmarking and the benefits it can bring if applied correctly and consistently.

Lateral Canthotomy/Cantholysis Performance Gap Analysis and Training Recommendations for Expeditionary Physicians.

Preservation of life, preservation of limb, and preservation of eyesight are the priorities for military medical personnel when attending to casualties. The incidences of eye injuries in modern warfare have increased significantly, despite personal eye equipment for service members. Serious eye injuries are often overlooked or discovered in a delayed fashion because they accompany other life- and limb-threatening injuries, which are assigned a higher priority. Prehospital military ocular trauma care is to shield the eye and evacuate the casualty to definitive ophthalmic care as soon as possible, with exceptions for treatment of ocular chemical injury and orbital compartment syndrome. Retrospective analysis of eye injuries in recent conflicts identified gaps in clinical capabilities with up to 96% of ocular injuries being suboptimally managed. Ocular compartment syndrome (OCS) is a complication associated with orbital hemorrhage, where significant morbidity occurs as a result of increasing intracompartment pressure. The ischemic tolerance of the retina and optic nerve is approximately 90 minutes, so OCS must be rapidly diagnosed and aggressively treated through lateral canthotomy/cantholysis (LC/C) to prevent permanent vision loss. LC/C procedures consist of using hemostats to crush the lateral canthal fold and cutting the lateral canthal tendon from the inferior crus to relieve increasing intracompartment pressure. The purpose of this study was to examine the baseline capabilities of military physicians and surgeons to accurately and independently perform the LC/C procedures and identify performance gaps that could be closed through focused professional development activities. This study received institutional review board approval at our institution. A total of 60 subjects voluntarily participated in the study from emergency medicine (15), general surgery (28), and ophthalmology (17). All procedural assessments were performed 1:1 by expert faculty ocular trauma specialists using a high-reliability eye trauma simulator (Sonalysts, Inc.). The competency standard was set at independent and accurate completion of all procedural components and all critical procedural components. Analyses were performed using descriptive statistics and analysis of variance to examine between-group differences (P < 0.05). There was a significant difference between the total score performance and the critical score performance for the three groups (P < 0.001). Outcomes indicate a significant linear relationship between the expertise level of the clinical provider and the procedural performance of LC/C. Outcomes demonstrate the baseline surgical capabilities of the general surgeons transferred to LC/C performance; however, they were unfamiliar with the anatomy and the procedural techniques and requirements. The group of emergency medicine participants demonstrated performance gaps not only in the same areas as the general surgeons but also in their baseline surgical abilities. This suggests that different professional development activities are necessary for surgeons and physicians tasked with performing LC/V procedures. We identified significant performance gaps among emergency medicine physicians, general surgeons, and ophthalmologists in their abilities to recognize and treat OCS through LC/C procedures. These sight-saving procedures are a critical competency for forward-situated clinicians in expeditionary contexts. We identified the need for targeted approaches to professional development for closing the performance gaps for both emergency medicine physicians and general surgeons.

The truant distributor: retain or replace?

Learning outcomes This case highlights the challenges faced by a young and inexperienced Area Sales Manager (ASM), early in her career. This is an often-encountered situation by fresh graduates. Through the analysis of the case, the students will be able to: ■ understand challenges a young manager faces in taking over a new, unfamiliar and underperforming territory; ■ analyze and learn to manage data and identify performance gaps in the territory, by selecting the right metrics; ■ learn the factors for evaluating the performance of current intermediaries (distributors); and ■ appreciate the importance of managing all stakeholders – internal team and building a strong relationship with the intermediaries – both distributors and retailers. Case overview/synopsis Kavita Kaur, the new Area Sales Manager at Broadway India Pvt. Ltd. (BIPL), had just taken over the Chhattisgarh sales territory in January 2020. Fresh out of a B-school, it was her first job, and her allotted territory was severely lagging growth at only 1%, compared to an all-India country growth at 13% in 2019, over the previous year. The territory was operated by established intermediaries (distributors) with long associations with BIPL. Based on her data analyses of distributors’ performance, Kaur started her retail visit with the highest selling distributor’s area (Sharda Agencies) to confirm her understanding of what the data had shown her. Following her retail visit and a meeting with Sharda Agencies, the situation turned for the worse. An email bordering to a threat from him took her aback. Kaur now had to make a choice to ensure growth in her new territory. Her options were between placating the current distributor or appointing a new one – should she retain or replace? Both had their own risks. Complexity academic level This case is intended for use at the postgraduate level in courses such as sales management, channel management and strategic marketing courses, as well as in executive management programs. The case is relevant from the context of channel management in India, where channel intermediaries can be very demanding. The case will give students a practical hands-on decision-making situation, where there are complexities of quantitative and qualitative nature. It will also help young graduates prepare for real life situations where the assigned territory is struggling in performance and a lot is expected from the new recruits. Supplementary materials Teaching notes are available for educators only. Subject code CSS 8: Marketing.

Taking a snapshot of Extension and Advisory Systems performance and outcomes: insights on a semi-quantitative evaluation approach

ABSTRACT Purpose To evaluate pluralistic Extension and Advisory Services (EAS) systems performance and outcomes, and share the experiences made with applying a participatory semi-quantitative approach allowing for cross-country comparability. Design/methodology/approach The Food and Agriculture Organization of the United Nations (FAO) developed the ‘Extension and Advisory Services (EAS) System – Yardstick’ (EAS-Y), a semi-quantitative assessment approach relying on expert-based scores to evaluate the EAS system performance on the one hand, and users’ scores to measure the system outcomes on the other. The tool was applied in three countries, Costa Rica, Ecuador, and Peru. Findings Results revealed an overall weak performance on most assessed criteria. Experts pointed out a lack of adequate policies addressing agricultural extension, insufficient funding, and poor infrastructure. On the other hand, the increased focus on sustainability, increased inclusiveness levels, and steady uptake of digitalization technologies are areas where progress was recently made. On the outcomes side, users perceived EAS contributed mainly to acquiring technical skills, while less to entrepreneurial and social skills. Practical Implications EAS-Y represented a user-friendly and cost-effective solution to identify performance gaps and assess outcomes in a semi-quantitative way. Therefore, we consider the latter has the potential to be applied to prioritize areas for intervention and guide decision-making processes. Theoretical implications The commonly existing data gap not allowing for a quantitative evaluation of pluralistic EAS systems can be overcome using a participatory evaluation tool that relies on expert and user’s judgments. Originality/Value We used an innovative evaluation approach to assess pluralistic extension systems in three Latin American countries.

Team Performance in High-Fidelity Simulations of Postpartum Hemorrhage Management [A336

INTRODUCTION: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and presents care teams with unique, time-sensitive challenges. Simulation provides a way to evaluate team performance with no risk to patients. Identification of common errors is important to target training and optimize outcomes. METHODS: High-fidelity simulation exercises were conducted at a national obstetric critical care conference between 2014 and 2019. A simulated case of a PPH preceded by placental abruption was performed by multidisciplinary teams using high-fidelity simulators. Team performance was evaluated using a standardized checklist of key actions, and each item was scored as “not done”, “poorly done”, or “well done”. Descriptive statistics were then compiled for analysis. The study was reviewed and determined to be exempt by the hospital institutional review board. RESULTS: Complete performance data was available for 155 teams. Appropriate diagnosis of etiology of the hemorrhage (uterine atony) and timely recognition of the need for operative management was well done by most teams (91% and 92.3%, respectively). However, a significant number of teams demonstrated poor performance regarding inspection for lacerations (34.2%) and checking for retained products of conception (38.1%). Additionally, poor performance was identified for timely initiation of blood transfusion (11.6%) and activation of a massive transfusion protocol (20.6%). CONCLUSION: Thorough assessment of time-sensitive care interventions revealed specific deficits in team performance of PPH. High-fidelity simulation provides opportunities for exposure to obstetric emergency and may help to both target and determine the effectiveness of trainings designed to address these identified performance gaps.

Unmasking a Vulnerable Patient Care Process: A Qualitative Study Describing the Current State of Resident Continuity Clinic in a Nationwide Cohort of Internal Medicine Residency Programs

BackgroundResidents serve as access points to the health care system for the most vulnerable patients in the United States. Two large academic medical centers have identified performance gaps between resident and faculty physicians. Our intent in this study was to measure the scope of resident-faculty performance gaps in a nationwide sample and identify potential targets for intervention. MethodsThis is a qualitative study of 12 residency programs representing 4 out of 5 US regions. Main measures include perceptions of population health performance in resident versus faculty populations, description of precepting model employed, perceptions of differences between resident and faculty patients, and handoff processes at the time of graduation. ResultsOf the 8 programs that routinely compare resident and faculty performance, half had confirmed the presence of outcome disparities on routine population health metrics. Seven out of 12 programs employ a 1:1 preceptor:resident comanagement structure. Ten of the 12 programs perceived that resident panels were more psychosocially complex; 2 had a formal process to measure this. Four of the 12 programs had a process to monitor patient loss to follow-up after resident transition. ConclusionsResident-faculty performance disparities may be a widespread problem nationally. Potential targets for intervention include increased preceptor engagement, improving access for empanelment in the faculty practice for vulnerable patient populations, and employing more robust handoff practices. Integrating a culture of quality improvement to continuously monitor important educational metrics such as outcome disparities, panel demographics, educational continuity, and patient loss in the resident panel should be a routine practice for academic health centers.

Framework and determinants of benchmarking: a theoretical analysis and case study in Vietnam

PurposeThis study aims to develop a benchmarking model with productivity, management, and sustainability indicators (PMS), measure the performance of furniture firms in Vietnam, explore the causes of performance gaps, and identify the barriers and factors of benchmarking practice.Design/methodology/approachThe article uses both qualitative and quantitative methods. Literature review, exploratory interviews and a grounded-theory process are employed to develop a benchmarking framework and identify performance gaps, barriers and factors of benchmarking practice. The PMS benchmarking model and quantitative analysis are utilized to assess performance indicators.FindingsThe study proposes the PMS benchmarking model and measures performance indicators of furniture firms. The sources of performance gaps are explored as design, material supply, the economy of scale, market, management systems and openness. Benchmarking practice encounters barriers of difficult indicators, unsuitable firms, insufficient benchmarking knowledge, reluctance to share data, unavailable and unreliable data, and weak engagement. Benchmarking practice is determined by core factors: leader; internal factors: systems, engagement, strategy, scope, culture; external factors: customers, suppliers, associations, support, competition.Practical implicationsFirms could learn benchmarking indicators and the causes of these gaps to improve their performance. When implementing a benchmarking study, scholars and practitioners need to pay attention to barriers and factors of the benchmarking practice to ensure effective results.Originality/valueThis study develops the PMS benchmarking model and estimates performance indicators in an emerging country with the performance gap justification. It provides readers with benchmarking barriers with solutions and success factors of benchmarking practice.