Improve Quality Standards Research Articles

Let’s be effective, let the patients talk! Does ‘patient intelligence’ have an effect on improvements in quality within the healthcare environment?

Let’s be effective, let the patients talk! Does ‘patient intelligence’ have an effect on improvements in quality within the healthcare environment? Nadine van DongenVan Dongen Research Ltd, London, UKAbstract: This paper examines the interaction of patients within the context of efficiency in the pharmaceutical environment. Measurements of quality standards in healthcare are reviewed with an emphasis on the question of whether ‘patient intelligence’ can improve quality standards in healthcare. Something given particular consideration is the ethical point of view versus the business point of view, in relation to the integration of patients into the decision-making process of a healthcare organization. The paper focuses on the formal and informal reasons for involvement of patients in corporate and/or market access strategies for healthcare organizations.Keywords: healthcare, decision-making process, efficiency, patient intelligence, patients

Taking patients' voices into account within quality systems: a comparative study

This study aims to explore whether and how patient voices had been taken into account within quality management systems in Hospital A in Britain and Hospital B in Taiwan. The two hospitals were purposefully selected and the data were collected over six months, via documents, interviews, and a semi-structured questionnaire. A mixed method strategy within an overall qualitative framework (i.e. managerial-operational-technical) was used to make comparisons between them. A number of strategies were developed by both Hospital A and Hospital B to take patients' voice into account within quality systems. In an attempt to improve quality standards of services, both hospitals used patient satisfaction surveys relating to specific services to understand patients' opinions about care in outpatient services, inpatient services, or emergency services. They also set up patient suggestion boxes and managed complaints data to understand what patients needed and wanted. There is very limited literature related to the comparison of quality systems. In particular, this study explores the mechanisms to take patients' voices into account within quality systems. The most important distinction between the two hospitals is that in Hospital A, complaints are managed by a quality manager, while in Hospital B the Social Work Department (SWD) is responsible for dealing with patient complaints. In practice, it is more effective for quality officers to take care of complaints management than social workers, in terms of using complaints to improve quality.

Zirconization™: The future of coating pretreatment processes: Alternative, phosphate-free, eco-friendly pretreatment procedure addresses energy and chemical consumption while improving product quality.

Summary Zirconization creates a sustainable manufacturing process that is free of phosphates and minimizes water, chemical, and energy usage while maintaining and/or improving quality standards. Certainly, some people will contend there are some advantages to traditional phosphate chemistry. First, it is readily available and is likely what a company is using now, and there is a comfort zone in dealing with a proven process. Second, the number of people available in the marketplace that have worked with traditional phosphate chemistry is large compared to those who have any experience in the newer transitional metal chemistry. Finally, change is difficult because people inherently do not like it and there may be circumstances where it is difficult because of approvals or specifications. As an example, contracts may call for resubmission of parts if a new process is adopted that could affect the quality of the parts. If the change is for something that is too new, the customer may also have misgivings, which makes it complicated for the supplier to make an alteration. However, the benefits will likely outweigh the costs of change. Hank Jeanneret, group vice president, Commercial Vehicle Products, Leggett & Platt, a pioneer in the use of transition metal-based chemistry, put it this way: “It is a much less expensive approach to the preparation of our parts for finishing at an increased throughput, with benefits in reduced energy and water consumption and the closure of source of liquid discharge and solid waste from the plant, thereby simplifying our environmental reporting and reducing compliance costs.” In one five-month study on a production line operating five and a half days a week at 20 hours a day, one user realized an annualized reduction in total process costs from $55,000 to $21,000 (Fig. 18). Ted Schreyer, vice president of operations for a custom coater, has experienced the benefits of utilizing the Ziroconization process. “Given the process efficiencies, environmental and cost trade-offs, I cannot foresee any reason to ever switch back to iron phosphate,” he said. To be certain, the Zirconization Process will not be appropriate for all manufacturers, but it is a process that you can ill afford to not consider.

Tannic Acid as an Important Tool to Improve Quality Standards of Commercial RO/NF Membranes

Tannic Acid as an Important Tool to Improve Quality Standards of Commercial RO/NF Membranes

Potato yield and metabolic profiling under conventional and organic farming

Consumers interest for organic agriculture and environmental-friendly agricultural products is increasing. Nevertheless, cultivation protocols in organic farming are not sufficiently standardized to guarantee product quality stability, a parameter which is critical for further expansion of this niche market. Variable responses in terms of quality and quantity of the harvested product often arise from complex interactions between agronomic and environmental factors. Here we report on the effects of different levels of nitrogen fertilization (0, 50, 150, 200 kg N ha −1) and irrigation regime (50% and 100% replenishment of the evaporation determined using a Class A pan, plus a non-irrigated control) on yield and accumulation of primary metabolites of two potato cultivars (Agria and Merit) grown under conventional and organic farming systems. Organic farming caused a 25% marketable yield reduction with a higher percentage of large tubers under conventional farming, whereas irrigation increased the marketable yield and the percentage of large tubers. Nitrogen fertilization affected the marketable yield and significantly interacted with the irrigation regime in modifying potato yield and quality. Farming protocol, cultivar, irrigation and nitrogen fertilization all affected both amino acid contents and composition with a significant decrease of most essential amino acids in coincidence with highest nitrogen levels. An increased water availability caused an accumulation of reducing sugars in potato tubers only in organic farming, whereas such accumulation was not observed under conventional farming. These results indicate that cultivar-specific genetic determinants and cultivation factors, including the farming system, may strongly and specifically interact to affect important quality parameters of potato tubers. This should be considered to improve quality standards in organic farming.

Breast cancer screening in the Netherlands: audit and training of radiologists

The National Expert and Training Centre has for the past 15 years been in charge of medical and technical quality control in the Dutch population-based screening program. Audit is an important tool for keeping up with and improving quality standards. Between 1994 and 2002, we visited most of the 28 central units of the screening program twice, making over 50 audits in total. During audits, we reviewed interval cancers and Stage II screen-detected cancers. Referral rates for subsequent exams varied from 0.43% to 1% in the first series and had increased to 0.6% to 1.6% in the next audits. This led to higher detection rates (first series 2.4–4.0/1,000; second series 3.6–4.7/1,000). For women aged 50 to 69 years, detection rate in subsequent screening exams was 3.9 per 1,000 in 1999. Review of interval cancers showed fewer cases with tumor signs retrospectively visible on the previous screening mammograms (first series 54%, second series 44%). Because of the small numbers of reviewed cases (usually 80 interval- and 40 screen-detected cancers), resulting figures have relatively wide confidence intervals. Presentation of audit results in scatter diagrams can aid comparison with other central units. In most central units, over 80% of screen-detected malignancies are T1 invasive tumors or ductal carcinoma in situ. In 70% of screen-detected invasive cancers, axillary lymph nodes were negative. Results are generally in agreement with expectations stated at the start of the program.

Data quality probes—exploiting and improving the quality of electronic patient record data and patient care

Increasing reliance is being placed on electronic medical records to support clinical care and achieve improved quality standards. In order for clinical information systems (CIS) to deliver excellence the data within it needs to be complete, consistent and accurate. This capture of data is critical but forms only part of the procedure in delivering quality health care during the clinician-patient encounter. A number of processes are involved in this encounter, each of which has to be performed flawlessly to deliver a perfect outcome. This paper outlines a method of assessing the quality of these processes involved in healthcare provision and data quality within a CIS. It proposes the principle of Data Quality Probes (DQP) to assess the performance of the whole encounter system. The main feature of this is the generation of a query which clinical knowledge predicts should not retrieve any cases in a system performing flawlessly. Any cases retrieved (which fail the DQP) indicate an error in either data quality or clinical judgment. This approach is applied practically within the paradigm of a UK family practice testing the hypothesis that a series DQPs can provide a valuable method for monitoring both the data accuracy of a CIS and the provision of quality patient care.

Transformations in Japanese education policy for quality management

The pursuit of heightened educational quality and equalized educational opportunities in the Japanese public school system is now losing its functional integrity. The new educational policy from the 1990’s onwards, was meant to focus on the divisional roles to be taken on by the private and public schools in trying to limit the public schools’ role to offer educational opportunities only to the general students. Behind this policy, there lies a rapid spread of despair towards the public school system based on the opinion that high quality education cannot be obtained by public schools, which base their philosophy on providing equal but uniform education. In a realistic sense, the new educational policy perhaps indicates Japan’s recognition of the present ‘at risk’ educational situation. Yet unfortunately, this shift in direction will concurrently signify the inevitable all-out dismantling of what Japan has prided as the pre-eminent feature of its school education system. This issue of improving quality standards in public schools certainly requires a divergent approach. It should be undertaken through individualized reform, school by school.

Effects of overtime work and additional resources on project cost and quality

Delays are an endemic feature of the construction industry. Typically, when a delay occurs in a project, the project manager often expedites progress through activity‐crashing with respect to available float and time‐cost relationships. An accelerated schedule is thus obtained either by prescribing overtime working hours or by procuring additional resources or a combination of both. However, excessively prolonged overtime work can generate quality problems, such as rework, and additional resources. With this in mind, there is a need for a model to assist project managers with understanding the complex nature of attaining a trade‐off between overtime working and the procurement of additional resources. Thus, using system dynamics modelling, the effects of prolonged overtime work on project cost and quality are examined. To overcome project delays, several options representing various combinations of prescribing over‐time work and injecting additional resources are analysed. Utility theory is then applied to determine the most appropriate solution for mitigating project delays. The modelling approach offered in this paper should be particularly useful for large projects and for projects on confined sites where potential cost savings and improved quality standards are likely to be the most significant.

Effects of overtime work and additional resources on project cost and quality

Delays are an endemic feature of the construction industry. Typically, when a delay occurs in a project, the project manager often expedites progress through activity‐crashing with respect to available float and time‐cost relationships. An accelerated schedule is thus obtained either by prescribing overtime working hours or by procuring additional resources or a combination of both. However, excessively prolonged overtime work can generate quality problems, such as rework, and additional resources. With this in mind, there is a need for a model to assist project managers with understanding the complex nature of attaining a trade‐off between overtime working and the procurement of additional resources. Thus, using system dynamics modelling, the effects of prolonged overtime work on project cost and quality are examined. To overcome project delays, several options representing various combinations of prescribing over‐time work and injecting additional resources are analysed. Utility theory is then applied to determine the most appropriate solution for mitigating project delays. The modelling approach offered in this paper should be particularly useful for large projects and for projects on confined sites where potential cost savings and improved quality standards are likely to be the most significant.

The 100% satisfaction guarantee: Ensuring quality at Hampton Inn

AbstractFor many companies, improving quality standards and keeping customers satisfied are key concerns in maintaining a competitive position in the marketplace. But these intangible goals often can be difficult to achieve in practice. For the Hampton Inn hotel chain, the solution has come in the form of an innovative customer satisfaction guarantee, which not only helps the company ensure quality and satisfaction on an ongoing basis, but also makes definite contributions to the bottom line.

Nurses rush in where angels fear to tread

When the Patient’s Charter initiative was announced a couple of years ago, it was generally greeted as a ‘good thing’. At last there were explicit targets for a range of patient services and, by and large, the NHS has responded admirably, despite concerns about whether the Patient's Charter was driven by a genuine desire to further improve quality standards or enhance political standings in the run-up to a general election.

TQM and Services: Implementing Change in the NHS

Examines the developing importance of the quality issue in the service sector and highlights common barriers to the successful implementation of total quality management principles (TQM). Such information provides managers in complex service organizations such as the National Health Service (NHS) with valuable lessons for improving quality standards. Illustrates how TQM principles could and in a few cases are already being applied to the NHS in the light of the 1989 Government proposals for reform. Such efforts are in the early stages of development and therefore guidelines are proposed to assist management in sensitive areas for implementing change.

Quality Assurance Ward Audit

Describes a methodology for measuring standards of patient care available on wards. The quality assurance ward audit is a self‐contained package developed as a management tool to maintain and wheŕe necessary improve quality standards on individual wards. Describes the main features of the package, together with the audit process. These have been designed with practicality, ease of use and consistency of application in mind. Outlines the roles of assessor, ward staff and patients in the audit. Stresses the importance of feedback to staff, and the use of the ward audit as a motivator. Describes the mechanisms for using the audit as part of the management process, not just a one‐off audit event, and outlines some of the positive achievements resulting from use of the quality assurance ward audit.