Integrated Quality Improvement Research Articles

Improving Engagement in Residential Treatment for Substance Use Disorders: An Integrated Care Quality Improvement Project for Individuals With Mental Health and Substance Use Disorders

Substance use disorder continues to pose significant challenges in the United States, with increasing opioid-related fatalities. Residential recovery treatment programs are effective; however, high attrition rates impact successful long-term outcomes. This quality improvement project aimed to enhance patient engagement in treatment for mental health and substance use disorder to improve retention rates. It also implemented an integrated care approach incorporating psychotherapy, psychopharmacologic interventions, and recovery support services. The project was conducted using a 2-group predesign and postdesign, analyzing 134 admissions. The approach resulted in a statistically significant increase in patient engagement in treatment from 24% to 92%. Substance use relapse rates significantly reduced from 25% to 12%, and a clinically meaningful increase in the 3-month retention rate was noted. Integrated care is a promising strategy to improve outcomes for individuals receiving care for co-occurring disorders via residential treatment settings. Future studies should explore integrative models of care, patient motivation, and retention in residential treatment centers.

Strategy to Improve the Quality of Madrasah Education Through Madrasah Diniyah (Madin) in Min 16 Bener Meriah Aceh

The purpose of this study was to determine the concept of organizing Madrasah Diniyah (Madin) Min 16 in Aceh. The concept of Madrasah Diniyah (MADIN) at MIN 16 Bener Meriah has the following characteristics: focusing on customers, both internal and external customers, having a high obsession with quality, using a scientific approach in decision making and problem solving, having a long-term commitment, requiring teamwork, continuous process improvement, providing education and training, providing controlled freedom, unity of purpose, and involving and empowering human resources. Meanwhile, the implementation of Integrated Quality Improvement Management in Madrasah includes Quality Strategy Planning (vision, mission, objectives, long-term institutional strategy, monitoring and evaluation), improving process quality (curriculum and learning process), improving the quality of Human Resources. Resources (HR), improving environmental quality, improving service quality, improving output quality

The Integration of Quality Improvement and Health Care Simulation: A Scoping Review.

Quality improvement (QI) and simulation employ complementary approaches to improve the care provided to patients. There is a significant opportunity to leverage these disciplines, yet little is known about how they are utilized in concert. The purpose of this study is to explore how QI and simulation have been used together in health care. This scoping review includes studies published between 2015 and 2021 in 4 databases: CINAHL, Embase, PubMed, and Scopus. The search yielded 921 unique articles.18 articles met the inclusion criteria and specifically described QI and simulation collaborative projects. Of the 18 articles, 28% focused on improvements in patient care, 17% on educational interventions, 17% on the identification of latent safety threats (LSTs) that could have an impact on clinical care, 11% on the creation of new processes, 11% on checklist creation, and 6% on both LST identification and educational intervention. The review revealed that 61% of the included studies demonstrated a concurrent integration of simulation and QI activities, while 33% used a sequential approach. There is a paucity of studies detailing the robust and synergistic use of QI and simulation. The findings of this review suggest a positive impact on patient safety when QI and simulation are used in tandem. The systematic integration of these disciplines and the use of established reporting guidelines can promote patient safety in practice and in the literature.

Improving quality through simulation; developing guidance to design simulation interventions following key events in healthcare

Simulation educators are often requested to provide multidisciplinary and/or interprofessional simulation training in response to critical incidents. Current perspectives on patient safety focus on learning from failure, success and everyday variation. An international collaboration has led to the development of an accessible and practical framework to guide the implementation of appropriate simulation-based responses to clinical events, integrating quality improvement, simulation and patient safety methodologies to design appropriate and impactful responses. In this article, we describe a novel five-step approach to planning simulation-based interventions after any events that might prompt simulation-based learning in healthcare environments. This approach guides teams to identify pertinent events in healthcare, involve relevant stakeholders, agree on appropriate change interventions, elicit how simulation can contribute to them and share the learning without aggravating the second victim phenomenon. The framework is underpinned by Deming’s System of Profound Knowledge, the Model for Improvement and translational simulation. It aligns with contemporary socio-technical models in healthcare, by emphasising the role of clinical teams in designing adaptation and change for improvement, as well as encouraging collaborations to enhance patient safety in healthcare. For teams to achieve this adaptive capacity that realises organisational goals of continuous learning and improvement requires the breaking down of historical silos through the creation of an infrastructure that formalises relationships between service delivery, safety management, quality improvement and education. This creates opportunities to learn by design, rather than chance, whilst striving to close gaps between work as imagined and work as done.

Integrating Quality Improvement Curriculum and Group Projects: A Neurology Resident-Guided Initiative (P4-7.006)

Integrating Quality Improvement Curriculum and Group Projects: A Neurology Resident-Guided Initiative (P4-7.006)

From Data to Delivery: Integrating Quality Improvement in Perinatal and Neonatal Care.

From Data to Delivery: Integrating Quality Improvement in Perinatal and Neonatal Care.

Twelve tips for creating a longitudinal quality improvement and safety education for early health professions students

Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes.

Leveraging Quality Improvement Principles for Radiology Sustainability: Bridging Advocacy and Action

The healthcare industry is a top polluter, and the United States healthcare is among the worst offenders worldwide. Radiology contributes disproportionately to the carbon footprint of healthcare and may contribute up to 1% of global greenhouse gas emissions. This commentary underscores the untapped potential within radiology departments to integrate quality improvement principles with sustainability. By embracing these principles and setting environmental quality standards, radiologists can transition from sustainability advocacy to improvements in their radiology practices.

Reducing unplanned hospital admissions from care homes: a systematic review

Background Care homes predominantly care for older people with complex health and care needs, who are at high risk of unplanned hospital admissions. While often necessary, such admissions can be distressing and provide an opportunity cost as well as a financial cost. Objectives Our objective was to update a 2014 evidence review of interventions to reduce unplanned admissions of care home residents. We carried out a systematic review of interventions used in the UK and other high-income countries by synthesising evidence of effects of these interventions on hospital admissions; feasibility and acceptability; costs and value for money; and factors affecting applicability of international evidence to UK settings. Data sources We searched the following databases in December 2021 for studies published since 2014: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews; Cumulative Index to Nursing and Allied Health Literature; Health Management Information Consortium; Medline; PsycINFO; Science and Social Sciences Citation Indexes; Social Care Online; and Social Service Abstracts. ‘Grey’ literature (January 2022) and citations were searched and reference lists were checked. Methods We included studies of any design reporting interventions delivered in care homes (with or without nursing) or hospitals to reduce unplanned hospital admissions. A taxonomy of interventions was developed from an initial scoping search. Outcomes of interest included measures of effect on unplanned admissions among care home residents; barriers/facilitators to implementation in a UK setting and acceptability to care home residents, their families and staff. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. We used published frameworks to extract data on intervention characteristics, implementation barriers/facilitators and applicability of international evidence. We performed a narrative synthesis grouped by intervention type and setting. Overall strength of evidence for admission reduction was assessed using a framework based on study design, study numbers and direction of effect. Results We included 124 publications/reports (30 from the UK). Integrated care and quality improvement programmes providing additional support to care homes (e.g. the English Care Homes Vanguard initiatives and hospital-based services in Australia) appeared to reduce unplanned admissions relative to usual care. Simpler training and staff development initiatives showed mixed results, as did interventions aimed at tackling specific problems (e.g. medication review). Advance care planning was key to the success of most quality improvement programmes but do-not-hospitalise orders were problematic. Qualitative research identified tensions affecting decision-making involving paramedics, care home staff and residents/family carers. The best way to reduce end-of-life admissions through access to palliative care was unclear in the face of inconsistent and generally low-quality evidence. Conclusions Effective implementation of interventions at various stages of residents’ care pathways may reduce unplanned admissions. Most interventions are complex and require adaptation to local contexts. Work at the interface between health and social care is key to successful implementation. Limitations Much of the evidence identified was of low quality because of factors such as uncontrolled study designs and small sample size. Meta-analysis was not possible. Future work We identified a need for improved economic evidence and the evaluation of integrated care models of the type delivered by hospital-based teams. Researchers should carefully consider what is realistic in terms of study design and data collection given the current context of extreme pressure on care homes. Study registration This study is registered as PROSPERO database CRD42021289418. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (award number NIHR133884) and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 18. See the NIHR Journals Library website for further project information.

Integrating quality improvement into healthcare operations: A system's approach

A palpable pulse on organizational culture is imperative for allowing senior leadership to understand the current state and use this as a starting point to measure the gap between the current state and where the organization should be to meet strategic goals related to quality and safety. Knowledge gleaned from causal analysis and coding of safety events provides the organization with that information. Our organization was unknowingly making decisions on a small quantity of coded and classified events, which led to mistakes on our journey to becoming a high-reliability organization.To remedy this, the Quality and Safety Team improved the user interface of the event reporting system and created standard work for all frontline staff, physicians, area managers and senior leaders. After several interventions, we reduced the time between reported events and documented resolution by 15.28% and increased the quantity of coded and classified safety events tenfold. These changes improved our organization's ability to make better informed decisions and plot a more precise course on the journey to becoming a high-reliability organization.

Interprofessional implementation of the Global Malnutrition Composite Score quality measure.

Malnutrition in hospitalized patients can impact health outcomes, quality of life, and health equity. Quality improvement initiatives and quality measurement can help improve the care of those hospitalized patients with malnutrition. The new Global Malnutrition Composite Score (GMCS) was recently adopted by the Centers for Medicare & Medicaid Services (CMS) as a health equity-focused measure. Beginning in 2024, the GMCS is available for reporting through the CMS Hospital Inpatient Quality Reporting Program. The GMCS provides an opportunity to elevate the importance of patient nutrition status and evidence-based interventions throughout the interdisciplinary hospital decision-making process. To promote this opportunity, the American Society for Parenteral and Enteral Nutrition (ASPEN) held an "Interprofessional implementation of the Global Malnutrition Composite Score" webinar as part of its 2022 Malnutrition Awareness Week programming. This article summarizes the underlying rationale and significance of the GMCS measure and showcases clinical observations about integrating quality improvement and measurement into the acute care setting, as presented during the webinar.

Abstract 1: A Learning Collaborative Model to Empower Rural Rwandan Health Centers to Improve the Quality of Screening for Women’s Cancers

Abstract Purpose: Screening and early detection initiatives for breast and cervical cancer are public health priorities in sub-Saharan Africa, but sustainable strategies to monitor screening quality in rural health facilities are not well-described. We sought to empower rural primary care clinicians to monitor and improve screening quality and integrate quality improvement (QI) into routine practice through a learning collaborative in 8 health facilities participating in a breast and cervical cancer screening initiative in Burera district, Rwanda. We evaluated the model’s impact on participant knowledge/attitudes and QI projects’ success. Methods: Two-day didactic sessions in March 2022 addressed quality measurement and QI implementation. QI knowledge/attitudes were assessed before and after training using a brief written survey and compared using paired t-tests. Participants (all nurses) then identified a cancer screening problem at their health facility that could be solved using QI methods and planned projects. All health center (HC) trainees focused on increasing the proportion of eligible women screened for cervical cancer in their sectors, via educational campaigns. District hospital (DH) team members aimed to reduce missed referral visits. At subsequent meetings, teams discussed projects and next steps. Results: Three clinicians from each of 7 HCs and 2 from the DH (n=23) participated in training; 22 took pre- and post-training surveys. Baseline mean knowledge scores (66.5%,SD 11.8) improved following training (82.4%,SD 12.0,p<0.001). After training, 22(100%) reported interest in being more engaged in QI. In the 6 months following project implementation, HCs saw a 4.8-fold increase in the mean number of patients screened across 7 HCs (35.4,SD 17.1) compared to 6 months prior (7.5,SD 2.6). Efforts to reduce missed visits could not be assessed due to inability of the cancer screening electronic medical record to track patients across facilities. Conclusion: A learning collaborative model engaged rural primary care clinicians in evaluating and improving cancer screening practices. QI knowledge improved and HCs met initial project goals. Though projects focused on patient volume, future initiatives should examine other critical quality measures i.e., referral completion and time to cancer diagnosis. Improving data collection systems is essential to facilitate availability of follow-up data and patient tracking and empower clinicians to monitor care quality. Citation Format: Jean-Marie Vianney Dusengimana, Jean de Dieu Uwihaye, Amanda Fata, David Tuyisenge, Aphrodis Ndayisaba, Vestine Rugema, Marie Louise Uwineza, Lawrence N. Shulman, Cyprien Shyirambere, Lydia E. Pace. A Learning Collaborative Model to Empower Rural Rwandan Health Centers to Improve the Quality of Screening for Women’s Cancers [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 1.

An episode-based assessment for the adverse effects of air mass trajectories on PM2.5 levels in Astana and Almaty, Kazakhstan

PM2.5 pollution is a severe problem in most cities in Kazakhstan and is a leading cause of premature deaths globally. This study examines the temporal variation of PM2.5 levels and the effect of air mass transportation dynamics on episodic air pollution in Kazakhstan's two largest cities. In 2021 annual PM2.5 concentrations in Astana (22.5 μg m−3) and Almaty (35.3 μg m−3) exceeded the annual WHO limit by 4.5 and 7.1 times, respectively. The daily limits surpassed 151 days in Astana and 217 days in Almaty. PM2.5 levels were highest in winter averaging 35.3 μg m−3 (Astana) and 76.0 μg m−3 (Almaty) over the heating season, with coal combustion as a main contributor. The HYSPLIT model was used to assess the impact of air mass trajectories on pollution episodes and clean air events. Cluster and concentration-weighted trajectory analyses showed that air pollution episodes in both cities were associated with the anticyclone-blocking effect. While both cities were exposed to the influence of long-range transported pollutants, Astana was more frequently impacted by distant sources. Given the transboundary nature of air pollution in both cities and the complex relationship between meteorology and emission sources, a regional integrated air quality improvement strategy is needed.

The Theory of Planned Behavior as a Framework to Identify Attitudes and Perceptions of Athletic Trainers towards Quality Improvement

Purpose: The BOC announced a concept for continuing professional certification for athletic trainers (ATs), including an optional quality improvement (QI) project to examine practice performance. The purpose of this study was to examine current attitudes, perceived control and subjective norms of ATs regarding QI. Method: Data was collected using a qualitative descriptive design. A web-based survey was distributed via email and social media. Open-ended questions were evaluated by two independent coders using a general inductive approach. Results: Three major themes emerged: reservations about QI, benefits of QI, and impacts on the profession. Conclusions: When integrated into the Theory of Planned Behavior model, results show that ATs demonstrate positive attitudes towards QI and agree that optimal patient outcomes are essential. However, many ATs perceive that they lack the appropriate knowledge about QI, how to implement QI, and the resources needed to be successful. Possible recommendations include a systems approach in which athletic training organizations and regulatory bodies consider providing ATs strategies to improve perceived control, such as continuing education opportunities and tools to advocate for resources. Additionally, the integration of QI into athletic training is a cultural shift; professional organizations may benefit from acknowledging and promoting enhanced clinician and patient outcomes.

An Integrated Air Quality Improvement Path of Energy-Environment Policies in the Guangdong-Hong Kong-Macao Greater Bay Area

Energy-related clean air measures in the Guangdong–Hong Kong–Macao Greater Bay Area (GBA) can yield substantial air quality improvement benefits and promote energy structure optimization. Here, we first evaluate the reduction effect of the stringent energy-related clean air measures in the GBA during the 13th Five-Year Plan period. First, a reduction of 19.3% emission in air pollutant equivalent was measured in 2020 compared to 2015. Second, we compare the energy structure development and air quality benefits of energy-environment policy scenarios by 2025 (SBAU, SA, SO) geared towards proposing integrated energy-environment development paths of air quality improvement. Under SBUA, SA and SO, the annual average PM2.5 concentration will be 21.7, 19.9 and 18.1 μg/m3, respectively, and the total energy demand would be controlled within 318.9, 300.6 and 282.3 Mtce in the GBA in 2025, reaching 7.5%, 8.4% and 9.4% of SO2, 23.5%, 29.3% and 35.4% of NOX, 18.2%, 19.6% and 22.7% of primary PM2.5, and 25.1%, 29.9% and 34.7% of VOCs emission reductions compared to 2020, respectively. Our study proposes that it is necessary for the GBA to jointly set up regional air quality improvement targets and issue integrated regional energy-environment policies in the process of building an “Air Quality Improvement Pioneering Demonstration Area”.

Network evaluation of an innovation platform in continuous quality improvement in Australian Indigenous primary healthcare

BackgroundFrom 2014 to 2019, the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI) was evaluated as an innovation platform focusing on continuous quality improvement in Indigenous Australian primary healthcare. Although social network analysis (SNA) is a recognized method for evaluating the functioning, collaboration and effectiveness of innovation platforms, applied research is limited. This study applies SNA to evaluate the CRE-IQI’s functioning as an innovation platform.MethodsTwo surveys (2017, 2019) were conducted using social survey and network methods. Survey items covered respondent characteristics, their perceptions of the CRE-IQI’s performance, and its impact and sociometric relationships. Members’ relationship information was captured for the CRE-IQI at three time points, namely start (retrospectively), midpoint and final year, on three network types (knew, shared information, collaborated). SNA software was used to compute standard network metrics including diameter, density and centrality, and to develop visualizations. Survey and network results were addressed in a workshop held by members to develop improvement strategies.ResultsThe response rate was 80% in 2017 and 65% in 2019 (n = 49 and 47, respectively). Between 2017 and 2019, respondents’ mean ratings of the CRE-IQI’s functioning and achievements in meeting its goals were sustained. They perceived the CRE-IQI as multidisciplinary, having effective management and governance, and incorporating Indigenous research leadership, representation and ways of working. Respondents recognized high levels of trust amongst members, rated “good communication and coordination with participants” highly, and “facilitating collaboration” as the CRE’s most strongly recognized achievement. In collaboration and information-sharing networks, average path length remained low in 2017 and 2019, indicating good small-world network properties for relaying information. On average, respondents shared information and collaborated with more CRE members in 2017 than 2019. However, in both 2017 and 2019 there were new collaborations and information-sharing outside of direct collaborations. CRE-IQI outcomes included: evidence generation; knowledge transfer and skills development in quality improvement; research capacity-building, career development; mentoring; grant support; development of new projects; health service support; and policy impact.ConclusionsThis study shows the utility of network analysis in evaluating the functioning, and collaboration, at the individual, organizational and health system levels, of an innovation platform, and adds to our understanding of factors enabling successful innovation platforms.

Integrating Quality Improvement and Community Engagement Education: Curricular Evaluation of Resident Population Health Training

The Accreditation Council for Graduate Medical Education requires all residents be trained in population health, but the most effective training strategies to impact care of patients and populations are not well established. The purpose of this study is to assess resident self-efficacy and expected application of population management skills through iterative experiential, longitudinal, team-based training in the office and community settings. Using a prospective longitudinal curricular evaluation, we surveyed residents at a single institution from 2014-2020, evaluating self-efficacy in population health skills as well as perceived impact on patient care and future practice. We collected surveys before and after participating in a 3-year, longitudinal, team-based, experiential population health curriculum that integrates clinic-based quality improvement and community engagement projects. Fifty-nine of 68 residents (87%) responded to the presurvey, and 42/56 (75%) responded to the postsurvey. We observed significant increases in resident self-efficacy in all population health skills. All respondents reported finding common population health skills that were applicable in both office and community settings; 81% reported care of their continuity clinic patients changed because of taking part in the curriculum. Finally, 94% of respondents reported the intention to use population health skills and incorporate quality improvement (75%) and community engagement (100%) in future practice. Teaching population health management skills in both office and community settings allows residents to integrate and apply these skills across settings and may enhance their use in patient care and future practice.

Identifying Contextual Factors and Strategies for Practice Facilitation in Primary Care Quality Improvement Using an Informatics-Driven Model: Framework Development and Mixed Methods Case Study.

BackgroundThe past decade has seen increasing opportunities and efforts to integrate quality improvement into health care. Practice facilitation is a proven strategy to support redesign and improvement in primary care practices that focuses on building organizational capacity for continuous improvement. Practice leadership, staff, and practice facilitators all play important roles in supporting quality improvement in primary care. However, little is known about their perspectives on the context, enablers, barriers, and strategies that impact quality improvement initiatives.ObjectiveThis study aimed to develop a framework to enable assessment of contextual factors, challenges, and strategies that impact practice facilitation, clinical measure performance, and the implementation of quality improvement interventions. We also illustrated the application of the framework using a real-world case study.MethodsWe developed the TITO (task, individual, technology, and organization) framework by conducting participatory stakeholder workshops and incorporating their perspectives to identify enablers and barriers to quality improvement and practice facilitation. We conducted a case study using a mixed methods approach to demonstrate the use of the framework and describe practice facilitation and factors that impact quality improvement in a primary care practice that participated in the Healthy Hearts in the Heartland study.ResultsThe proposed framework was used to organize and analyze different stakeholders’ perspectives and key factors based on framework domains. The case study showed that practice leaders, staff, and practice facilitators all influenced the success of the quality improvement program. However, these participants faced different challenges and used different strategies. The framework showed that barriers stemmed from patients’ social determinants of health, a lack of staff and time, and unsystematic facilitation resources, while enablers included practice culture, staff buy-in, implementation of effective practice facilitation strategies, practice capacity for change, and shared complementary resources from similar, ongoing programs.ConclusionsOur framework provided a useful and generalizable structure to guide and support assessment of future practice facilitation projects, quality improvement initiatives, and health care intervention implementation studies. The practice leader, staff, and practice facilitator all saw value in the quality improvement program and practice facilitation. Practice facilitators are key liaisons to help the quality improvement program; they help all stakeholders work toward a shared target and leverage tailored strategies. Taking advantage of resources from competing, yet complementary, programs as additional support may accelerate the effective achievement of quality improvement goals. Practice facilitation–supported quality improvement programs may be opportunities to assist primary care practices in achieving improved quality of care through focused and targeted efforts. The case study demonstrated how our framework can support a better understanding of contextual factors for practice facilitation, which could enable well-prepared and more successful quality improvement programs for primary care practices. Combining implementation science and informatics thinking, our TITO framework may facilitate interdisciplinary research in both fields.

Rising through the pandemic: a scoping review of quality improvement in public health during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic generated a growing interest in and need for evidence-based tools to facilitate the implementation of emergency management strategies within public health practice. Quality improvement (QI) is a key framework and philosophy to guide organizational emergency response efforts; however, the nature and extent to which it has been used in public health settings during the COVID-19 pandemic remains unclear.MethodsWe conducted a scoping review of literature published January 2020 – February 2021 and focused on the topic of QI at public health agencies during the COVID-19 pandemic. The search was conducted using four bibliographic databases, in addition to a supplementary grey literature search through custom Google search engines and targeted website search methods. Of the 1,878 peer-reviewed articles assessed, 15 records met the inclusion criteria. An additional 11 relevant records were identified during the grey literature search, for a total of 26 records included in the scoping review.ResultsRecords were organized into five topics: 1) collaborative problem solving and analysis with stakeholders; 2) supporting learning and capacity building in QI; 3) learning from past emergencies; 4) implementing QI methods during COVID-19; and 5) evaluating performance using frameworks/indicators.ConclusionsThe literature indicates that QI-oriented activities are occurring at the organizational and program levels to enhance COVID-19 response. To optimize the benefits that QI approaches and methodologies may offer, it is important for public health agencies to focus on both widespread integration of QI as part of an organization’s management philosophy and culture, as well as project level activities at all stages of the emergency management cycle.

Computer integrated work-space quality improvement of the C4 parallel robot CMM based on kinematic error model for using in intelligent measuring

ABSTRACT Computer aided optimization and quality improvement of the performance of industrial machinery, without changing the original design, is one of the important challenges of intelligent manufacturing science, especially for robotic systems. In this paper, improving the performance of the new C4 robot serving as a coordinate measuring system (CMM) was considered. Since the efficiency of a robot is directly related to its work-space, calculating the quality improved work-space of this mechanism was studied. The new inverse and forward error models considering 48 error parameters were obtained using inverse kinematics. Afterward, a sensitivity analysis of the mechanism was implemented. Using the inverse kinematics and the discretization method, the work-space was calculated. Applying a new method, singularity tolerance, singular and quasi-singular points of the work-space were determined. In this proposal of a new computer integrated quality improvement algorithm, the work-space was investigated in various aspects including singularity, dexterity, and sensitivity analysis. The comparison between various indices for dexterity analysis was implemented and reliability and accuracy index was presented. Finally, the quality improved work-space was achieved without any physical changes to the structure. Selecting high-quality regions of work-space for operational intelligently can help to gain accurate results in industrial applications especially measuring tasks.