Integrated Quality Assurance Research Articles

A generic IDEFO model of quality assurance information systems for the design-to-order manufacturing environment

In spite of advances in computer technologies, information processing, automation technologies, manufacturing processes, and the push for integration across all functional areas toward a totally automated manufacturing system, the suggestion is that quality assurance is usually missing. On the other hand, quality-based competition is showing that quality management based on inspection is far from reality and that producing defect-free products is not enough. It is necessary to know the customers first and then to satisfy, or surpass, their requirements in order to remain competitive. In the context of company-wide quality and ISO9000, this can be achieved by designing quality into every aspect of an organization as part of an integrated quality assurance system. In this paper, a structural model for integrated quality assurance information systems (QAIS's) using IDEFO methodology, is presented. It is intended that a knowledge-based expert system linked to this structural model will provide a DSS to assist design of quality assurance systems with appropriate information flows to suit the requirements of various business profiles.

The Risk Manager's Desk Reference

Providing the information needed on integrating quality assurance and risk management, understanding risk management in a managed care environment, and programme development, this reference offers concise information on various challenging and ethical issues.

Integrating Quality Assurance and Total Quality Management/Quality Improvement

Hospitals have joined other industries in the quest for quality improvement. Most healthcare organizations have processes in place to meet the quality assurance standards of the Joint Commission on Accreditation of Healthcare Organizations. The challenge is to integrate these two similar, but different, structures into one efficient and effective mechanism for quality. One hospital's effort to develop a pilot program to combine total quality management/quality improvement and quality assurance in a cost-effective and efficient manner is described.

A PRACTICAL MODEL INTEGRATING QUALITY ASSURANCE INTO ENVIRONMENTAL MONITORING1

ABSTRACT: A model of comprehensive environmental monitoring process with integral quality assurance is presented. This model views the monitoring process as iterative cycles of a series of elements: design, plan, protocols, preparation, field liaison, sample collection, sample handling, laboratory analysis, data transmission, data validation, data approval, data provision, statistical analysis, and reporting. Quality assurance is linked to each element, not just to laboratory analysis. The program of quality assurance ensures that environmental monitoring data are compatible with the project goals, are comparable between various sampling agencies, and maintain a high degree of scientific credibility. The key characteristics of the overall quality assurance process are detailed documentation, timely resolution of problems, regular reporting, and routine independent audits.

Supplementation of breastfed infants: does continuing education for nurses make a difference?

Supplementation of breastfed newborns in the first few days of life is a common practice that interferes with the establishment of lactation and is related to early cessation of breastfeeding. Quality assurance audit results at a large maternity hospital led to the development of a continuing education program to increase nurses' knowledge of breastfeeding and thereby reduce supplementation. An integrated quality assurance and research methodology was selected to analyze the impact of the education and yield results that would be more generalizable and interest a wider audience. Findings revealed no change in supplementation behavior occurred following a four-week education program. Only 33 percent of newborns in the study were unsupplemented during their hospital stay. Formula was the most often used supplement. Continuing education alone was not effective in changing behavior. As shown in the literature, post-course reinforcement of behavior needs to be built into the cost of the program to implement and sustain desired changes.

Computer integrated quality assurance

The use of computers in quality assurance is increasing. The number and type of applications are increasing. This paper addresses some of the applications and some of the integration problems associated with computer integrated quality assurance.

New developments of the nondestructive testing technique in view of an integral quality assurance system. (In German) Berner, K. Stahl Eisen, Vol. 109, No. 3, pp. 73–82 (13 Feb. 1989)

New developments of the nondestructive testing technique in view of an integral quality assurance system. (In German) Berner, K. Stahl Eisen, Vol. 109, No. 3, pp. 73–82 (13 Feb. 1989)

Recent developments of nondestructive testing from the viewpoint of an integrated quality assurance system for a steelworks : Berner, K. Stahl und Eisen, Vol. 109, No. 3, pp. 141–150 (1989)

Recent developments of nondestructive testing from the viewpoint of an integrated quality assurance system for a steelworks : Berner, K. Stahl und Eisen, Vol. 109, No. 3, pp. 141–150 (1989)

Recent developments of nondestructive testing from the viewpoint of an integrated quality assurance system for a steelworks Berner, K. Stahl und Eisen, Vol. 109, No. 3, pp. 141–150 (1989)

Recent developments of nondestructive testing from the viewpoint of an integrated quality assurance system for a steelworks Berner, K. Stahl und Eisen, Vol. 109, No. 3, pp. 141–150 (1989)

New developments of the nondestructive testing technique in view of an integral quality assurance system. (In German) : Berner, K. Stahl Eisen, Vol. 109, No. 3, pp. 73–82 (13 Feb. 1989)

New developments of the nondestructive testing technique in view of an integral quality assurance system. (In German) : Berner, K. Stahl Eisen, Vol. 109, No. 3, pp. 73–82 (13 Feb. 1989)

The Department of Defense's External Civilian Peer Review of Medical Care

To the Editor.— Dr Kellys1excellent editorial comments that followed the article entitled A First Report of the Department of Defense External Civilian Peer Review of Medical Care2raised several points. The integrated quality assurance system that is used by the US Air Force actually goes well beyond civilian external peer data. Approximately 5% of the cases that pass criteria are also looked at through 1 or more of 20 other quality of care mechanisms. Sharing Dr Kelly's view that review criteria should be continually validated, quality assurance planners at the Department of Defense set up monthly reviews to do just that when the project was begun. Also sharing Dr Kelly's concern that cases in which no occurrence screening criteria had ostensibly been violated should be checked, the air force performs a verification audit on 5% of all discharges for which no positive occurrences were identified.

Integrating Quality Assurance and Cost Accounting to Facilitate Management Efficiency

A medication error example illustrates how potential labor costs can be calculated, thereby allowing health care administrators to choose the intervention method with the greatest cost/benefit ratio. This method, which can help QA professionals integrate risk management, decision analysis, and utilization review activities, represents the first step in examining cost/benefit ratios with respect to improved patient-care outcomes.

Case mix measures: DRGs and alternatives.

A decade ago, most practitioners and researchers in health services hardly ever encountered the term case-mix. Today, of course , considerations of case-mix dominate discussions of reimbursement for health services of all types. Since the advent of Medicare's case-mix based Prospective Payment System (PPS) in 1983 , the definition and measurement of case-mix have become a principal preoccupation not only of financial specialists but also of utilization coordinators, insurance claims reviewers , those who manage and market hospital information systems, and institutional and community plan­ ners. And in part because the development of case-mix based payment for hospitals constitutes so dramatic an example of the rapid incorporation of health services research into large-scale public policy, issues of case-mix also constitute one of those rare arenas in which the state of the art in both research and policy development intersect, and in which researchers and policymakers continuously trade information and often trade places . Ironically, much of the impetus for development of case-mix based pay­ ment systems, in hospitals and elsewhere , has arisen from concerns about measuring, assuring, and improving the quality of services, and especially from concerns about integrating quality assurance and payment mechanisms. Yet much of the controversy surrounding PPS and similar systems has involved their purported adverse effects on the quality of care. The between payment and quality is a lot more complicated­ if, indeed, one can talk usefully about a relationship at all-than is often assumed, both by laymen and many economists. Systems of case-mix measurement and payment are themselves often extremely complex. Clear­ cut summative judgments will not generally fit the facts. While we hope in

Bacteriological quality assurance (BQA) of mechanically deboned meat (MDM)

Adequacy of bacteriological quality assurance during the commercial production of mechanically deboned meat (MDM) was assessed. Lax standards of hygiene during production were observed, resulting in high numbers of Staphylococcus aureus, viz. 10 4 to 10 5 cfu g −1, and severe contamination with Enterobacteriaceae: 10 5 to 10 6 cfu g −1. These data indicate that measures of hygiene observed during boning of carcasses and during collection, storage and transport of bones or poultry parts should be markedly tightened, while conditions of refrigerated storage of raw materials and MDM should be improved. Use of bones of poor sensory quality (discoloration, abnormal smell) generally resulted in MDM of inferior bacteriological quality. Phage typing, biotyping and assessment of enterotoxin production was carried out with 136 St. aureus cultures, isolates from mechanically deboned pork produced at one plant. Fifty-five per cent of the isolates was not typable, 28% was typable with human phages, 8% with bovine phages. The majority of the strains could not be explicitly assigned to any Meyer and/or Hájek and Marŝálek types. Applying the simplified system of Devriese to eighteen strains isolated in our investigation, ten were found to belong to the poultry ecovar, one to the bovine ecovar, while seven strains were non-host specific. None of the isolates produced enterotoxins A–E. Microbiological inspection of end products is recommended as part of an integrated quality assurance system. The following reference values for the final product (maximal colony counts to be expected under GMP conditions expressed as 95th percentile) were calculated: Pig MDM: log 10 mesophilic colony count 6·8 and log 10 cfu mesophilic Enterobacteriaceae g −1 4·8; Poultry MDM: log 10 mesophilic colony count 6·6 and log 10 cfu mesophilic Enterobacteriaceae g −1 4·7.

Quality assurance and program evaluation.

Some common forces have led to increased attention to quality assurance and program evaluation in the United States. However, these two types of public accountability have developed relatively independently, resulting in somewhat different but related approaches to examining health care. The similarities and differences between quality-of-case assurance and program evaluation are discussed as related to their definitions and approaches to data collection and utilization. Pressures to integrate quality assurance and program evaluation and evidence of a convergence in the two types of assessment activities are also presented. The article concludes with a discussion of the future role of the states and localities in assuming responsibility for these two types of accountability.

Assuring The Reliability Of ProductionProcesses Using FMEA Method

Today, the economic success of industrial companies is defined by low production costs, short delivery times and reliable product quality. These three factors are included in the integral quality assurance system which primarily takes into account the needs and the requirements of customers, and consequently enables the company to participate efficiently on the competitive market. To this end, preventive quality assurance methods should be used in companies. They serve to anticipate potential failures in time and to prevent their occurrence. This is possible with the known FMEA method (Failure Modes and Effects Analysis). Some requirements of the TQM (Total Quality Management) system are given as well as our computerised solution, i.e. a software package developed at the Faculty of Technical Sciences Department of Mechanical Engineering, Laboratory for Production Systems Planning. The methods presented in this contribution assure the determination of potential risks, and the analysis and the prevention of failure effects or their moderation. The reliability analysis leads to a wide spectrum of technical safety requirements which are used to precisely assess the reliability of production systems. RELIABILITY OF PRODUCTION PROCESSES AND THE PHYLOSOPHY OF TQM To be successful in present concurrent markets, industrial companies must assure short delivery times, low production costs and adequate Transactions on Information and Communications Technologies vol 8, © 1994 WIT Press, www.witpress.com, ISSN 1743-3517 450 Software Quality Management quality of products. Therefore it is of great importance to introduce and apply preventive methods of quality assurance so that potential failures could be predicted in time and their occurence prevented. The level of safety and reliability of production systems is determined by laws, technical rules and standards. Reliability and consequently the quality of production processes are comprehensive terms which exceed the limits of legal, economic and technical regulations, and increasingly reflect the policy, phylosophy and culture of a nation. The goal of Total Quality Management system (TQM) is the overall economic success of the company which depends not only on time and cost factors but also strongly on the reliability of production processes. Figure 1 shows that reliability, which is actually quality in certain time, is twofold: external and internal reliability. EXTERNAL RELIABILITY • quality of products • quality of services INTERNAL RELIABILITY • total quality of the product from its conception to its manufacture • quality of supplies • quality as production phylosophy TOTAL QUALITY MANAGEMENT SYSTEM Figure 1: Role of reliability in quality management system The notion of reliability is not narrowed only to technical development but is broadened to human relations which bring about steady improvements of working efficiency of individuals and working teams. This is precisely the goal of the Total Quality Management system. Man remains the basic creator of quality and directly influences all planned and systems measures for winning customers' confidence and satisfying Transactions on Information and Communications Technologies vol 8, © 1994 WIT Press, www.witpress.com, ISSN 1743-3517