Preventive Quality Management Research Articles

Machine learning-based prediction of harmful algal blooms in water supply reservoirs

Abstract Harmful algal blooms (HABs) pose a potential risk to human and ecosystem health. HAB occurrences are influenced by numerous environmental factors; thus, accurate predictions of HABs and explanations about the predictions are required to implement preventive water quality management. In this study, machine learning (ML) algorithms, i.e., random forest (RF) and extreme gradient boosting (XGB), were employed to predict HABs in eight water supply reservoirs in South Korea. The use of synthetic minority oversampling technique for addressing imbalanced HAB occurrences improved classification performance of the ML algorithms. Although RF and XGB resulted in marginal performance differences, XGB exhibited more stable performance in the presence of data imbalance. Furthermore, a post hoc explanation technique, Shapley additive explanation was employed to estimate relative feature importance. Among the input features, water temperature and concentrations of total nitrogen and total phosphorus appeared important in predicting HAB occurrences. The results suggest that the use of ML algorithms along with explanation methods increase the usefulness of predictive models as a decision-making tool for water quality management.

Robust Parameter Design for Cyclone System Based on Dual-Response Surface Method and Multiobjective Genetic Algorithm.

To realize the predictive control of coal preparation quality and ensure that the quality of washing products is close to the minimum coal quality requirement of coal blending to the greatest extent is one of the important means to maximize production and maintain the interests of customers and enterprises. Therefore, the feasibility of introducing the double response surface method and multiobjective genetic algorithm to solve the aforementioned problems is further discussed. By selecting the controllable factors and noise factors affecting the output and determining their respective value levels, the product table method is used to design the robust parameter design test, and the experimental results are obtained, according to the experimental data, the second-order polynomial model of the mean and standard deviation of each response characteristic is established, and the effectiveness of the model is analyzed. Then, the double-response optimization function of each response characteristic is established according to the type of response characteristic. Finally, the corresponding parameter values are solved by multiobjective genetic algorithm. The internal and external surface method is used to design and run 60 tests. Through optimization analysis, the robust parameter settings are 150.68 kpa, 0.18143.73 kpa, and 30%, and the optimal output is ash 8.499%, which yields 69.54%, meeting the requirements of stakeholders. Moreover, compared with the traditional optimization design method, the superiority of the proposed method is verified, which shows that this method is conducive to the transformation of the coal preparation plant from fire-fighting quality management to preventive quality management and provides support for the accurate control and systematic management of the production process of the coal preparation plant.

Identification of leading factors supporting decisions in preventive quality management

Purpose: The main aim of the article is to present the results of research of entrepreneurs who maintain a certified quality management system in terms of leading factors supporting decisions of a preventive approach to management. Design/methodology/approach: Interview method conducted in manufacturing companies with an implemented and certified quality management system using CATI technique Findings: Research has shown that in large industrial enterprises the key stimulants of preventive actions are, above all, efficient information flow, technical and organizational order, as well as consistent pursuit of the goal. Smaller enterprises put the main emphasis on maintaining good relations with the environment, safety and ergonomics of work, as well as skillful selection of suppliers. Research limitations/implications: The authors of the paper see the need to continue research in the field of in-depth analysis of selected factors in relation to the effectiveness of the actions taken and the possibility of supporting information. Practical implications: Entrepreneurs with knowledge of key stimulants will make decisions more consciously and focused on a targeted analysis of data in order to search for relevant premises to prevent non-compliance. Originality/value: This paper concerns key factors influencing a preventive approach that can support decision-making. For the purposes of multicriteria decision-making processes, it is valuable to know the key stimuli characteristic of effective preventive actions. An additional value of the article is the showing of the factors with a differentiation by company size. This enables a more relevant focus of the research results. Keywords: decision making, prevention of non-conformities, quality management. Category of the paper: Research paper.

Customer complaints monitoring with customer review data analytics: An integrated method of sentiment and statistical process control analyses

This study presents a data-driven method to monitor customer complaints for efficient service quality management. Recognising the value of customer reviews as a pool of 'voice of the customer', we propose an integrated method of sentiment and statistical process control analyses. The use of customer review data for statistical process control analysis extends the scope of research and application from the supplier perspective to customer-centric service quality management. The sentiment analysis enables systematic identification of a customer satisfaction score from customer review data while the statistical process control chart analysis allows early detection of significant customer complaints and prevents service failures. The integration of two analyses makes it possible to monitor customer complaints at acceptable time and cost. We applied and validated the proposed method using a mobile game service, offering a guideline for its implementation and customisation. The proposed method is expected to be used as an effective tool for customer complaints monitoring over time, which enables responsive and preventive quality management.

Critical incidents of outsourcing processes in pharmaceutical supply chain: A mixed-methods approach

Purpose: In this paper, a practical framework is presented for the successful integration of buyers and contract organizations based on the Critical Incident Technique (CIT).Methodology: The initial pool of situations was developed inductively according to qualitative data provided by ten experts in the field of outsourcing in pharmaceutical supply chain. Another group of experts evaluated these situations with regard to their degree of realism as well as relevance and allocated them to the five constructs (1) employee competence, (2) management commitment, (3) communication between organizations, (4) organizational culture, and (5) regulatory framework.Findings: The findings of the study show that communication appears to be the most frequent reason while regulatory framework seems to be the last frequent reason for critical incidents during outsourcing. Contract giver and service provide show diverging perceptions about the situations’ degree of realism and relevance. Analysis of the interrater agreement shows that the allocation to a single construct is a challenge due to the critical incidents’ complexity and multidimensionality.Originality: The critical incidents database and the presented framework serve as preventive behavioral-based quality management for the pharmaceutical supply chain.

Sampling the Food-Processing Environment: Taking Up the Cudgel for Preventive Quality Management in Food Processing (FP).

The Listeria monitoring program for Austrian dairies and cheese factories was established in 1988. The aim was to control the entrance of L. monocytogenes into the food-processing environment (FPE), preventing the contamination of food under processing. The Austrian Listeria monitoring program comprises four levels of investigation, dealing with routine monitoring of samples and consequences of finding a positive sample. Preventive quality control concepts attempt to detect a foodborne hazard along the food-processing chain, prior to food delivery, retailing, and consumption. The implementation of a preventive food safety concept provokes a deepened insight by the manufacturers into problems concerning food safety. The development of preventive quality assurance strategies contributes to the national food safety status and protects public health.

Medical-Environmental Assessment and Forecasting of Socially Significant Pathology of the Population of the Republic of Dagestan

Aim. The environmental-epidemiological monitoring of socially significant pathology and its forecasting for the development of effective preventive measures and environmental quality management methods in the Republic of Dagestan. Material and Methods . An epidemiological analysis of public health indicators was carried out in 41 municipalities and 10 urban districts of the Republic of Dagestan. This was carried out through current and retrospective analysis of regional health indicators, medical-geographical and mathematical statistical analysis. The data sources for the main indicators reflect the epidemiological situation in the Republic of Dagestan from 1997 to 2016. Results. An understanding of the status of the main epidemiological indicators of the condition of public health of the region's rural and urban population was obtained and future dynamics predicted. An integrated assessment of the well-being of the territory of the republic revealed areas and cities with adverse trends in public health in the main groups of socially significant and environmentally-related pathologies. Conclusions. An integrated assessment of the state of well-being in the Republic of Dagestan by groups of epidemiological indicators of general morbidity, general morbidity of various age groups of the population, socially significant and environmentally-caused morbidity, as well as a forecast of their dynamics, revealed adverse trends in public health in rural populations of Tsuntinskiy, Akhtynskiy, Gunibskiy, Kulinskiy, Tabasaranskiy, Nogayskiy, Novolakskiy, Suleiman-Stalskiy, Khasavyurtskiy, Tarumovskiy districts and of the cities of Kaspiysk, Dagestanskie Ogni, Makhachkala and Kizilyurt. An analysis of the sources of supplies of drinking water revealed a positive correlation between heavy metals content and adverse trends in socially significant pathology in the regions of Northern Dagestan.

IMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEM IN A NUTRITION UNIT ACCORDING TO ISO 9001:2008

the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients. to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit. the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation. a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013. the implementation of a QMS causes a reorganization of the activities of the Unit in order to meet customer's expectations. Documenting these activities ensures a better understanding of the organization, defines the responsibilities of all staff and brings a better management of time and resources. QMS also improves the internal communication and is a motivational element. Explore the satisfaction and expectations of patients can include their view in the design of care processes.

Sampling the food processing environment: taking up the cudgel for preventive quality management in food processing environments.

The Listeria monitoring program for Austrian cheese factories was established in 1988. The basic idea is to control the introduction of L. monocytogenes into the food processing environment, preventing the pathogen from contaminating the food under processing. The Austrian Listeria monitoring program comprises four levels of investigation, dealing with routine monitoring of samples and consequences of finding a positive sample. Preventive quality control concepts attempt to detect a foodborne hazard along the food processing chain, prior to food delivery, retailing, and consumption. The implementation of a preventive food safety concept provokes a deepened insight by the manufacturers into problems concerning food safety. The development of preventive quality assurance strategies contributes to the national food safety status and protects public health.

Organizational Culture, Team Climate, and Quality Management in an Important Patient Safety Issue: Nosocomial Pressure Ulcers

Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score ≤ 18) and preventive quality management at ward level. No associations were found between organizational culture, team climate, or preventive quality management at the ward level and the prevalence of nosocomial pressure ulcers. Institutional quality management was positively correlated with preventive quality management at ward level (adj. β 0.32; p < 0.001). Although the prevalence of nosocomial pressure ulcers varied considerably across wards, it did not relate to organizational culture, team climate, or preventive quality management at the ward level. These results would therefore not subscribe the widely suggested importance of these factors in improving health care. However, different designs and research methods (that go beyond the cross-sectional design) may be more informative in studying relations between such complex factors and outcomes in a more meaningful way.

Translational medicine as implementation science in the field of monitoring HIV and TB. New concepts emanating from resource‐poor countries

In the last decade, there has been generous support by Western nations to deal with the HIV/AIDS epidemic and accompanying plethora of infections, a significant portion of the aid is extended to resource-restricted countries (1). The wave of support has contributed to the development of a branch of biomedical activity, referred to as translational medicine. This new field covers two areas: (i) the ‘‘translational medicine proper’’ (T-1) to establish proofs of concepts mostly in animal models that lead to pilot studies in humans, and (ii) ‘‘the translational medicine-2’’ (T-2, also referred to as ‘‘implementation science’’) for optimizing already established medical concepts in rich and poor countries alike, for wider applications in communities (2). Fledgling journals which carry the ‘‘translational’’ title clearly favor T-1 publications; by contrast, on the pages of Clinical Cytometry mostly T-2 topics are featured as clinical implementations of diagnostically relevant developments. For two reasons, the T-2 field is subject to political scrutiny. First, In 2008, US $ 15.6 billion was spent on AIDS programs in low and middle income countries. Currently, a very high proportion (50%) of these are coming from external, including generous North American, sources and these may not be sustainable. Furthermore, the calculated trends reveal that this expenditure is to shoot up to 2–3 times higher levels, and that a major epidemic will still be with us in 2031 without a change in approach (3). Second, medical care in the West is, by tradition, expensive (4). The health care practiced in the US appears to be in the 37th position with respect to cost efficiency (5). Consequently, when suggesting that from now on the resource-restricted partners must contribute more to their HIV care/prevention (3), the possibilities of modifying diagnostics according to the local needs using local implementation science must be considered. This field in Africa has been revitalized since generic antiretroviral therapy (ART) became affordable. During the last decade requirements for simplifying diagnostics has frequently been advocated in the pages on Clinical Cytometry (6,7). When African health care workers are faced with acute crisis, they are often proven to be inventive. Evidence is gathering that the technologists in resource-poor regions are capable of developing and/or modifying methods in order that these are elegantly simplified for more affordable large scale testing formats. Some of these efforts represent improvements of precision, accuracy, quality assessment, and training (8–10). In his recent book, Nigel Crisp, the former Chief Executive of the National Health Service of the United Kingdom (11) explains that ‘‘poor countries do not need a diluted version of what rich countries have now, and may have an easier time building a better system from little.’’ Inspired by his approach, in this editorial, we would like to briefly review five recent papers (12–16). But first we need to consider two significant changes in the global outlook which influence the use of diagnostics. In 2006, the WHO recommended that all HIV positive patients start ART when their CD4 T-cell count fell to 200 cells/mm. In patients with CD4 counts between 200 and 350 cells/mm, the initiation of ART was optional on the basis of these patients showing some symptoms (Grade 2–4) or were still asymptomatic (Grade 1). However, in countries with poor resources this guideline was frequently interpreted as to start ART at 200/mm, reaching many patients too late (17,18) even at levels as low as 50–150 CD4 T-cells/mm. Recently, it has also been shown that earlier start of ART at higher CD4 T-cell counts reduces mortality and morbidity rates (17,18). Therefore WHO, in unison with other regulatory bodies, now recommends ART to be

Systematische Risikoanalyse der medizinischen Leistungsprozesse durch detaillierte Mitarbeiterbefragungen – eine effektive Basis zur Optimierung der Patientensicherheit

Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.

Manager&apos;s role in Preventive Action and Quality Management Education

Manager&apos;s role in Preventive Action and Quality Management Education

Qualitätssichernde Maßnahmen hinsichtlich Mykotoxinen in der Getreidemühle

In the present study the quality management system of 39 milling companies was investigated regarding the analysis and the prevention of mycotoxin contamination. 21 companies- mainly companies with a high processing volume - established a quality management system according to DIN EN ISO 9000ff. In view of previous studies the data indicated an improvement of quality management systems in the milling industry during the last years. Nevertheless some powerful instruments of preventive quality management like a supplier assessment have still not been efficiently used in many companies. The monitoring of mycotoxins or the participation in existing monitoring programmes is mainly limited to companies with a high production volume. It is recommended that monitoring programmes should become more attractive for small- and medium-sized companies. Further the development of quality management systems for small and medium-sized companies is required.

Provider group characteristics & quality report card performance: a cross-sectional study in a managed care setting.

We describe 1 health plan's annual, incentive-based, provider group quality report card (Scorecard) and identify trends in Scorecard performance among 142 California provider groups. We explore variation in Scorecard performance by provider group characteristics. Scorecard evaluates provider groups on standardized measures of performance including preventive screening, patient satisfaction, and quality management operations and infrastructure. In a cross-sectional study, we use linear regression to measure associations between provider group characteristics and performance on the 1997 Scorecard. Provider group performance trends (1996-1997) revealed improvement on 6 Scorecard indicators. Regional differences in performance were also shown. Multivariate results indicate that group location in northern California (P = .01), IPA (independent practice association) status (P = .02), older group age (P = .02), and higher mean patient age (P < .01) were independently associated with higher 1997 Scorecard total scores. Member education was marginally associated with performance. Group size, member income, and gender distributions were not independently associated with Scorecard performance. Results of this study suggest that (among Blue Cross of California's contracted provider groups) older, more established groups; groups located in northern California; IPAs; and groups with a patient demographic mix characterized by higher than network average mean age and a lower than network average proportion of members with a college education or greater were more likely to perform well on Scorecard.

Quality in Germany ‐ an overview

Regarding preventive quality management, Germany was lagging behind for many years. Managers relied on the famous mark “Made in Germany” for too long. They did not realize that international competition had tightened. However, times have changed. Starting with the boom in ISO certifications, Germany is getting back on track again. Today, total quality management and business excellence concepts are gaining ground. Positive trends regarding both applications for Germany’s Ludwig‐Erhard‐Preis and the use of self‐assessment show that the quality movement has got a new impetus.

Optimierung eines konventionellen Dokumentationssystems auf der chirurgischen Intensivstation - ein Beitrag zu Kostenreduktion und präventivem Qualitätsmanagement?

In Intensive Care Units (I.C.U.), the lack of staff and funds require the mobilisation of organisational reserves in order to ensure high-quality patient care. Traditional occupational-group organised documentation systems are burdened with lack of clarity, limited utilisation by the staff, insufficient information content and difficulties in synoptic patient monitoring. They cannot meet the demands of modern intensive-care medicine. At the inauguration of our Surgical I.C.U. in June 1992, an occupational-group oriented documentation system was introduced and put into operation. Because of negative repercussions on patient care, it was replaced by a patient-centered, conventional prescription and documentation system in April 1993. In April 1994, an evaluation of the patient-centered system was carried out. We report on our initial problem analysis, the subsequent developmental and introductory phases, and the results after having used the system in our I.C.U. for one year. Data condensation, standardised data recording, as well as structured prescription, examination, assessment and decision processes, saved 730 working hours for medical and nursing staff per year, reduced the cost for documentation materials by 58% and improved the extent of data recording. In our experience, improving a conventional documentation system is a suitable instrument to support cost reduction and preventive internal quality management in the I.C.U.