Continuous Improvement Process Research Articles

Enhancing Learning Performance of students in Tourism major at Ba Ria - Vung Tau University

Ba Ria – Vung Tau University, a tourism education institution in Vietnam, has implemented a multifaceted approach to optimize the learning performance of its tourism management students. This article examines the university’s strategies, which include curriculum design and relevance, integration of technology and digital literacy, experiential learning and industry partnerships, mentorship and career guidance, fostering student engagement and well-being, and a continuous improvement and evaluation process. The university’s comprehensive initiatives aim to prepare the next generation of tourism professionals by enhancing their knowledge, practical skills, and overall competitiveness in the dynamic and rapidly evolving tourism industry.

How COVID-19 pandemic affected business excellence: case studies from Greek companies

PurposeThis paper is the third part of a research effort that aims to identify how various crises affected basic business processes using Institut Européen d'Administration des Affaires (INSEAD’s) industrial excellence framework (IEF) in large organizations.Design/methodology/approachThis research compares three data sets from the same four companies against quality management benchmarks, with a span of more than two decades: (1) data collected in 2005 operating under a financially thriving corporate environment; (2) data collected in 2015, operating under a strong financial crisis and (3) data collected in 2022, operating under the serious COVID-19 crisis.FindingsThe authors identify the characteristics that helped them navigate successfully through almost two crises in a row. These companies successfully navigated crises by applying assessment and continuous improvement processes, forging close relationships with their suppliers and training their people systematically.Practical implicationsThe findings can be adopted by practitioners who wish to navigate their organizations during serious crises. Researchers and academics may also find this study interesting for managing quality during a pandemic.Originality/valueThere are not many studies that investigate how the pandemic influenced the quality management practices in organizations in Greece in sequential crises. This paper brings insights into the enduring advantages of adopting a quality framework.

Benchmarking medical laboratory performance on a global scale.

Laboratory performance as a relative concept needs repetitive benchmarking for continuous improvement of laboratory procedures and medical processes. Benchmarking as such establishes reference levels as a basis for improvements efforts for healthcare institutions along the diagnosis cycle, with the patient at its center. But while this concept seems to be generally acknowledged in laboratory medicine, a lack of practical implementation hinders progress at a global level. The aim of this study was to examine the utility of a specific combination of indicators and survey-based data collection approach, and to establish a global benchmarking dataset of laboratory performance for decision makers in healthcare institutions. The survey consisted of 44 items relating to laboratory operations in general and three subscales identified in previous studies. A global sample of laboratories was approached by trained professionals. Results were analyzed with standard descriptive statistics and exploratory factor analysis. Dimensional reduction of specific items was performed using confirmatory factor analysis, resulting in individual laboratory scores for the three subscales of "Operational performance," "Integrated clinical care performance," and "Financial sustainability" for the high-level concept of laboratory performance. In total, 920 laboratories from 55 countries across the globe participated in the survey, of which 401 were government hospital laboratories, 296 private hospital laboratories, and 223 commercial laboratories. Relevant results include the need for digitalization and automation along the diagnosis cycle. Formal quality management systems (ISO 9001, ISO 15189 etc.) need to be adapted more broadly to increase patient safety. Monitoring of key performance indicators (KPIs) relating to healthcare performance was generally low (in the range of 10-30% of laboratories overall), and as a particularly salient result, only 19% of laboratories monitored KPIs relating to speeding up diagnosis and treatment. Altogether, this benchmark elucidates current practice and has the potential to guide improvement efforts and standardization in quality & safety for patients and employees alike as well as sustainability of healthcare systems around the globe.

Bio-refinery of palm kernel expeller waste into attached microalgal biodiesel, the life cycle analysis of waste biomass-to-energy

The exploitation of solid carbon waste in the form of palm kernel expeller served two purposes: (i) providing nutrients for microalgal growth and (ii) serving as a medium for the adhesion of microalgal cells. This study examined the life cycle assessment of biodiesel production from attached microalgae, a less explored domain as compared with conventional microalgal system focusing on energy and environmental feasibility aspect. The computed environmental impact indicated that harvesting and lipid production had contributed significantly to the overall impact, though the global warming potential remained low (5.2 × 10−4 kg CO2 eq.). The establishment of scenario analysis had revealed that solvent recovery options resulted in about 48–55 % damage recovery, giving significant decline in the environmental impacts. In terms of energy sustainability, the study revealed a net energy ratio of 0.52, suggesting that the energy output is less than the energy invested. While falling short of ideal energy sustainability, the ratio surpassed that of conventional petroleum diesel and many previous microalgal technologies. Despite challenges, the findings accentuated the importance of continuous improvement in microalgal biofuel processes for enhancing energy efficiency and reducing environmental impact.

Nachhaltige Steigerung der Produkt- und Prozessqualität

Abstract The quality in the product creation process is of crucial importance for manufacturing companies in terms of customer satisfaction and thus economic success. However, a growing variety and increasing product requirements pose challenges to the achievable product quality and the necessary processes. As a result, quality defects often occur in the development, manufacturing, and the application of a product. To be able to sustainably learn from the errors that have occurred and to initiate a suitable process of continuous product improvement as a company, the introduction of QRQC (Quick Response Quality Control) may be necessary. To illustrate the implementation of such a methodological approach, this article exemplarily presents the introduction and functionality of a problem-solving system at Liebherr Hydraulikbagger GmbH.

Der Ursache auf der Spur

Abstract Integrating mental stress into general risk assessment is crucial for protecting and promoting health and safety of the workforce. This article examines the process of mental stress risk assessment while emphasizing the significance of moderated workshops as a participatory approach to work design, along with associated challenges and solutions for deriving measures to improve working conditions. Furthermore, it highlights the importance of evaluating the effectiveness of measures as an essential component of continuous improvement processes.

Innovation and Adaptation of Social Studies Learning in Curriculum Development

Social Sciences is a subject that studies aspects of the field of science related to humans, the environment and the interaction activities between them. There are several complaints about social studies education, such as getting bored easily, not being able to memorize, the lesson material is not related to daily life, and the learning process is monotonous, namely students spend more time listening and taking notes. Apart from that, the implementation of social studies learning tends to deliver material according to textbooks and the methods used are not varied, namely more lecture methods and not using various learning media. So the students' attitudes during the learning process are like joking around with their classmates, sleeping and doing other activities as a result of which the material presented is not understood. So it is very important to determine innovation and adaptation of social studies learning in the development of the current educational curriculum. The method used is library research or literature review. Library research includes general processes such as systematic identification of theories, literature exploration, and analysis of documents that contain information related to the research topic. Based on the results of the study, the forms of social studies learning innovation in curriculum development are; actualization of social studies learning, project-based learning, student-centered approach, use of technology, field trips, connection with the real world, performance-based evaluation, creativity and expression, collaboration between subjects, continuous process improvement. Meanwhile, the form of adaptation itself is by implementing differentiation learning which consists of; content differentiation, process and product differentiation.

Are resources and demands from accountability policies productive? How leaders build district capacity in response to school turnaround policy

PurposeAs school districts evolve in their ability to actively support schools and educators, they must simultaneously contend with external policies that create additional demands on time and resources. This includes accountability policies aimed at increasing district and school capacity. This study uses Malen and Rice’s (2004) dual dimensions of capacity building to look at how district and charter leaders responded to the demands of Michigan’s Partnership Model, a district-based approach to school turnaround, focusing on how they tried to build capacity in response to the policy and whether and why these capacity building approaches were perceived as productive.Design/methodology/approachSemi-structured interviews were conducted with 22 out of 29 Partnership leaders between October 2019 to March 2020 in the second year of policy implementation. Data were analyzed using a combination of index-coding and thematic analysis.FindingsMost leaders perceived the resources associated with the reform as useful, but the productivity of capacity building efforts was limited because some resources were not adequately matched to what they perceived as a core problem: the recruitment and retention of teachers. Engagement with the reform resulted in building informational and social capital because it fostered collaboration and continuous improvement processes, but leaders perceived technical partnerships as more productive than community partnerships.Originality/valueTurnaround reforms like the Partnership Model that increase resources for districts and schools likely offer a better chance at success than those that simply focus on accountability threats without accompanying support because they give leaders new opportunities to coordinate and align resources, processes and ideas.

Analysis of the Steelmaking Process via Data Mining and Pearson Correlation.

The continuous improvement of the steelmaking process is a critical issue for steelmakers. In the production of Ca-treated Al-killed steel, the Ca and S contents are controlled for successful inclusion modification treatment. In this study, a machine learning technique was used to build a decision tree classifier and thus identify the process variables that most influence the desired Ca and S contents at the end of ladle furnace refining. The attribute of the root node of the decision tree was correlated with process variables via the Pearson formalism. Thus, the attribute of the root node corresponded to the sulfur distribution coefficient at the end of the refining process, and its value allowed for the discrimination of satisfactory heats from unsatisfactory heats. The variables with higher correlation with the sulfur distribution coefficient were the content of sulfur in both steel and slag at the end of the refining process, as well as the Si content at that stage of the process. As secondary variables, the Si content and the basicity of the slag at the end of the refining process were correlated with the S content in the steel and slag, respectively, at that stage. The analysis showed that the conditions of steel and slag at the beginning of the refining process and the efficient S removal during the refining process are crucial for reaching desired Ca and S contents.

Developing Dashboard Analytics and Visualization Tools for Effective Performance Management and Continuous Process Improvement

Performance management and continuous process improvement are essential for businesses to monitor how well their operations are running, find ways to improve them, and bring about good change. However, making decisions based on data in these areas can be challenging because performance data is complicated. This research looks into how panel analytics and data visualization tools can help manage performance well and make processes better all the time. A literature study is done on performance management frameworks, process improvement methods, data visualization techniques, and dashboard solutions that are already out there. The Lean, Six Sigma, and balanced scorecard methods are looked at for success indicators and metrics. It also looks into data visualization tools' design principles and methods like dashboards, tables, charts, and interactive features. Interviews, observations, document reviews, and internal files are ways a case organization gathers both primary and secondary data. Key performance indicators for quality, delivery, productivity, safety, and customer happiness are found in several different business roles and processes. To look at performance trends and relationships, SPSS is used for descriptive statistics and hypothesis testing. Interactive dashboard examples that use different data visualization methods are created by thinking about how the user will experience it, how it will work with other systems, and how it will help them make decisions. Dashboards let you dig deeper into processes, determine why problems happen, and compare actuals to goals. Usability testing checks how easy the tools are and how well decision-makers can learn from them. The results show that dashboard analytics can make handling performance and improvement projects easier based on data. Insights made it possible to keep track of KPIs, find methods that were not working well, and work together across teams. There are also talks about problems with data quality and change management.

Bridging technology and care: integrating web-based PROMs in mental health services for refugees: a study on clinician training and technology adoption.

This study explores the integration of a web-based electronic database technology containing patient-reported outcome measures (PROMs) with electronic health records for refugees with PTSD, emphasizing the systematic inclusion of patient perspectives in clinical decision-making. Our research addresses the notable gap in literature regarding training clinicians for the competent integration of health information technology in healthcare. The training program developed aimed at equipping clinicians, particularly inexperienced with technology, to effectively utilize an electronic PROM system for collecting systematic patient information. Our study is set in the context of the Mental Health Services (MHS) in Denmark, focusing on a specialized clinic for treating trauma-affected refugees. The multidisciplinary team involved in this project reflects a wide range of healthcare professionals. The training program employed a variety of activities over nearly 2 years, adapting to feedback and aiming to engage clinicians in continuous improvement processes. Analyzing qualitative data with thematic analysis we interpreted that the training's extended focus on discussion of the implementation process, with limited hands-on experience, potentially reinforced clinicians' hesitations toward new technology, rather than reducing them. Clinicians prioritized immediate concerns over potential long-term benefits. Despite this, their approach reflects a strong commitment to patient welfare and careful evaluation of new practices. Notably, there were also positive engagements with the technology, highlighting its potential in patient care. This study concludes that the successful integration of technology in clinical settings hinges on its alignment with clinicians' workflows, respect for their professional judgment, and clear benefits to patient care.

Enhancing Cancer Care Through Quality Initiatives: The Uganda Cancer Institute Experience With the Quality Oncology Practice Initiative.

Cancer care in low- and middle-income countries (LMICs) faces numerous challenges, such as limited resources, infrastructure constraints, and a shortage of specialized training. To address these challenges, innovative quality improvement (QI) approaches are required. The Quality Oncology Practice Initiative (QOPI) by the ASCO provides a framework for improving care quality through evidence-based standards. This article explores how QOPI has been adapted to the local context of the Uganda Cancer Institute (UCI) and highlights the importance of aligning international best practices with local health care realities to bridge disparities in care standards. The adaptation of the QOPI program at UCI commenced with a collaborative meeting with the ASCO-QOPI team in 2020. A tailored implementation plan was developed focusing on incorporating ASCO's QOPI measures and additional metrics relevant to the Ugandan context, engaging multidisciplinary teams, and optimizing resource use by leveraging existing resources for data collection and analysis. The execution of the plan relied heavily on staff training, participatory data collection, and continuous quality improvement processes that utilized data-driven methodologies. A retrospective analysis of QOPI data of UCI from 2020 to 2023 shows significant improvements in oncology care quality, highlighted by an upward trend in QOPI assessment scores across various metrics. These reflect the journey of UCI toward aligning its oncology care practices with international standards despite facing significant challenges. UCI's experience demonstrated the feasibility and impact of implementing international QI programs in LMICs. The success demonstrates that significant improvements in cancer care quality can be achieved in resource-constrained settings through adaptability, stakeholder engagement, and strategic resource optimization. UCI's journey is a model for other LMICs seeking to raise their cancer care standards, demonstrating that QI is necessary and attainable worldwide.

Creating a national model to build anti-cancer stewardship and quality improvement initiatives.

e23219 Background: The Department of Veterans Affairs (VA) Pharmacy Benefits Management (PBM) Services created a national stewardship with focus on anti-cancer therapeutics within a disease-specific cohort. Building a model to focus on Veterans with a common malignancy is a novel approach. A toolkit was built containing resources to support initiatives to promote standardization of practice and monitor outcomes as a continual quality improvement process. This model was piloted in Veteran patients with Chronic Myeloid Leukemia (CML) since Tyrosine Kinase Inhibitors (TKIs) account for the second highest utilization among outpatient oral anti-cancer therapies in VA . Methods: Business rules identified Veterans Integrated Service Network (VISN) CML cohorts by using data and diagnostic coding (ICD-10; SNOMED CT) from the VA Electronic Health Record (EHR): primary care and hematology/oncology visits, inpatient stays, and problem lists. Medication Use Evaluations (MUEs) were developed: MUE #1: Veterans who received a drug other than imatinib as their initial VA prescription If new initiation, documented reason(s) for drug selection If continuation, prior drug therapy history MUE #2: Veterans who switched from first to second-line TKI Documented reason(s) for switch to 2L Documentation of adverse drug reaction (ADR) in the EHR. Results: 16 VISNs participated in the MUEs. Patient counts are each ~25% of the total CML cohort; ~50% of patients received imatinib 1L and have not switched to 2L. Responses for MUE #1 (N = 559) 293 (52%) continued therapy originally started outside VA with 71% of these patients (n = 208) without documentation of prior imatinib 266 (48%) newly initiated therapy with top documented reasons Intermediate/high risk scoring: 109 (41%) Reason not documented: 80 (30%) Cited FDA indication for CML without clinical justification: 35 (13%) Responses for MUE #2 (N = 576) Top documented reasons for switch from 1L to 2L therapy ADR: 325 (56%) Resistance / inadequate response: 132 (23%) Disease progression: 117 (20%) Only 59 (18%) who experienced an ADR had it documented in the EHR allergies / adverse reactions section. Conclusions: Disease-focused oncology stewardship in a national healthcare system is feasible. Imatinib remains the preferred TKI and accounts for the highest utilization. Oncology Stewardship activities based on the results include education on disease coding, an educational document on why to use imatinib in the 1L setting, and a medication safety article to emphasize documentation of ADRs. In our 1L to 2L MUE, ADRs were the most common reason for patients to be switched to 2L. Future activities include an education sheet on managing TKI ADRs and criteria for a potential treatment-free remission. Further interventions in TKI prescribing may be instituted in select sites. Following initiatives for CML, Anti-Cancer Stewardship Program will be expanded to other oncologic diseases.

Analysis of Relationships between Non-conformities, Process Maturity and Continual Improvement in Information Security Management Systems

Abstract In the current global context, companies need a defined minimum level of information security to recognize and deal with related threats and risks. Due to market, customer or legal requirements, specifications and requirements for information security are implemented uniformly according to standards such as the information security management standard ISO/IEC 27001 or industry-specific standards such as Trusted Information Security Assessment Exchange - TISAX, ISO IEC 27019 Energy Utility Information Security Standard. The conformity to these standard requirements within the established management system is checked during periodically required audits. However, there are various reasons for which, even after many years of audits in companies, there are still insufficient process implementations for information security requirements. The aim of the paper is to analyze the status of conformity and thus also the process maturity in selected samples of companies that have already had information security management systems (ISMS) implemented for several years. In detail, the reasons for deviations from the minimum requirements with associated risks for the security of information in companies were analyzed, which allow conclusions to be drawn about possible process improvements. The paper also analyzes why, despite established measures and existing expertise, only a limited level of process maturity is achieved on average. Other possible approaches to the implementation procedure for dealing with non-conformities in information security are also considered. The results of this research show that there is a need for an adjusted continuous improvement process, which makes risks resulting from insufficient process maturity more visible. Proposals for such improvements are listed.

Moving from Prove to Improve: A collaborative continuous quality improvement process for advancing clinical and translational science

Moving from <i>Prove</i> to <i>Improve</i>: A collaborative continuous quality improvement process for advancing clinical and translational science

Research on U-band Fiber Lasers

The U-band fiber laser has attracted the attention of many researchers and industry due to its outstanding performance characteristics. U-band fiber laser is a type of laser that operates in the ultraviolet wavelength range, and its research background mainly stems from the demand for ultraviolet lasers in scientific research, medical treatment, material processing, and other fields. However, traditional ultraviolet lasers often use gas laser media, which have large volume, high power consumption, and high maintenance costs, limiting their promotion in practical applications. Therefore, researchers have begun to explore the use of fiber optic technology to achieve miniaturization, efficiency, and stability improvement of ultraviolet lasers. This article provides an overview of the working principle and application fields of U-band fiber lasers and proposes the future development direction of U-wave fiber lasers. Intended to provide useful references for further research on fiber lasers. Through continuous technological innovation and process improvement, this paper promote the further development of U-band fiber laser technology, expand its application areas, improve performance and stability, and promote its widespread application in industrial and scientific research fields.

#1772 Comparison of interpretation of acid-base disorder in patients with critical illness: nephrologist versus ChatGPT

Abstract Background and Aims The generative pre-trained transformer (GPT), a type of large language model (LLM), is now playing a huge role in driving innovation in fields of medical education, diagnosis and treatment and with a process of continuous improvement it will itself be able to become beacons of sustainability. Medical professionals expect that they may have help from LLMs to diagnose patients more accurately and efficiently, but it is unclear whether current LLMs are well-trained and validated on real-world clinical data. In this study, we compared the performance of ChatGPT, a representative LLM, MDCalc, an online medical calculator, and human nephrologist for their diagnostic accuracies of acid-base gas analysis in critically ill cases. Method This study included 130 patients admitted to intensive care unit with varying medical conditions. All variables were obtained during the first 24 hours after admission. Results The Fleiss’ Kappa between the interpretations of nephrologist, ChatGPT and MDCalc with the acid-base gas analysis for acid-base disorders showed that Fleiss’ Kappa value was −0.138 (95% CI −0.216 to −0.059), indicating no agreement among the judgments of human doctor, LLM and online medical calculator in critically ill patients for the interpretation of acid-base status. MDCalc showed that all patients had mixed acid-base disorders while nephrologist that 4 patients had simple acid-base disorder and 1 patient had normal acid-base balance. By contrast, ChatGPT reported that 51 patients had only simple acid-base disorder. Furthermore, according to ChatGPT, normal acid-base balance was found in 27 patients, who were all diagnosed as having acid-base disorders by MDCalc or nephrologist. Conclusion We found that current ChatGPT does not yet provide better diagnostic performance for interpreting acid-base balance in critically ill patients who with usually have mixed acid-base disorders compared with an existing online medical calculator or nephrologist.

Seed for the Future: Agricultural Advancement and Innovation for Sustainability Food Systems in Tanza, Cavite

Through the perspectives and adaptations of local farmers, this qualitative case study explores agricultural innovations and progress toward sustainable food systems in Tanza, Cavite. Using purposive sampling, the study included eight participants to investigate several important topics, including technology integration, the role of institutions and the government, and the continuous improvement of processes within the agricultural community. Six main themes are revealed by the results: an evolution from conventional to organic farming methods; the technological revolution enhancing productivity; overcoming challenges by innovative solutions; substantial government support affecting agricultural practices; the value of lifelong learning for ongoing development; and innovative farming methods such as the "rap giant" approach. These themes show how Tanza, Cavite, is experiencing a dynamic transition to more efficient and sustainable farming methods, supported by technology and legal structures that improve production, environmental sustainability, and community well-being.

Peripheral vascular bioresorbable scaffolds: Past, present, and future

As peripheral vascular disease affects more and more people in the world, interventional treatment of peripheral blood vessels evolves from percutaneous transluminal angioplasty to bioresorbable vascular scaffolds (BVS). At present, the materials of peripheral vascular bioresorbable scaffolds mainly include polymers and metal materials, and have achieved certain clinical application effects. Examples of these BVS are provided, and their advantages and defects are discussed. Poly-L-lactic acid is most commonly used in polymer BVS. There have been some polymer BVS entering clinical research for peripheral blood vessels since the 10 s, and have various outcomes. Metal materials for BVS mainly include magnesium alloy, iron alloy, and zinc alloy. The improved magnesium alloy BVS show excellent antiplatelet adhesion ability and can reduce the formation of acute stent thrombosis in clinical research. The iron alloy BVS and zinc alloy BVS also show excellent performance in animal experiments. The drug coating of BVS is expected to be improved. Finally, prospects of future development are highlighted. With the continuous improvement of manufacturing and drug-coating process, their therapeutic effect is expected to continue to improve.

Supervision of essential patient safety actions in medical units in a health institution.

To determine the importance of the supervision of the essential patient safety actions (AESP) in the different Medical Units of the different levels of care in Mexico City. The concern for quality in health care, understood as the safety of patients, is a fundamental aspect that involves the authorities and operational personnel. Supervisions were carried out in the different medical units of Mexico City. Positive correlations were observed between the implementation of the AESP and the number of damages, incidents, events and errors existing in the medical units. The supervision of the AESP program should be aimed at the prevention and management of risks in health care, recognizing the occurrence of adverse events as a reality resulting from a gradual work of a whole process of continuous improvement.