Quality Assurance Organization Research Articles

About unsolved problems of quality management in health care

Ensuring a high level of quality of care is the main task of any medical organization. The first stage of its solution is proper quality control. In the article, problems that make it difficult to solve these problems are considered. They are: the imperfection of the legislative base, the lack of a clear understanding of the quality criteria by the leaders of medical organizations and subjects of control, different approaches to its evaluation and interpretation of indicators, the lack of differentiation of tasks for achieving certain indicators by management levels, the recommendatory nature of orders and standards for the need for their compliance, the lack of systematic approach to the organization of control and quality assurance, the lack of special training for managers in the field of quality management. Only a systematic approach to solving these problems will lead to a significant improvement in the quality of medical care.

DEVELOPING A MODEL OF SN-PT-BASED INTERNAL ACADEMIC QUALITY ASSURANCE SYSTEM IN THE EDUCATIONAL TRAINING INSTITUTION OF THE MILITARY ACADEMY MAGELANG

Military Academy is an educational training institution in the field of defense, which implements the changes of the quality assurance system based on the ten components of the Army education to the internal academic quality assurance system that is based on the Higher Education National Standards (SN-PT). Military Academy requires strengthening to find a model of appropriate quality assurance system in order to be accreditable by the National Accreditation Board of Higher Education. This study aims to (1) analyze the current quality assurance system in the Military Academy; (2) develop an appropriate SN-PT based model of internal academic quality assurance system in the Military Academy; (3) examine the feasibility of the appropriate SN-PT based internal academic quality assurance system in the Military Academy. This study implemented a research and development approach, employing data sourced from the informants, events and documents. The data were drawn through interviews, observation, and documentation; its validity was tested by tools and resources triangulation. The data were then analyszed using interactive techniques with reduction, display, and conclusion steps. The results of the study: (1) the quality assurance system in the Military Academy is running properly but it still requires further development; (2) the SN-PT based of internal academic quality assurance system implemented in the Military Academy uses the 10 basic education components retained by elaboration, little changes, and additions, related to general quality standards of the SN-PT, including the organizational structure, standards of academic quality, mechanism of the quality assurance system, and SN-PT based internal academic quality assurance system. (3) The results of the feasibility studies indicate that the development of the SN-PT based internal academic quality assurance system model in the Military Academy Magelang is feasible and appropriate. Conclusion: Military Academy requires development in terms of organizational structure quality assurance, academic quality standards, quality assurance mechanisms, and internal academic quality assurance system based

Achievements and Lessons Learned from Vietnam’s Higher Education Quality Assurance System after a Decade of Establishment

Higher education quality assurance and accreditation was officially implemented inVietnamover twelve years ago. From a totally centralized model,Vietnam’s accreditation system has been becoming more independent, especially with the establishment of accrediting agencies. The first accreditation certificates were also awarded to universities that met quality standards and criteria. This paper investigates the development ofVietnam’s higher education quality assurance and accreditation for the last decade since the national quality assurance organization was established. The study first synthesizes the results achieved within this system, both in policy and practice, leadership and management. It also discusses human resources development for quality assurance and accreditation in the national context. Next, the paper highlights the self-evaluation and external evaluation activities, two most important steps of the accreditation process. In addition, building quality culture within higher education institutions is also paid attention to. Finally, lessons from the establishment and development ofVietnam’s accreditation are drawn. This study looks at an overall picture ofVietnam’s higher education quality assurance system since its establishment with a focus on policy, practice, leadership and management. It also hopes to contribute to the literature related to accreditation ofVietnam’s higher education.

Designing an Index for Criteria of the Organization's Quality Assurance in Agricultural Extension in Egypt (ORGAQUALEX) تصمیم مقیاس لمعاییر ضمان جودة المنظمة فی الإرشاد الزراعی فی مصر (ORGAQUALEX)

يستهدف البحث الحالي محاولة تصميم مقياس لمعايير ضمان جودة المنظمة في الإرشاد الزراعي بحيث تتوافر له دلالات ثبات وصدق مقبولة، بحيث يمکن الإستناد إليه عند الرغبة في تطبيق معايير ضمان الجودة في الإرشاد الزراعي. وبعد استعراض الأدبيات المتعلقة بضمان الجودة في المؤسسات الخدمية أمکن تحديد خمسة أبعاد رئيسية يمکن اعتبارها مکونات المقياس وهي: 1) القدرة المؤسسية والميدانية للجهاز الإرشادي، 2) التخطيط الإستراتيجي ودعم الإدارة العليا للجودة في الإرشاد الزراعي، 3) الترتيبات الإدارية بالجهاز الإرشادي، 4) ثقافة وکفاءة الإتصالات المؤسسية للجهاز الإرشادي، وأخيرا 5) قدرات العاملين بالجهاز الإرشادي، وتتضمن 67 معيارموزعة على المحاور سالفة الذکر. ولتحقيق الصدق الظاهري تم عرض المقياس على مجموعة من المحکمين لإبداء الرأي حول مناسبة العناصر الفرعية والعبارات التي تعکسها، وقد أسفرت نتيجة التحکيم عن التوصل إلى تصميم مبدئي للمقياس والعناصر الفرعية لوحداته ووصل عدد المعايير (العبارات) إلى 66 معيار. ولتحقيق هدف الدراسة تم اختيار العاملين بالإدارة المرکزية للإرشاد الزراعي، حيث بلغ حجم العينة 32 مبحوثا يمثلون 58.2% من جملة الزراعيين العاملين بالادراة المرکزية للإرشاد الزراعي (55 مهندسا زراعيا). وقد تم جمع البيانات الميدانية خلال شهري مارس وأبريل عام 2016. وتم استخدام التکرارات، والنسب المئوية، والمتوسط الحسابي، والانحراف المعياري، معامل الارتباط البسيط، واختبارات الصدق والثبات في عرض النتائج. وقد بلغت قيمة معامل ثبات المقياس (ألفا کرونباخ) 0.971، کما بلغت قيمة معامل الصدق الذاتي 0.985 ، ومعامل الصدق الإحصائي 0.986 وهي معاملات صدق مناسبة لتطبيق المقياس. وبعد تصحيح وحدات المقياس إما بالحذف أو التعديل بلغ عدد المعايير (العبارات) المعبرة عن المقياس 66 عبارة منها 12 معيار تمثل القدرة المؤسسية والميدانية للجهاز الإرشادي، 9 لمحور التخطيط الإستراتيجي ودعم الإدارة العليا للجودة في الإرشاد الزراعي، 16 لمحور الترتيبات الإدارية بالجهاز الإرشادي، 16 لمحور ثقافة وکفاءة الإتصالات المؤسسية للجهاز الإرشادي، وأخيرا 13 معيار لمحور قدرات العاملين بالجهاز الإرشادي.

Barriers to the Implementation of the Nursing Approach in Public Hospitals in Lubumbashi in the Democratic Republic of Congo: A Cross-Sectional Descriptive Study

Introduction: The nursing approach (NA) is the essence of the nursing profession. However, its implementation is almost absent in the hospitals of the Democratic Republic of Congo (DRC). Objectives: The aim of this study was to determine nurses’ knowledge, attitudes and practices in relation to the nursing approach and to identify barriers to the implementation of this approach. Methods: To achieve these objectives, we carried out a cross-sectional descriptive study among the nurses of the 11 public hospitals of Lubumbashi, from June to September 2015. Thanks to a validated questionnaire, we collected the data by interview, supported by participatory observation. Results: The results showed that 67.6% of respondents were trained on NA; However, 99.3% did not know the exact number of NA steps and 62.6% did not cite any steps; The majority (93.5%) of trainees on NA find that this process provides quality patient care; 100% of the sample wish to put it into practice; 100% of the sample need continuous training on NA including 67.6% to improve knowledge and 32.4% to learn; 89.1% of those trained reported not practicing NA, but participating direct observation gave 100% of non-practice. The barriers to implementation of the NA were inadequate nursing staff (75.6%), inadequate equipment (71.5%), lack of time (62.6%), lack of theoretical and practical knowledge (47.2%), lack of nursing records (26%) and lack of institution for nursing care within the hospital (17%). Conclusion: Therefore, capacity building of nurses through continuing education, as well as initial training on NA, would increase their knowledge, reinforce positive attitude and promote its implementation, all supported by improved working conditions and the implementation of a professional nursing quality assurance organization.

Diagnostic Immunohistochemistry: What Can Go Wrong and How to Prevent It.

-There are a number of critical factors that can lead to incorrect results if the diagnostic pathologist performing immunohistochemistry is unaware of, or not vigilant about, their influence. -To highlight 3 arenas in which errors may be introduced. -For choosing the correct primary antibody, selection of the most appropriate antibodies for a given clinical application can be aided by obtaining information from the vendor; however, this can yield incomplete information. There are a number of online databases that have comparisons of antibodies from different vendors, particularly with respect to their use and properties. Reading the published literature can assist in this process, particularly with respect to determining antibody sensitivity and specificity, but it is a daunting task to keep up with all of the immunohistochemistry-related papers published. Finally, Web sites of a number of quality assurance organizations are accessible and can provide a wealth of information comparing the "real world" performance characteristics of different antibodies to the same target protein. False-positive signals can result from a number of factors, including the use of inappropriately high antibody concentration, and "pseudospecific" signal that is in the wrong compartment of the cell. False-negative signal can result from factors such as use of a nonoptimized epitope retrieval method. It is critical that epitope retrieval methods be optimized for each antibody employed in the laboratory. -By paying attention to these potential problems, the "black box" of diagnostic immunohistochemistry can be made more transparent.

A Proposed Model for Sustaining Quality Assurance Using TQM Practices in Small and Medium Scale Industries

In earlier decades several studies made on Total Quality Management (TQM) practices in small and medium scale enterprises. By compiling the various research works that were carried out during 2010-2015 in the field of Small and Medium-Scale Industries (SMSIs) TQM can be broadly conceptualized in to as flexible and rigid practices. From the limited level of investigations so far made on the various research works it has lead in identifying the different factors that influence TQM practices in SMSIs and its supplementary growth. The purpose of this article is to examine the influence of flexible and rigid TQM practices in SMSIs. It gives a broad overview of how TQM practices are constructed and how it acts on the various quality improvements. This work is expected to widely sensitize the TQM practices in SMSIs and how quality assurance in organizations will have to gain its place in future.

Incident Learning in Pursuit of High Reliability: Implementing a Comprehensive, Low-Threshold Reporting Program in a Large, Multisite Radiation Oncology Department

Incident learning programs have been recognized as cornerstones of safety and quality assurance in so-called high reliability organizations in industries such as aviation and nuclear power. High reliability organizations are distinguished by their drive to continuously identify and proactively address a broad spectrum of latent safety issues. Many radiation oncology institutions have reported on their experience in tracking and analyzing adverse events and near misses but few have incorporated the principles of high reliability into their programs. Most programs have focused on the reporting and retrospective analysis of a relatively small number of significant adverse events and near misses. To advance a large, multisite radiation oncology department toward high reliability, a comprehensive, cost-effective, electronic condition reporting program was launched to enable the identification of a broad spectrum of latent system failures, which would then be addressed through a continuous quality improvement process. A comprehensive program, including policies, work flows, and information system, was designed and implemented, with use of a low reporting threshold to focus on precursors to adverse events. In a 46-month period from March 2011 through December 2014, a total of 8,504 conditions (average, 185 per month, 1 per patient treated, 3.9 per 100 fractions [individual treatments]) were reported. Some 77.9% of clinical staff members reported at least 1 condition. Ninety-eight percent of conditions were classified in the lowest two of four severity levels, providing the opportunity to address conditions before they contribute to adverse events. Results after approximately four years show excellent employee engagement, a sustained rate of reporting, and a focus on low-level issues leading to proactive quality improvement interventions.

Understanding the Concept of Quality Assurance

The general objective of this paper is to demonstrate the understanding of the concept of quality assurance in Europe. In doing so this paper provided: (1) a definition of quality and quality assurance; (2) an illustration of hierarchy in quality assurance organizations in Europe; (3) a commentary on the Bologna process; (4) a description of the quality assessment process and timeline; (5) a comparison of the US accreditation system and European quality assurance system; and (6) the role of European governments in the quality assurance process.

The Evolution of Management Theories: A Literature Review

Abstract This paper provides an overview of the evolution of management theories with an emphasis on human resource management (HRM). It examines the early philosophical viewpoints which laid the foundation for the development of management theories. It traces the evolution of management theories from the pre-industrial revolution through the two world wars to the era of rapid economic growth of the 1960s to the 1980s. In recent years, management theories had become more multi-faceted where emphasis has shifted from behavioural science to organisational structures and quality assurance. With rapid globalisation and increasing importance of cultural awareness, the paper concludes that more research will be needed in the area of cross-cultural and multi-national human resource management.

Refreshing the eLearning guidelines

First launched in 2005, the New Zealand eLearning Guidelines (NZeLgs) provided a set of questions to drive improvement in the tertiary sector’s capability to deliver eLearning. This paper describes a joint AKO Aotearoa/New Zealand Tertiary College (NZTC) funded project which has updated and enhanced the guidelines (eLg) for the tertiary sector during 2013 /2014 and which now provides access via a new website: (www.elg.ac.nz). The guidelines provide prompts for good practice as a guide to designing, implementing and enhancing eLearning for an expanded range of participants in the process – the learner, the teacher, the manager, the organisational leader and quality assurance bodies. The process of how the refreshed guidelines came to be will be shared, along with the principles underpinning the prompts for each of the different perspectives which have been designed to foster quality provision of eLearning for the sector.

A roadmap towards improving managed security services from a privacy perspective

This paper proposes a roadmap for how privacy leakages from outsourced managed security services using intrusion detection systems can be controlled. The paper first analyses the risk of leaking private or confidential information from signature-based intrusion detection systems. It then discusses how the situation can be improved by developing adequate privacy enforcement methods and privacy leakage metrics in order to control and reduce the leakage of private and confidential information over time. Such metrics should allow for quantifying how much information that is leaking, where these information leakages are, as well as showing what these leakages mean. This includes adding enforcement mechanisms ensuring that operation on sensitive information is transparent and auditable. The data controller or external quality assurance organisations can then verify or certify that the security operation operates in a privacy friendly manner. The roadmap furthermore outlines how privacy-enhanced intrusion detection systems should be implemented by initially providing privacy-enhanced alarm handling and then gradually extending support for privacy enhancing operation to other areas like digital forensics, exchange of threat information and big data analytics based attack detection.

The changing role of quality assurance in the pharmaceutical industry.

ICH Q10. Pharmaceutical Quality System emphasizes that senior management is responsible for the quality system. Thus, it is not the quality assurance organization that has the primary responsibility for the quality system. With this shift of responsibilities, what can quality assurance do to help senior management fulfill their responsibility? How can quality assurance be more proactive, add more value? What new skills does quality assurance need to have in order to perform its new role? This article attempts to answer these questions.

Quality Assurance Organization Selection Factors for Highway Design and Construction Projects

A project quality assurance organization (QAO) assigns project quality responsibilities and relationships, both for design and construction. In the highway sector, all project quality roles and responsibilities have historically been assigned to the state highway agency (SHA), an accepted and well-understood industry practice. However, increasing use of alternative project delivery methods and reductions in SHA staffing are having an impact on traditional QAO practices. SHAs are increasingly selecting alternative QAOs, but they are making these selections in an ad hoc manner because of limited staff knowledge and experience, and a lack of guidance from the research community. Highway design and construction quality research focuses almost exclusively on inspections, observations, corporate quality, warranties, and materials testing, resulting in a gap in the research about shifts in project quality roles and responsibilities. This research extends the civil engineering quality management body of knowledge by identifying factors that influence the selection of QAOs and rating the appropriateness of the QAOs for each selection factor. Because of the complexity of the topic, scope of the decision process, and the limited project data available, structured interviews and the Delphi method were chosen to explore the selection factors. The research discovered 10 factors: project size, project complexity, project delivery method, project schedule sensitivity, availability of agency project staff, agency project staff experience, agency culture, industry ability to manage their own quality, trust between agency and industry, and amount of quality risk to shift away from the agency. The research provides the highway industry with new understanding of the effects that each selection factor has on the fundamental QAOs. This fundamental knowledge will allow SHAs to make more informed QAO selections.

How to achieve harmonisation of laboratory testing —The complete picture

Harmonisation is likely to be an important contributor to ensure high quality laboratory testing, thus potentially improving patient outcome. Efforts for harmonisation must be made in the total testing process, from test requesting to communication of the laboratory test results and its consequences to the patient. In this article, suggestions are given about what level of harmonisation is possible at the various steps of the testing process, who could be responsible for facilitating and monitoring the effects of harmonisation, and what are likely barriers to achieving harmonisation. Harmonisation can be achieved at local, national and international levels, and will be most challenging when it involves more than one profession as in the extra-analytical phases. Key facilitators will be laboratory associations, regulatory bodies and accreditation systems, whereas barriers are likely to be reimbursement systems or economic factors, opinion leaders and manufacturers. A challenge is to try to turn barriers into facilitators. Harmonisation effects can in most settings be monitored by external quality assurance organisations provided that schemes are expanded to cover all relevant steps and phases. We must combine our efforts, both within our profession as well as in cooperation with others, to achieve harmonisation of the total testing process, in the best interests of the patient.

Reconciling organisational culture and external quality assurance in higher education

Organisational culture and external quality assurance have both been presented as significant drivers of effectiveness, efficiency and excellence in higher education institutions. However, these assumptions have not been critically examined given the philosophical, conceptual and methodological contestations surrounding both constructs. A meta-theoretical analysis of organisational culture and external quality assurance was conducted followed by an empirical study into their interrelationship. The study found that organisational culture was ephemeral, multidimensional and characterised simultaneously by conflict, consensus and indifference and was in a constant state of flux. In addition, external quality assurance appears to have purposes that go beyond its stated morally just and public good motives. The research revealed that organisational culture demonstrated managerial, collegial, transformative and political characteristics, which closely resonated with the role of external quality assurance as an agent of control, empowerment, transformation and of the state, respectively. The study concluded that authentic and enduring academic quality would most likely result within the university when the empowerment and transformation roles strengthen the collegial and transformative cultures.

WE‐G‐141‐01: The Imaging and Radiation Oncology Core (IROC) Group: A Proposed New Clinical Trial Quality Assurance Organization

Purpose: The NCI is implementing the new National Clinical Trial Network (NCTN) Program in 2014 reducing the number of existing study groups from ten to five. The NCTN Program also requires a new combined Imaging and Radiation Oncology Core (IROC) service to provide a uniform QA program. Methods: The six existing clinical trial QA centers, Radiological Physics Center, Quality Assurance Review Center, RTOG QA Center, Image Guided Therapy Center, ACRIN Core Lab and the CALGB Imaging Core Lab have combined to form IROC. The interdependencies between diagnostic imaging and radiation therapy (RT) will be synergized in IROC eliminating duplication of services within the network and optimizing efficient and effective workflows. A major strength of this new organization will be the development of consistent standard operating procedures for all imaging and RT aspects of the NCTN as well as to facilitate a seamless flow of imaging and RT datasets across the network. Results: IROC, administered though the American College of Radiology will provide the scientific and technical expertise in both diagnostic imaging and RT to the entire NCTN Program capitalizing on existing infrastructure and expertise at QA centers currently providing services to the NCI Cooperative Groups. IROC's organizational structure will allow the delivery of a broad array of imaging and RT QA services including Site Qualification; Trial Design Support; Credentialing; Data Management and Case Review. IROC will work closely with the leadership of each Network Group and NCI to assure them that imaging and RT data used by the Groups for protocol analysis are accurate. Conclusion: The proposed IROC Group has hundreds of collective years of experience conducting clinical trial QA and fully understands the QA needs/dataflow requirements of clinical trials to maintain the highest quality clinical trial data that will not obscure the outcomes of clinical trials. This work was supported by PHS grants CA10953, CA21661, CA029511 and CA081647 awarded by NCI, DHHS.

Fundamental Project Quality Assurance Organizations in Highway Design and Construction

Alternative project delivery methods and reductions in state highway agency staffing are changing project quality assurance organizations (QAO) or the assignment of project quality management roles and responsibilities in the industry. Although fundamental quality roles and responsibilities remain the same, the assignment of these roles and responsibilities is shifting away from agencies and is doing so in an ad hoc manner because of project time constraints and lack of research and guidance on the topic. Most research that pertains to highway project quality has focused on quality control levels, material specifications, inspections, and observations; there is a gap in the research about overall project quality organizations. This paper addresses that gap by providing a better understanding of highway project QAOs and guidance about assignments of quality management roles and responsibilities. The research identified five fundamental highway project QAOs through a national survey of industry, a literature review, and an analysis of the content of documents from 66 projects. The resulting five fundamental highway project QAOs are Deterministic, Assurance, Variable, Oversight, and Acceptance.

Globalization, Governance, and the Diffusion of the American Model of Education: Accreditation Agencies and American-Style Universities in the Middle East

This article is principally concerned with the transnational and domestic governance regimes that oversee American-style universities in the Persian Gulf region. In the current context of globalization, social scientists have examined the mechanisms by which organizational practices are transferred when transnational corporations establish subsidiaries in other countries or when international nongovernmental organizations collaborate with partners in the developing world to create externally developed prescriptions translated into locally viable action. Comparatively little work, however, has been done on the challenges of exporting, from one cultural and political context to another, an institution of higher education or a particular model for how higher education should be practiced. Although a variety of actors feature in the process of conveying organizational practices and cultural scripts, this article focuses primarily on the role of accreditation agencies and the practice of accreditation. In theorizing the relationship between the following four actors, i.e., external accrediting agencies, locally based quality assurance organizations, ministries of higher education, and Western universities located in the Gulf, Noori argues that the New Medievalism provides an analytically useful explanatory framework for understanding issues of governance with respect to American-style universities in the Gulf region.

Project Quality Assurance Organization Selection for Highway Design and Construction Projects

The assignment of project quality roles and responsibilities in the highway industry makes up a project quality assurance organization (QAO). Historically, all project quality roles and responsibilities have been assigned to the state highway agency (SHA), an accepted and well-understood practice in the industry. However, increasing use of alternative project delivery methods and reductions in SHA staffing are having an impact on traditional QAO practices. In response, SHAs are increasingly selecting QAOs in an informal manner because of time constraints, limited staff knowledge and experience, and a lack of guidance from the research community. Most highway quality research focuses on inspections, observations, corporate quality, warranties, and materials testing, with a resulting gap in the research about shifts in roles and responsibilities in project QAOs. This research attempts to bridge this gap by investigating and identifying fundamental QAOs in the industry, identifying factors that influence the selection of QAOs, exploring relationships between QAOs and selection factors, and presenting a systematic process to assist SHAs in selecting QAOs. The process presented in this paper provides a consistent, efficient, justifiable, and defensible approach for selecting project QAOs. The QAO selection process also provides SHAs with opportunities for identifying, discussing, and understanding potential impacts of different QAOs on different projects.