Quality Assurance Provisions Research Articles

ENGLISH MEDIUM INSTRUCTION IN THE CONTEXT OF INTERNATIONALISATION OF UNIVERSITIES IN KAZAKHSTAN: A SYSTEMATIC REVIEW OF LITERATURE

This paper undertakes a comprehensive review of the existing literature concerning English-medium instruction (EMI) within Higher Education Institutions in Kazakhstan. EMI is a fast growing global phenomenon pushed by the internationalisation of higher education in pursuit of building a competitive, highly qualified human capital. An upward trend is observed in the number of universities incorporating English-medium programs, with 44 universities currently facilitating special EMI groups. In order to explore the research on EMI, scientific literature from featured electronic databases was searched by inserting the relevant key words. Our research discloses that a preponderance of studies examining EMI in Kazakhstan focuses on graduate programs, leaving undergraduate-level EMI relatively unexplored. Moreover, the provision of quality assurance for EMI, an essential element that incorporates the needs of all stakeholders, is a considerably under-studied area. The scarcity of knowledge in this area lends urgency and relevance to our research.

Implementation of Novel Quality Assurance Program for Hepatitis C Viral Load Point of Care Testing.

All patients should have access to accurate and timely test results. The introduction of point of care testing (PoCT) for infectious diseases has facilitated access to those unable to access traditional laboratory-based medical testing, including those living in remote and regional locations, or individuals who are marginalized or incarcerated individuals. In many countries, laboratory testing for infectious diseases, such as hepatitis C virus (HCV), is performed in a highly regulated environment. However, this is not the case for PoCT, where testing is performed by non-laboratory staff and quality controls are often lacking. An assessment of the provision of laboratory-based quality assurance to PoCT for infectious disease was conducted and the barriers to participation identified. A novel approach to providing quality assurance to PoCT sites, in particular those testing for HCV, was designed and piloted. This novel approach incudes identifying and validating sample types that are inactivated and stable at ambient temperature, creating cost-effective supply chains to facilitate logistics of samples, and the development of a smart phone-enabled portal for data entry and analyses. The creation and validation of this approach to quality assurance of PoCT removes the barriers to participation and acts to improve the quality and accuracy of testing, reduce errors and waste, and improve patient outcomes.

Rapid On-Site Evaluation Technical Exercise Using Digital Pathology: Peer Comparison in an External Quality Assurance Setting

Background: The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) is a world leader in the provision of external quality assurance (EQA) for pathology laboratories. The development and delivery of new programmes are designed to meet the evolving needs of our participants and pathology practice. A cytopathology technical programme was established in 2018 to provide proficiency testing in routine cytopreparatory techniques. The cytopathology technical pilot focused on standard operating procedures and laboratory performance during rapid on-site evaluation (ROSE). The exercise aimed to assess the diagnostic adequacy and provide technical recommendations on each of the whole slide images from four fine-needle aspiration biopsy (FNAB) samples of the thyroid in a setting of ROSE. Methods: Four whole slide imaging cases, each comprising one Diff-Quik^TM stained preparation of an FNAB of the thyroid, were provided to all laboratories currently enrolled in the RCPAQAP Cytopathology diagnostic programmes. Each scanned image represented one slide from the first pass collected by a radiologist under ultrasound guidance. Participating laboratories were encouraged to distribute the exercise to individual staff members who attend ROSE procedures. A laboratory practice questionnaire was also conducted. Results: There were a total of 186 submissions received for the assessment across the four virtual cases provided. Although the assessment of on-site adequacy by participants showed high concordance across some of the cases, there was variation in the initial diagnostic evaluation and technical recommendation. Conclusions: ROSE has been adopted as a standard procedure in many laboratories worldwide. A peer comparison of participating laboratories in an EQA exercise has highlighted ROSE as susceptible to variation across standard operating procedures, the provision of diagnostic adequacy, diagnostic feedback to the attending clinician, and technical recommendation.

Review of lyophilisation of external quality assurance program material

Sample integrity is a critical factor in provision of external quality assurance (EQA) programs. As part of the RCPAQAPs initiative to ensure and improve the quality of our products, a revised stability testing procedure was implemented in 2018. The RCPAQAP’s Tryptase program displayed reduced stability when exposed to 37oC for prolonged periods, although this could be mitigated when samples were lyophilised. In 2020, Tryptase EQA material was provided in lyophilised form, to be reconstituted at the time of testing.

Institutional accreditation of online institutions in the Anglophone Caribbean: synergies and misalignments

ABSTRACT This article explores the status of quality assurance provisions, internal and external, for online education in the Anglophone Caribbean region and provides a comparative analysis of current global trends. The findings of that analysis show that there is a misalignment between the provisions of the external quality assurance agencies and needs of the online institutions, particularly in the region. However, it also highlights the existence of a regional framework policy for quality assurance of online programmes which, if implemented, could alleviate much of the disconnect between the national external quality assurance agencies and the online institutions. Finally, it suggests the need for greater harmonisation between the standards of the various national quality assurance agencies and alignment to regional and international quality assurance for online models.

Quality assuring the professional doctorate

PurposeThis paper aims to critically examine the quality of professional doctorates (PDs) from the perspective of programme supervisors in terms of how quality assurance provisions have to meet their expectations.Design/methodology/approachThe study employed an interpretative approach, using semi-structured interviews and online semi-structured questionnaire to generate data from 25 programme supervisors across universities in the UK. Data analysis and interpretation were carried out using the interactive data analysis approach (Miles and Huberman, 1994), the “bottom–up” approach to data analysis (Creswell, 2012) and the interpretative strategy recommended by Mason (2002). Four themes emerged from the data that encapsulated programme advisors’ perspectives: characteristics of supervisors; opportunities in institutional quality assurance provision; challenges in quality assurance process for PDs; and supervisors’ views on how quality assurance in PD can be enhanced.FindingsQuality assurance provisions have not adequately provided for the unique characteristics of PDs owing to a number of issues including lack of clarity on the philosophy and focus of PDs and conflicting perspectives among PD supervisors relating to what should ideally constitute a quality assurance process for PDs. This paper argues that to develop a relevant and robust quality assurance provision for PDs, it would be essential to ensure that the PD fundamental philosophy and focus are coherently explained. In addition, it is crucial to ensure that quality assurance provisions cover not only the academic rigor of higher level learning but also the value and potential impact of outcomes on practice and the professions. The paper also highlights a list of useful suggestions from supervisors on how to enhance quality assurance.Research limitations/implicationsThe research identifies a number of issues confronting quality assurance in PDs and the need for academics and policymakers to work together to deal with these to achieve the full value in PDs. As the research was based on a sample of 25 supervisors in a conference, it would be difficult and unsustainable to generalise. Hence, further research using large sample sizes of supervisors and other stakeholders based on whole programmes would be useful to achieve a sustained understanding of how quality assurance provisions of PDs have to meet expectations of the professions and professional contexts.Practical implicationsTo get the practical value and benefits of PDs, all stakeholders (academics, policymakers and professionals) would need to work together to ensure that appropriate quality assurance processes are developed to reflect the unique nature of the programmes.Originality/valueThe paper provides a critical perspective to the current debate on quality assuring PDs from the perspective of PD supervisors who have generally been left out. It highlights issues related to quality assuring PDs, the misalignment between quality assurance provisions and the philosophy and expectations of PDs, and suggests ways through which these can be appropriately addressed to enhance quality assurance in PDs. The main contribution from this research is that it brings to the fore what supervisors, who are a part of the major players in the PD process, think about the current state of quality assurance and what can be done to make it more effective.

Assessment of present status and action plan development of vegetable seed enterprise in Rukum, Nepal

Vegetable seed enterprise is a highly potential sub-sector for the economic growth of rural farmers in Nepal. Rukum has been known as the most important district for vegetable seed production since long time because of favorable agro-climatic condition. However, Rukums' sub-sector is facing several limitations including organized production and marketing, technology adoption and entrepreneurship development. This study has been carried out to assess the vegetable seed sub-sector of Rukum and propose action plans accordingly for the sustainable seed enterprise development. The study conducted stakeholder workshop and field survey; consulted district line agencies, seed producers and cooperatives, agro-vets and seed companies, and reviewed previous works. The study found that there were many individual farmers, farmers' groups and cooperatives being involved in vegetable seed production in the district. The role of private sector is emerging rapidly with higher share in the seed marketing. The public sector is still a major player for conducting research; and provision of source seeds, quality assurance and other support services. Strategic efforts and action plans are needed to push the existing traditional seed sub-sector towards commercial venture. Technology adoption for quality seed production, processing and marketing; transformation of the classical seed sub-sector into a competitive and sustainable enterprise; organized and demand led seed production programs; and coordination and participatory approaches among stakeholders in seed value chain activities are highly recommended.

FINANCIAL ASPECTS OF THE FUNCTIONING OF THE MARKET OF MEDICAL SERVICES AND PURCHASE OF MEDICINES

The modern problems of formation of the market of medical services are analyzed. Attention is drawn to the resource provision of medical institutions, the provision of medical services and medicines in the context of medical reform. The effectiveness of the regulation of financial and price aspects of the provision of medical services through the program of state financial guarantees, the use of modern forms of procurement of medicines and medicines, the establishment of a tariff for medical services related to the provision of primary health care, quality assurance and availability of medicines has been analyzed. The approaches to improving the efficiency and quality of provision of medical services at the regional level are substantiated.

Quality assurance for forensic expert-candidates

The author provides an overview of the quality assurance provisions of the new, 2016 Hungarian law on forensic experts on expert-candidates.

The BMUS guidelines for regular quality assurance testing of ultrasound scanners.

The provision of Ultrasound Quality Assurance (QA) across the UK is variable. In some areas, a comprehensive service is provided, usually by a Medical Physics Department, but many clinical ultrasound services have no formal QA programme. Where there is no formal QA programme, it might be expected that ultrasound users would report and ensure repair of obvious faults, such as mechanical damage or “drop-out”, but anecdotal evidence from around the country tells us that this is not always the case. On many modern scanners, faults are masked by advanced processing. Professional bodies in the UK and around the world1–4 have been providing and updating ultrasound QA guidelines for over 35 years, but the implementation of QA has been inconsistent. There are many possible reasons for this inconsistency, including the lack of a legislative requirement, availability of Medical Physics services, sonography workload and a view that formal QA is unnecessary. Legislation requires QA for other imaging modalities, where ionising radiations are used. The legislation is designed to protect staff, patients and members of the public from the effects of radiation, but enforcing bodies expect QA to include assessment of image quality as well as radiation dose. Medical Physics Departments do not all have expertise in ultrasound, and the distribution of Ultrasound Physicists around the country changes with retirements and career development moves. The most stable and consistent physics support for ultrasound seems to be where services are provided on a regional, rather than local, basis. Sonography workload is a growing issue for QA services, affecting both sonographer engagement and access to equipment. The fairly widely held view that QA is unnecessary is challenged by the facts. In addition to anecdotal reports of failure of some users to report and remedy obvious faults, there is increasing evidence in the literature of the efficacy of formal QA programmes identifying more subtle deterioration of imaging performance.5–9 Sonographers should note that in signing off a report, they are certifying that their equipment is fit for purpose. The importance of QA for diagnostic equipment has been recognised in the UK by the Department of Health,10 the Care Quality Commission,11 the National Health Service Litigation Authority12 and the Medical and Healthcare Products Regulatory Authority.13 It will be a condition of contracts in the reforming National Health Service and is mandatory for ultrasound equipment used in NHS Screening Programmes.2,14,15 The new emphasis on user testing in a number of recent QA guidelines1–4 gives sonographers the opportunity to establish their own QA programme, even where there is no physics support for further testing and no test equipment. The tests are not time consuming, and some elements will already be carried out in departments complying with local infection control and equipment management requirements. The aim of the QA guidelines published in this issue is to empower sonographers to take a leading role in demonstrating the consistency of performance of their equipment for the benefit of their patients. Please take up the challenge.

First do no more harm …

Purpose – The purpose of this article is to alert those in positions of trust and authority that there is an urgent need for improvement throughout the entire health profession credentialing process to fix defects at every stage, from employer responsibilities all the way up to licensing board responsibilities and government oversight. Design/methodology/approach – This paper takes the form of a narrative review. Findings – The assumption that layers of safeguards prevent dangerously incompetent or impaired practitioners from continuing to practice in American hospitals is, unfortunately, just that – an assumption. While the vast majority of healthcare professionals uphold the standards of their professions, a recent public health vulnerabilities report reveals serious defects throughout those safeguard layers and widespread harm that results from actions of relatively few determined miscreants who manage to evade them. This not only undermines public trust, but underscores ways in which governing boards, hospital executives and directors have found themselves liable for failings of their institution's quality assurance provisions. That vulnerability report is the result of investigation into one healthcare worker whose narcotic thefts and drug tampering resulted in thousands of patients exposed, dozens infected with hepatitis C, across several states and multiple missed opportunities to constrain. Originality/value – Findings of the Maryland state investigation, coupled with other documents, show that long-recognized ethical and legal responsibilities are not being met effectively.

On-Chip Imaging of Schistosoma haematobium Eggs in Urine for Diagnosis by Computer Vision

BackgroundMicroscopy, being relatively easy to perform at low cost, is the universal diagnostic method for detection of most globally important parasitic infections. As quality control is hard to maintain, misdiagnosis is common, which affects both estimates of parasite burdens and patient care. Novel techniques for high-resolution imaging and image transfer over data networks may offer solutions to these problems through provision of education, quality assurance and diagnostics. Imaging can be done directly on image sensor chips, a technique possible to exploit commercially for the development of inexpensive “mini-microscopes”. Images can be transferred for analysis both visually and by computer vision both at point-of-care and at remote locations.Methods/Principal FindingsHere we describe imaging of helminth eggs using mini-microscopes constructed from webcams and mobile phone cameras. The results show that an inexpensive webcam, stripped off its optics to allow direct application of the test sample on the exposed surface of the sensor, yields images of Schistosoma haematobium eggs, which can be identified visually. Using a highly specific image pattern recognition algorithm, 4 out of 5 eggs observed visually could be identified.Conclusions/SignificanceAs proof of concept we show that an inexpensive imaging device, such as a webcam, may be easily modified into a microscope, for the detection of helminth eggs based on on-chip imaging. Furthermore, algorithms for helminth egg detection by machine vision can be generated for automated diagnostics. The results can be exploited for constructing simple imaging devices for low-cost diagnostics of urogenital schistosomiasis and other neglected tropical infectious diseases.

Beginning teacher standards for physical education: Promoting a democratic ideal?

The framing of teaching standards within restrictive managerial or collaborative democratic ideologies impacts significantly on initial teacher education. Semi-structured interviews were used to explore teacher educators’ ( n = 13) perspectives on beginning teacher standards for physical education teacher education in Ireland. Teacher educators favoured a standards-based approach to support consensus within the profession and clear expectations for beginning teachers. They suggested that provision of quality assurance through increased accountability and regulation could enhance the status of the profession based on a democratic ideology of teacher professionalism. The potential of standards to foreground a particular ideology of teacher professionalism is discussed.

Universal Auditory Screening of Neonates and Hearing Disorders in Childhood

The decision was taken to make universal newborn hearing screening (UNHS) mandatory across Germany as of January 1, 2009. (The Federal Joint Committee [Gemeinsamer Bundesausschuss], which is the main self-governing body of health care providers and health insurance companies in Germany, announced a decision to amend the pediatric guidelines in its statement dated June 19, 2008, entitled Einfuhrung eines Neugeborenen-Horscreenings [Introduction of Auditory Screening of Neonates], as was previously reported in Deutsches Arzteblatt; see Dtsch Arztebl 2008; 105[43]: A 2239 [article in German].) This program enables the earlier diagnosis and treatment of uni- or bilateral hearing impairment of magnitude 35 dB or more in newborn children. The introduction of nation-wide UNHS was also the major topic of the 25th Scientific Meeting of the German Society for Phoniatry and Pediatric Audiology [Deutsche Gesellschaft fur Phoniatrie und Padaudiologie, DGPP], which was held in Dusseldorf in September 2008. Until now, UNHS was performed in only some of the German federal states. It became mandatory across the country at the beginning of this year, along with the associated quality assurance mechanisms and provisions for follow-up care. Thus, a child’s first test for potential hearing impairment no longer takes place at the age of about two and half years, as in the past, but rather shortly after birth. The experts predict that this will bring about long-term improvements in speech acquisition and educational opportunities.

Quality assurance in the european higher education area

Most European countries have introduced systematic quality assurance as part of an overall governance reform aimed at enhancing universities’ autonomy. Researchers and economic entrepreneurs tend, however, to underestimate the political dimension of accreditation and evaluation when they consider the contribution of quality assurance to the economic competitiveness of universities and/or the economic system as a whole. I intend to shed light on this aspect of quality assurance by 1) analysing how the provision of quality assurance is constrained by the institutional setting in place, and 2) studying the implications of that constraint on the constitution of a national and international market of quality assurance agencies. I begin the analysis by commenting on the political stake in the emergence of a German market of competing quality assurance agencies, then highlight the irreducible dimension of national politics in creating a European market of quality assurance agencies.

CMS Announces New Hospice Regulations

CMS Announces New Hospice Regulations

IPOS Sutherland Memorial Lecture: psycho‐oncology and health care research

Remarkable changes of health-care systems, increasing costs of health care and of social inequality in modern societies, an aging population and the increase of chronic illnesses such as cancer implicate various future challenges for the provision of health care. Health-care research aims to improve the effectiveness and efficiency of patient-oriented services involving the evaluation of innovative treatment approaches and settings. It deals with the patients' path through different areas of health-care systems in order to identify significant factors for the provision of quality assurance of structures and resources concerning treatments, processes and health outcomes. Health-care research focusses on three main topics that play an important role for quality management: (1) the admission to health-care services and assessment strategies including indication, utilization and specificity of settings and target groups; (2) the treatment process including the implementation, standardization and flexibility of services and dose-effect relationship of interventions; (3) health-care outcome including effectiveness and efficiency of interventions and services, the cost-benefit relationship and the transfer from research to health-care practice. Given the objectives of health-care research, the topics of health-care research in psychosocial care for cancer patients include the study of structural conditions of psycho-oncological services, the epidemiology of distress and mental disorders and the subjective need of psycho-oncological support in cancer patients, the improvement of psycho-oncological measures and assessment strategies in daily treatment, the study of psycho-oncological interventions under routine conditions, and quality assurance. Requirements of future health-care research and developments of psycho-oncology including aspects of orientation, strategies, health-care equity, and resources are discussed.

Abstracts from the Association of British Clinical Diabetologists (ABCD) meetings

Abstracts from the Association of British Clinical Diabetologists (ABCD) meetings

World Health Organization/HIVResNet Drug Resistance Laboratory Strategy

With rapidly increasing access to antiretroviral drugs globally, HIV drug resistance (HIVDR) has become a significant public health issue. This requires a coordinated and collaborative response from country level to international level to assess the extent of HIVDR and the establishment of efficient and evidence-based strategies to minimize its appearance and onward transmission. In parallel with the rollout of universal access to HIV treatment, countries are developing protocols based on the recommendations of the World Health Organization (WHO) to measure, at a population level, both transmitted HIVDR and HIVDR emerging during treatment. The WHO in collaboration with international experts (HIVResNet Laboratory Working Group), has developed a laboratory strategy, which has the overall goal of delivering quality-assured HIV genotypic results on specimens derived from the HIVDR surveys. The results will be used to help control the emergence and spread of drug resistance and to guide decision makers on antiretroviral therapy policy at national, regional and global level. The HIVDR Laboratory Strategy developed by the WHO includes several key aspects: the formation of a global network of national, regional and specialized laboratories accredited to perform HIVDR testing using a common set of WHO standard and performance indicators; recommendations of acceptable methods for collection, handling, shipment and storage of specimens in field conditions; and the provision of laboratory technical support, capacity building and quality assurance for network laboratories. The WHO/HIVResNet HIVDR Laboratory Network has been developed along the lines of other successful laboratory networks coordinated by the WHO. As of August 2007, assessment for accreditation has been conducted in 30 laboratories, covering the WHO‘s African, South-East Asia, Western Pacific, and the Caribbean Regions.

Advanced Practice Organ Procurement Techniques: Insertion of Arterial Catheters

Placement of arterial catheters by organ procurement coordinators is becoming more common. Classroom and clinical training in this technique and provision of appropriate quality assurance and supportive policies/procedures by organ procurement programs will ensure the coordinators' success. This discussion reviews technical aspects of insertion of catheters into the radial, femoral, and axillary arteries, potential complications, and alternative noninvasive methods of measuring blood pressure.