Quality Circles Research Articles

Are quality promotion initiatives in Austrian and Italian general practices associated with higher patient satisfaction and quality of life? Results from the interventional study 'IQuaB'.

The objective was to assess the changes in quality of life (QoL) and patient satisfaction of chronically ill patients in general practices in Salzburg (Austria) and South Tyrol (Italy) after implementation of a combined intervention addressing quality of care of general practitioners (GPs). Furthermore, the correlation between QoL/patient satisfaction and quality of care provided by the GPs (measured by a quality score based on quality indicators [QIs]) was investigated. The non-controlled pre-post study involved GPs and patients with chronic conditions. The intervention consisted of self-audit, benchmarking and quality circles. QIs were extracted in the participating practices in 2012 (preintervention) and 2014 (postintervention). Before and after the intervention, a patient survey was conducted including EQ-5D (measuring health-related QoL), a patient participation scale and parts of the European Task Force on Patient Evaluations of General Practice questionnaire (measuring patient satisfaction). Mann-Whitney U-tests, chi-square tests and Spearman's rank correlation were applied for statistical analysis. Fifty-six GPs participated in the study. 1,710 patients returned the questionnaire in 2012, and 1,374 in 2014. Mean EQ-5D index (QoL) was similar in Salzburg and South Tyrol in both years: 2012 Salzburg 0.85 (95% CI 0.84-0.87), South Tyrol 0.85 (95% CI 0.84-0.86); 2014 Salzburg 0.84 (95% CI 0.83-0.86), South Tyrol 0.84 (95% CI 0.83-0.86). Patient satisfaction was higher in Salzburg than in South Tyrol at baseline (EUROPEP: mean percentage of best response 61.5% vs. 49.1%, p<0.000) and also at follow-up (61.9% vs. 49.2%; p<0.000). No significant correlation between quality score and QoL/patient satisfaction was detected. Thus, the impact of the intervention was not significant within the intermediate time periods analysed in the study. Improvements in quality of care do not necessarily also improve patient-relevant outcomes, which are probably more associated with other factors than with medical quality (e.g. availability of the GP, waiting times and communication-related issues).

MATERIAL MANAGEMENT IN A MANUFACTURING COMPANY

Materials management in manufacturing enterprises is undoubtedly one of the most important areas of its functioning. The article aims to present the essence of the selected area and make the reader aware of its rank. The first chapter presents theoretical issues regarding the area of interest of the article. These include, among others: the supply process, its planning method, supply logistics, material management, the role of supply in material flow planning, material demand planning, material flow control methods in enterprises, purchase and supply planning in the material supply process, methods of choosing supply sources and ABC analysis in material management. The second chapter presents the company. It contains its general characteristics. Then the focus was on the characteristics of supply logistics, order planning procedure, materials management, methods and factors affecting the choice of supply sources. After analyzing the material management and analysis of the current level of inventories using the ABC method, there was an indication of problems existing in the company. The search for their causes and proposals of effective solutions began. The methods and tools that were used were: MRP method, quality circles and a carousel of ideas used in their operation, as well as cause and effect analysis using the Ishikawa diagram. Several other solutions have also been proposed. All, however, were intended to eliminate the problem. All calculations and analyzes created for the purposes of this article have been supported by company data and direct interview with employees responsible for the supply process.

Progress of GP clusters 2 years after their introduction in Scotland: findings from the Scottish School of Primary Care national GP survey.

BackgroundThe concept of GP clusters is derived from 'quality circles' in general practice in Europe and Canada. GP clusters commenced across Scotland in 2016 to improve the quality of care of local populations.AimTo determine GPs' views on clusters, and the robustness of bespoke questions about them.Design & settingA cross-sectional national survey of work satisfaction of GPs in Scotland took place, which was conducted in July 2018–October 2018.MethodAn analysis of bespoke questions on GP clusters was undertaken. The questions were completed by quality leads (QLs) and all other GPs in a nationally representative sample of GPs.ResultsIn total, 2456 responses were received from 4371 GPs (56.4%). QLs reported that clusters were meeting regularly, and were friendly and well organised but not always productive. Support for cluster activity (data, health intelligence, analysis, quality improvement methods, advice, leadership, and evaluation) was suboptimal. Factor analysis identified two separate constructs (cluster meetings [CMs] and cluster support [CS]), which were minimally influenced (<2%) by GP and practice characteristics. Non-QLs (75% of all GPs) were generally satisfied with the two-way communication with the cluster QLs, but the great majority (>70%) reported no positive changes in various aspects of quality improvement. Factor analysis of these items indicated two constructs (cluster knowledge and engagement [CKE] and cluster quality improvement [CQI]), which were minimally affected by GP and practice characteristics.ConclusionGP clusters are ‘up and running’ in Scotland but are at an early stage in terms of perceived impact and appear to be in need of more support in order to improve quality of care. The bespoke questions developed on clusters have robust construct validity, suitable for future surveys.

Medium duty truck quality circle to reduce defect per unit in overall cab in white

Medium duty truck quality circle to reduce defect per unit in overall cab in white

General practitioners' clinical practice on the management of cystitis in Normandy, France: A clinical vignettes‐based study

The objective was to measure the quality of clinical practice for the management of cystitis in adult women in general practice by collaborating with quality circles and the regional centre for antibiotic counsel. This descriptive cross-sectional study was performed in 2018 in Normandy, France. A questionnaire composed of clinical vignettes was used to evaluate practices of general practitioners (GPs) with regard to cystitis classified into four categories: simple, at risk of complication, recurrent, and caused by multidrug-resistant bacteria. The 2017 French Infectious Diseases Society's guidelines were used as a reference. A total of 142 GPs participated in the study (45.5% of the solicited). Fosfomycin-trometamol and pivmecillinam were cited as first-line treatments for simple cystitis by 134 (94%) and 38 (27%) participants, respectively. For at risk of complication cystitis, the treatments cited were cefixime by 64 participants (45%), ofloxacin by 50 (35%), pivmecillinam by 49 (35%), fosfomycin-trometamol by 38 (27%), nitrofurantoin by 36 (25%), and amoxicillin-clavulanic acid by 28 (20%). Mean compliance rates were 85% for simple cystitis, 39% for at risk of complication cystitis, 60% for recurrent cystitis and 14% for cystitis caused by multidrug-resistant bacteria. Two criteria had less than 10% of the compliant answers: comprehensive knowledge of cystitis complication risk factors (9%) and positivity thresholds of urine cultures (10%). In this study, diagnostic means, follow-up testing, and simple cystitis treatment (with fosfomycin predominantly mentioned) were broadly compliant. The use of critical antibiotics was too frequent for at risk of complication cystitis. There may be a need to improve the knowledge of professionals on antibiotic resistance and appropriate antibiotic use.

Failure Analysis and Improvement of Defective Clamping Pad During Leak Testing Process Using Kepner-Tregoe Analysis

In industries, the breakage of the clamping pad in the leak testing machine is a common and challenging problem during product quality control process. In the same context, it becomes essential to identify the possible causes creating hindrance to component clamped on leak testing machine. This paper presents a systematic and iterative methodology for analysing the failure and providing possible improvements in clamping pad for the successful operation of leak testing machine. The investigation of working environment of leak testing machine, Kepner-Tregoe (K-T) analysis, seven quality control tools, and quality circle concept are used to provide the root cause of the cracks and failure of clamping pad. Based on the failure analysis, suitable actions are suggested and implemented with process redesign. The improved process design led to negligible failures from the preliminary failure rate. The entire methodology is universal in nature and can be employed for failure analysis in a wide variety of industrial problems.

Non-Interventional Studies in a Large Community Hospital and Implementation of the General Data Protection Regulation (GDPR)

The General Data Protection Regulation (GDPR) is applicable as of May 25, 2018 in all member states to harmonize data privacy laws across Europe. GDPR impacts also on medical data research. Non-interventional studies (NIS) in hospital are an important part of health services research and might need to be assessed by the local data protection officer. This study investigates all NIS (in house or sponsored) initiated between April 1, 2017 and July 31, 2018 in Nuremberg Hospital and their methods dealing with the GDPR. All studies in Nuremberg Hospital have to be reported to the study center of Nuremberg Hospital. We implemented some actions to fullfill GDPR, e. g. checklist for GDPR, quality circle, and all studies were assigned to a data protection officer specialized in scientific and clinical studies. We analyzed in each study the kind of data encryption (e. g., pseudonymous vs. anonymous), the need for approval from the official ethics commitee according to §15BO, and the need for approval from the hospital data protection officer. The data was analyzed using descriptive statistics. After GDPR came into effect, more NIS were started (n=77 vs. n=59), especially investigator-initiated NIS increased significantly (+84%, p<0.01). The majority of inhouse studies were dealing with absolute anonymous data (before GDPR: n=28 anonymous vs. n=4 pseudonymous; after R: 51 vs.7; n.s.). 22 studies, mostly IITs (86%), needed a statement of the local data protection officer and used a patient's information. After GDPR 19% of in-house NIS showed the need for a statement of approval from the ethics committee (accordingly to §15BO) (before GDPR 12.5%; n.s.). One year after GDPR was implemented, the average processing time of the data protection officer for an NIS was 10.5 work days. Investigator-initiated NIS are an important part of scientific research at Nuremberg Hospital. After GDPR, there was an increase in the number of self-initiated studies. Standardized procedures and simple actions help implement GDPR in medical research without critical delays at the start of study.

Using the quality circle approach to empower disadvantaged youth in addressing cyberbullying: an exploration across five European countries

ABSTRACT Digital communication technologies play an important role in the social development of young people, but can create vulnerabilities to cyberbullying and other negative online experiences. The Blurred Lives project aimed to tackle cyberbullying innovatively using a co-participatory approach, collaborating with 14–16-year olds living in areas of socio-economic disadvantage in five European countries. In phase one, 2,658 teenagers were surveyed on their internet use and any unpleasant online experiences. This data informed the second phase where the participating countries worked together with 237 adolescents across 10 schools with adult facilitators to create original anti-cyberbullying resources for teachers, parents/carers, peers, and social media providers using the Quality Circle approach. This methodology adopts an ethos of working together to solve a problem in small, peer-led groups. Each group was tasked with creating a resource for one of the target audience groups. The final resources comprise a rich variety of different formats including videos, comic strips, a board game, leaflets, posters, and newsletters. The pupil feedback highlights, for most but not all participants, an increased knowledge of cyberbullying and e-safety skills, as well as enhanced problem-solving skills, levels of confidence, and group work skills. Several operational challenges are also discussed, including the importance of school-level support, planning, staffing, and finding an appropriate balance between facilitator support and pupil agency.

Organ Donation - Management from Donor Identification to Organ Procurement

According to the Transplantation Act (TPG), clinics and transplant commissaries (TxB) are obliged to ensure quality in donor evaluation. They are supervised. TxBs exist in every hospital that carries out organ harvesting and are always available. They are responsible for the conception of the organ donation process and should manage each individual case from the evaluation to the implementation of the patient's wishes.The evaluation for potential organ donors should be routine and supported by IT technology. The intensive care team must inform the TxB about living patients who "come into consideration" as organ donors. Reasons for exclusion can be known rejection, absolute medical contraindications and loss of function of all transplant organs. ICBF (irreversible cessation of brain function) deceased without reasons for exclusion must be reported to the DSO immediately. Talks with relatives about the neurological outcome, the ICBF diagnostics and organ donation are of fundamental importance for the implementation of the (presumed) wish of the potential organ donor and the relatives. The aim of the talks should be a sound decision with which the relatives can conclude. The TxBs support the ICU team to achieve this.Organ donation should be handled like an emergency. Typical bottlenecks are the instrument-based examinations and the availability of the operating room. The TxBs should draw up a schedule, communicate this to the interfaces and be available at all times during the entire organ donation process. Documentation of all details is important, as the TxBs must prepare detailed individual case analyses for quality assurance purposes and forward them to the clinic management and the DSO. Quality circles and especially peer review procedures are used and recommended as further QM tools.

Reporting incidents involving the use of advanced medical technologies by nurses in home care: a cross-sectional survey and an analysis of registration data

BackgroundAdvanced medical technologies (AMTs), such as respiratory support or suction devices, are increasingly used in home settings and incidents may well result in patient harm. Information about risks and incidents...

Quality Circle: A Methodology to Enhance the Plant Capacity through Why-Why Analysis

In the manufacturing firms, hospitals, banks, schools and research institutes etc., total customer satisfaction with products and services have very much importance and also necessary for their survival. Quality services and reducing wastages of all types are the primary need of every organisation. Quality Circle is (QC) is one of the techniques that can be utilised to solve industrial problems and can reduce the rejection level. In present paper, QC concept is implemented to solve wastage problem by taking a real case study of an automobile industry. The observed data was analysed through various problem solving techniques such as 80/20 rule and fishbone diagram etc. Finally, Why-Why analysis was carried out to identify the root cause of the problem and suggested actions to solve the problem. The following results were obtained: Gradually reduction in materials wastage minimises the rejection and hence reduces the overhead expenses of the firm. Further, QC helps in motivating employees to do their best for the organisation, which not only improves the productivity of the organisation, but also helps in discovering hidden talent and creative skill of the workforce. Finally, QC helps in developing the sense of belongingness towards organisations.

A Case Study on the Improvement Activities of Quality Circle by Improving Attorney System

A Case Study on the Improvement Activities of Quality Circle by Improving Attorney System

Comparative Analysis of Companies Using and Not Using Six Sigma in Human Resource Management

The Global Village is nothing more than the natural consequence of widespread innovation and technological progress. Organizations strive vigorously to gain a competitive edge in the context of the current trends in the global business environment. So, in order to achieve and deliver excellent performance, such businesses have embraced the use of quality circles. Companies like these aren't shy about telling the world about their efforts to improve quality across the board. Improving quality has evolved into a crucial business strategy for all corporations. Because of this, businesses have been able to learn about and put into practice quality methods like Six Sigma practices, which aim to reduce faults and boost productivity in production.

Quality Circles and Intra-Organizational Group Cohesiveness

Quality Circles and Intra-Organizational Group Cohesiveness

Nursing Education Intervention Effects on Pain Intensity of Nursing Home Residents with Different Levels of Cognitive Impairment: A Cluster-Randomized Controlled Trial.

PurposePain management in nursing homes is challenging and pain prevalence remains high. The objective of this study was to improve the pain situation of nursing home residents following a nursing-related educational intervention within a cluster-randomized controlled trial (2016–2018).ParticipantsClusters were nursing homes from one nursing home operator in Bavaria, Germany. Nursing home residents who were permanently registered in the facilities, at least 60 years of age, and who themselves or their legal guardians provided informed consent were included.InterventionIn addition to the implementation of pain nurses and pain care assistants, staff of the intervention group received an educational intervention in pain management, containing classroom (quality circles) and web-based training for nurses.MethodsBased on the Mini-Mental State Examination (MMSE), residents were either interviewed (MMSE 10–30) using self-report instruments or observed (MMSE 0–9) by proxy assessment. The primary outcome in residents able to self-report was maximum pain intensity according to Brief Pain Inventory (BPI); in those not able to self-report treatment-relevant pain above cut-off (≥2) on the Pain Assessment in Advanced Dementia (PAINAD).ResultsOut of 20 randomly selected clusters, 9 nursing homes from the control, and 6 nursing homes from the intervention group participated. Multilevel linear (n=347 residents, MMSE 10–30) and logistic regression (n=222 residents, MMSE 0–9) analyses were conducted. Maximum pain intensity was higher after intervention (B=1.32, p<0.01), decreased with a better quality of life (B=−0.07, p<0.001), and was lower when dementia diagnoses were present (B=−1.12, p<0.01). PAINAD scores before and after intervention did not differ significantly (OR=0.89, p=0.724), but chances to exhibit treatment-related pain were higher with decreasing MMSE (OR=0.94, p<0.05).ConclusionWhile no significant positive intervention effect was measured, findings suggest nurses’ raised awareness towards pain management. Overall results indicate that large-scale educational interventions seem to be less effective in complex nursing home settings without also including specific individual-based intervention measures.

Physicians', Nurses' and Pharmacists' Perceptions of Determinants to Deprescribing in Nursing Homes Considering Three Levels of Action: A Qualitative Study.

Background: Polypharmacy and the use of potentially inappropriate medications are frequent safety issues among nursing home (NH) residents. Deprescribing can significantly reduce the number of drugs used, medication costs, and mortality. This qualitative study sought to understand and compare the perceptions and practices of nurses, pharmacists, and physicians regarding deprescribing in Swiss NHs, referring to an implementation approach on three levels of action: the individual, the institution, and the healthcare system. Methods: Two focus groups were held with 21 participants: one focus group with 11 pharmacists, another with 10 nurses and six semi-structured interviews with physicians were conducted and focused on their individual experience and practices. They were audiotaped and fully transcribed, and a content analysis was performed using to MAXQDA (Ver 12) software. Results: (1) At an individual level, physicians were concerned by consequences of deprescribing in terms of safety. Nurses were closest to residents and stressed the importance of finding the right time, creating a bond of trust before deprescribing and considering the purpose of the stay in the NH. Pharmacists relied on structured guides for deprescribing, which led their reflection and practice. All professionals saw the complexity of the clinical situations, as well as residents’ and relatives’ fears of interruption of care. (2) At an institutional level, the professionals stressed the lack of time to discuss patients’ health and treatment, while pre-existing interprofessional collaboration, specifically, quality circles, seemed useful tools to create common knowledge. In order to reduce prescriptions, better coordination between physicians, nurses, pharmacists and specialists seemed crucial. (3) At the health system level, funding still needs to be provided to consolidate the process, go beyond organisational constraints and ensure deprescribing serves the patient’s wellbeing above all. Conclusions: At the individual level of implementation, the different healthcare professionals expressed specific concerns about deprescribing, depending on their defined role in NHs. Their perspective about the different levers to promote deprescribing at institutional and healthcare system levels converge towards interprofessional collaboration supported by the healthcare system. Specific funding and incentives are therefore needed to support a sustainable interprofessional team.

Evaluation of Quality Circle (QC) program implementation barriers in Indian SMEs with ISM methodology

Evaluation of Quality Circle (QC) program implementation barriers in Indian SMEs with ISM methodology

An Integrated Model for Improving the Performance of Engineering Institutes under Multiple External and Internal Disruptions

In the last sixty years many affiliated and autonomous colleges, and national institutes have faced a large number of external and internal disruptions, campus unrest, disputes, court cases and even punishment to the Chief Executive Officers (CEOs). Many disruptions are due to multiple external controls from central and state governments, affiliating universities, councils (AICTE and Governing Councils), commissions (UGC, and other Commissions) and authoritative politicians. All these disruptions resulted in low performing institutes. This further aggravated due to improper selection of the CEOs of the institutes/universities, and chairpersons of the Board of Governors. A qualitative research has been undertaken to critically review the state of affairs and suggest strategies, models and solutions to overcome the multiple disruptions through quality circles constituted as a part of faculty development programs on institutional development, leadership and innovation. A four- stage model has been developed. In the first stage the external disruptions have to be minimized, in the second stage the internal disruptions are to be eliminated, in the third stage establishing facilitating centers for rapid transformation, and a fourth stage for implementing transformation initiatives are to be done. Without implementing the three stage reforms, the desired transformations may not be achieved.

Developing of Management: Choice and Implementation of New Tools

The research presented in this article shows the experience of implementing new Managerial tools in context of management and employees’ development which is carried out in the large vehicle manufacturing company GM Uzbekistan. The paper describes the details of some new management techniques implementation and evaluated the results of implementation. Analysis of the results of innovation activity, questionnaire survey and special interview reveals of main influenced factors. Result of the research illustrates the importance of in-company culture and managerial style, empowerment and involvement of personnel, top management support and managerial stress, education and training programs. The management of the JVC General Motors Uzbekistan has actively tried to induce new managerial tools and techniques as Continuous Improvement activity through Employee’s Suggestion System, Quality circle, 5S, TPM and others and MBO — Management by Objectives as tools for activation personnel potential and establishing self-managed teams within company employees. Within the framework of the visions of the Continuous Improvement a common understanding has developed, and the future direction of development has been negotiated. The history of Continuous Improvement in General Motors Uzbekistan demonstrates that success of new managerial techniques is not easy. The focus on the real problem areas, as quality, was, however, not a failure even though the targets were not met. The new managerial technology of human factor activating was later successfully utilized in the introduction of the focused Improvement team. The conclusion drawn from this is that management of company should, if possible, focus on collectivism aimed for real, vitally important areas and creative leaders.

The role of universities for workplace innovation: a Turkish case

Universities have three essential functions. One is educational and other is about generating knowledge and technology. The last one is related to the bridge between the theory and practice that is being practically engaged to the society that is generally called “Service”. In many of them, to educate the citizens and citizen-leaders for the society is a much more important mission then the latter. They do this through their commitment to the transformative power of a liberal arts and sciences education. While focusing on the educational issues of students, university administrators should also take into consideration the training needs of their own administrative personnel, since they are among the fundamental internal customers of the university. Creating an innovative workplace for all is essential at a contemporary university, since it is accepted as one of the role model workplaces within society. This paper emphasises the crucial need and the steps of in-service training programmes for administrative personnel, which contributes to the educational and managerial quality of higher education institutes. As a sample case, an in-service training programme is shared for the training needs of the administrative personnel of a Turkish State University, located in Istanbul, after conducting a detailed needs analysis. Following the response of the sample university to the research findings, the paper concludes with reflections on alternative institutional structures, based on Quality Circles / İmece Circles.