Quality Management Audit Research Articles

School Committees' Effectiveness in the Context of School-based Management Policy

The background of this research is the granting of broad educational autonomy to schools, which is a big concern for the government of Indonesia. School-based Management (SBM) appears as an alternative to the new paradigm of education management offered. One of the characteristics of SBM is inseparable from the participation of the community. School Committee is a forum for parents, communities, stakeholders, and entrepreneurs in school development and can bridge the interests of all the parties. To date, not many School Committees have been able to play an effective role in supporting the implementation of education in schools. One of the contributing factors is that the institutional design is not seriously empowered into an independent and professional institution. This study aimed to examine the effectiveness of school committees in school-based quality improvement management. The study method is qualitative descriptive. Data were collected through interviews, observation, and documentation. Validation of the collected data was done through triangulation techniques. The results showed that thematically the author underlined four important things, namely: first, the school committee has effectiveness as a consideration partner, material support, financial, thought and energy, and learning mediator; second, quality improvement strategies can be achieved through efforts to improve school subject competence and involvement in competitions; third, to measure the results of achievements, an education quality management audit is carried out, and; fourth, the budget as one of the determining factors in achieving school goals and objectives must be optimized by utilizing the flexibility of implementing Law No. 23 of 2014 and optimizing available resources. This research has implications for considerations in the preparation of internal school strategies to prioritize school needs and recommendations related to budget policies and inventory of school components.
 Keywords: effectiveness, School Based Management, School Committee

Assessing nuclear medicine practices: a critical evaluation of QUANUM through a quality improvement perspective and its wider relevance.

Quality Management Audits in Nuclear Medicine (QUANUM) is an initiative conceived by the International Atomic Energy Agency to enhance global standards in Nuclear Medicine practices. Acknowledging the intricate regulatory frameworks and the necessity for multidisciplinary collaboration, QUANUM has gained global acceptance, demonstrating widespread implementation and positive impacts on patient care. This manuscript critically evaluates the QUANUM program through the lens of quality improvement (QI), by employing established and validated QI tools. Our analysis identifies areas of conformance, underscores key strengths inherent to QUANUM, and pinpoints further learning opportunities for continuous enhancement. Additionally, we assert that the insights derived from scrutinizing this global project within Nuclear Medicine, have valuable implications for departments aspiring for establishing good quality management systems, thereby contributing to the improvement of patient care.

Quality audits of nuclear medicine practices in a middle-income African setting.

The International Atomic Energy Agency (IAEA) introduced a Quality Management Audits in Nuclear Medicine (QUANUM) programme, to improve nuclear medicine practice standards aligned with international standards through self-assessments. The absence of quality management audits in nuclear medicine departments could potentially result in a compromise in the safety and quality of patient care. To date, there is no evidence that quality audits have been conducted in nuclear medicine departments of this middle-income country. This quality audit, therefore, assessed conformance to the IAEA QUANUM programme in four nuclear medicine departments. The study adopted a quantitative methodological exploratory approach. The IAEA QUANUM programme was used to audit nuclear medicine services' overall activity such as clinical practice, management, radiopharmacy, general and radiation safety, quality assurance, operations and services. The data was collected via document analysis in four nuclear medicine department identified as Sites A-D. Overall results showed that Site A conformed with 247 out of 370 (67%) counts and non-conformed with 123 out of 370 (33%) counts whilst Site B conformed with 205 out of 342 (60%) counts and non-conformed with 137 out of 342 counts (40%). Site C conformed with 259 out of 345 (75%) counts and non-conformed with 86 out of 345 (25%) counts. Site D conformed with 166 out of 349 (48%) counts and non-conformed with 183 out of 349 (52%) counts. The study yielded 125 overall recommendations. All the sites demonstrated good compliance to international standards in radionuclide therapy. Site A complied poorly in strategies and policies, whilst Site B complied poorly in quality control of equipment. Site C showed poor compliance to human resource development and Site D showed aspects pertaining to administration and management as well as evaluation of quality systems.

Status of Pre-analytical Quality Management of Laboratory Tests at Primary Clinics in Korea.

The quality of laboratory test results is crucial for accurate clinical diagnosis and treatment. Pre-analytical errors account for approximately 60%-70% of all laboratory test errors. Laboratory test results may be largely impacted by pre-analytical phase management. However, primary care clinics currently do not have pre-analytical quality management audit systems. We aimed to understand the current status of pre-analytical quality management in laboratory medicine in Korean primary care clinics. Questionnaires were designed to focus on essential components of the pre-analytical process of primary care clinics. An online survey platform was used to administer the survey to internal medicine or family medicine physicians in primary care clinics. A total of 141 physicians provided a complete response to the questionnaire. In 65.2% of the clinics, patient information was hand-labeled rather than barcoded on the specimen bottles; 14.2% of clinics displayed only one piece of patient information (name or identification number), and 19.9% of clinics displayed two pieces of information. Centrifuges were not available in 29.1% of the clinics. Institutions carrying out the National Health Screening Program (NHSP) used more barcode system and had more centrifuges than institutions that did not carrying out the NHSP. Pre-analytical quality management is inadequate in many primary clinics. We suggest implementation of a mandatory management system, allowing for a pre-analytical quality management to be carried out in primary care clinics.

Responsible scientific research at Inserm: a field study

In France, Inserm (National Institute of Health And Medical Research) puts considerable effort into scientific integrity and quality management since more than 10 yr. Quality managers are present in about one hundred of the three hundred Inserm Units (the “Unit” at Inserm is an individualized research laboratory, with a head which is nominated by the President of Inserm and a defined life span. Usually, Units are the result of partnerships of Inserm with universities, university hospitals and other research organizations). When Quality management audits are performed, various dysfunctions are noted. Some of these are related to scientific integrity and Questionable Research Practice. Since an increasing number of Inserm Units disposes of Quality management systems according to the ISO 9001 standard, Inserm promotes since several years ISO 9001 management concepts and tools to improve scientific integrity. “Scientific integrity” as used in the missions of the (American) Office of Research Integrity (ORI, https://ori.hhs.gov/policies-ori-mission) and materialized in the Singapore statement on Research integrity (https://wcrif.org/statement). The Singapore Statement is not a regulatory document and does not represent the official policies of the countries represented at the conference. Rather, the intent of the Singapore Statement is to provide ethical guidance which research organizations, governments, and scientists can use to develop policies, regulations, and codes of conduct (World Conference on Research Integrity, https://wcrif.org/statement). Inserm, like others (Bouter, Account. Res. 22, 148–161 (2015)), believes that ISO 9001 research management favors good quality and integrity of research. In this field study the degree of awareness and whether scientists in Inserm Units are ready to make specific efforts to foster integrity and quality of their research was investigated. This study shows that a majority of scientists considers integrity and quality as being necessary. However, it appears that knowledge and understanding of integrity and quality in research should be improved. An effort has to be made to increase this level, specific actions have to be taken but scientists at Inserm are willing to make this effort.

Stratification of Integrated Cancer Center in Indonesia to Improve the Access to Care

Background and context: Indonesia as one of the low- and middle-income countries has not had a classification of cancer services yet. This classification will be very important for standardization and equalization of cancer services for all Indonesian people to access the cancer services provided. Based on Social Security Administering Agency of Health report, advanced stage of cancer have absorbed ∼17% national health budget (the third largest in financing National Health Insurance) but the outcome of the services still not good enough. Dharmais National Cancer Center (NCC) has the task of establishing cancer services system in stages throughout Indonesia by arrange the cancer services strata in Indonesia and develop its roadmap of achievement to improve the access to care. Aim: To build the stratification of integrated cancer center (ICC) in Indonesia by Health Ministerial Decree to improve access to care as a part of cancer control planning. Strategy/Tactics: 1. Build the concept of integrated cancer center stratification in Indonesia by assess the instrument of Director General of Health Services, Ministry of Health that conduct a comprehensive stratification of cancer services especially for diagnostic radiology services, nuclear medicine and radiotherapy to support the cancer services development plan in Indonesia. Currently, internal audit of radiology quality management has been developed by adopt the International Atomic Energy Agency (IAEA) standards issue with 3 instruments used to assess the radiology quality management, namely: a. Quality Assurance Audit for Diagnostic Radiology Improvement and Learning (QUAADRIL). b. Quality Management Audits in Nuclear Medicine Practices (QUANUM). c. Quality Assurance Team of Radiation Oncology (QUATRO). 2. Conducted an audience with Minister of Health to present the concept of integrated cancer center stratification in Indonesia and to initiate Ministry of Health decree as a regulation. The decree will be follow up by disseminate to all national, provincial and regional referral hospitals so they will have internal audit by IAEA to be mapping. Program/Policy process: 1. Dharmais NCC offer a model of cancer referral networking capabilities as a part of integrated national referral systems that includes preventive, promotive, curative and rehabilitative services for various levels of health care facilities with level strata as ICC strata 1, strata 2, strata 3 and NCC. 2. Encouraging the immediate issuance of Ministry of Health policy in the form of decree or regulation as the legal aspects of implementation. Outcomes: The Minister of Health agree with the proposed stratification of integrated cancer center and process the ministerial decree. What was learned: The stratification of integrated cancer center in Indonesia is very important needed to promote the NCCP especially in access to care so the cancer cases will find and treat in early stage due to closer access.

Regular Quality Management Audit in Nuclear Medicine Services - A Dynamic Approach of Self Improvement

Abstract not availableBangladesh J. Nuclear Med. 19(1): 51-55, January 2016

Examining Quality Management Audits in Nuclear Medicine Practice as a lifelong learning process: opportunities and challenges to the nuclear medicine professional and beyond.

This essay will explore the critical issues and challenges surrounding lifelong learning for professionals, initially exploring within the profession and organizational context of nuclear medicine practice. It will critically examine how the peer-review process called Quality Management Audits in Nuclear Medicine Practice (QUANUM) of the International Atomic Energy Agency (IAEA) can be considered a lifelong learning opportunity to instill a culture of quality to improve patient care and elevate the status of the nuclear medicine profession and practice within the demands of social changes, policy, and globalization. This will be explored initially by providing contextual background to the identity of the IAEA as an organization responsible for nuclear medicine professionals, followed by the benefits that QUANUM can offer. Further key debates surrounding lifelong learning, such as compulsification of lifelong learning and impact on professional change, will then be weaved through the discussion using theoretical grounding through a qualitative review of the literature. Keeping in mind that there is very limited literature focusing on the implications of QUANUM as a lifelong learning process for nuclear medicine professionals, this essay uses select narratives and observations of QUANUM as a lifelong learning process from an auditor's perspective and will further provide a comparative perspective of QUANUM on the basis of other lifelong learning opportunities such as continuing professional development activities and observe parallelisms on its benefits and challenges that it will offer to other professionals in other medical speciality fields and in the teaching profession.

An Expert System for Auditing Quality Management Systems in Construction

Abstract: This article introduces a system called Construction Quality Management Audit (CQMA) Expert that assesses the performance of a quality management system (QMS) implemented in a construction firm. CQMA Expert is programmed by using MATLAB's GUI components and its Fuzzy Logic Toolbox. CQMA Expert's rule base is constructed using information obtained from auditors of QMSs. CQMA Expert imports the quality requirements relative to the many quality management processes specified in ISO 9000, processes audit inputs, and generates consistent decisions relative to conformance to standards. It provides an interactive user interface for recording evidence collected during the audit and clearly states the reasons for the conclusions. It contributes to continuous quality improvement because (1) it enhances the maintenance of a QMS by quantifying its performance, (2) it assists with and facilitates the implementation of the duties of auditors in charge of assessing the performance of a QMS, (3) it simplifies the burdensome process involved in keeping track of the audit results of the many quality management processes investigated, and (4) it reduces the impact of the variability caused by the use of different auditors assessing different quality management processes. Case studies based on Section 4.11 of the ISO 9000 standard entitled “Control of inspection, measuring and test equipment” are used to illustrate the system and verify its usability and validity.

Quality management in the prophylaxis of venous thrombembolism - Results of a survey including 464 medical and surgical patients

We surveyed the quality of risk stratification politics and monitored the rate of entries to our company-wide protocol for venous thrombembolism (VTE) prophylaxis in order to identify safety concerns. Audit in 464 medical and surgical patients to evaluate quality of VTE prophylaxis. Patients were classified as low 146 (31 %), medium 101 (22 %), and high risk cases 217 (47 %). Of these 262 (56.5 %) were treated according to their risk status and in accordance with our protocol, while 9 more patients were treated according to their risk status but off-protocol. Overtreatment was identified in 73 (15.7 %), undertreatment in 120 (25,9 %) of all patients. The rate of incorrect prophylaxis was significantly different between the risk categories, with more patients of the high-risk group receiving inadequate medical prophylaxis (data not shown; p = 0.038). Renal function was analyzed in 392 (84.5 %) patients. In those patients with known renal function 26 (6.6 %) received improper medical prophylaxis. If cases were added in whom prophylaxis was started without previous creatinine control, renal function was not correctly taken into account in 49 (10.6 %) of all patients. Moreover, deterioration of renal function was not excluded within one week in 78 patients (16.8 %) and blood count was not re-checked in 45 (9.7 %) of all patients after one week. There were more overtreatments in surgical (n = 53/278) and more undertreatments in medical patients (n = 54/186) (p = 0.04). Surgeons neglected renal function and blood controls significantly more often than medical doctors (p-values for both < 0.05). We found a low adherence with our protocol and substantial over- and undertreatment in VTE prophylaxis. Besides, we identified disregarding of renal function and safety laboratory examinations as additional safety concerns. To identify safety problems associated with medical VTE prophylaxis and "hot spots" quality management-audits proved to be valuable instruments.

Reverse Quality Management

The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

A high-quality-supplier selection model for supply chain management and ISO 9001 system

Supplier selection process for supply chain management (SCM) and ISO 9001 quality management system environments is considered. Determining suitable suppliers in the supply chain has become a key strategic consideration. However, the nature of these decisions is usually complex and unstructured. This paper proposes a high-quality-supplier selection (HQSS) model to deal with supplier selection problems in supply chain management. In selecting a supplier, quality management factors are considered first, and then price, delivery, etc. Quality management factors include a quality management audit, product testing, engineering work force, capability index, training time, etc., based on a five-interval scale. Next, the HQSS model determines the final solution by considering factors such as price, production lead-time, and delivery time.