Quality Management Program Research Articles

Quality Management to Improve CSF Gram Stain Turnaround Time.

With appropriate turnaround time (TAT), cerebrospinal fluid (CSF) Gram stains can provide rapid, clinically actionable information in patients with meningitis. Monitoring CSF Gram stain TAT at our institution revealed workflow gaps that were causing result reporting delays. We then implemented a new quality management program to improve TAT. We reviewed the TAT of all CSF specimens submitted for bacterial culture received between August 1, 2016, and July 31, 2020, and began prospectively monitoring CSF Gram stain TAT in January 2019. We then implemented the following changes in April 2019: (i) monthly reviews of TAT with staff, (ii) hand-off sheets for shift transitions, and (iii) pre- and post-shift walk throughs including centrifuge checks. A total of 6913 samples were included in the analysis. CSF samples with TAT > 60 min decreased from 27.3% to 9.89% (P < 0.0001), and median TAT decreased by 9 min (P < 0.0001) with significantly reduced variability. These changes were sustained throughout the follow-up period across all shifts and shift transitions. A new monthly quality metric allowed us to track CSF Gram stain TAT, identify barriers to TAT goals, and implement workflow changes that significantly improved TAT without the need for costly interventions.

Quality Management of Prehospital Airway Programs: An NAEMSP Position Statement and Resource Document

Prehospital airway management encompasses a multitude of complex decision-making processes, techniques, and interventions. Quality management (encompassing quality assurance and quality improvement activities) in EMS is dynamic, evidence-based, and most of all, patient-centric. Long a mainstay of the EMS clinician skillset, airway management deserves specific focus and attention and dedicated quality management processes to ensure the delivery of high-quality clinical care. It is the position of NAEMSP that: All EMS agencies should dedicate sufficient resources to patient-centric, comprehensive prehospital airway quality management program. These quality management programs should consist of prospective, concurrent, and retrospective activities. Quality management programs should be developed and operated with the close involvement of the medical director. Quality improvement and quality assurance efforts should operate in an educational, non-disciplinary, non-punitive, evidence-based medicine culture focused on patient safety. The highest quality of care is only achieved when the quality management program rewards those who identify and seek to prevent errors before they occur. Information evaluated in prehospital airway quality management programs should include both subjective and objective data elements with uniform reporting and operational definitions. EMS systems should regularly measure and report process, outcome, and balancing airway management measures. Quality management activities require large-scale bidirectional information sharing between EMS agencies and receiving facilities. Hospital outcome information should be shared with agencies and the involved EMS clinicians. Findings from quality management programs should be used to guide and develop initial education and continued training. Quality improvement programs must continually undergo evaluation and assessment to identify strengths and shortcomings with a focus on continuous improvement.

Prehospital Pediatric Respiratory Distress and Airway Management Training and Education: An NAEMSP Position Statement and Resource Document

Although pediatric airway and respiratory emergencies represent high-acuity situations, the ability of EMS clinicians to effectively manage these patients is hampered by infrequent clinical exposure and shortcomings in pediatric-specific education. Cognitive gaps in EMS clinicians’ understanding of the differences between pediatric and adult airway anatomy and respiratory physiology and pathology, variability in the training provided to EMS clinicians, and decay of the psychomotor skills necessary to safely and effectively manage pediatric patients experiencing respiratory emergencies collectively pose significant threats to the quality and safety of care delivered to pediatric patients. NAEMSP recommends: Pediatric airway education should include discussion of the factors that make pediatric airway management challenging. EMS agencies should provide pediatric-specific education that addresses recognition and treatment of pediatric respiratory distress based upon pathophysiology affecting upper airways, lower airways, cardiovascular systems, or extrinsic causes of disordered breathing. Pediatric airway training should also differentiate between hypoxic and hypercapnic respiratory failure. Education should emphasize that the cognitive and psychomotor skills requisite in management of pediatric respiratory emergencies will differ across patient age groups. EMS clinicians should be provided education and training in technology-dependent children and children and youth with special health care needs. EMS clinicians should receive initial and ongoing education and training in pediatric airway and respiratory conditions that emphasizes the principle of using the least invasive most effective strategies to achieve oxygenation and ventilation. Initial and continuing pediatric-focused education should be structured to maintain EMS clinician competency in the assessment and management of pediatric airway and respiratory emergencies and should be provided on a recurring basis to mitigate the decay of EMS clinicians’ knowledge and skills that occurs due to infrequent field-based clinical exposure. Integration of clinician education programs with quality management programs is essential for the development and delivery of initial and continuing education intended to help EMS clinicians attain and maintain proficiency in pediatric airway and respiratory management.

Quality Management of Prehospital Pediatric Respiratory Distress and Airway Programs: An NAEMSP Position Statement and Resource Document

The unique challenges of pediatric respiratory and airway emergencies require the development and maintenance of a prehospital quality management program that includes pediatric-focused medical oversight and clinical care expertise, data collection, operational considerations, focused education, and clinician competency evaluation. NAEMSP recommends: Medical director oversight must include a focus on pediatric airway and respiratory management and integrate pediatric-specific elements in guideline development, competency assessment, and skills maintenance efforts. EMS agencies are encouraged to collaborate with medical professionals who have expertise in pediatric emergency care to provide support for quality management initiatives in pediatric respiratory distress and airway management. EMS agencies should define quality indicators for pediatric-specific elements in respiratory distress and airway management and benchmark performance based on regional and national standards. EMS agencies should implement both quantitative (objective) and qualitative (subjective) measures of performance to assess competency in pediatric respiratory distress and airway management. EMS agencies choosing to incorporate pediatric endotracheal intubation or supraglottic airway insertion must use pediatric-specific quality management benchmarks and perform focused review of advanced airway management.

Prehospital Supraglottic Airways: An NAEMSP Position Statement and Resource Document

Supraglottic airway (SGA) devices provide effective conduits for oxygenation and ventilation and may offer protection from gastric aspiration. SGA devices are widely used by EMS clinicians as both rescue and primary airway management devices. While in common use for more than four decades, major developments in SGA education, science, and technology have influenced clinical strategies of SGA insertion and use in prehospital airway management for patients of all ages. NAEMSP recommends: SGAs have utility as a primary or secondary EMS airway intervention. EMS agencies should select SGA strategies that best suit available resources and local clinician skillset, as well as the nature of their clinical practice setting. EMS agencies that perform endotracheal intubation must also equip their clinicians with SGA devices and ensure adequate training and competence. In select situations, drug-assisted airway management may be used by properly credentialed EMS clinicians to facilitate SGA insertion. Confirmation of initial and continuous SGA placement using waveform capnography is strongly encouraged as a best practice. When it is functioning properly, EMS clinicians should refrain from converting an SGA to an endotracheal tube. The decision to convert an SGA to an endotracheal tube must consider the patient’s condition, the effectiveness of SGA ventilations, and the clinical context and course of initial SGA insertion SGA training, competency, and clinical use must be continuously evaluated by EMS agencies using focused quality management programs.

National society for histotechnology workload study

ABSTRACT In June and July 2021, the National Society for Histotechnology (NSH) conducted an online survey designed to assess productivity and staffing in the clinical histology laboratory. The Productivity Benchmarking Survey was developed by the NSH Quality Management Committee. The survey of histology professionals provides critical data that may be used to inform staffing decisions and develop a quality management program. To create usable data the findings were segmented by a range of variables including facility type and size, and productivity related to grossing, embedding, microtomy, and ancillary duties. This study draws a connection between perceived operational efficiencies and the presence of a program or process used to assess employees quality performance for grossing,embedding, and microtomy. A followup survey is planned to further understand these particular employee assessment programs or processes.

Quality and safety in clinical nutrition

Clinical nutrition and food provision in a hospital environment must be regulated by quality management programs that ensure maximum clinical benefit and maximum patient safety. This article gives an overview of quality management in clinical nutrition and hospital feeding. Likewise, keys and critical points to be taken into account in all the processes and threads that are carried out during specialized nutritional support and alimentation of patients are analyzed.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

Thực trạng và một số yếu tố ảnh hưởng đến văn hóa an toàn người bệnh của nhân viên y tế bệnh viện đa khoa quốc tế Vinmec Nha Trang năm 2021

Aim: Describe reality and analysis of affecting factors on patient safety culture (PSC) of medical staff (MS) in Vinmec Nha Trang International Hospital in 2021 (IGH). Research design: Cross-sectional research design integrates quantitative and qualitative research, was carried out from December 2020 to May 2021 in Vinmec Nha Trang International Hospital. The researcher had performed on 240 MS used the structured tickets with PSC HSOPSC scales of AHRQ, performing 4 in-depth interviews (IDI) with the director of the hospital, The head of the general planning department, The head of the nursing factor, The hospital quality manager and 2 focus group discussions (FGD) with 16 MS. The data were analyzed with SPSS 20.0 software using suitable descriptive statistics, qualitative information was analyzed and cited by topic. Results: The positive feedback on PSC is 83,3%, which is good. In which, the supporting field of the leaders in patient safety (PS) had the highest positive rating (95,7%). The handover and transfer patients field had the lowest positive rating (61,9 %). The IDS and FGD results indicate that these factors as the characteristics of MS, hospital management, and working environment influence PSC. Recommendation: Continue to maintain the implementation of quality management programs on patient safety. The leadership needs to implement the message of not sanctioning or reducing the level of punishment for voluntary incident reporting errors (RE) to improve the percentage of health workers who actively RE. Keywords: Patients safety culture, factors affecting patient safety culture, Vinmec NhaTrang International Hospital.

Evaluating incident learning systems and safety culture in two radiation oncology departments.

IntroductionRadiation oncology patient pathways are complex. This complexity creates risk and potential for error to occur. Comprehensive safety and quality management programmes have been developed alongside the use of incident learning systems (ILSs) to mitigate risks and errors reaching patients. Robust ILSs rely on the safety culture (SC) within a department. The aim of this study was to assess perceptions and understanding of SC and ILSs in two closely linked radiation oncology departments and to use the results to consider possible quality improvement (QI) of department ILSs and SC.MethodsA survey to assess perceptions of SC and the currently used ILSs was distributed to radiation oncologists, radiation therapists and radiation oncology medical physicists in the two departments. The responses of 95 staff were evaluated (63% of staff). The findings were used to determine any areas for improvement in SC and local ILSs.ResultsDifferences were shown between the professional cohorts. Barriers to current ILS use were indicated by 67% of respondents. Positive SC was shown in each area assessed: 69% indicated the departments practised a no‐blame culture. Barriers identified in one department prompted a QI project to develop a new reporting system and process, improve departmental learning and modify the overall ILS.ConclusionAn understanding of SC and attitudes to ILSs has been established and used to improve ILS reporting, feedback on incidents, departmental learning and the QA program. This can be used for future comparisons as the systems develop.

Organizational aspects of personnel’s intangible motivation in the enterprises QMS

The presented research reveals the concept of intangible motivation of personnel. The definitional content of this category has been formed, the place, components, basic principles, approaches to implementation, as well as the psychological basis of motivation, have been determined. The co-evolutionary mechanisms of the system of intangible motivation and implementation of the quality management system at the enterprise have been determined, an important attribute of which is the permanence and consistency of the use of general principles. The need to implement the principles of a quality management system is determined at all stages of personnel management, in particular: selection and assessment of personnel, adaptation and training, team building, development and attraction. In the course of the study, it was confirmed that systematic training of employees on quality issues, tools and principles of the quality management system is an important element of improving and managing quality in organizations, because training and development has a significant impact on the quality provided by the organization on a regular basis through quality education and training activities, quality-oriented rewards and programs are essential to achieve quality management objectives. Quality management initiatives and programs require the support, input and cooperation of all workers and their effective involvement. The main psychological motivational components of the enterprise personnel in the structure of the enterprise quality management system have been determined, namely: awareness, responsibility and competence. The importance of such tools of the quality management system as policy and goals in the context of the formation of a motivational strategy is emphasized. Proposals have been formulated for the implementation of non-material motivation using the toolkit of general principles and approaches of the enterprise quality management system. Key words: quality management system, process, business process, management, principle, intangible motivation, activator.

Guiding the Standardization in Acute Leukemia Service Delivery through the Development of Organizational Requirements

Guiding the Standardization in Acute Leukemia Service Delivery through the Development of Organizational Requirements

Improving radiotherapy safety and efficiency with the customized ARIA oncology information system.

To improve safety and efficiency of radiotherapy process by customizing a Varian ARIA oncology information system following the guidelines provided in AAPM TG-100 report. First, failure mode and effects analysis (FMEA) and quality management program were implemented for radiotherapy process. We have customized the visual care path in the ARIA system and set up a series of templates for simulation, prescription, contouring, treatment planning, and multiple checklists. Average time of activities' completion and amount of planning errors were compared before and after the use of the customized ARIA to evaluate its impact on the efficiency and safety of radiotherapy. Completion time and on-time completion rate of the key activities in the care path are improved. The time of OAR/targets contouring decreases from (1.94±1.51) days to (1.64±1.07) days (p = 0.003), with the on-time completion rate increases from 77.4%to 83.3%(p = 0.048). Treatment planning time decreases from (0.81±0.65) days to (0.55±0.51) days (p < 0.001), with the on-time completion rate increases from 96.6%to 98.3%(p = 0.163). Waiting time of patients decreases from (4.50±1.83) days to (4.04±1.34) days (p < 0.001), with the on-time completion rate increases from 81.9%to 89.7%(p = 0.003). In addition, the average plan error rate decreases from 5.5%(2.9%for safety errors and 2.6%for non-normative errors) to 2.4%(1.6%for safety errors and 0.8%for non-normative errors) (p = 0.029). Our study demonstrates that the customized ARIA system has the potential to promote efficiency and safety in radiotherapy process management. It is beneficial to organize and accelerate the treatment process with more effective communications and fewer errors.

Variation in septic system effluent inputs to tributaries in multiple subwatersheds and approaches to distinguish contributing pathways and areas

Quantifying the contribution of septic systems to contaminant, including nutrient, loading to streams is needed in many watersheds to inform water quality management programs. However, this quantification is challenging due to the distributed locations of septic systems and uncertainties regarding the pathways delivering effluent from septic systems (functioning and failing) to a stream. The objectives of this study were firstly to evaluate how septic effluent inputs to streams vary with stream discharge conditions for multiple subwatersheds with different characteristics (i.e., geology, septic system density, and typical age), and secondly to examine new approaches for distinguishing the pathways and the contributing areas delivering septic effluent to streams. These approaches use the artificial sweetener acesulfame as a conservative tracer for septic effluent in applications of: (i) stream concentration-discharge (C-Q) relationships using low frequency sampling data, (ii) hysteresis behavior in event-based C-Q relationships, and (iii) longitudinal stream sampling. For all nine subwatersheds studied, the amount of septic effluent reaching the subwatershed outlets was considerably higher during high stream discharge (event) conditions compared to low discharge (baseflow) conditions, suggesting pathways other than groundwater may also be important. Generally, the percentage of septic effluent reaching the outlets was less for subwatersheds with newer households compared to those with older households. The combined interpretation of low frequency and event-based C-Q relationships indicate that complex pathways control the delivery of septic effluent to the subwatershed outlets. The interpretations suggest that groundwater pathways may dominate in some subwatersheds, while more rapid pathways associated with failing septic systems (e.g., overland runoff) may be important in others. Finally, longitudinal stream sampling illustrate the potential of acesulfame data to identify key areas contributing septic effluent to the stream. The novel approaches used here can be applied to guide future investigations aiming to quantify and manage water quality impairment from septic systems.

DESAIN KONSEPTUAL DIGITALISASI MANAJEMEN MUTU PADA INDUSTRI FMCG

Industry 4.0 era encourage FMCG manufacture industries in Indonesia to continuously innovating through digital technology adoption in their process, including quality management. Quality management digitalization in manufacture industry in Indonesia is now at the level of leaving paperwork documentation and analog communication in quality control; and have started to adopt computerized database and analysis. The absent of national software provider and academic study focusing on quality management digitalization concept has become an obstacle for Indonesia to evolve in Industry 4.0 era. This paper intended to provide conceptual design of integrated quality management digitalization to support FMCG industries in effective decision making and compliance to quality control plan; and to stimulate national software provider to develop digitalized quality management program. The research use descriptive qualitative method through literature review of articles indexed in Garuda and Mendeley from 2017 to 2020 to make sure if there any previous research studied quality management digitalization for FMCG industry, and thus the review will be used as a strong reason to develop concept of quality management digitalization. The result showing no research found that exclusively studied about quality management digitalization for FMCG, and thus concept of quality management digitalization for FMCG is proposed as a baseline foundation for program developer to develop an integrated software in quality management digitalization for FMCG.

A Machine-Learning Approach for Extracting Modulus of Compacted Unbound Aggregate Base and Subgrade Materials Using Intelligent Compaction Technology

This study presents a rigorous approach for the extraction of the modulus of soil and unbound aggregate base materials for quality management using intelligent compaction (IC) technology. The proposed approach makes use of machine-learning methods in tandem with IC technology and modulus-based spot testing as a local calibration process to estimate the mechanical properties of compacted geomaterials. A calibrated three-dimensional finite element (FE) model that simulates the proof-mapping process of compacted geomaterials was used to develop a comprehensive database of responses of a wide range of single and two-layered geosystems. The database was then used to develop different inverse solvers using artificial neural networks for the estimation of the modulus from the characteristics of the roller and information about the geomaterials. Several instrumented test sites were used for the evaluation and validation of the inverse solvers. The proposed approach was found promising for the extraction of the modulus of compacted geomaterials using IC. The accuracy of the inverse solvers is enhanced if a local calibration process is incorporated as part of a quality management program that includes the use of in situ measurements using modulus-based test devices and laboratory resilient modulus testing. Moreover, compaction uniformity plays a key role in the retrieval of the modulus of geomaterials with certainty. The proposed approach fuses artificial intelligence with mechanistic solutions to position IC as a technology that is well suited for the quality management of compacted materials.

Lean Implementation Barriers and the duality of lean in an Organisations

Lean strategy is all about elimination of waste and redundant process; competitive benchmarking, introducing continuous improvement programs, preventive maintenance optimization, cycle time reduction, just-in-time (JIT), new process improvement, quality management programs, value engineering, self-directed work team, total quality management. The study investigates how people and duality of lean impacts lean implementation in organizations, looking at the case of the food processing manufacturing firms in Nigeria. To achieve the objective, the study employed Structural Equation Modelling (PLS-SEM) using data collected from 340 questionnaire collected from food processing firms in Nigeria. It was discovered from the study that factors hindering implementation of lean could be in the form of poor communication strategy within organisation, organizational culture, organisational knowledge, management support, policies on human development. The paper concludes that lean implementation does not have a stand-alone methodology, but the existence or lack of the identified factors may make or hinder successful implementation of lean especially in the food processing manufacturing companies in Nigeria.

Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019

SummaryBackgroundPrevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)—a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019.MethodsBased on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010–19 period.FindingsGlobally, there were 2·26 million (95% uncertainty interval 2·07 to 2·45) new cases of tracheal, bronchus, and lung cancer, and 2·04 million (1·88 to 2·19) deaths and 45·9 million (42·3 to 49·3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3·26 million (3·03 to 3·51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23·3% (12·9 to 33·6) globally and the number of larynx cancer cases increased by 24·7% (16·0 to 34·1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7·4% (−16·8 to 1·6) and age-standardised incidence rates of larynx cancer decreased by 3·0% (−10·5 to 5·0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0·9% (−8·2 to 10·2) for tracheal, bronchus, and lung cancer and decreased by 0·5% (−8·4 to 8·1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64·2% (61·9–66·4) of all deaths from tracheal, bronchus, and lung cancer and 63·4% (56·3–69·3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019.InterpretationThe numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations—namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings.FundingBill & Melinda Gates Foundation.

Examining the integration of continuous improvement and strategic planning in select pharmaceutical companies in India: a case study

PurposeThe objective of the study is to examine the extent to which pharmaceutical companies in India rely on traditional planning approaches rather than the new learning approach to strategic planning. In addition to that, the study also seeks to examine the perceived ability of the pharmaceutical companies in India to integrate continuous improvement goals and product quality into the overall strategic planning and success in implementing total quality management (TQM) programs examined through three particular continuous improvement mindsets.Design/methodology/approachThe study collected data from select pharmaceutical companies in India through survey technique using a standardized questionnaire through online mode. A descriptive statistical analysis is performed to examine the extent of integration of strategic planning and continuous improvement in the select pharmaceutical companies in India.FindingsThe results of the study indicate that pharmaceutical companies in India still rely greatly on traditional planning methods for strategic planning. However, a shift is also observed toward adoption of best practice management and modern strategic management techniques. The study also demonstrates that continuous improvement goals and strategies are included into the corporate strategic planning.Research limitations/implicationsThe study employs only descriptive statistics, and no hypotheses are generated in the study because the objective is not to generalize the findings. The process of formulating quality goals and integrating them with strategy is typical to any company. Therefore, the findings cannot be generalized. The findings of the study do not given any insights into the strategic quality management process due to online mode of data collection. Also, the focus on the study is on the internal management of quality in an organization and factors in the external environment or in the value chain outside the firm, influencing strategic management of quality are beyond the scope of present study.Practical implicationsConsidering the significance of quality of products, an understanding of the link between quality and strategic goals helps the managers in pharmaceutical industry to align the strategic planning goals with quality goals ensuring that the entire organization moves in same strategic direction.Originality/valueThe strong focus quality in pharmaceutical industry in India has given impetus to development of well-managed quality programs on the shop-floor to remain competitive and survive in the highly competitive global markets. However, no such study is conducted so far to understand the extent to which continuous improvement or TQM practices are integrated into strategic planning in the pharmaceutical companies in India.

Water Quality Modelling of River Mahanadi using Principal Component Analysis (PCA) and Multiple Linear Regression (MLR)

Surface water quality is one of the critical environmental concerns of the globe and water quality management is top priority worldwide. In India, River water quality has considerably deteriorated over the years and there is an urgent need for improving the surface water quality. The present study aims at use of multivariate statistical approaches for interpretation of water quality data of Mahanadi River in India. Monthly water quality data pertaining to 16 parameters collected from 12 sampling locations on the river by Central Water Commission (CWC) and Central Pollution Control Board (CPCB) is used for the study. Cluster analysis (CA), is used to group the sampling locations on the river into homogeneous clusters with similar behaviour. Principal component analysis (PCA) is quite effective in identifying the critical parameters for describing the water quality of the river in dry and monsoon seasons. PCA and Factor Analysis (FA) was effective in explaining 69 and 66% of the total cumulative variance in the water quality if dry and wet seasons respectively. Industrial and domestic wastewaters, soil erosion and weathering, soil leaching organic pollution and natural pollution were identified as critical sources contribution to pollution of river water. However, the quantitative contributions were variable based on the season. Results of multiple linear regression (MLR) are effective in explaining the factor loadings and source contributions for most water quality parameters. The study results indicate suitability of multivariate statistical approaches to design and plan sampling and sampling programs for controlling water quality management programs in river basins.