Quality Of Programs Research Articles

Departure Decisions: Exit Survey of Family Medicine Residency Directors.

Program director (PD) tenure, continuity, and stability may enhance residency program quality, yet many PDs do not stay long in their positions. No prior study has taken a comprehensive census of departing PDs to determine reasons for leaving the role. This study aimed to survey all exiting family medicine (FM) PDs to identify decision factors contributing to their departure. From October 2021 to October 2022, we sent a web-based exit survey to all departing FM PDs. The survey asked departing PDs to rate the strength of 36 factors in the decision to exit the PD role in terms of job satisfaction, accomplishments, career choices, workload, preparation, expectations, and support. We used the Fisher exact test to assess all 36 decision factors and PD characteristics for significant associations with shorter or longer PD tenures. PDs submitted 73 surveys out of 109 invitations (67.0% response). We analyzed 68 with complete data. The median PD tenure was 5.6 years (mean 6.9 years). Most respondents (66/68, 97.1%) identified three or more strong factors in their decision to leave. The strongest factors reflected stable residency programs, an established succession plan, a desire for more personal/family time, and a sense that the time was right. PDs with tenures longer than 3 years were more likely to have completed the National Institute for Program Director Development (P=.001). PDs leave the position for multiple reasons, often positive, and not necessarily due to lack of support and preparation. Further exploration of decision factors may inform strategies to support PDs in their positions.

Real-world treatment patterns, resource utilization and costs in biliary tract cancers in the USA.

Aim: To evaluate real-world treatment patterns, survival and healthcare-resource utilization in US patients with advanced biliary tract cancers (BTC) receiving systemic therapy.Patients & methods: This study used claims data from the Healthcare Integrated Research Database (HIRD®) linked to clinical data from the Cancer Care Quality Program (January 1, 2015-September 30, 2020).Results: Of 413 patients, 84.5% received gemcitabine-based first-line (1L) treatment, 46% received second-line treatment, and 16.5% received third-line (3L) treatment. All-cause mortality was 53% and approximately 70% of patients had ≥1 inpatient visit. The total mean per-patient-per-month all-cause costs were $19,589 for 1L and $33,534 for 3L treatment.Conclusion: Results showed poor survival, significant resource use and high costs as treatment line progresses for patients with advanced BTC.

Factors Affecting Chinese Students’ Selection of Tourism and Hospitality Management Undergraduate Programs

ABSTRACT While China has long been recognized as the primary target market for all tertiary institutions, existing knowledge about factors affecting Chinese students’ choice of tourism and hospitality management (THM) undergraduate programs is surprisingly scarce. The primary objective of this study is to identify key determinants affecting Chinese students’ selection of THM undergraduate programs. Drawing on data provided by Chinese high school graduates who plan to pursue higher education majoring in THM, this study finds Chinese students consider push factors and particularly career prospects, program quality, and career support as highly important factors when they select THM undergraduate programs. Pull factors, such as financial capability and social influence (e.g. advice from friends), are comparatively less influential in Chinese students’ program choice. The robustness of the results is ascertained after cross-comparing the results from data collected before and after the outbreak of COVID-19. The resulting knowledge of this study provides a good foundation for universities’ management to formulate sound marketing strategies that appeal to prospective applicants from China.

The Study of APIPA Model Concept Development through the Application of Analytical Hierarchy Process (AHP)

Improving the quality of teacher performance programs certainly requires the important role of teachers and school leaders. The role of teachers can be seen in the implementation of performance programs which require systematic and structured evaluation of performance programs. The results of the evaluation and monitoring of the implementation of the teacher performance program by school leaders are used as material for consideration in making decisions about the quality level of the teacher performance program. Making this decision is very difficult for a school leader in evaluating teacher performance programs. In this case, a modified program evaluation was developed by the CIPP model program evaluation with ALKIN model program evaluation. The research used Development Research (R&D) using 4D design (Define, Design, Development, Dissemination). The Define stage conducts a literature review regarding weaknesses in the CIPP and ALKIN model program evaluation syntax. The Design stage prepares the topology related to the main ideas of the program evaluation development syntax. The Development stage carries out operational definitions and indicators for each program evaluation syntax. The dissemination stage carries out an expert judgment or assessment of the experts who are analyzed using the analytical Hierarchical Process (AHP) to determine the consistency of the program evaluation development concept. The results using AHP are consistent with the concept of developing the APIPA model program evaluation which has the syntax Assessment, Planning, Implementation, Product, and Appreciation for evaluating teacher performance programs.

A group decision-making model for architectural programming in megaprojects

PurposeDue to the complexity and diversity of megaprojects, the architectural programming process often involves multiple stakeholders, making decision-making difficult and susceptible to subjective factors. This study aims to propose an architectural programming methodology system (APMS) for megaprojects based on group decision-making model to enhance the accuracy and transparency of decision-making, and to facilitate participation and integration among stakeholders. This method allows multiple interest groups to participate in decision-making, gathers various perspectives and opinions, thereby improving the quality and efficiency of architectural programming and promoting the smooth implementation of projects.Design/methodology/approachThis study first clarifies the decision-making subjects, decision objects, and decision methods of APMS based on group decision-making theory and value-based architectural programming methods. Furthermore, the entropy weight method and fuzzy TOPSIS method are employed as calculation methods to comprehensively evaluate decision alternatives and derive optimal decision conclusions. The workflow of APMS consists of four stages: preparation, information, decision, and evaluation, ensuring the scientific and systematic of the decision-making process.FindingsThis study conducted field research and empirical analysis on a practical megaproject of a comprehensive transport hub to verify the effectiveness of APMS. The results show that, in terms of both short-distance and long-distance transportation modes, the decision-making results of APMS are largely consistent with the preliminary programming outcomes of the project. However, regarding transfer modes, the APMS decision-making results revealed certain discrepancies between the project's current status and the preliminary programming.Originality/valueAPMS addresses the shortcomings in decision accuracy and stakeholder participation and integration in the current field of architectural programming. It not only enhances stakeholder participation and interaction but also considers various opinions and interests comprehensively. Additionally, APMS has significant potential in optimizing project performance, accelerating project processes, and reducing resource waste.

Protocol for the Australian Type 1 Diabetes National Screening Pilot: Assessing the feasibility and acceptability of three general population screening models in children.

One third of Australian children diagnosed with type 1 diabetes present with life-threatening diabetic ketoacidosis (DKA) at diagnosis. Screening for early-stage, presymptomatic type 1 diabetes, with ongoing follow-up, can substantially reduce this risk (<5% risk). Several screening models are being trialled internationally, without consensus on the optimal approach. This pilot study aims to assess three models for a routine, population-wide screening programme in Australia. An implementation science-guided pilot study to evaluate the feasibility, acceptability and costs of three screening models in children will be conducted between July 2022 and June 2024. These models are as follows: (1) Genetic risk-stratified screening using newborn heel prick dried bloodspots, followed by autoantibody testing from 11 months of age; (2) genetic risk-stratified screening of infant (6-12 months) saliva followed by autoantibody testing from 10 months of age; and (3) autoantibody screening using capillary dried bloodspots collected from children aged 2, 6 or 10 years. Cohorts for each model will be recruited from targeted geographic areas across Australia involving ≥2 states per cohort, with a recruitment target of up to 3000 children per cohort (total up to 9000 children). The primary outcome is screening uptake for each cohort. Secondary outcomes include programme feasibility, costs, parental anxiety, risk perception, satisfaction, well-being and quality of life, and health professional attitudes and satisfaction. This pilot is the first direct comparison of three screening implementation models for general population screening. Findings will provide evidence to inform a potential national screening programme for Australian children. ACTRN12622000381785.

An Investigation into Vocational Preferences among University Students: A Case Study of Lahore Pakistan

The preference for general academic degrees over technical education among youth in Pakistan is a trend that has been observed in recent years. This trend may be attributed to several factors, such as the perception that general academic degrees are more prestigious than technical education degrees, the belief that general academic degrees offer more diverse career opportunities and lack of awareness about the benefits of technical education. The preference for general academic degrees over technical education is not unique to Pakistan. This trend may be observed in many other countries as well. Therefore, the current study aimed to learn from student`s observations enrolled in general academic degrees to implement best practices in order to address this trend in Pakistan. A multifaceted approach was required to address the preference for general academic degrees over technical education among youth in Pakistan. This multifaceted approach focused on raising awareness, improving the quality of technical education programs, addressing the underlying factors, and learning from the experiences of other countries. Data was collected via a cross-sectional survey from the students of University of Management and Technology (UMT). The statistical results showed a significant association among low preference for technical education, preference for general university education, and preference for a white-collar job. Therefore, it was crucial to raise awareness regarding the benefits of technical education to address this trend. These benefits include development of practical skills, potential for higher earning, and alignment with the needs of labor market.

The association between perceived social support and future decent work perception: A moderated mediation model

This study examined the relationship between perceived social support, career exploration, and future decent work perception among undergraduate teacher education students in Fujian Province, China. The research focused mainly on the moderating role of proactive personality in these relationships. Data from 542 valid questionnaires revealed that perceived social support significantly influenced career exploration, impacting students' perceptions of future decent work. More importantly, our analysis showed that proactive personality intensified the positive effects of social support on career exploration activities, enhancing students' outlook on their future careers. These findings confirmed social cognitive theory's relevance in understanding career development processes and highlighted the potential of proactive personality traits to leverage social resources more effectively. Given the evolving educational demands and the current socio-economic conditions in China, our study suggested that educational programs should emphasize nurturing proactive behaviors and strengthening social support systems to better prepare students for future professional challenges. These insights were crucial for educators aiming to enhance the quality and effectiveness of teacher education programs, promoting a more robust entry into the workforce for future educators.

Kualitas Program Layanan Homecare Terhadap Tingkat Kepuasan Pasien : Literature Review

Background: Homecare is recovery, independence, fulfilling basic needs,choose the treatment nedded are called homecare, influences the success of health development. In overcoming health problems, health workers must be able to increase their professionalism in carrying out their duties to provide the best and highest quality services, so that patients and family members feel satisfied as measured by the factors. Purpose: This literature review research aims to find out how the quality of homecare service programs influences the level of patient satisfaction. Methods: There were 14 journals used in the literature review. Journal searches are carried out through Four databases : Google Scholar, Crossref, ProQuest, Emerald Insight.Results: Literature analysis shows that, there is a relationship between reliability, responsiveness, assurance, emphaty and tangible with the level of patient satisfaction.Conclusion: The quality of home services is influenced by several factors, the focus of quality measurement in Indonesia and several countries is similar. In other countries, quality seen in the nursing process, staff skills are called assurance. Quality is conceptualized as a continuous process, coordination of professional groups, prioritizing patient safety standards is called tangible, timeliness called responsiveness. In Indonesian quality is measured in five factors are tangible, responsiveness, reliability, assurance and empathy. These factors are most related to patient satisfaction in homecare services.

Using Accreditation Standards for Internal Quality Assurance for Tertiary General English Program in Vietnam

The mixed-method study used a quantitative questionnaire to collect feedback from teachers and program directors regarding the current practices of quality assurance approaches in General English (GE) training programs at their higher education institutions (HEIs). Additionally, the study sought their evaluation of applying accreditation schemes to ensure the quality of GE training programs using a semi-structured interview. The results indicated that the quality assurance measures implemented in the GE training program were generally perceived as effective and aligned with industry standards and best practices. However, there needs to be a comprehensive QA approach that covers areas of improvement related to the learners' needs and expectations and the implementation of QA approaches for curriculum effectiveness. Informants were found to have positive evaluations of the application of the existing accreditation schemes for GE training programs at HEIs in Vietnam. Research on the effectiveness of a specific accreditation scheme implemented at particular HEIs in Vietnam will be conducted in the future.

Post Anesthesia Care Unit Comprehension Safety Program Quality Improvement Project on De-escalation of Patients

Post Anesthesia Care Unit Comprehension Safety Program Quality Improvement Project on De-escalation of Patients

A stepwise implementation of the Slovenian National Diabetic Retinopathy Screening Program - evaluation of the first 4.5 years.

This retrospective cohort study aimed to assess the characteristics of patients enrolled in the national diabetic retinopathy (DR) screening program and evaluate the selected program's quality elements in the first five years after implementation. Patients who underwent DR screening between February 2018 and June 2022 at the University Medical Centre Ljubljana were included. General patient characteristics (age, sex, type and therapy of diabetes mellitus (DM), duration of DM, blood HbA1c levels), best corrected visual acuity, stage of DR, presence of sight-threatening diabetic retinopathy (STDR), and selected quality indicators (quality of photographs, re-screening interval, time to treatment) were recorded and evaluated. A total of 34 654 screening examinations were performed on 13 513 patients with diabetes. The majority (77.3%) had Type 2 diabetes, with a mean DM duration of 9.74 ± 9.87 years. In 55.9% of patients, DM duration was less than ten years, and the mean HbA1c was 7.33% ± 1.49. DR signs were noted in 29.1% of patients and 0.89% of patients exhibited STDR. After establishing the diagnosis of STDR, treatment was initiated in 3.43 ± 1.98 months. Implementing the DR screening program provides valuable insights into managing diabetic retinopathy nationwide. It allows for the early detection of sight-threatening DR and facilitates timely and effective treatment, which could help prevent severe visual impairment.

Assessment of expanded programme on immunization routine data quality in the upper east region of Ghana

BackgroundData quality is a major challenge for most health institutions and organizations across the globe. The Ghana Health Service, supported by other non-governmental organizations, has instituted various strategies to address and improve data quality issues in regional and district health facilities in Ghana. This study sought to assess routine data quality of Expanded Programme on Immunization, specifically for Penta 1 and Penta 3 vaccines.MethodsA descriptive cross-sectional study design was used for the study. A simple random sampling method was used to select thirty-four health facilities across seven sub-municipalities. Records from the Expanded Programme on Immunization (EPI) Tally Books and Monthly Vaccination Summary Report were reviewed and compared with data entered into the District Health Information Management System 2 (DHIMS2) software for the period of January to December 2020. The World Health Organization Data quality self-assessment (DQS) tool was used to compare data recorded in the EPI tally books with monthly data from summary reports and DHIMS2. Data accuracy ratio was determined by the data quality assessment tools and STATA version 14.2 was used to run additional analysis. A data discrepancy is when two corresponding data sets don’t match.ResultsThe results showed discrepancies between recounted tallies in EPI tally books and summary reports submitted as well as DHIMS2. Verification factor of 97.4% and 99.3% and a discrepancy rate of 2.6 and 0.7 for Penta 1 and Penta 3 respectively were recorded for tallied data and summary reports. A verification factor of 100.5% and 99.9% and a discrepancy of -0.5 and 0.1 respectively for the same antigens were obtained for the summary reports and DHIMS2. Data timeliness was 90.7% and completeness was 100% for both antigens.ConclusionThe accuracy of Penta 1 and Penta 3 data on EPI in the Upper East Region of Ghana was high. The data availability, timeliness and completeness were also high.

Advancing ocular oncology care through teleophthalmology: a patient-centric perspective

ObjectiveAssessing patient satisfaction is an important component of understanding a program's efficacy and quality. The purpose of this study is to evaluate patient satisfaction with a teleophthalmology program tailored for ocular oncology that provides screening, remote assessment, care planning, and follow-up. Study designRetrospective survey. MethodsAn adapted version of the Telehealth Satisfaction Scale, consisting of the 8 questions plus 5 additional questions specific to the teleophthalmology program, was used to survey patients. The teleophthalmology program involves diagnostic imaging, remote physician assessments, and follow-up phone calls from health care team members to deliver results to patients. For reporting, the Consensus-Based Checklist for Reporting of Survey Studies was used. T-tests explored satisfaction differences across demographics and teleophthalmology visits. ResultsAmong the 95 patients contacted, 91 agreed to participate in the survey (96% response rate). Participants exhibited high overall satisfaction with the teleophthalmology program, reflected in a mean Telehealth Satisfaction Scale score of 28.88 (SD = 3.35 of 32). The median number of teleophthalmology visits completed was 4.0 (range of 1–8 appointments). No significant differences in satisfaction were found on the basis of age (P = 0.56), urban or rural residence (P = 0.17), or the number of telemedicine appointments (P = 0.51). ConclusionsThis analysis displays high satisfaction levels among patients within an ocular oncology clinic participating in the current telemedicine program, irrespective of age, geography, or number of teleophthalmology visits. Participants reported having their health care needs met with minimal clinical encounters due to remote consultations and telephone communications.

Evaluation Resources for Asthma Programs and Beyond.

Evaluation can ensure the quality of public health programs. Systematic efforts to identify and fully engage everyone involved with or affected by a program can provide critical information about asthma programs and the broader environment in which they operate. To assist evaluators working at programs funded by the Centers for Disease Control and Prevention (CDC's) National Asthma Control Program (NACP), we developed a package of tools that build on the CDC's 1999 Framework for Program Evaluation in Public Health. The resulting suite of evaluation tools guides evaluators through a structured but flexible process, engaging a diverse array of interest holders and actively involving them in evaluation planning and implementation, all while strengthening their capacity to meaningfully contribute to the evaluation process. For our newest tool, our team reviewed the recent evaluation literature to create an enhanced version of the 1999 framework that describes important elements of professional evaluation practice. Although the original framework describes the steps to take in conducting an evaluation and the standards for a high-quality evaluation, our enhanced framework includes an explanation of how evaluators should approach their work: by incorporating critical reflection, interpersonal competence, situational awareness, and cultural responsiveness. In this article, we highlight many of the evaluation resources our team has created since the NACP's inception, culminating in a free e-text called Planting the Seeds of High-Quality Program Evaluation in Public Health. Public health professionals working in many types of programs - not just asthma - may find these resources useful.

Determinants and outcomes of preterm births in Nigerian tertiary facilities.

To describe the incidence, and sociodemographic and clinical factors associated with preterm birth and perinatal mortality in Nigeria. Secondary analysis of data collected through the Maternal Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) Programme. Data from births in 54 referral-level hospitals across Nigeria between 1 September 2019 and 31 August 2020. A total of 69 698 births. Multilevel modelling was used to determine the factors associated with preterm birth and perinatal mortality. Preterm birth and preterm perinatal mortality. Of 62 383 live births, 9547 were preterm (153 per 1000 live births). Maternal age (<20 years - adjusted odds ratio [aOR] 1.52, 95% CI 1.36-1.71; >35 years - aOR 1.23, 95% CI 1.16-1.30), no formal education (aOR 1.68, 95% CI 1.54-1.84), partner not gainfully employed (aOR 1.94, 95% CI 1.61-2.34) and no antenatal care (aOR 2.62, 95% CI 2.42-2.84) were associated with preterm births. Early neonatal mortality for preterm neonates was 47.2 per 1000 preterm live births (451/9547). Father's occupation (manual labour aOR 1.52, 95% CI 1.20-1.93), hypertensive disorders of pregnancy (aOR 1.37, 95% CI 1.02-1.83), no antenatal care (aOR 2.74, 95% CI 2.04-3.67), earlier gestation (28 to <32 weeks - aOR 2.94, 95% CI 2.15-4.10; 32 to <34 weeks - aOR 1.80, 95% CI 1.3-2.44) and birthweight <1000 g (aOR 21.35, 95% CI 12.54-36.33) were associated with preterm perinatal mortality. Preterm birth and perinatal mortality in Nigeria are high. Efforts should be made to enhance access to quality health care during pregnancy, delivery and the neonatal period, and improve the parental socio-economic status.

Defining optimal left ventricular assist device short-term outcomes may provide insight into programmatic quality assessment

BackgroundPatients have substantial variability in perioperative outcomes after left ventricular assist device (LVAD) implant. A perioperative multidimensional tool integrating mortality, adverse events (AEs), and patient-reported outcomes to assist in quality improvement initiatives is needed. MethodsPatients undergoing HeartMate 3 LVAD implant (1/1/2017 and 1/31/2024) in the Society of Thoracic Surgeons’ Intermacs registry were studied. A Cox proportional hazard multivariable analysis incorporating AEs as time-varying covariates for mortality out to 180 days was used to generate the Intermacs Short-Term Composite Quality (INSITE) score, reflecting the adjusted hazard ratio (HR) for mortality contributed by each AE, applying global ranking methodology. In those alive and on support at 6 months, multivariable logistic regression (odds ratio, OR) was used to examine the impact of AEs on health-related quality of life (QOL) at 180 days, captured through the INSITE-QOL score. Failure to achieve ≥1 point increase in visual analog scale (VAS) from baseline was the event in the QOL analysis. ResultsOf 13,148 patients, 4,389 (33.4%) suffered at least one AE or death through 180 days. Stroke (survival: HR 13.1; QOL: HR 1.7), dialysis (survival: HR 31.4; QOL: HR 4.2), prolonged respiratory failure (survival: HR 5.7; QOL: HR 2.3), reoperation (Survival: HR 3.4; QOL: HR 1.6) and right heart failure (survival: 5.0; QOL: HR 1.4), contributed to both mortality and failure to improve QOL at 180 days (all p<0.05). The median INSITE and INSITE-QOL scores were 0.0 [0.0,1.6] and 0.0 [0.0,0.0], respectively. At 9.4% (n=17) of centers, a high INSITE score (≥13) was present in 15% of patients while the top 25% of centers had perfect INSITE-QOL scores in at least 75% of patients. ConclusionsAEs after LVAD confer differential impact on mortality and QOL, enabling development of global rank outcome scores. Given the high mortality hazard conferred by 180-day AEs, center-specific quality interventions aimed at reducing early complications provide the greatest opportunity to improve long-term survival and QOL.

ASCO Domestic Quality Programs.

A growing sense of the need to define good-quality cancer care has emerged in the past decade of the 20th century. The goals were to assess, improve, and reward quality. Animated debates between cancer care delivery academic and community organizations, governmental agencies, and insurance companies have led to multiple initiatives and pilot projects. ASCO was on the cutting edge of quality in oncology movement. We can define three phases, overlapping rather than sequential, in ASCO's journey. The first phase was generating definitions of good-quality care characterized by the publication of ASCO guidelines. The second phase was the creation of the tools to measure the implementation of standards of care with the creation of the Quality Oncology Practice Initiative (QOPI). The third phase was the launch of a comprehensive approach to cancer care quality as illustrated by QOPI Certification, then the more complete iteration, ASCO Certified Program. The latter is the most elaborate program to define quality from the patient and health care providers' perspective on one hand and governmental agencies and insurance providers' perspective on the other. Since the publication of the Ensuring Quality Cancer Care Report in 1998 to the ASCO Certified in 2023, a quarter century has elapsed. ASCO did not operate in a vacuum. Through collaborative efforts, reacting to and interacting with various players, it has advocated for positive change. During this period, ASCO has led the movement of quality in oncology intelligently and with the upmost sense of responsibility toward the patients, health care professionals, and society at large. While many of these efforts began domestically, their reach is extending globally through research, education, and the promotion of equitable care.

Exploring Clusters of Novice Programmers’ Anxiety-Induced Behaviors During Block- and Text-Based Coding: A Predictive and Moderation Analysis of Programming Quality and Error Debugging Skills

The study investigates the potential of anxiety clusters in predicting programming performance in two distinct coding environments. Participants comprised 83 second-year programming students who were randomly assigned to either a block-based or a text-based group. Anxiety-induced behaviors were assessed using physiological measures (Apple Watch and Electrocardiogram machine), behavioral observation, and self-report. Utilizing the Hidden Markov Model and Optimal Matching algorithm, we found three representative clusters in each group. In the block-based group, clusters were designated as follows: “stay calm” (students allocating more of their time to a calm state), “stay hesitant” (students allocating more of their time to a hesitant state), and “to-calm” (those allocating minimal time to a hesitant and anxious state but displaying a pronounced propensity to transition to a calm state). In contrast, clusters in the text-based group were labeled as: “to-hesitant” (exhibiting a higher propensity to transition to a hesitant state), “stay hesitant” (allocating significant time to a hesitant state), and “stay anxious” (remaining persistently anxious in a majority of the coding time). Additionally, our results indicate that novice programmers are more likely to experience anxiety during text-based coding. We discussed the findings and highlighted the policy implications of the study.

Urgency of management and supervision guidance and counseling in an effort to create responsive and quality services

This study investigates the importance of management and supervision in ensuring the quality and success of school counseling programs. Effective management practices involve planning, organizing, and overseeing counseling services to ensure they align with students' needs and deliver effective, efficient, and high-quality support. Supervision provides counselors with essential guidance, monitors service delivery quality, and promotes professional development through skill improvement and problem-solving. This collaborative approach fosters communication, accountability, and continuous program improvement. Ultimately, strong management and supervision empower counselors to deliver high-quality services that benefit students, parents, and school staff