Quality Safety Research Articles

The Joint Commission Journal on Quality and Patient Safety 50th Anniversary Article Collections: Handoffs and Care Transitions

The Joint Commission Journal on Quality and Patient Safety 50th Anniversary Article Collections: Handoffs and Care Transitions

Remanufacturing as a circular design strategy in healthcare: integrating socio-technical and environmental-economic assessments

AbstractThis paper examines the role of remanufacturing in healthcare as a key circular design strategy, particularly for medical devices, assessing its socio-technical, environmental, and economic dimensions of sustainability. Through a detailed case of ultrasound catheters, it demonstrates how remanufacturing can lead to resource conservation, cost savings, and enhanced product lifecycles in health care without compromising quality and patient safety. The study argues for systemic changes in healthcare practices to fully integrate remanufacturing, underscoring its role beyond a technical solution.

Private Equity Ownership in Healthcare: Quality and Patient Safety Are in Jeopardy.

Private Equity Ownership in Healthcare: Quality and Patient Safety Are in Jeopardy.

Continuous Innovation and Reinvention: Excellence in Healthcare Quality and Patient Safety

<p>林口長庚紀念醫院於1978年落成啟用，為衛生福利部評定優等之醫學中心與重度級急救責任醫院，亦是國內規模最大的醫療機構。為落實與提升醫療品質與病人安全，設立醫療品質暨病人安全委員會，並成立品質管理中心，統籌醫療品質與病人安全業務上之執行與分析檢討推動，透由健全醫療品質與病人安全管理架構、醫療品質與病人安全提升策略、醫療作業標準化、積極發展智慧醫療，在歷任院長及同仁持續耕耘下，持續進行內部的創新和改革，精進全方位智慧醫院，高評價通過多項國際認證肯定，展現卓越之價值與提供卓越的醫療服務。</p> <p> </p><p>The Chang Gung Memorial Hospital, Linkou inaugurated in 1978, is designated by the Ministry of Health and Welfare as a top-tier healthcare center and a critical emergency hospital, rendering it the largest healthcare institution in the country. To enforce and enhance healthcare quality and patient safety, the hospital established the Healthcare Quality and Patient Safety Committee and the Quality Management Center. These bodies coordinate the execution and analysis of initiatives aimed at improving healthcare quality and patient safety through a robust management framework, enhancement strategies, standardization of medical operations, and the active development of smart healthcare solutions. Under the continuous efforts of successive directors and staff, the hospital consistently pursues internal innovation and reform. It has advanced as a comprehensive smart hospital, highly recognized through numerous international certifications, demonstrating its exceptional value and providing outstanding healthcare services.</p> <p> </p>

Transforming construction: The growing role of mechatronics in building our infrastructure

Mechatronics, the synergistic integration of mechanical engineering, electrical engineering, control engineering, and computer science, is progressively transforming the construction industry. This paper explores how mechatronic technologies are being applied across the construction lifecycle to enhance productivity, quality, safety, sustainability, and cost-effectiveness. Core mechatronic technologies changing construction include automated material handling systems, advanced construction robotics, sensor networks for monitoring, laser scanning for accurate modeling and control, and building information modeling (BIM) software. Mechatronics offers multifaceted benefits spanning from enhanced labor productivity and construction velocity to superior quality control, safety, and process optimization. However, realizing the immense potential of mechatronics in construction requires overcoming key challenges including high upfront costs, lack of technical skills, organizational resistance, integration difficulties, and reliability concerns. With thoughtful leadership and implementation, mechatronics promises to revolutionize construction, shifting it towards more automated, streamlined, and optimized techniques. This paper delineates the tremendous potential of mechatronics in construction regarding benefits, technologies, and challenges. The outlook is promising for intelligent mechatronic systems to profoundly enhance productivity, quality, and safety as construction progresses towards greater automation and optimization.

Totally Endoscopic Replacement of the Ascending Aorta and the Aortic Root including the Aortic Valve via Right Mini-Thoracotomy: A Multicenter Study.

Background: Recently, minimally invasive access via right anterolateral mini-thoracotomy (RAMT) has been gaining popularity in cardiac surgery. This approach is also an option for surgeons performing aortic surgery. The aim of this study is to present our surgical method, highlighting the total endoscopic minimally invasive approach via RAMT for replacement of the ascending aorta (AAR) with or without involvement of the aortic root and the aortic valve. Methods: Clinical data of 44 patients from three participating institutions with AAR with or without involvement of the aortic valve or aortic root via RAMT between April 2017 and February 2024 were retrospectively analyzed. According to surgical procedure, patients were divided into two groups, in the AAR and in the Wheat/Bentall group with concomitant valve or root replacement. Operative time, length of ventilation, perioperative outcome, length of intensive care unit (ICU) as well as postoperative hospital stay, and mid- and long-term results were retrospectively analyzed. Results: Mean age was 61.4 ± 10.7 years old with a frequency of male gender of 63.6%. Mean cardiopulmonary bypass (CBP) time and aortic cross-clamping time was 94.9 ± 32.5 min and 63.8 ± 25.9 min, respectively. CPB and aortic clamp time were significantly lower in AAR group. In the first 24 h, the mean drainage volume was 790.3 ± 423.6 mL. Re-thoracotomy due to bleeding was zero. Sternotomy was able to be avoided in all patients. Patients stayed 35.9 ± 23.5 h at ICU and were discharged 7.8 ± 3.0 days following surgery from hospital. Mean ventilation time was 5.8 ± 7.6 h. All patients survived and 30-day mortality was 0.0%. At a median follow-up time of 18.2 months, all patients were alive. The results were similar in both groups. Conclusions: The full endoscopic RAMT approach with 3D visualization is a safe, feasible and promising technique that can be transferred in the field of aortic surgery without compromising surgical quality, postoperative outcomes, or patient safety when performed by an experienced team in a high-volume center.

TRANSFORMING INDUSTRIES WITH ARTIFICIAL INTELLIGENCE: PRACTICAL ASPECTS

This article reveals the transformative impact of Artificial Intelligence (AI) in various industrial sectors, emphasizing its pivotal role in enhancing operational efficiency. It explores AI-driven predictive maintenance in manufacturing, highlighting improved equipment reliability and cost efficiency through data analytics and machine learning. It also shows AI's significant influence in reshaping supply chain and logistics, focusing on enhanced efficiency and data-driven decision-making. Furthermore, it addresses AI's integration in quality control, safety, and product design. Finally, the article discusses AI's contribution to end-to-end optimization in industry, revealing its capability in automating complex processes and enabling smarter decision-making. Overall, this analysis emphasize AI's growing popularity and its transformative potential across different industrial applications.

Peran Serta Sekolah dan Guru Pada Murid Dalam Mengembangkan Program Makanan Jajanan Sekolah Yang Sehat

School snacks are foods that are usually sold at school and are known as snacks or snacks, lunches for students at school. Usually in the form of foods that are easy to carry and eat such as chips, candy or biscuits. School snacks can be snacks, drinks, ice cream or snacks that students can buy during break times or when they go home. School snacks are usually sold around or near the school, such as in the canteen, in nearby shops, or at snack outlets. School snacks need to be considered because they affect students' health and nutrition, and can affect their learning performance and behavior. Therefore, school snacks must be ensured to be quality and healthy. To ensure student health and academic success. Therefore, school snacks must be ensured to be high quality and healthy to ensure students' health, academic success and good behavior. Institutions have an important role in controlling snacks around schools. Institutions must make clear policies about permitted snacks, such as limiting oily, sweet, salty snacks, or foods with certain food additives. Schools must organize and select snack suppliers that meet quality and food safety standards. Schools must provide education about nutrition and health to ensure students understand the importance of healthy eating. Schools must provide healthy alternative foods such as fruit, vegetables or healthy biscuits for students.

Patient safety climate research in primary care dentistry: A systematic scoping review.

Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. To systematically explore the evidence regarding assessing patient safety climate in dentistry. We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.

Adriatic Sea Fishery Product Safety and Prospectives in Relation to Climate Change

This bibliographic study addresses key aspects related to fishing, product safety, and climate change in the Adriatic Sea region. The examination of product safety focuses on the assessment of contaminants originating from human activities such as industry, mining, agriculture, and household waste disposal. The contamination of the aquatic environment has emerged as a pressing global concern, extending to the Adriatic basin. Aquatic organisms, including fish, are prone to accumulating pollutants directly from polluted water sources and indirectly through the food web. The bio-accumulation of potentially hazardous substances, particularly heavy metals, pesticides, PCBs, PAHs, and antibiotic resistance in aquatic organisms, poses a significant threat to human health. Climate change effects will deplete our seafood supply in terms of quantity and safety owing to negative consequences such as higher levels of pollution, parasites, viruses, infections, acidification, and toxicities such as shellfish poisoning. Global food safety strategies should be developed to reduce greenhouse gas emissions and promote environmentally friendly technology, which indirectly affects seafood quality and microbiological safety, especially for the Adriatic Sea, which is part of the Mediterranean Sea, characterized by the most polluted waters in the world.

Ultraviolet technology application in urban water supply and wastewater treatment in China: Issues, challenges and future directions

This study thoroughly explores the application of Ultraviolet (UV) water treatment technology in urban wastewater treatment and water supply in China, highlighting its crucial role in enhancing water quality safety. UV technology, with its environmentally friendly and low-carbon characteristics, is deemed more in line with the demands of sustainable development compared to traditional chemical disinfection methods. The widespread application of UV technology in urban wastewater treatment in China, particularly in the context of urban sewage treatment, is examined. However, to better promote and apply UV technology, there is a need to deepen the understanding of this technology and its application among a broad base of users and design units. The importance of gaining in-depth knowledge about the performance of UV water treatment equipment, the design calculation basis, and operational considerations, as well as the ongoing development of relevant standards, is underscored to ensure that the equipment used in projects complies with engineering design and production requirements. Furthermore, the positive trend of UV technology in the field of advanced oxidation, indicating a promising trajectory for engineering applications, is pointed out. Regarding the prospects of industrial development, a thorough analysis is conducted in the article, emphasizing the necessity for all stakeholders to collaborate and adopt a multi-level approach to promote the sustainable development and application of UV water treatment technology. This collaborative effort is crucial for providing effective safeguards for China's environment, ecology, and human health.

PENDAMPINGAN IMPLEMENTASI HAZARD ANALYSIS CRITICAL CONTROL POINT (HACCP) DAN PENGENDALIAN MUTU BORAKS “CV SOLO MARSUDI LUHUR” MOJOLABAN, SUKOHARJO.

The quality and food safety management system currently implemented is HACCP (Hazard Analysis Critical Control Point). Supporting factors that are pre-requisites for the effectiveness of implementing HACCP as a quality control system is the fulfillment of basic feasibility requirements . For It is necessary to know the level of implementation of basic feasibility, the level of implementation of HACCP as well HACCP implementation strategy. This research uses a qualitative approach. The method used is descriptive verification to obtain an accurate and actual picture of the facts and nature of the relationships between phenomena discovered by CCP in the process flow . The research results show that the level of implementation is feasible basic and implementation levels HACCP at CV Marsudi Luhur, producer of non-borax onion shells , namely, the strategy for implementing HACCP in the processing of non-borax onion shells at CV Marsudi Luhur , namely a strategy to improve quality assurance and food safety as well as environmental quality at the research location. From the results This research can be concluded that the shell processing unit at the research location at CV Marsudi Luhur has not implemented a quality control system and HACCP properly. Research result It is hoped that this can be used as a basis for further research for quality and safety assurance food and environmental quality for making non-borax onion shells around Sukoharjo district.

Innovative Application of Artificial Intelligence Technology in Bank Credit Risk Management

With the rapid growth of technology, especially the widespread application of artificial intelligence (AI) technology, the risk management level of commercial banks is constantly reaching new heights. In the current wave of digitalization, AI has become a key driving force for the strategic transformation of financial institutions, especially the banking industry. For commercial banks, the stability and safety of asset quality are crucial, which directly relates to the long-term stable growth of the bank. Among them, credit risk management is particularly core because it involves the flow of a large amount of funds and the accuracy of credit decisions. Therefore, establishing a scientific and effective credit risk decision-making mechanism is of great strategic significance for commercial banks. In this context, the innovative application of AI technology has brought revolutionary changes to bank credit risk management. Through deep learning and big data analysis, AI can accurately evaluate the credit status of borrowers, timely identify potential risks, and provide banks with more accurate and comprehensive credit decision support. At the same time, AI can also achieve real-time monitoring and early warning, helping banks intervene before risks occur and reduce losses.

Development of nursing handoff competency scale: a methodological study

BackgroundNursing handoff competency is the ability of the nurse performing the handoff to select and interpret the necessary information for patient care and to convey it efficiently to the nurse accepting the handoff. Nursing handoff is an important nursing task that ensures nursing care continuity, quality and patient safety. This study aimed to develop a scale to measure nursing handoff competency and verify its validity and reliability.MethodsThis study adopted a methodological design. A research process included three phases: (1) scale development (literature review and interviews); (2) scale validation (validity and reliability); (3) standard setting. Data were collected from 496 clinical nurses currently working in hospital wards, intensive care units, and emergency rooms, and who independently perform a handoff in South Korea.ResultsThe final scale comprises a self-reported 4-points Ilert scale with 25 items based on four factors: knowledge on handoff methods, identification of patient information, judgment and transfer of nursing situation, and “formation of supportive relationships. Construct validity, criterion-related validity, and discrimination validities were verified and the fitness of the scale revealed good results in confirmatory factor analysis. The Cronbach’s α of the whole tool was.912 and the cut-off score for satisfied/unsatisfied was.72.ConclusionsThe developed scale can evaluate the nurse’s handoff competencies and determine whether training is necessary. The measurement results of the scale can be used to select training subjects and compose the contents of the education program.

A sensitive paper-based vapor-test kit for instant formalin detection in food products

A colorimetric sensing method based on a paper-based vapor-test kit was successfully developed for the selective and sensitive real-time monitoring of formalin in food samples. The device was specifically designed to efficiently extract and detect formalin simultaneously. A microcentrifuge tube was used as the sample solution container, with the inner cap serving as the reaction and detection zone. Formalin was converted into gaseous formaldehyde through controlled heating, which was then extracted and collected on a filter paper coated with Nash's reagent. The color change on paper was used for formalin quantification using a smartphone for detection and image analysis. Under optimal conditions, our method provided a linear range of 0.5–75 mg L−1 with a detection limit of 0.11 mg L−1. This method effectively determined formalin in fresh food and vegetable samples, with recoveries ranging from 92 to 111%, demonstrating comparable accuracy to the standard method for practical food quality control and safety.

Critical test result management at Danish hospital laboratories: a national survey

Critical test results in clinical laboratories are crucial for timely patient care, serving as indicators of potentially life-threatening conditions. Despite their importance, a notable heterogeneity in management practices exists globally. This study investigates the current practices of managing critical results at Danish clinical biochemistry laboratories and identifies areas prone for improvement. A comprehensive online survey was distributed to all 21 Danish clinical biochemistry laboratories regarding their critical result management, including documentation practices, critical limit selection, and quality assurance measures. A total of 17 laboratories (81%) responded. The answers revealed a generally uniform approach to managing critical results, with all laboratories having 24-h reporting, local instructions and using the telephone as communication channel. However, variations were noted in documentation practices and critical limit selection. Notably, 23.5% of the laboratories reported that one out of every ten critical results was not reported, indicating a significant risk of delayed critical results. This is further complicated by the limited use of predefined timeframes for reporting and also, only few laboratories actively monitored response times. The findings emphasize the need for more standardized documentation and evaluation practices to align with international standards and to enhance patient safety. While the laboratories showed a commitment to standardized procedures, the study emphasizes the necessity of a National or Nordic guideline to supplement the ISO 15189:2022. This study is a step towards optimizing critical result management, not only in Danish clinical biochemistry laboratories but also across various laboratory specialties, thereby improving overall laboratory quality, efficiency, and patient safety.

The microplastics distribution characteristics and their impact on soil physicochemical properties and bacterial communities in food legumes farmland in northern China

Microplastics (MPs) pose a threat to farmland soil quality and crop safety. MPs exist widely in food legumes farmland soil due to the extensive use of agricultural film and organic fertilizer, but their distribution characteristics and their impact on soil environment have not been reported. The abundance and characteristics of MPs, soil physical and chemical properties, and bacterial community composition were investigated in 76 soil samples from five provinces in northern China. The results showed that the abundance of MPs ranged from 1600 to 36,200 items/kg. MPs in soil were mostly fibrous, less than 0.2 mm, and white. Rayon, polyester and polyethylene were the main types of MPs. The influences of MPs on soil physicochemical properties and bacterial communities mainly depended on the type of MPs. Notably, polyethylene significantly decreased the proportion of silt particles, and increased the nitrate nitrogen content as well as the abundance of MPs-degrading bacteria Paenibacillus (p < 0.05). Moreover, bacteria were more sensitive to polyesters in soil with low concentration of organic matter. This study indicated that MPs in food legumes farmland soil presented a higher-level. And, they partially altered soil physicochemical properties, and soil bacteria especially in soil with low organic matter.

COVID-19 Mitigation in a K-12 School Setting: A Case Study of Avenues: The World School in New York City.

In this case study, we describe a well-resourced private school in New York City that implemented COVID-19 mitigation measures based on public health expert guidance and the lessons learned from this process. Avenues opened in New York City in 2012 and has since expanded, becoming Avenues: The World School, with campuses in São Paulo, Brazil; Shenzhen, China; the Silicon Valley, California; and online. It offers education at 16 grade levels: 2 early learning years, followed by a prekindergarten through grade 12. We describe the mitigation measures that Avenues implemented on its New York campus. We compare COVID-19 case prevalence at the school with COVID-19 case positivity in New York City, as reported by the New York State Department of Health. We also compare the school's indoor air quality to ambient indoor air quality measures reported in the literature. The school's mitigation measures successfully reduced the prevalence of COVID-19 among its students, staff, and faculty. The school also established a consistently high level of indoor air quality safety through various ventilation mechanisms, designed to reduce common indoor air pollutants. The school received positive parent and community feedback on the policies and procedures it established, with many parents commenting on the high level of trust and quality of communication established by the school. The successful reopening provides useful data for school closure and reopening standards to prepare for future pandemic and epidemic events.

Reducing airline accident risk and saving lives: financial health, corporate governance, and aviation safety

PurposeThis study investigates the impact of financial health and corporate governance on aviation safety, aiming to fill a critical gap in existing research. The purpose of this study is to identify how these factors influence the safety records of airlines and provide insights for regulators, airlines and stakeholders to enhance aviation safety.Design/methodology/approachUsing a comprehensive international sample spanning 1950–2009 and later, this empirical analysis draws on diverse databases. The authors examine 372 airlines across 70 countries from 1990 to 2016. The research uses statistical models to analyze the relationship between financial indicators, corporate governance quality and aviation safety, addressing limitations of prior single-country studies.FindingsThe findings reveal a significant inverse relationship between financial health and accident propensity, with profitable airlines exhibiting lower accident rates. Additionally, airlines with higher corporate governance quality, characterized by qualified directors and stable leadership, experience fewer accidents. The study identifies key factors such as pilot errors, mechanical failures and adverse weather, contributing to approximately 75% of accidents, emphasizing the importance of organizational control.Practical implicationsThis research has crucial implications for aviation safety policies and practices. Regulators and international organizations, such as International Civil Aviation Organization and International Air Transport Association, should allocate resources to supervise financially vulnerable airlines and those with lower governance quality. Governments might consider incentivizing safety practices through tax deductibility for relevant expenses. Shareholders are encouraged to prioritize qualified, younger and less busy directors, recognizing their impact on safety performance.Originality/valueThis study contributes to existing literature by addressing methodological biases and offering a comprehensive international perspective. The identification of a link between financial health, corporate governance and accident rates in the aviation industry provides valuable insights. The research informs policymakers, regulators and industry stakeholders on effective strategies to improve safety by considering financial and governance factors under their control.

Study on the Impact of Land Use Change on Ecosystem Services in the Water Source Area of the Middle Route Project of S-N Water Diversion

The South-to-North Water Diversion Project, a major project in China, is of great significance to alleviate the shortage of water resources in the north, and the ecological environment in the middle water source area has the most critical impact on water quality safety. As a natural resource and asset, ecosystem services in the water source area of the Middle Route of the South-to-North Water Diversion Project not only provide important resources and services for human beings but also are the necessary basis for the survival and development of other organisms on the earth.As an integral part of the earth’s economy, the value of ecosystem services in the water source area of the Middle Route of the South-to-North Water Diversion Project directly or indirectly contributes to human welfare. Scientific use of land resources can promote the upgrading and transformation of ecosystem services in the water source area of the Middle Route of the South-to-North Water Diversion Project. Based on this, this paper focuses on the impact of land use change on ecosystem services in the water source area of the middle route of South-to-North Water Diversion and its prevention strategies.