Continuous Improvement Strategies Research Articles

A Mapping Model of the Sustainability Hospital Buildings in Post Occupancy Evaluation: A Bibliometric Analysis

Post Occupancy Evaluation (POE) has proven to be an important tool for assessing interior environmental quality and a useful strategy for continuous building quality improvement in addition to standard tools. This study aims to provide an integrated evaluation model for occupant needs by investigating how the Sustainability Hospital Buildings are related to POE. This research employs a qualitative method with Bibliometric Analysis. The information used in this study was obtained by searching the keywords "Post Occupancy Evaluation" in the Scopus database from 2010 to February 2022. The identification of the time range resulted in the discovery of 305 documents. Overall, the sustainable Buildings scores were positively associated with intelligent buildings (r= 0,584). In addition, the sustainable Buildings had a significant relationship with low-energy buildings, low carbon building design, green building performance, and green buildings with correlation coefficients ranging from 0.5833 to 0.550. Concurrently, Hospital Building and sustainable building design showed a correlation (r= 0,538). Therefore, with the aspect of the sustainable Building in the hospital can determine a strategy for designing hospital buildings that produce results hospital management will be able to keep the building's quality, both in terms of indoor air quality and comfort. Keywords: Post occupancy evaluation, Sustainability Building, Bibliometric, Hospital

FACTORS THAT INFLUENCE WORLD CLASS MANUFACTURING ADOPTION IN DEVELOPING COUNTRIES

The prevailing global competitive environment requires continuous improvement approaches that integrate the entire organisation, from strategic management to operational performance. World class manufacturing (WCM) is a continuous improvement strategy that defines the logic, rigour, and detail of how organisations can achieve sustainable operational performance and customer satisfaction improvements. The paper investigates the factors influencing the successful implementation and sustaining of WCM in the South African manufacturing industry. A qualitative descriptive approach is employed to probe the views and opinions of WCM practitioners in a global manufacturing company with a footprint in South Africa and in other African countries, who were enrolled via purposeful sampling. The findings revealed that management commitment significantly influences achieving a successful WCM system. Furthermore, running WCM as a system could mitigate noticeable barriers identified in this study. The study could substantially enhance industrial engineering practice by revealing aspects to consider when implementing and running a WCM system.

Развитие функциональности механизмов технологической платформы 1С: Предприятие для расширения возможностей адаптации типовых конфигураций

Under conditions of modern challenges 1C is actively expanding its presence due to migration of Russian enterprises to import-independent business applications. This is achieved through consistent strategy of own ecosystem development and continuous im-provement of the product line aimed at expanding their functionality. Capabilities of 1C: En-terprise platform allow adapting typical applied solutions and eliminate functional gaps in business processes automation using customization mechanism. Extension mechanism, which appeared in 8.3.6 platform version, has already passed rather serious path of evolu-tionary development significantly increasing its functionality.

Management and disclosure of quality issues in forensic science: A survey of current practice in Australia and New Zealand

The investigation of quality issues detected within the forensic process is a critical feature in robust quality management systems to provide assurance of the validity of reported results and inform strategies for continuous improvement and innovation. A survey was conducted to gain insight into the current state of practice in the management and handling of quality issues amongst the government service provider agencies of Australia and New Zealand. The results demonstrate the value of standardised quality system structures for the recording and management of quality issues, but also areas where inconsistent reporting increases the risk of overlooking important data to inform continuous improvement. With new international changes requiring mandatory reporting of quality issues, this highlights compliance challenges that agencies will face. This study reinforces the need for further research into the standardisation of systems underpinning the management of quality issues in forensic science to support transparent and reliable justice outcomes.

A MCDM Methodology to Analysis Strategies and Factors of Lean Production in Sustainability Development

Increases in sustainability performance and the adoption of innovative strategies for continuous improvement were driven by the need for production companies to compete in an increasingly globalized economy. Better operational performances are achieved when sustainable Production is included in industrial processes because wastes, costs, and environmental effects are reduced, and ergonomic requirements are met. To improve their performance and maintain a leading position in the market, several companies have turned to sustainable production practices. The study's goal is to improve the implementation of traditional Lean Production (LP) by creating an integrated Single valued neutrosophic Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA) method. The PAPRIKA is extended under a neutrosophic set. PAPRIKA is used to compute the weights of criteria by comparing the criteria. Also, the PAPRIKA method is used to rank and select the best strategy. The application is performed on the steps of the PAPRIKA method.

Options of modelling refurbishment in LCA: continuous improvement strategy and next life cycle approach

Compared to other goods, buildings have a long lifespan. It is therefore the norm and not the exception that adaptation will be needed at some point in their life cycle to changing environmental conditions, technical progress and new/additional user requirements. The adaptation of existing buildings to future challenges in the form of refurbishment contributes to sustainable development. The proportion of refurbishments is increasing in both absolute and relative terms in the building sector in Europe. It is therefore surprising that the modelling particularities of refurbishment in the context of a life cycle-based environmental performance assessment are still neglected in the EN-standards. The paper deals with these particularities. Specifically, it presents a typology of approaches starting with a distinction between planned refurbishment as B5 and unforeseen refurbishment as an independent design and construction task / next life cycle, as well as the status of the discussion in selected countries. Recommendations for action for the life cycle assessment are given for specific decision-making situations.

Implementation of Industrial Traceability Systems: A Case Study of a Luxury Metal Pieces Manufacturing Company

Technological advances have shown an accentuated growth trend, which is directly proportional to the quality of life in today’s society. As a result, the business market is becoming increasingly competitive and customers are becoming more demanding, forcing companies to look for new tools and adopt new work methodologies to improve their flexibility, effectiveness and efficiency, ensuring a better response to market needs. In this context, the tools for tracking objects, totally or partially automatic, are considered essential technologies to all kinds of analysis and the treatment of business data, providing several benefits to companies, including waste reduction, identification of bottlenecks, cost reduction, improvement of product quality and the entire flow of business information. A case study of an industrial company specializing in machining, polishing and galvanoplasty of metallic alloys, small size pieces to be incorporated in luxury fashion accessories, is presented. Derived from the difficulties underlying the implementation of a traceability system supported by identification technologies and obtaining data in an automatic way, the focus of the study is based on the identification of a base model, with sequential steps, which allows any industrial company to adapt these types of technological tools and systems. Based on the pillars of knowledge acquired through a bibliographic review on the subject, as well as on the recognition of the whole production flow, this work makes use of an implementation model already developed, studied and tested, supported by a project viability analysis measuring the benefits obtained with the results found after the respective implementation. Production performance increased with the implementation of a traceability system, as the time worked throughout the flow decreased. Production performance prior to implementation was around 98.6%. Applying a Kaizen (continuous improvement) strategy and based on the times collected in the pilot test, this indicator rose by 0.5%, obtaining a production performance of 99.1%, corresponding to an annual increase of 99 pieces. The integration of a robust and simple traceability system supported by automatic identification and data capture (AIDC) technologies in this industrial environment allowed for automated data collection and processing. In addition to the financial and productive benefits, this Industry 4.0 implementation encompasses a huge medium- to long-term impact in functional and monitoring terms, providing enormous aid to the management of production flows.

Police Leadership 2.0.: A comprehensive systematic review of the literature

Abstract Police are required to operate in complex social, political, and organizational environments. Nowadays, challenging times highlight the role that police leaders play in ensuring that the organization is effective in dealing with such environments. The purpose of this paper is to expand the systematic review of literature of Pearson-Goff and Herrington (2014, ‘Police Leadership: A Systematic Review of the Literature.’ Policing: A Journal of Policy and Practice 8(1): 14–26) by: (1) including studies after the date considered by the authors; (2) following the PRISMA-P approach to systematic reviews; and (3) include European studies. Based on 7,041 records, which ended up in 101 eligible empirical pieces, evidence supports previous findings about what are the characteristics of police leaders as well as the actions expected by them. This comprehensive systematic review also identifies additional characteristics and actions that are important nowadays in police leadership. Overall, the current study encourages future studies on the thematic, and contributes to practitioners aiming to develop continuous improvement strategies inside the police.

Healthy Work Environments: An Interprofessional Partnership Model to Promote Positive Workplace Culture

Background: Healthy work environments (HWEs) are a primary focus of leaders in health care. Many nurse- specific HWE initiatives exist to improve workplace culture; however, workplace harm persists. An interprofessional partnership model is needed to sustain healthy workplace cultures to promote engagement among providers and employees, and safe, high-quality patient care. Methods: The 5-Stage Process® is a method for teams to openly examine workplace behavior, co-creating their future using continuous quality improvement strategies of Team Building, Assessment, Implementation, Evaluation, and Sustainability. To ensure success, each stage should be completed with focused attention to the concrete strategies the team needs to take to sustain the healthy work environment. Results: The entire 5-Stage Process® was used by interprofessional teams from the specialties of Perinatology and Radiology at major health care institutions in the Midwest and Perioperative in the Northeast United States. Each team implemented one-on-one conflict resolution techniques, and one team noted improvements in employee engagement scores from 60% to 86%, patient satisfaction from 74% to 85%, safety perception scores from 70% to 79%, and teamwork perception scores from 82% to 84%. Conclusion: The interprofessional partnership 5-Stage Process® may be a successful method to continuously improve workplace cultures and ultimately improve patient safety and provider and staff satisfaction. Sustaining healthy work environments requires leaders’ constant focus and dedication to partnership techniques to ensure that new healthy behaviors persist.

Engaging All Stakeholders to Create a Trusted, Data-Driven, Process Improvement Approach to Addressing Learner Mistreatment

Problem: Learner mistreatment has remained an ongoing challenge in academic medicine despite accreditation requirements mandating that every program has systems in place to prevent and respond to mistreatment. While efforts vary across institutions, much remains unanswered in the literature about best practices. Additionally, for the foreseeable future, challenges in the learning environment will likely continue and potentially worsen, given the confluence of multiple external stressors including the COVID-19 pandemic, faculty burnout and general political divisiveness in the nation. It is essential, therefore, to focus on indicators of improvement via process metrics such as knowledge and awareness of mistreatment policies and procedures, willingness to report, reasons for not reporting, and satisfaction with having made a report, while simultaneously focusing on the more complex challenge of eliminating mistreatment occurrences. Intervention: We describe the aspects of our mistreatment prevention and response system first implemented in 2017 along with process and outcome measures. The interventions included expanding our policy outlining appropriate conduct in the teacher-learner relationship; a graduated response protocol to allegations of mistreatment with a clear escalation approach; an online reporting system; a graduate medical education exit survey which mirrors the AAMC Graduation Questionnaire on mistreatment; a robust communication and professional development campaign; a comprehensive data dashboard; and a comprehensive summary report dissemination plan. Context: The interventions were implemented at the largest allopathic medical school in the U.S., with nine campuses across the state. The system is available to all learners, including medical students, graduate students, residents, and fellows. Impact: Both institutional and national data sources have informed the continuous improvement strategies. Data from internal reporting systems, institutional surveys, and national data are presented from 2017 to 2021. Findings include an increasing number of incidents reported each year, including confidential reports from students who include their contact information rather than report anonymously, which we view as an indicator of learner trust in the system. Our data also show consistent improvements in learners’ awareness of the policy and procedures and satisfaction with having made a report. We also include other data such as the nature of complaints submitted and timeliness of our institutional response. Lessons Learned: We present several lessons learned that may guide other institutions looking to similarly improve their mistreatment systems, such as a close partnership between faculty affairs, diversity affairs, and educational affairs leadership; communication, professional development, and training through multiple venues and with all stakeholders; easily accessible reporting with anonymous and confidential options and the ability to report on behalf of others; policy development guidance; data transparency and dissemination; and trust-building activities and ongoing feedback from learners.

Systematic Design of Energy-Saving Action Plans for Taiwan Campus by Considering Economic Benefits and Actual Demands

In response to the future net zero emissions plan in Taiwan, the campus shoulders the university’s social responsibility and educational significance. Recently, energy conservation and carbon reduction have become common goals for every campus. However, there is a common problem to be addressed in terms of how to take into account the economic benefits and the continuous improvement strategy regarding actual demands. In this study, a systematic design of energy-saving action plans for a Taiwan campus by considering economic benefits and actual demands is demonstrated. By taking National Taiwan University of Science and Technology in Taiwan as an example, eight energy-saving action plans during the period from 2016 to 2020 are introduced, and the effectiveness of these topologies is verified by real implementations. Action plans contain the installation of a smart energy management system, elevator power recovery devices, circulating fans, and lighting delay switches; the replacement of old air-conditioners, fluorescent lamps, and high-sodium streetlights; and load consolidation and low-efficiency transformers replacement. Upon evaluation, the estimated electricity savings can achieve up to 16% of annual electricity consumption, and the payback period is about 5.22 years. Upon application, the actual power saving amounts to about 3,076,260 kWh for approximately 15.5% of the power consumption of Taiwan Tech in 2020.

La formación continua y la superación profesional del Licenciado en enfermería. Retos y desafíos

The annual analyzes of postgraduate activity allow observing possible changes and planning their future development to improve the generation of knowledge in nursing professionals, which is why the professional improvement activities are planned and executed in such a way that the expected results are achieved with minimum expenditure of time, movement and human, material and financial resources. The objective is to design a strategy for continuous training and professional improvement in the Nursing career at the University of Medical Sciences of Cienfuegos. Theoretical and empirical methods were used for the design of the strategy. The strategy is designed taking into account different moments for continuous training and professional improvement, it is a work tool elaborated on the basis of the systemic nature of professional improvement, which is permanent, continuous, active and developer, guiding the use of the different organizational forms of the postgraduate.

A multicenter study of gender bias in student evaluations of teaching in pharmacy programs

IntroductionStudent evaluations of teaching (SET) are widely used to assess effectiveness of teaching. Studies conducted to assess the presence of gender bias in SET have produced mixed results. The purpose of this study was to evaluate the presence and degree of gender bias in SET of didactic courses in United States pharmacy programs. MethodsA three-year, retrospective, multi-institutional analysis of anonymous SET data were analyzed from required didactic courses. Analysis included gender, SET questions, mean scale score, and number of students responding to each question. A hierarchical linear model was used to compare the gender difference with the normalized SET scores as the outcome. ResultsA total of 2114 SET scores were included from seven pharmacy schools across eight campuses. Analysis of the results revealed that the combined data were skewed secondary to one institution whose results fell significantly outside the mean. When this school was excluded, the difference between SET scores did not differ by gender, b = 0.021, t(1,702) = 0.69, P = .49, with similar SET scores for female faculty (mean = 4.41, SD = 0.35, range = 2.54–5) and male faculty (mean = 4.44, SD = 0.32, range = 2.67–5). ConclusionsAfter secondary analysis, the aggregated data showed no significant difference between ratings of male and female instructors. However, there were differences within individual programs. This illustrates the importance of applying assessment principles to SET to determine the presence of bias so that continuous quality improvement strategies may be applied.

Compatibility of supply chain and lean construction principles from the main contractor’s perspective

The supply chain has contributed significantly to the success of many different industries. However, the supply chain in construction has a low level of maturity, which leads to many doubts about development ability. Meanwhile, lean construction is a production mindset based on systematic principles of continuous improvement, waste elimination, and collaborative strategy change. Although there are many differences, the supply chain in construction and development based on the principles of lean construction is worth considering. In this article, the author uses a matrix of principles to evaluate the compatibility of the supply chain in construction with lean building principles from the main contractor's perspective. The research results obtained in this paper show high compatibility, which can help contractors change their mindset toward developing a lean supply chain.

Ensuring the Market Competitiveness of Companies Using Quality Strategies

Products obtained from cereal processing have always been considered essential components of a balanced diet. These products provide
 about 45% of the total protein to the human body daily, 65% of total calories, and a significant intake of carbohydrates, vitamins, and mineral salts. The quality of milling and bakery products must ensure consumer satisfaction and safety. This can be achieved through a continuous improvement of the processes, products/services, but also of the quality management system of the players in this market. This paper presents the results of the implementation of the strategy of continuous quality improvement in a Romanian company operating in the milling and bakery sector.

Implementing Team-Based Innovation in Primary Health Care in British Columbia

Improving health services integration for patients with complex needs is a national priority in Canada. Health systems in all provinces grapple with the rising complexity of patients and the services they need. Team-based primary health care (PHC) models have been implemented in diverse ways to improve patients' experiences, increase the coordination of care, improve population health and reduce costs. While some provinces have more than two decades of experience with PHC teams, others such as British Colombia (BC) have made changes more recently. We conducted an in-depth analysis of 12 provincial policy documents produced since 2011 to study the evolution of interprofessional models in PHC. BC has integrated team-based care through overarching policy support and funding from the provincial government. Structural practice changes to support team-based care, such as Primary Care Networks (PCNs), were designed to address the quadruple aim, a framework designed to improve health system performance through integrated primary care. Policies have addressed the vision and goals of team-based care, but discussion of processes that support teams, such as a strategy for capitation-based funding and team composition, were non-specific. Finally, there is a significant need for a provincial strategy for continuous quality improvement and evaluation of reforms.

OP0169 INPATIENT DISCONTINUATION OF ALLOPURINOL – A QUALITATIVE IMPROVEMENT (QI) INITIATIVE

BackgroundGout is a chronic inflammatory arthritis induced by hyperuricemia and manifested by recurrent acute flares of debilitating joint pain, when left untreated. Allopurinol is often used as long-term urate lowering therapy. Discontinuation of allopurinol leads to worsening flares, disability, poor quality of life, and frequent use of acute care facilities. Recent data revealed that 56% of hospitalized patients had allopurinol discontinued during an episode of acute gout flare, suggesting an unmet need for ongoing provider education (1). Gout flares are 14 times more likely to develop in patients who have allopurinol discontinued upon admission to the hospital (2).ObjectivesWe performed a qualitative analysis of the current rate of discontinuation of allopurinol during hospitalizations at an academic hospital in order to develop a continuous improvement model.MethodsWe leveraged our electronic health records (EHR) to obtain data on gout patients admitted to the university hospital from 2019-2020, with IRB approval. Patients on allopurinol as an active home medication that was discontinued during hospitalization and/or after hospital discharge were included to calculate the rate of discontinuation. Lean thinking methodology with A3 process mapping for root cause analysis (RCA) was utilized. We first identified stakeholders involved in medication reconciliation – nurses and various providers, including trainees, and invited them to participate in an anonymous survey to understand the rationale behind allopurinol discontinuation during hospitalization. Next, we created countermeasures and actionable recommendations that could be implemented at an institutional level.ResultsA total of 2138 patients who were hospitalized had allopurinol listed as an active home medication. Of these, 364 (17%) did not receive allopurinol during hospitalization. Based on the survey data, providers chose to discontinue allopurinol due to the following factors – acute gout flare, renal impairment, gastrointestinal issues, cytopenia, drug interactions, NPO status, and always discontinued the medication. The RCA revealed layers of reasoning at various levels of the medication reconciliation process which impacted the decision-making algorithm. This in turn led to discontinuation during the admission and subsequent omission of allopurinol on the discharge medication list. Several actionable and high-impact recommendations emerged as countermeasures, including – a) pharmacy involvement at admission medication reconciliation, b) creation of a clinical practice guideline, and c) automated routing by EHR to standardized guidelines when allopurinol was discontinued on admission (Figure 1).Figure 1.Countermeasures and Implementation PlanConclusionThere is evidence of inappropriate discontinuation of allopurinol that leads to gout flares in the outpatient setting and unnecessary resource utilization. We developed an implementation plan to mitigate this systematically at an institutional level. Testing these recommendations next to devise a standardized protocol as a continuous improvement strategy may help improve gout care and patient outcomes.

Evaluating Strategies to Promote Effective, Multidisciplinary Team Collaboration in School Mental Health

Multidisciplinary teams of school- and community-employed mental health, health, and educational staff work together in schools to offer a full continuum of mental health promotion, prevention, early intervention, and treatment services and supports. Intentional teaming structures and practices are essential to ensure teams deliver effective, coordinated services and supports. The current study investigated the extent to which continuous quality improvement strategies improved school mental health team performance during a 15-month national learning collaborative for 24 school district teams. All teams significantly improved their average teaming performance from baseline to the end of the collaborative (t(20) = −5.20, p < .001). Plan-Do-Study-Act (PDSA) cycles allowed teams to rapidly evaluate specific quality improvement changes to improve their performance. Teams with the most improvement focused on increasing multidisciplinary team membership, avoiding duplication and promoting efficiency, and connecting to community mental health providers/resources.

Continuous Quality Improvement by Statistical Process Control Implementation in Cocoa Agroindustry

Downstream sector development for agricultural commodities will encourage agroindustry, increase added value and farmers' income. The development of small-medium cocoa agroindustry is one of the downstream sector development strategies for cocoa. Product quality is one of the problems affecting the performance of cocoa-based agroindustry. Chocolate products face obstacles to meet the quality. Besides, consumers want organoleptic tests related to aroma and flavor as an additional requirement. Statistical Quality Control (SQC) is a method that could maintain production quality at a minimum cost level and achieve efficiency. SQC can see the defect in the production and trend of increasing or decreasing to make improvements. This study aims to analyse the quality of cocoa products with the application of SQC as a continuous improvement strategy. The research method uses a case study. The research phase includes observations, interviews, documentation, measurements, and literature studies. Implementing SQC used check sheets, histograms, Pareto diagrams, and cause-and-effect diagrams related to the product of chocolate by sensory evaluation. Control is carried out in the conching and tempering. Based on a simple SQC, the small-medium cocoa agroindustry can obtain alternative production improvements to increase the final product quality.

Some aspects of communication ethics as a premise for improving quality management in the field of education

Quality education is an imperative of our times. An essential part of this process is effective communication of the actors involved. Interaction and resilience skills and the beneficial effects of communication are extremely important in a modern world, with a wide range of communication means. In this context, in the paper we have focused on analyzing the contribution of communication to the improvement of professional ethics and to the relaxation of some, still existing situations in the educational field, namely the phenomenon of labeling. The authors conclude, that in order for the common approach of the actors involved to be effective, there is a need for a strategy of continuous improvement, a certain way of approaching and resolving the tasks of personal training without distorting the audience’s personality. The purpose of the research is to identify strategies for optimizing communication as a basis for learning progress and thereby improving quality management in education. A special aspect was the highlighting of the contribution of European projects to the qualitative development of the educational environment. The authors approached a research methodology that focused on studying bibliographic sources in the field, analysis and synthesis of information obtained, data extrapolation and generalization, etc.