Success Of Efforts Research Articles

Application of forecast‐informed reservoir operations at US Army Corps of Engineers dams in California

AbstractThe US Army Corps of Engineers (USACE) prescribes flood control operations for reservoirs it regulates in watershed‐specific water control manuals (WCMs), which can be decades‐old and may not capture changed conditions in the watersheds or include the benefit of state‐of‐the‐science weather and streamflow prediction. Considering the specific characteristics of a reservoir, forecast‐informed reservoir operations (FIRO) may be used to enhance flood risk reduction, improve water availability, and achieve other benefits. The first FIRO pilot project at Lake Mendocino in California focused on determining if water supply reliability could be improved using FIRO without increasing flood risk. The final report concluded that FIRO concepts could indeed improve water supply reliability while enhancing flood risk reduction. Subsequently, USACE chose additional reservoir systems in California with different characteristics as additional pilot study locations to further investigate FIRO concepts. These successful FIRO efforts have provided justification to continue its expansion beyond the initial pilot sites. The lessons learned from the FIRO pilot projects are being used to inform the development of the FIRO Screening Process, a screening level framework intended to scale up the implementation of FIRO. The lessons learned could support FIRO implementation at suitable USACE reservoirs by updating WCMs.

Creating Caring Campuses: A Faculty‐Led Approach

ABSTRACTCaring Campus–Faculty is a program that supports faculty as they develop and implement “behavioral commitments” designed to help students feel a sense of belonging and to support them in their educational journey. Developed by the Institute for Evidence‐Based Change, Caring Campus was evaluated by the Community College Research Center (CCRC) from 2019 to 2023. In this article, we describe Caring Campus as practiced by faculty, as well as findings from the research on implementation practices and outcomes. We also share the experiences of Delta College, which has been implementing its own version of Caring Campus for a number of years. Caring Campus allows faculty to take leadership in student success efforts by changing instructional practices in ways that can improve student experiences and outcomes. Further, as they implement Caring Campus strategies, faculty encourage changes in the culture of the college in ways that support students as well as their own engagement with their work and each other.

The next generation of physician-researchers: undergraduate medical students’ and residents’ attitudes, challenges, and approaches towards addressing them

BackgroundUndergraduate medical education and residency training are critical periods for conducting research. Medical diagnoses and therapies are direct results of successful research efforts that have advanced several scientific fields. This review highlights the importance of incorporating scientific research training into the curricula of undergraduate medical education and residency programs.MethodsWe utilized key databases such as PubMed, Web of Science, and Google Scholar to conduct a narrative review of English-language articles published between 2002 and 2024. Ultimately, we selected 49 studies that examined the attitudes of undergraduate medical students and residents toward research, the common challenges they encounter while participating in research activities, and the strategies that support and encourage their involvement, all in alignment with our study objectives and keywords. In addition, we identified several relevant themes, including the value of research experience in shaping well-rounded medical professionals; the integrity of research practices in residency selection, which addresses concerns such as the arms race and misrepresentation, as well as the balance between quality and quantity; striking a balance between research and clinical training while promoting equity and inclusion; and effective programs and mentorship strategies to enhance research engagement.ResultsTranslating the positive attitudes of undergraduate medical students and residents into improved knowledge and practice necessitates the development of structured mentoring programs and advanced training systems. Institutions must provide the necessary tools, guidance, and support to overcome research barriers. This will help establish an environment in undergraduate medical education and residency training that values research, facilitates access to it, and integrates it into the curriculum.ConclusionsTo address the critical shortage of physician-researchers and improve evidence-based medical practice, it is crucial for medical schools to focus on research education and create avenues for student involvement. By tackling research challenges and implementing supportive strategies, these efforts empower the next generation of physician-researchers to embrace research, contribute to medical progress, and uphold the highest standards of patient care.

Factors associated with severe malaria-related mortality among hospitalized children under five years of age in Eastern Province of Rwanda: a cross-sectional study using hospital records from 2017 to 2021

BackgroundMalaria remains a significant concern for children under five in malaria-endemic regions. Rwanda’s successful efforts in malaria treatment reduced nationwide cases, but high mortality persists in the Eastern and Southern provinces. This study aimed to investigate the clinical features of severe malaria and to identify the death risk factors among under-five children in Eastern province Hospitals.MethodsThis cross-sectional study assessed severe malaria-related mortality and associated factors among children aged under five years in hospitals of Eastern Province, Rwanda, from 2017 to 2021. Data were collected from hospital records, and descriptive statistics and logistic regression were used for data analysis.ResultsFactors associated with severe malaria-related mortality included coma (aOR: 10, 95% CI: 1.2–82.5, p = 0.03), Vomiting (aOR: 5.2, 95% CI: 1.0–26.0, p = 0.04), four or more days of illness before consultation (aOR: 30.9, 95% CI: 8.7–109.9, p < 0.01). On the other hand, a low parasitaemia level (aOR: 0.01, 95% CI: 0.0–0.1, p < 0.01).ConclusionIn conclusion, coma, vomiting, and healthcare delays increased mortality in children with severe malaria. Prompt treatment, proper assessments, protocol adherence, and caregiver education on early symptom recognition are crucial for improving outcomes.

ADVOCACY STRATEGY IN OPTIMIZING THE USE OF VILLAGE FUNDS FOR THE STUNTING PREVENTION PROGRAM IN EAST SUMALATA DISTRICT

Stunting is a critical public health issue in North Gorontalo Regency, and efforts to prevent it during the First 1000 Days of Life face significant challenges, particularly due to insufficient allocation of village funds for stunting prevention initiatives. This research aims to explore effective communication and advocacy strategies for securing village fund support for the stunting prevention program focused on the First 1000 Days of Life at the village level in East Sumalata District, North Gorontalo Regency. The study employs a descriptive qualitative approach, utilizing document analysis, observations, interviews, and focus group discussions to examine village fund management and assess the effectiveness of advocacy strategies. The findings indicate that an effective advocacy strategy for securing village fund allocations for the stunting prevention program involves informal communication with a persuasive approach directed at regional leaders. Key elements include presenting accurate target data, referencing relevant regulations, submitting well-prepared activity proposals, and obtaining recommendation letters from local authorities such as the Head of the Office or the Subdistrict Head. Given the sensitivity and limitations of village budget discussions, consistent monitoring of advocacy proposals is essential to ensure program implementation. Support from regional leaders and partner organizations is crucial for successful advocacy efforts.

Cinéma théâtral: stardom and performance in the Tradition of Quality

ABSTRACT Departing from the directorial focus of debates about the Tradition of Quality, this article examines stardom and performance as central to late 1940s and 1950s mainstream French cinema. Authorship is not discarded but understood as a power dynamic in which directors and performers, alongside other contributors, struggle for control over characters and narrative. The article first establishes the main elements of quality performance, building on André Bazin’s concept of cinéma théâtral. Examples, drawn from major stars (Fernandel, Pierre Blanchar, Pierre Fresnay, Jean Gabin, Edwige Feuillère and Michèle Morgan), highlight the crucial importance of elocution and language, a dimension of performance that is often neglected. The article then focuses on Brigitte Bardot in two quality films, En cas de malheur/Love is my Profession (Claude Autant-Lara, 1958) and La Vérité/The Truth (Henri-Georges Clouzot, 1960). B.B.’s iconoclastic image and her departure from prevailing notions of ‘good acting’ provoke a ‘dissonant’ performance, which illuminates further, by contrast, the Tradition of Quality’s acting norms. Conversely, Autant-Lara’s and Clouzot’s variously successful efforts to blend Bardot seamlessly into quality aesthetics betray their wish to modernise their cinema at a pivotal historical moment when the Tradition of Quality was under assault from the emerging New Wave.

A comparative study on semen quality and cryopreservation ability in Italian native chicken breeds

This study provides a comparative assessment of fresh semen quality and sensitivity to cryopreservation in several Italian chicken breeds. The research involved 145 roosters from 13 breeds. The results showed a wide variability in all the parameters considered among the different breeds, especially in the quantitative variables of fresh semen, such as volume and concentration. For the qualitative characteristics (sperm membrane integrity and motility parameters), the variability across breeds was more pronounced for frozen than fresh semen. Interestingly, apart from total motility in fresh semen, breed had a significant effect on all semen quality parameters in both fresh and thawed ejaculates. Considering the overall qualitative characteristics, the Robusta maculata, Siciliana, and Mericanel della Brianza breeds produced ejaculates with better semen quality compared to other Italian breeds. By evaluating the main parameters of semen quality, our results underline the potential of these traits to influence the reproductive success and genetic conservation. The Bionda piemontese, Bianca di Saluzzo, Livorno bianca, Pepoi, and Siciliana breeds showed better resilience to cryopreservation, suggesting the need for breed-specific protocols to optimise semen quality after thawing. Importantly, the research highlights the central role of semen quality for both immediate fertilisation success and long-term conservation efforts. Future studies integrating OMICS technologies could elucidate molecular markers influencing breed-specific differences, helping to refine cryopreservation techniques and improve conservation strategies for indigenous Italian chicken breeds. This work contributes valuable insights to global efforts aimed at safeguarding poultry genetic diversity and sustainability.

Community-based propagation to scale up educational innovations in sustainability

Many high-quality educational innovations are freely available, and some are known to motivate evidence-based climate and sustainability action. Typically, efforts to propagate educational innovations rely on outreach and word-of-mouth diffusion, but these approaches tend to achieve little. We develop and analyse a dynamic computational model to understand why and to test other propagation strategies. Our analysis reveals that outreach has limited impact and does little to accelerate word-of-mouth adoption under conditions typical in higher education. Instead, we find that community-based propagation can rapidly accelerate adoption, as is also shown by a small number of successful real-world scaling efforts. This approach supports a community of ‘ambassadors’, facilitating and rewarding their sharing the innovation with potential adopters. Community-based propagation can generate exponential growth in adopters, rapidly outpacing outreach and word-of-mouth propagation. Without it, we are unlikely to rapidly scale the educational innovations needed to build urgently needed capacity in sustainability.

Digital Marketing and Its Impact on Organizational Attraction: An Analytical Study of the Opinions of a Sample of Administrative Leaders in the Public Telecommunications and Information Technology Company

The main purpose of this research is to understand the role of digital marketing in the Public Telecommunications and Information Company by exploring its four dimensions (communication channels, social media, digital relations, and digital technologies) in enhancing its organizational attractiveness. The problem of the research, the company is struggling how to cover all consumer needs and preferences, comprehend their behavior, and set specific objectives to improve organizational attraction, whether to increase subscribers or enhance interactions with other companies. Digital marketing requires sustained time and effort for long-term success, which is why this research aims to provide a set of marketing mechanisms to address the problem, potentially through electronic platforms or social media. To achieve objective of the research, the descriptive-analytical approach was used. A questionnaire was the main tool used to collect data and information was distributed to a sample of the company's middle management leaders (119) in the Public Telecommunications and Information Company. the researchers employed a series of descriptive statistical techniques that included the arithmetic mean, standard deviation, coefficient of variation, and simple regression coefficient by using the statistical program (SPSS. V.26). The results confirmed the significant impact of digital marketing on enhancing the leaders' ability to increase organizational attractiveness, enabling them to execute their assigned activities and tasks more effectively. Paper type: Research paper.

Recent Advances in Therapeutic Approaches Against Ebola Virus Infection.

Ebola virus (EBOV) is a genus of negative-strand RNA viruses belonging to the family Filoviradae that was first described in 1976 in the present-day Democratic Republic of the Congo. It has intermittently affected substantial human populations in West Africa and presents itself as a global health menace due to the high mortality rate of patients, high transmission rate, difficult patient management, and the emergence of complicated autoimmune disease-like conditions post-infection. EBOV or other EBOV-like species as a biochemical weapon pose a significant risk; hence, the need to develop both prophylactic and therapeutic medications to combat the virus is unquestionable. In this review work, we have compiled the literature pertaining to transmission, pathogenesis, immune response, and diagnosis of EBOV infection. We included detailed structural details of EBOV along with all the available therapeutics against EBOV disease. We have also highlighted current developments and recent advances in therapeutic approaches against Ebola virus disease (EVD). The development of preventive vaccines against the virus is proving to be a successful effort as of now; however, problems concerning logistics, product stability, multi- dosing, and patient tracking are prominent in West Africa. Monoclonal antibodies that target EBOV proteins have also been developed and approved in the clinic; however, no small drug molecules that target these viral proteins have cleared clinical trials. An understanding of clinically approved vaccines and their shortcomings also serves an important purpose for researchers in vaccine design in choosing the right vector, antigen, and particular physicochemical properties that are critical for the vaccine's success against the virus across the world. Our work brings together a comprehensive review of all available prophylactic and therapeutic medications developed and under development against the EBOV, which will serve as a guide for researchers in pursuing the most promising drug discovery strategies against the EBOV and also explore novel mechanisms of fighting against EBOV infection.

Normal Accident Theory and Learning from Major Accidents at the National Aeronautics and Space Administration (NASA).

A review of NASA’s accident history through the lens of Normal Accident Theory (NAT) offers insights into the prospects for safety during the Artemis Program. NAT is applied to NASA’s four major human spaceflight accidents: the Apollo launch pad fire, Apollo 13, Challenger and Columbia. NAT predicts that in the complex and tightly coupled systems used for human spaceflight, an accident type known as the “normal accident”, is inevitable. These accidents are attributable to hidden system interactions that overwhelm the cognitive abilities of human operators and, thereby, escape detection. A review of the four official accident reports and supporting secondary analyses suggests NASA has had one such accident: Apollo 13. It was also the only major accident without injury and a successful recovery effort. NAT would categorize the other three as component failure accidents. Unlike normal accidents, component failure accidents are not inevitable. They stem from an organization’s failure to appropriately monitor, assess and mitigate the risk associated with a faulty component. In such cases, NAT would ask if production pressures, often rooted in scheduling and resource constraints, were a factor.Production pressures are ultimately imposed on organizations through the exercise of power. These pressures impede an organization’s ability to adequately assess risk and increase the likelihood of component failure accidents. The substantial organizational literature on NASA’s human spaceflight accidents has yielded potential remedies to help mitigate the risks associated with production pressure. This paper discusses these remedies and their potential safety benefits. It also proposes a modification to a safety governance mechanism recommended by the Columbia Accident Investigation Board (CAIB). The resulting changes could help NASA, and other organizations administering high risk technologies, further improve safety.

Mechanisms of extracellular vesicle uptake and implications for the design of cancer therapeutics.

The translation of pre-clinical anti-cancer therapies to regulatory approval has been promising, but slower than hoped. While innovative and effective treatments continue to achieve or seek approval, setbacks are often attributed to a lack of efficacy, failure to achieve clinical endpoints, and dose-limiting toxicities. Successful efforts have been characterized by the development of therapeutics designed to specifically deliver optimal and effective dosing to tumour cells while minimizing off-target toxicity. Much effort has been devoted to the rational design and application of synthetic nanoparticles to serve as targeted therapeutic delivery vehicles. Several challenges to the successful application of this modality as delivery vehicles include the induction of a protracted immune response that results in their rapid systemic clearance, manufacturing cost, lack of stability, and their biocompatibility. Extracellular vesicles (EVs) are a heterogeneous class of endogenous biologically produced lipid bilayer nanoparticles that mediate intercellular communication by carrying bioactive macromolecules capable of modifying cellular phenotypes to local and distant cells. By genetic, chemical, or metabolic methods, extracellular vesicles (EVs) can be engineered to display targeting moieties on their surface while transporting specific cargo to modulate pathological processes following uptake by target cell populations. This review will survey the types of EVs, their composition and cargoes, strategies employed to increase their targeting, uptake, and cargo release, and their potential as targeted anti-cancer therapeutic delivery vehicles.

Competitive advantages of transparency: How anti-corruption initiatives can drive innovation and growth in the energy sector

This review examines the role of anti-corruption initiatives in driving innovation and growth within the energy sector, with a particular focus on emerging markets. As global demand for energy continues to rise, the imperative for ethical and transparent business practices grows stronger. This study synthesizes current literature on anti-corruption measures, transparency initiatives, and their impacts on competitive advantage in the energy industry. Through a comprehensive analysis of case studies and empirical research, we identify several key mechanisms through which transparency can foster innovation and drive growth. These include enhanced stakeholder trust, improved access to capital, attraction of top talent, and the creation of an ethical corporate culture that encourages innovation. Our findings suggest that successful anti-corruption initiatives in the energy sector require a nuanced understanding of local contexts, strong leadership commitment, and the strategic use of technology. The review also highlights the potential of open data platforms and blockchain technology in facilitating transparency and compliance. By identifying key factors contributing to successful anti-corruption efforts and their subsequent impacts on innovation and growth, this study provides valuable insights for policymakers, industry leaders, and researchers working towards a more transparent and innovative energy sector. Future research directions are proposed to further explore the long-term impacts and scalability of these initiatives across different market contexts.

A Review of Sanitation Options and Programming in Ghana, West Africa

This review examines Ghana’s progress in sanitation. These efforts include the containment, transport, treatment, and disposal or reuse of human waste. This research specifically examined the current sanitation processes and programming efforts within Ghana, West Africa. Some reports indicate that Ghana is the second dirtiest country in Africa and the seventh dirtiest country in the world. A review of the current water, sanitation, and hygiene (WASH) options within the country indicates that significant efforts need to be undertaken. There are multiple toilet options and current practices within the country for the disposal of excrement. Unfortunately, the municipal sewer systems and wastewater treatment facilities within the country are either broken down or severely inadequate compared to their surrounding population. Current WASH programming, extension efforts, and key factors affecting the uptake of sanitation investment are reviewed. The price point where consumers would utilize sanitation products and services was analyzed, as well as the cost-to-benefit ratio of specific technologies for community members. This review demonstrated that initiatives should be undertaken to provide more sanitation professionals, renovate and expand urban municipal sewerage systems, and provide basic access to rural community areas. It was recommended that future programming, extension, and policy efforts be intentional and include relevant stakeholders and community members to provide a greater opportunity for establishing successful and substantial efforts.

Policy Priorities to Build and Sustain the U.S. Semiconductor Manufacturing Workforce

Enhancing the United States’ global competitiveness in semiconductor manufacturing hinges on addressing the country’s substantial shortages of skilled technicians, scientists, and engineers. An initial focus on building the technician workforce offers a critical opportunity to develop advanced manufacturing capacity underlying multiple strategic technologies and to expand economic opportunities to broader sections of the population. The National Center for the Advancement of Semiconductor Technology (Natcast), a non-profit created to operate the public-private National Semiconductor Technology Center established by the CHIPS Act, is uniquely positioned to break down silos and maximize the value of workforce development (WFD) efforts within and outside government and across the U.S. In this role, Natcast should promptly roll out the announced Workforce Center of Excellence and prioritize activities that individual WFD stakeholders cannot accomplish on their own, including: 1) provide centralized information on semiconductor labor market dynamics and existing resources for WFD; 2) regularly convene communities of practice among government, industry, and educational institutions to boost cross-sectoral alignment and share best practices; 3) fund awareness campaigns about semiconductor career pathways to increase public engagement; and 4) establish program evaluation mechanisms to guide the scaling up of successful WFD efforts. Together, these strategic policy priorities can seize on today’s historical investments and political momentum to build the foundation for a resilient U.S. manufacturing workforce.

Promoting student success and retention through care teams and case management at small institutions

AbstractCare teams, an important structure at most institutions of higher education, coordinate the work of various units to intervene with students who are at risk of attrition, academic failure, and/or are experiencing socio‐emotional struggles. The authors provide various examples of how case management and Care Teamwork is structured in the small institution setting. Using their institutions as case studies, the authors provide examples of various collaborative structures that coordinate case management and support at‐risk students; and situate this work in the small institution setting, with particular attention to the expectations that these institutions and students’ families have for high touch student success efforts; and discuss ways in which technology supports and contributes to case management and Care Team work.

Assessing the role of the for-profit private healthcare sector in malaria elimination efforts in Bangladesh: a cross-sectional study of challenges and opportunities

BackgroundAmong 13 endemic districts, the Chittagong Hill Tracts bear more than 90% of Bangladesh’s malaria burden. Despite the private sector’s prominence in rural healthcare, its role in malaria management remains underutilized. This study aimed to strategize leveraging the for-profit private sector, such as diagnostic and treatment centers, to bolster national malaria surveillance and control, advancing Bangladesh toward malaria elimination by 2030.MethodsThis mixed-method study commenced with a questionnaire-based cross-sectional survey followed by selected focused group discussions (FGDs) among the participants. Three FGDs were held with the for-profit service providers so that further insights and qualitative viewpoints of them can be utilized in situation analysis. Based on the endemicity and strategic priorities, a comprehensive mapping of private for-profit facilities from the regions comprising 15 sub-districts across 8 chosen districts (7 malaria endemic districts and the rest non-endemic districts) was created. For the non-endemic zone, the sub-districts were selected based on their proximity to an area with high malaria transmission.ResultsAmong the 104 representative participants, majority were male (n = 92, 88.5%), had a diploma in their respective fields (n = 53, 51%) and were involved either in laboratory work (n = 49, 47.1%) or as owners/managers of health centers (n = 41, 39.4%). The selected health facilities were close to the corresponding Upazila Health Complexes (mean distance 2.8 km), but were distantly located from the designated district hospitals (mean distance 48.9 km). The main sources of RDT kits (62.3%) and anti-malarial drugs (63.2%) were local wholesale markets. A large share of the corresponding facilities neither provided malaria treatment services (81.7%) nor worked with the NMEP (93.3%).ConclusionsThis study highlights challenges and recommendations for engaging private for-profit health facilities in Bangladesh’s malaria elimination efforts. The identified challenges include low-quality RDTs, staff shortages, and inadequate capacity building. Recommendations emphasize effective training, stakeholder interaction, and enhanced oversight for successful malaria control efforts.

Selection and Effect of Plant Growth-Promoting Bacteria on Pine Seedlings (Pinus montezumae and Pinus patula).

Forest cover is deteriorating rapidly due to anthropogenic causes, making its restoration urgent. Plant growth-promoting bacteria (PGPB) could offer a viable solution to ensure successful reforestation efforts. This study aimed to select bacterial strains with mechanisms that promote plant growth and enhance seedling development. The bacterial strains used in this study were isolated from the rhizosphere and endophyte regions of Pinus montezumae Lamb. and Pinus patula Schl. et Cham., two Mexican conifer species commonly used for reforestation purposes. Sixteen bacterial strains were selected for their ability to produce auxins, chitinase, and siderophores, perform nitrogen fixation, and solubilize inorganic phosphates; they also harbored genes encoding antimicrobial production and ACC deaminase. The adhesion to seeds, germination rate, and seedling response of P. montezumae and P. patula were performed following inoculation with 10 bacterial strains exhibiting high plant growth-promoting potential. Some strains demonstrated the capacity to enhance seedling growth. The selected strains were taxonomically characterized and belonged to the genus Serratia, Buttiauxella, and Bacillus. These strains exhibited at least two mechanisms of action, including the production of indole-3-acetic acid, biological nitrogen fixation, and phosphate solubilization, and could serve as potential alternatives for the reforestation of affected areas.

Meritocracy seen through the eyes of its champions: a comparative study of educational elites

This paper explores the way in which elite students from Germany and Romania understand the role of talent, effort, and structural factors in shaping educational success and failure. The image of a successful student aligns with the requirements of the selection processes, with Romanian students emphasising effort, and German students projecting an image of effortless achievement. Although most students acknowledged structural inequalities played into the selection processes, they did not seem to doubt the intelligence and skills of those who were selected to the most prestigious tracks and streams. By exploring the way in which students at prestigious universities talk about success and failure, this paper captures some ways in which they resist reproducing meritocratic discourses, and other ways in which they perpetuate the myth of meritocracy.

Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality

BackgroundHealthcare systems aim to enhance the health status and well-being of the individuals and populations they serve. To achieve this, measuring and evaluating the quality and safety of services provided and the outcomes achieved is essential. Like other countries, Romania faces challenges regarding the quality of care provided in its public hospitals. To address this, the Romanian Ministry of Health initiated reforms in 2022, including implementing a pay-for-performance model based on quality indicators. This paper presents a descriptive analysis of processes, methods, results and lessons learned from developing and piloting a set of Quality of Care indicators for Romanian public hospitals.MethodsWorld Health Organization’s Athens Office on Quality of Care and Patient Safety assisted Romania in developing and piloting a set of quality-of-care indicators for public hospitals. The development phase included defining indicator domains, identifying potential indicators across these domains, and defining the final indicator set. The piloting phase involved selecting and recruiting piloting hospitals, developing data collection and validation methods and tools, training hospital staff, and collecting and analysing indicator data. Piloting ended with an evaluation workshop. Mixed, quantitative and qualitative methods were used, including literature reviews, stakeholder consultation workshops, survey instruments developed for this study, modified Delphi panels and consensus-building meetings. National stakeholders were actively involved throughout the process.ResultsFour priority domains were defined for quality-of-care indicators for Romanian public hospitals: patient safety, patient experience, healthcare workforce training and safety, and clinical effectiveness. 25 core indicators were selected across these domains. During the pilot, hospitals achieved an average completion rate of 90% for data submission, with all domains rated equally relevant during post-pilot evaluations. Lessons included the need for supportive legislation, improved internal auditing practices and enhanced staff training, refinement of indicator data collection methods and alignment of indicators with hospital-specific contexts.ConclusionsThis work presents a significant stride in improving Romanian public hospitals’ quality of care and patient safety. It underscores the importance of high-level commitment, stakeholder engagement, and robust data practices in driving successful quality improvement efforts. Emphasising the role of data-driven and patient-centric approaches in achieving optimal healthcare outcomes, lessons learned offer insights for the continuation of quality improvement work in Romania but also for healthcare systems elsewhere.