PurposeThe aim of this research is to empirically assess the nine dimensions of the Total Quality Management (TQM) model, which have been categorized into four blocks: the top management block, the ...supplier block, the process management block and the customer block. The nine dimensions represent key strategic activities of company performance. A comparative analysis of companies with ISO 9001 certification and those without certification in a developing country during the COVID-19 pandemic is carried out.Design/methodology/approachA survey was administered to the management of 259 Peruvian goods companies (in the mining, repair and manufacturing sectors) during the COVID-19 pandemic. The survey consisted of 35 Likert-scale items, which were grouped into the following nine TQM dimensions: Top management (leadership), quality planning, quality audit and assessment, product design, suppliers' quality management, process control and improvement, education and training, quality circles and focus on customer satisfaction. Then, Cronbach's alpha, the Kolmogorov–Smirnov test, the Mann–Whitney U test and means were computed for each of the dimensions. This analysis made it possible to estimate significant differences between ISO 9001 certified and non-certified goods companies in terms of the dimensions.FindingsThe results showed that, for ISO 9001 certified companies, the averages for all of the dimensions were significantly different from those of non-certified companies, except for the education and training dimension. ISO 9001 certified companies scored higher than non-certified companies in the TQM dimensions. For both certified and non-certified companies, the leadership dimension had the highest average and the quality circles dimension had the lowest average.Originality/valueThis study addresses two main gaps highlighted in the research on quality management: the application of Quality Management Systems (QMS) in developing countries like Peru, and the impact of ISO 9001 on the performance of goods companies during the COVID-19 pandemic.
South Korea was the first to administer the Indoor Air Quality Control Act in 1996, followed by Taiwan’s implementation in 2012. This study investigated indoor air quality (IAQ) in public facilities ...before and after the enactment of Taiwan’s Indoor Air Quality Management (IAQM) Act in 2012 to assess the effectiveness of the Act. The study also calculates health risks for employers, and consumers/visitors separately. The mean concentration of carbon dioxide (CO2) after the IAQM Act’s enactment was higher than before, except for government offices. The lowest attainment rates for CO2, below 80%, were 73% in hospitals and 78% in libraries. As for formaldehyde, average concentrations were higher after the IAQM Act’s implementation, except for the exhibition room and library. Notably, improvements in particulate matter with a diameter less than 2.5 μm (PM2.5) levels were evident in hospitals and libraries compared to other environments (attainment rates increased from 85% to 100% and 89% to 94%, respectively). However, in schools, preschools, and public transport spaces, unattainment rates worsened. Regarding cancer risk from formaldehyde exposure in the public, the 95% of upper risk limits ranged from 3.44×10−5 in the public transport system to 8.80×10−4 in preschools. Our findings highlight the necessity of integrating more measurement data after IAQM Act implementation and formulating management strategies based on risk assessments for future investigations.
The formulation of an adequate and practical Atmospheric Air Quality Management Plan at different spatial scales at local (micro), city (medium), national (macro)), and temporal (short and long term) ...is an indispensable solution to prevent the public from air pollution health risk. The air quality monitoring system provides regulatory agencies a comprehensive data of current air contaminants in a particular location. Then, air monitoring data of pollutants is processed into a dimensionless unit called the “Air Quality Index” (AQI); it serves as an information medium for the people to know the air quality health of their location and takes preventative steps accordingly (public participation). Thus, the AQI is a beneficial tool for the public, stakeholders, and regulators to understand the current state of air quality. AQI across the globe considers the number of pollutants (most of the developed countries and some developing countries considers PM
2.5
to measure the overall status of air quality being monitored), averaging time for which pollutants are measured, calculation method to compute air quality indices for each pollutant, calculation mode to aggregate the overall index, scale of an index, categories, colour coding scheme, and related descriptive terms of the pollutants. This article presents rationalized and extensive reviews of various Air Quality Index (AQI) models utilized worldwide from 1960 to 2021, comparing them based on several parameters such as types and number of pollutants (criteria or hazardous air pollutants), averaging time (long-term or short-term), calculation methods (linear or nonlinear), calculation modes single-pollutant (maximum value) or multi-pollutants (combined effect). By analysing the strengths and flaws of all the AQI models developed so far, it is recommended to develop a more reliable, extensible, and comparable AQI model to be employed as an executive tool for designing strategic pollution abatement programs to preserve public health.
Background and importanceThe activity of chemotherapy preparations is constantly evolving:It is increasing (+17% in our centre in 5 years).Particulate quality monitoring is recommended but rarely ...done in hospital pharmacies.The pharmacist, who is responsible for this activity, must anticipate these changes.Aim and objectivesWe first demonstrated the compliance of our controlled atmosphere area with the ISO 7 (at rest) and ISO 8 (during activity) criteria. Then we determined the factors significantly impacting on the particle rate in order to design a mathematical model that would predict the number of particles and thus better control the increase in activity.Material and methodsThe particle count was carried out according to the requirements of the ISO 7 and ISO 8 standards (particle size, sampling plan, volume, duration and height). We systematically recorded the following factors: date, time, number of people present in the controlled area, temperature, pressure, sampling location, sampling conditions (at rest or during activity) and equipment entering the ZAC mechanically cleaned or not. For the statistical analysis, a grouping of sampling points by critical sector (personnel entry and exit area, work area itself, material transfer and basket preparation area) was carried out. Data were analysed to perform the multivariate models required for predictive mathematical modelling (significant variables at the p=0.05 threshold).ResultsAll 994 samples (from 16 counting points) in our 80 m² depressed area complied with the ISO 7 and ISO 8 criteria for particulate contamination. Predictive mathematical modelling of the number of particles was based on the significant criteria ‘time of day’, ‘location of sampling’ and ‘number of people’.Conclusion and relevanceParticulate quality criteria were met at rest and especially during activity (which is rarely evaluated). These results could be related to the technical quality of the air plant (all new air and 25 air changes/hour) and the materials and characteristics of the PPE used (low particle release). By taking into account the factors integrated in the mathematical models, smoothing the number of people over the day and increasing the cleaning of risk areas, it will be possible to guarantee and better understand the particular quality of our areas.References and/or acknowledgementsNo conflict of interest.
Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing ...guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org.
Good Jobs, Bad Jobs provides an insightful analysis of how and why precarious employment is gaining ground in the labor market and the role these developments have played in the decline of the middle ...class. Kalleberg shows that by the 1970s, government deregulation, global competition, and the rise of the service sector gained traction, while institutional protections for workers—such as unions and minimum-wage legislation—weakened. Together, these forces marked the end of postwar security for American workers. The composition of the labor force also changed significantly; the number of dual-earner families increased, as did the share of the workforce comprised of women, non-white, and immigrant workers. Of these groups, blacks, Latinos, and immigrants remain concentrated in the most precarious and low-quality jobs, with educational attainment being the leading indicator of who will earn the highest wages and experience the most job security and highest levels of autonomy and control over their jobs and schedules. Kalleberg demonstrates, however, that building a better safety net—increasing government responsibility for worker health care and retirement, as well as strengthening unions—can go a long way toward redressing the effects of today’s volatile labor market. There is every reason to expect that the growth of precarious jobs—which already make up a significant share of the American job market—will continue. Good Jobs, Bad Jobs deftly shows that the decline in U.S. job quality is not the result of fluctuations in the business cycle, but rather the result of economic restructuring and the disappearance of institutional protections for workers. Only government, employers and labor working together on long-term strategies—including an expanded safety net, strengthened legal protections, and better training opportunities—can help reverse this trend.
The water source of the water diversion project from the Hanjiang River to the Weihe River is one of the most important drinking water sources in China. Its water quality is related to the water ...safety of the long-distance water diversion system from the Hanjiang to Weihe Rivers. In order to explore the spatiotemporal change trend of the water environment characteristics of the water source area and analyze the key factors that have a greater impact on it, this study collected 9 types of water environment physical and chemical parameters from 10 water quality monitoring sections from 2017 to 2019; the water environment characteristics of the water source area of the water diversion system from the Hanjiang River to the Weihe River were analyzed and evaluated by using the variance analysis method, the hierarchical cluster analysis method and the water quality identification index evaluation method. The results were as follows. (1) There was spatiotemporal heterogeneity in a number of physical and chemical parameters in the water body of the water source. In terms of time, the concentrations of COD
, COD, BOD
and F
were higher in the flood season (July-October) than in the non-flood season (November-June). The concentrations of DO, TP and TN in the non-flood season were higher than those in the flood season. Spatially, the concentration of physical and chemical parameters of the water body in the Huangjinxia Reservoir area was higher than that in the Sanhekou Reservoir area. (2) The water quality of the water source area was good. The comprehensive water quality reached the Class II water quality standard of surface water environmental quality. Time showed that the comprehensive water quality in the non-flood season was better than that in the flood season. Spatially, the overall water quality of the tributaries was better than that of the mainstream. TN is a key indicator that affects water quality. (3) The spatial and temporal differences in water quality in water source areas are mainly affected by factors such as rainfall, temperature and human activities. This study can provide a scientific and data basis for related research on maintaining and improving the quality of the ecological environment of the water source areas of the Hanjiang to Weihe River Water Diversion System.
...it will be important for the end users of the new ACC/AHA performance measure set to incorporate this risk assessment process in order to achieve successful implementation as a key component of ...quality improvement for patients with HBP. Because the current NCQA and CMS performance measures for controlling HBP assess only the population with ACC/AHA stage 2 HBP (6), the writing committee also felt that it was important to emphasize the 2017 Hypertension Clinical Practice Guidelines (4) recommendations to lower BP below the 130/80-mm Hg threshold for both ACC/AHA stage 2 and stage 1 patients. ...the writing committee was concerned that NCQA and CMS would be less likely to consider testing and adopting performance measures with denominator specifications different from those of the “Controlling High Blood Pressure” measure currently in widespread use (and recently revised in 2019) (10). ...the writing committee chose to promote flexible denominator congruity and harmonization (as defined by the National Quality Forum NQF) with both NCQA and CMS measure specifications in the new ACC/AHA performance measure set to promote its initial widespread use by clinicians and entities who support the treatment recommendations for ACC/AHA stage 1 HBP as emphasized in the 2017 Hypertension Clinical Practice Guidelines (4). ...the writing committee unanimously feels it important to include new harmonizing measures for stage 1 HBP and a composite measure (i.e., for ACC/AHA stage 2 and ACC/AHA stage 1 combined) that emphasize the importance of controlling HBP below the new ACC/AHA target of 130/80 mm Hg, as recommended by the 2017 Hypertension Clinical Practice Guidelines (4). Because of the importance of the promotion of intensive nonpharmacological “healthy lifestyle” modifications and home BP monitoring for patients with stage 2 HBP (as emphasized in the 2017 Hypertension Clinical Practice Guidelines (4), new performance measures to assess quality of care in this regard have been included. ...these new measures are currently not designed or intended to be used for accountability “standards” but rather to be used as a roadmap for solo/small physician offices, group practices, health systems, public health sites, accountable care organizations, and clinically integrated networks, etc., in their collective journeys to establish better and more standardized guideline-based systems of care for the many millions of patients with HBP across the United States.
Government has implemented various scattered and un-quantified control actions in Delhi city to reduce the air pollution levels; however, it still exceeds the National Ambient Air Quality Standards ...(NAAQS). The present study has been designed to assess the air quality status, identify Air Quality Control Region (AQCR), and evaluate control strategies in the city. Out of eight selected locations, ambient PM
10
, PM
2.5
, and NO
2
concentrations were found exceeding the daily as well as annual standards at selected AQCR with peak levels during post-monsoon than winter and summer. Anand Vihar was found to be most polluted and thus, selected as an AQCR. AERMOD performed satisfactorily in predicting pollutant concentration during winter and summer having an index of agreement in the range 0.54–0.80. PM
10
and PM
2.5
can be reduced substantially by increasing frequency of efficient mechanized cleaning of roads and sprinkling of water on the roads. Progressive decrease in NO
2
concentrations can be achieved by restricting entry of truck in the study area through alternate path. The cumulative impact of all selected control strategies indicates a substantial decrease in air pollution within AQCR. The study also suggests a policy framework to manage the urban air quality through local scale air quality guidelines.
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