An effective micro-level air quality management plan requires high-resolution monitoring of pollutants. India has already developed a vast network of air quality monitoring stations, both manual and ...real time, located primarily in urban areas, including megacities. The air quality monitoring network consists of conventional manual stations and real time Continuous Ambient Air Quality Monitoring Stations (CAAQMS) which comprise state-of-the-art analysers and instruments. India is currently in the early stages of developing and adopting economical portable sensor (EPS) in air quality monitoring systems. Protocols need to be established for field calibration and testing. The present research work is an attempt to develop a performance-based assessment framework for the selection of EPS for air quality monitoring. The two-stage selection protocol includes a review of the factory calibration data and a comparison of EPS data with a reference monitor, i.e. a portable calibrated monitor and a CAAQMS. Methods deployed include calculation of central tendency, dispersion around a central value, calculation of statistical parameters for data comparison, and plotting pollution rose and diurnal profile (peak and non-peak pollution measurement). Four commercially available EPS were tested blind, out of which, data from EPS 2 (S2) and EPS 3 (S3) were closer to reference stations at both locations. The selection was made by evaluating monitoring results, physical features, measurement range, and frequency along with examining capital cost. This proposed approach can be used to increase the usability of EPS in the development of micro-level air quality management strategies, other than regulatory compliance. For regulatory compliance, additional research is needed, including field calibration and evaluating EPS performance through additional variables. This proposed framework may be used as starting point, for such experiments, in order to develop confidence in the use of EPS.
Closing the loop on student feedback Shah, Mahsood; Cheng, Ming; Fitzgerald, Robert
Higher education,
07/2017, Letnik:
74, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Universities have a long history of collecting student feedback using surveys and other mechanisms. The last decade has witnessed a significant shift in how student feedback is systematically ...collected, analysed, reported, and used by governments and institutions. This shift is due to a number of factors, including changes in government policy related to quality assurance, and the increased use of the results by various stakeholders such as governments, institutions, and potential students and employers. The collection, analysis, and reporting of results are systematically carried out in many institutions worldwide. However, how to use student feedback to effectively improve student learning experience remains an issue to be addressed. This paper will contribute to this debate by comparing how Australian and Scottish universities use student feedback results to inform improvements. Based on thematic analysis of external quality audit reports of all Australian and Scottish universities, this paper suggests that universities have systematic processes to collect student feedback using a range of mechanisms, but limited work is done to use the data to inform improvements. This paper argues the need for universities to genuinely listen to student voice by facilitating partnership between students and institutions to act on their feedback as part of quality assurance.
To express a global view of care quality in major causes of mortality and morbidity in children and adolescences.
We used primary epidemiologic indicators from the Global Burden of Disease 1990-2017 ...database. We have created four secondary indices from six primary indices in order to assess the care quality parameters. We conducted a principal component analysis on incidence, prevalence, mortality, Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability Adjusted Life Years (DALYs) to create an index presented by quality-of-care index (QCI) to compare different countries.
The global QCI scores of respiratory infection, enteric infection, leukemia, foreign body aspiration, asthma, epilepsy, diabetes mellitus, dermatitis, road injury, and neonatal disorders have improved remarkably. These causes showed equal distribution of qualified care for both sexes. The global trend of QCI score for mental health showed a steady pattern during the same time and disparities favoring females was evident. The quality of care for these causes was notably higher in developed areas.
The global QCI revealed a universal growth in major causes of death and morbidity in <20y during 28 years. Quality of care is an associate of the level of country's development. Despite effective interventions, inequities still remain. Implementation of policies to invest in quality improvement and inequality elimination is needed.
Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China.
A national ICU QI ...program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated.
A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661, P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75), P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40), P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37), P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100), P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77), P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80), P = 0.1075).
The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.
Purpose
– The purpose of the paper is to explore the impact of total quality management (TQM) factors on performance dimensions of service companies.
Design/methodology/approach
– A research project ...was designed in the Spanish services sector. Companies that had already participated in activities with regard to business excellence were randomly selected and approached through a structured questionnaire, yielding a sample of 151 responding companies. By analyzing TQM implementation and company performance through the exploratory factor analysis, specific TQM factors and performance dimensions are extracted. The TQM factors that significantly influence the performance dimensions are determined through multiple linear regression analyses.
Findings
– According to the findings, the factors describing TQM implementation in service companies concern quality practices of top management, employee quality management, process management, employee knowledge and education and customer focus. Similarly, the performance dimensions revealed concern financial performance, operational performance, customer satisfaction and product/service quality performance. The TQM factors concerning customers, employees and top management significantly affect the performance dimensions.
Research limitations/implications
– The subjective data were collected from quality managers of a small-sized sample of companies operating in a European Union country and belonging to different services sub-sectors. Based on these limitations, future research studies are recommended.
Practical implications
– By focussing on specific TQM factors, a service company can improve its performance dimensions. In doing so, it can lay the foundations not only to survive but to be competitive in the current global scenario that is characterized by an economic downturn.
Originality/value
– This paper describes a reliable TQM model that can be implemented in the services sector and a means by which a service company can improve its performance.
Improving quality of intrapartum care will reduce intrapartum stillbirth and neonatal mortality, especially in resource-poor settings. Basic neonatal resuscitation can reduce intrapartum stillbirth ...and early neonatal mortality, if delivered in a high-quality health system, but there is a dearth of evidence on how to scale up such evidence-based interventions. We evaluated the scaling up of a quality improvement (QI) package for neonatal resuscitation on intrapartum-related mortality (intrapartum stillbirth and first day mortality) at hospitals in Nepal.
We conducted a stepped-wedge cluster randomized controlled trial in 12 hospitals over a period of 18 months from April 14, 2017, to October 17, 2018. The hospitals were assigned to one of four wedges through random allocation. The QI package was implemented in a stepped-wedge manner with a delay of three months for each step. The QI package included improving hospital leadership on intrapartum care, building health workers' competency on neonatal resuscitation, and continuous facilitated QI processes in clinical units. An independent data collection system was set up at each hospital to gather data on mortality through patient case note review and demographic characteristics of women using semi-structured exit interviews. The generalized linear mixed model (GLMM) and multivariate logistic regression were used for analyses. During this study period, a total of 89,014 women-infant pairs were enrolled. The mean age of the mother in the study period was 24.0 ± 4.3 years, with 54.9% from disadvantaged ethnic groups and 4.0% of them illiterate. Of the total birth cohort, 54.4% were boys, 16.7% had gestational age less than 37 weeks, and 17.1% had birth weight less than 2,500 grams. The incidence of intrapartum-related mortality was 11.0 per 1,000 births during the control period and 8.0 per 1,000 births during the intervention period (adjusted odds ratio aOR, 0.79; 95% CI, 0.69-0.92; p = 0.002; intra-cluster correlation coefficient ICC, 0.0286). The incidence of early neonatal mortality was 12.7 per 1,000 live births during the control period and 10.1 per 1,000 live births during the intervention period (aOR, 0.89; 95% CI, 0.78-1.02; p = 0.09; ICC, 0.1538). The use of bag-and-mask ventilation for babies with low Apgar score (<7 at 1 minute) increased from 3.2% in the control period to 4.0% in the intervention period (aOR, 1.52; 95% CI, 1.32-1.77, p = 0.003). There were two major limitations to the study; although a large sample of women-infant pairs were enrolled in the study, the clustering reduced the power of the study. Secondly, the study was not sufficiently powered to detect reduction in early neonatal mortality with the number of clusters provided.
These results suggest scaled-up implementation of a QI package for neonatal resuscitation can reduce intrapartum-related mortality and improve clinical care. The QI intervention package is likely to be effective in similar settings. More implementation research is required to assess the sustainability of QI interventions and quality of care.
ISRCTN30829654.
Aim
Examining health‐related quality of life (HRQoL) is important to improve patient care. In this study, we translate and evaluate the Finnish versions of the Food Allergy Specific Quality of Life ...Questionnaires (FAQLQs) from a Finnish perspective and undertake a detailed evaluation of the 10‐question Parent Form Questionnaire (FAQLQ‐PF10).
Methods
This validation study was performed to evaluate the Finnish versions of the FAQLQs. Validation was performed by analysing clinical characteristics, factor loadings and Cronbach's α reliability estimates. The inclusion criteria for participants in this study were having a doctor‐diagnosed food allergy or being a parent of a child with a doctor‐diagnosed food allergy and being able to answer the questionnaire in Finnish.
Results
Altogether, 247 questionnaires were completed in this study. Most of the respondents had multiple food allergies (77%, 189/247). Spearman's correlations related to the 10‐question parent form (FAQLQ‐PF10), the 30‐question parent form (FAQLQ‐PF) and the Food Allergy Severity Measurement‐Parent Form (FAIM‐PF) were statistically significant (p value = 0.000–0.007). The reliability of the Finnish versions of the FAQLQs measured by Cronbach's α was overall good (0.75–0.981).
Conclusion
The Finnish versions of the FAQLQs are reliable and suitable to use, and the FAQLQ‐PF10 has good usability.
The ubiquity of smartphones equipped with an array of sophisticated sensors, ample processing power, network connectivity and a convenient interface makes them a promising tool for non-invasive, ...portable food quality assessment. Combined with the recent developments in the areas of IoT, deep learning algorithms and cloud computing, they present an opportunity for advancing wide-spread, equitable and sustainable food analytical methods that could be used at each stage of food production and distribution.
This review focuses on the use of smartphone-based methods in food quality assessment and monitoring, with particular emphasis on the ones in which smartphones are used as detectors, either on their own or in conjunction with more elaborate analytical procedures. The role of these methods in common and equitable access to information on food quality is discussed, together with a consideration of the sustainability and greenness of the smartphone-based methods and a perspective on the methodology and validation. Additionally, recent developments and future research trends are also outlined.
Despite the persisting limitations resulting from technical difficulties and the complexity of the food sample matrix, smartphones will play an increasingly important role in popularizing the access to food analytical techniques for on-site analysis as a readily available and convenient integrated interface, connectivity and remote sensing platforms.
•Smartphones are a promising tool for non-invasive, portable food quality assessment.•New vistas are open by recent advances in network connectivity and machine learning.•Smartphones applications are in line with green and equitable chemistry.
Variability in medical practice in the United States leads to higher costs without achieving better patient outcomes. Clinical practice guidelines, which are intended to reduce variation and improve ...care, have several drawbacks that limit the extent of buy-in by clinicians. In contrast, standardized clinical assessment and management plans (SCAMPs) offer a clinician-designed approach to promoting care standardization that accommodates patients' individual differences, respects providers' clinical acumen, and keeps pace with the rapid growth of medical knowledge. Since early 2009 more than 12,000 patients have been enrolled in forty-nine SCAMPs in nine states and Washington, D.C. In one example, a SCAMP was credited with increasing clinicians' rate of compliance with a recommended specialist referral for children from 19.6 percent to 75 percent. In another example, SCAMPs were associated with an 11-51 percent decrease in total medical expenses for six conditions when compared with a historical cohort. Innovative tools such as SCAMPs should be carefully examined by policy makers searching for methods to promote the delivery of high-quality, cost-effective care.
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