3 resultados para Performance measurement (quality)
Resumo:
Introduction
Evaluating quality of palliative day services is essential for assessing care across diverse settings, and for monitoring quality improvement approaches.
Aim
To develop a set of quality indicators for assessment of all aspects (structure, process and outcome) of care in palliative day services.
Methods
Using a modified version of the RAND/UCLA appropriateness method (Fitch et al., 2001), a multidisciplinary panel of 16 experts independently completed a survey rating the appropriateness of 182 potential quality indicators previously identified during a systematic evidence review. Panel members then attended a one day, face-to-face meeting where indicators were discussed and subsequently re-rated. Panel members were also asked to rate the feasibility and necessity of measuring each indicator.
Results
71 indicators classified as inappropriate during the survey were removed based on median appropriateness ratings and level of agreement. Following the panel discussions, a further 60 were removed based on appropriateness and feasibility ratings, level of agreement and assessment of necessity. Themes identified during the panel discussion and findings of the evidence review were used to translate the remaining 51 indicators into a final set of 27.
Conclusion
The final indicator set included information on rationale and supporting evidence, methods of assessment, risk adjustment, and recommended performance levels. Further implementation work will test the suitability of this ‘toolkit’ for measurement and benchmarking. The final indicator set provides the basis for standardised assessment of quality across services, including care delivered in community and primary care settings.
Reference
• Fitch K, Bernstein SJ, Aguilar MD, et al. The RAND/UCLA Appropriateness Method User’s Manual. Santa Monica, CA: RAND Corporation; 2001. http://www.rand.org/pubs/monograph_reports/MR1269
Resumo:
Sea lice continue to be one of the largest issues for the salmon farming industry and the use of ballan wrasse (Labrus bergylta) as a biological control is considered to be one of the most sustainable solutions in development. Broodstock management has proved challenging in the initial phases due to the significant lack of understanding of basic reproductive physiology and behaviour in the species. The aim of the study was to monitor captive breeding populations throughout a spawning season to examine timing and duration of spawning,quantify egg production, and look at seasonal changes in egg quality parameters as well as investigate the parental contribution to spawning events. A clear spawning rhythm was shown with 3-5 spawning periods inclusive of spawning windows lasting 1-9 days followed by inter spawning intervals of 8-12 days. Fertilization rate remained consistently high (> 87.5%) over the spawning season and did not differ significantly between spawning populations. Hatch rate was variable (0-97.5 %), but peaked in the middle of the spawning season. Meanoocyte diameter and gum layer thickness decreased slightly over the spawning season with no significant differences between spawning populations. Fatty acid (FA) profile of eggs remained consistent throughout the season and with the exception of high levels of ARA (3.8 ± 0.5 % of total FA) the FA profile was similar to that observed in other marine fish species. Parental contribution analysis showed 3 out of 6 spawning events to be single paired mating while the remaining 3 had contributions from multiple parents. Furthermore, the proposed multiple batch spawning nature of this species was confirmed with proof of a single femalecontributing to two separate spawning events. Overall this work represents the first comprehensive data set of spawning activity of captive ballan wrasse, and as such and will be helpful in formulating sustainable broodstock management plans for the species.
