Using clinical indicators in a quality improvement programme targeting cardiac care

Rationale. The Brisbane Cardiac Consortium, a quality improvement collaboration of clinicians from three hospitals and five divisions of general practice, developed and reported clinical indicators as measures of the quality of care received by patients with acute coronary syndromes or congestive heart failure. Development of indicators. An expert panel derived indicators that measured gaps between evidence and practice. Data collected from hospital records and general practice heart-check forms were used to calculate process and outcome indicators for each condition. Our indicators were reliable (kappa scores 0.7-1.0) and widely accepted by clinicians as having face validity. Independent review of indicator-failed, in-hospital cases revealed that, for 27 of 28 process indicators, clinically legitimate reasons for withholding specific interventions were found in

Maximal triangle trades with foundation 5 (mod 6) - the final case

The maximum possible volume of a simple, non-Steiner (v, 3, 2) trade was determined for all v by Xhosrovshahi and Torabi (Ars Combinatoria 51 (1999), 211-223), except that in the-case v equivalent to 5 (mod 6), v >= 23, they were only able to provide an upper, bound on the volume. In this paper we construct trades with volume equal to that bound for all v equivalent to 5 (mod 6), thus completing the problem.