Improving patient privacy and confidentiality in one regional Emergency Department – a quality project

Background: Patient privacy and confidentiality (PPaC) is an important consideration for nurses and other members of the health care team. Can a patient expect to have confidentiality and in particular privacy in the current climate of emergency health care? Do staff who work in the Emergency Department (ED) see confidentiality as an important factor when providing emergency care? These questions are important to consider. Methods: This is a two phased quality improvement project, developed and implemented over a six month period in a busy regional, tertiary referral ED. Results: Issues identified for this department included department design and layout, overcrowding due to patient flow and access block, staff practices and department policies which were also impacted upon by culture of the team, and use of space. Conclusions: Changes successful in improving this issue include increased staff awareness about PPaC, intercom paging prior to nursing handover to remove visitors during handover, one visitor per patient policy, designated places for handover, allocated bed space for patient reviews/assessment and a strategy to temporarily move the patient if procedures would have been undertaken in shared bed space. These are important issues when considering policy, practice and department design in the ED.

Nurses driving change to improve access to education and quality in lcinical teaching : A partnership between Australia and Viet Nam

In Viet Nam, standards of nursing care fail to meet international competency standards. This increases risks to patient safety (eg. hospital acquired infection), consequently the Ministry of Health identified the need to strengthen nurse education in Viet Nam. This paper presents experiences of a piloted clinical teaching model developed in Ha Noi, to strengthen nurse led institutional capacity for in-service education and clinical teaching. Historically 90% of nursing education was conducted by physicians and professional development in hospitals for nurses was limited. There was minimal communication between hospitals and nursing schools about expectations of students and assessment and quality of the learning experience. As a result when students came to the clinical sites, no-one understood how to plan their learning objectives and utilise teaching and learning approaches appropriate to their level. Therefore student learning outcomes were variable. They focussed on procedures and techniques and “learning how to do” rather than learning how to plan, implement and evaluate patient care. This project is part of a multi-component capacity building program designed to improve nurse education in Viet Nam. The project was funded jointly by Queensland University of Technology (QUT) and the Australian Agency for International Development. Its aim was to develop a collaborative clinically-based model of teaching to create an environment that encourages evidence-based, student-centred clinical learning. Accordingly, strategies introduced promoted clinical teaching of competency based nursing practice utilising the regionally endorsed nurse core competency standards. Thirty nurse teachers from Viet Duc University Hospital and Hanoi Medical College participated in the program. These nurses and nurse teachers undertook face to face education in three workshops, and completed three assessment items. Assessment was applied, where participants integrated the concepts learned in each workshop and completed assessment tasks related to planning, implementing and evaluating teaching in the clinical area. Twenty of these participants were then selected to undertake a two week study tour in Brisbane, Australia where the clinical teaching model was refined and an action plan developed to integrate into both organisations with possible implementation across Viet Nam. Participants on this study tour also experienced clinical teaching and learning at QUT by attending classes held at the university, and were able to visit selected hospitals to experience clinical teaching in these settings as well. Effectiveness of the project was measured throughout the implementation phase and in follow up visits to the clinical site. To date changes have been noted on an individual and organisational level. There is also significant planning underway to incorporate the clinical teaching model developed across the organisation and how this may be implemented in other regions. Two participants have also been involved in disseminating aspects of this approach to clinical teaching in Ho Chi Minh, with further plans for more in-depth dissemination to occur throughout the country.

Assessment of requirements for establishment of a framework to enhance implementation of quality practices in building projects

Quality, in construction projects should be regarded as the fulfillment of expectation of those contributors involved in such projects. Although a significant amount of quality practices have been introduced within the industry, attainment of reasonable levels of quality in construction projects continues to be an ongoing problem. To date, some research into the introduction and improvement of quality practices and stakeholder management has been undertaken, but so far no major studies have been completed that comprehensively examine how greater consideration of stakeholders’ perspectives of quality can be used to contribute to final project quality outcomes. This paper aims to examine the requirements for development of a framework leading to more effective involvement of stakeholders in quality planning and practices thus ultimately contributing to higher quality outcomes for construction projects. Through an extensive literature review it highlights various perceptions of quality, categorizes quality issues with particular focus on benefits and shortcomings and also examines the viewpoints of major stakeholders on project quality. It proposes a set of criteria to be used as a basis for a quality practice improvement framework, which will provide project managers and owners with the required information and strategic direction to achieve their own and their stakeholders’ targets for implementation of quality practices leading to the achievement of improved quality outcomes on future projects.

Quality management system and construction performance

This paper discusses the level of effectiveness of quality principles and quality management system implementation and the relationship with performance of ISO9000 certified Indonesian contractors. It also discusses the statistical relationship between quality management systems (QMSs) and key performance indicators (KPIs) amongst a large sample of Indonesian construction companies. Data collected is from questionnaire surveys involving Quality Managers, Managers, and Project and Site Engineers representing 77 different companies. Results indicate that even though some contractors have not yet effectively implemented an effective QMS, most of the KPIs of respondent companies are still at the level of high performance. The statistical results show that the relationship between variables of ISO9000 QMS principles and contractors’ KPIs is significant. These results suggest that an increment in the implementation level of QMS principles can increase KPIs, however that much effort is still required for Indonesian contractors to fully effectively implement QMS principles and thus substantially improve performance against KPIs.

Cost efficiency v quality service : using CHAT as a tool for understanding change and transformation in work practices

This chapter provides an analysis of feedback from key stakeholders, collected as part of a research project, on the problems and tensions evident in the collective work practices of learning advisers employed in learning assistance services at an Australian metropolitan university (Peach, 2003). The term 'learning assistance' is used in the Australian higher education sector generally to refer to student support services that include assistance with academic writing and other study skills. The aim of the study was to help learning advisers and other key stakeholders develop a better understanding of the work activity with a view to using this understanding to generate improvements in service provision. Over twenty problems and associated tensions were identified through stakeholder feedback however the focus of this chapter is the analysis of tensions related to a cluster of problems referred to as cost-efficiency versus quality service. Theoretical modelling derived from the tools made available through cultural historical activity theory and expansive visibilsation (Engestrom and Miettinen, 1999) and excerpts from data are used to illustrate how different understandings of the purpose of learning assistance services impacts on the work practices of learning advisers and creates problems and tensions in relation to the type of service available (including use of technology),level of service available, and learning adviser workload.

Impact of urban traffic and climate change on water quality from road runoff

Urban traffic and climate change are two phenomena that have the potential to degrade urban water quality by influencing the build-up and wash-off of pollutants, respectively. However, limited knowledge has made it difficult to establish any link between pollutant buildup and wash-off under such dynamic conditions. In order to safeguard urban water quality, adaptive water quality mitigation measures are required. In this research, pollutant build-up and wash-off have been investigated from a dynamic point of view which incorporated the impacts of changed urban traffic as well as changes in the rainfall characteristics induced by climate change. The study has developed a dynamic object classification system and thereby, conceptualised the study of pollutant build-up and wash-off under future changes in urban traffic and rainfall characteristics. This study has also characterised the buildup and wash-off processes of traffic generated heavy metals, volatile, semi-volatile and non-volatile hydrocarbons under dynamic conditions which enables the development of adaptive mitigation measures for water quality. Additionally, predictive frameworks for the build-up and wash-off of some pollutants have also been developed.

Managing product quality and reliability under new challenges

This paper presents the findings of an investigation of the challenges Australian manufacturers are currently facing. A comprehensive questionnaire survey was conducted among leading Australian manufacturers. This paper reports the main findings of this study. Evidence indicates that product quality and reliability (Q & R) are the main challenges for Australian manufacturers. Design capability and time to market came second. Results show that there is no effective information exchange between the parties involved in production and quality control. Learning from the past mistakes is not proving to have significant effects on improving product quality. The technological innovation speed is high and companies are introducing as many as 5 new products in a year. This technological speed has pressure on the Q & R of new products. To overcome the new challenges, companies need a Q & R improvement model.

Investigating relationships between relationship quality, customer loyalty and cooperation : an empirical study of convenience stores' franchise chain systems

Small business has been shown to contribute significantly to a nation’s economic development. Small business owners typically confront challenges, uncertainty, and risks while operating new businesses. Franchising has become a way to minimize the risks of small business management (Chiou et al., 2004); however, a franchise system is not a guarantee of business success (Lee and Karkovista, 2001). A poor franchising relationship between franchisors and franchisees can result in franchise failure, such as termination and closure, or franchisee exit (Frazer and Winzar, 2005).

Saving bitrate vs. pleasing users : where is the break-even point in mobile video quality?

This paper presents a comprehensive study to find the most efficient bitrate requirement to deliver mobile video that optimizes bandwidth, while at the same time maintains good user viewing experience. In the study, forty participants were asked to choose the lowest quality video that would still provide for a comfortable and long-term viewing experience, knowing that higher video quality is more expensive and bandwidth intensive. This paper proposes the lowest pleasing bitrates and corresponding encoding parameters for five different content types: cartoon, movie, music, news and sports. It also explores how the lowest pleasing quality is influenced by content type, image resolution, bitrate, and user gender, prior viewing experience, and preference. In addition, it analyzes the trajectory of users’ progression while selecting the lowest pleasing quality. The findings reveal that the lowest bitrate requirement for a pleasing viewing experience is much higher than that of the lowest acceptable quality. Users’ criteria for the lowest pleasing video quality are related to the video’s content features, as well as its usage purpose and the user’s personal preferences. These findings can provide video providers guidance on what quality they should offer to please mobile users.

Cross-cultural comparisons of health-related quality of life in Australian and Japanese midlife women

Objective: The purpose of this study was to address (1) the existence of an association between menopausal status and the health-related quality of life (HRQOL) in Australian and Japanese women and (2) the relative contributions of menopausal status, modifiable lifestyle risk factors, health, and sociodemographic factors on HRQOL. Design: The Australian and Japanese Midlife Women's Health Study (AJMWHS) was a multisite, population-based study conducted in 2001 to 2002. Measures were conducted on data collected from a survey questionnaire used for a sample of women from Australia and Japan. HRQOL was assessed with seven subscales from the Short Form-36. Results: The differences seen in physical functioning, general health, and vitality are significant. The results support an effect of country of residence on physical functioning and general health. The impact of menopausal status on HRQOL was significantly associated with bodily pain and role-emotional. The country of residence did have a modifying effect on the relationship between menopausal status and physical functioning. After control for confounders, there was a significant difference between Australian and Japanese women for HRQOL. Menopausal status was not associated with HRQOL in the areas of general health and physical functioning. Modifiable lifestyle risk factors contributed more highly to HRQOL for the Australian women than for the Japanese women. If the women had a lowered body mass index, undertook physical activity, consumed dietary phytoestrogens, and used alcohol, their physical functioning seemed to be better. Differences were seen in the contributions to HRQOL in these areas, with lower body mass index in the Australian women and physical activity in the Japanese women being the highest predictors. Somatic and psychological symptoms seem to negatively affect both Japanese and Australian women's physical functioning, contributing more than sociodemographic factors, menopausal status, and behavioral determinants combined to general health and physical functioning. Conclusions: It is important that that consideration be given to incorporating the same tool within the cross-cultural design of studies so that comparisons between cultures and patterns of healthy aging can be made. The research suggests that there seems to be variations across Australian and Japanese midlife women in some areas of HRQOL and some factors that contribute to these areas.

Associations between perception of wellness and health-related quality of life, comorbidities, modifiable lifestyle factors and demographics in older Australians

Aim: The associations between perceived wellness and health-related quality of life, comorbidities and modifiable lifestyle factors in older adults were explored. Methods: Self-administered questionnaires including the Perceived Wellness Survey and the 36-Item Short Form of the Medical Outcomes Study version two were distributed to 328 community-living adults aged 65 years and over. Results: Results showed positive associations between perception of wellness and health-related quality of life. General health (r(249) = 0.66, P < 0.01), vitality (r(249) = 0.59, P < 0.01) and mental health (r(249) = 0.52, P < 0.01) had the strongest association; and social functioning (r(249) = 0.3, P < 0.01) and pain (r(249) = 0.36, P < 0.01) the lowest. Perceived wellness was influenced by hearing, mobility, memory, chronic disease, exercise, gambling and single status. Conclusion: The study identified that perceived wellness in older adults is a multidimensional construct.

Perceptions of data quality dimensions and data roles

Several authors stress the importance of data’s crucial foundation for operational, tactical and strategic decisions (e.g., Redman 1998, Tee et al. 2007). Data provides the basis for decision making as data collection and processing is typically associated with reducing uncertainty in order to make more effective decisions (Daft and Lengel 1986). While the first series of investments of Information Systems/Information Technology (IS/IT) into organizations improved data collection, restricted computational capacity and limited processing power created challenges (Simon 1960). Fifty years on, capacity and processing problems are increasingly less relevant; in fact, the opposite exists. Determining data relevance and usefulness is complicated by increased data capture and storage capacity, as well as continual improvements in information processing capability. As the IT landscape changes, businesses are inundated with ever-increasing volumes of data from both internal and external sources available on both an ad-hoc and real-time basis. More data, however, does not necessarily translate into more effective and efficient organizations, nor does it increase the likelihood of better or timelier decisions. This raises questions about what data managers require to assist their decision making processes.

Quality management in construction projects

[Quality Management in Construction Projects by Abdul Razzak Rumane, CRC Press, Boca Raton, FL, 2011, 434 pp, ISBN 9781439838716] Issues of quality management, quality control and performance against specification have long been the focus of various business sectors. Recently there has been an additional drive to achieve the continuous improvement and customer satisfaction promised by the 20th-century ‘gurus’ some six or seven decades ago. The engineering and construction industries have generally taken somewhat longer than their counterparts in the manufacturing, service and production sectors to achieve these espoused levels of quality. The construction and engineering sectors stand to realize major rewards from better managing quality in projects. More effort is being put into instructing future participants in the industry as well as assisting existing professionals. This book comes at an opportune time.

Leveraging the network information for evaluating answer quality in a collaborative question answering portal

Collaborative question answering (cQA) portals such as Yahoo! Answers allow users as askers or answer authors to communicate, and exchange information through the asking and answering of questions in the network. In their current set-up, answers to a question are arranged in chronological order. For effective information retrieval, it will be advantageous to have the users’ answers ranked according to their quality. This paper proposes a novel approach of evaluating and ranking the users’answers and recommending the top-n quality answers to information seekers. The proposed approach is based on a user-reputation method which assigns a score to an answer reflecting its answer author’s reputation level in the network. The proposed approach is evaluated on a dataset collected from a live cQA, namely, Yahoo! Answers. To compare the results obtained by the non-content-based user-reputation method, experiments were also conducted with several content-based methods that assign a score to an answer reflecting its content quality. Various combinations of non-content and content-based scores were also used in comparing results. Empirical analysis shows that the proposed method is able to rank the users’ answers and recommend the top-n answers with good accuracy. Results of the proposed method outperform the content-based methods, various combinations, and the results obtained by the popular link analysis method, HITS.