Transportation system management, air quality, and energy conservation /

Mode of access: Internet.

Managing healthcare quality in project management framework

Healthcare professionals routinely deploy various quality management tools and techniques in order to improve performance of healthcare delivery. However, they are characterised by fragmented approach i.e., they are not linked with the strategic intent of the organisation. This study introduces a holistic quality improvement method, which integrates all quality improvement projects with the strategic intent of the healthcare organisations. It first identifies a healthcare system and its environment. The Strengths, Weaknesses, Opportunities and Threats (SWOT) of the system are then derived with the involvement of the concerned stakeholders. This leads to developing the strategies in order to satisfy customers in line with the organisation's competitive position. These strategies help identify a few projects, the implementation of which ensures achievement of desired quality. The projects are then prioritised with the involvement of the concerned stakeholders and implemented in order to improve the system performance. The effectiveness of the method has been demonstrated using a case study of an intensive care unit at the Eric Williams Medical Sciences Complex Hospital in Trinidad. Copyright © 2007 Inderscience Enterprises Ltd.

Strategy paradigms for the management of quality:dealing with complexity

Quality management is dominated by rational paradigms for the measurement and management of quality, but these paradigms start to “break down”, when faced with the inherent complexity of managing quality in intensely competitive changing environments. In this article, the various theoretical strategy paradigms employed to manage quality are reviewed and the advantages and limitations of these paradigms are highlighted. A major implication of this review is that when faced with complexity, an ideological stance to any single strategy paradigm for the management of quality is ineffective. A case study is used to demonstrate the need for an integrative multi-paradigm approach to the management of quality as complexity increases.

Water quality and plankton populations in an earthen polyculture pond

O presente estudo foi realizado durante um ano em viveiro de produção de peixes, com a finalidade de avaliar o efeito da qualidade da água na comunidade planctônica em função do manejo adotado. Maiores densidades de Euglenophyceae, Chlorophyceae e Cyanobacteria estiveram associadas aos elevados teores de nitrato (1 a 210 mg.L-1). Densidades de Cyanobacteria acima de 90 ind.m³ × 10³ (85,5%) ocorreram quando as concentrações de nitrato estiveram ao redor de 210 mg.L-1, fósforo total menor que 106 mg.L-1 e temperatura acima de 25 °C. Elevada densidade de Rotifera também esteve associada às altas densidades de Cyanobacteria (dezembro). Dentre os organismos zooplanctônicos, os Rotifera foram os mais abundantes e somente Trichocerca sp. foi constante em todos os pontos amostrados. Dentre os Cladocera, a espécie mais representativa foi Diaphanosoma birgei, variando de 4 a 342 ind.L-1 (0,7 e 2,4%) durante o período de estudo. Os resultados mostram que qualidade da água e o manejo empregado neste viveiro apresentaram influência direta na população planctônica, em função da baixa profundidade e constante carga de nutrientes que são incorporados no viveiro por meio de alimentos, fertilizantes e fezes de peixes, que contribuem para o aparecimento de organismos planctônicos não desejáveis.

Quality of life and neuropsychological changes in mild head trauma - Late analysis and correlation with S100B protein and cranial CT scan performed at hospital admission

Introduction: mild head trauma (MHT) is defined as a transient neurological deficit after trauma with a history of impairment or loss of consciousness lasting less than 15 min and/or posttraumatic amnesia, and a Glasgow Coma Scale between 13 and 15 on hospital admission. We evaluated 50 MHT patients 18 months after the trauma, addressing signs and symptoms of post-concussion syndrome, quality of life and the presence of anxiety and depression. We correlate those findings with the S100B protein levels and cranial CT scan performed at hospital admission after the trauma. Method: patients were asked to fill out questionnaires to assess quality of life (SF36), anxiety and depression (HADS), and signs and symptoms of post-concussion syndrome. For the control group, we asked the patient`s household members, who had no history of head trauma of any type, to answer the same questionnaires for comparison. Results: total quality of life index for patients with MHT was 58.16 (+/-5), lower than the 73.47 (+/-4) presented by the control group. Twenty patients (55.2%) and four (11.1%) controls were depressed. Seventeen patients (47.2%) presented anxiety, whereas only eight (22.2%) controls were considered anxious. Victims of MHT complained more frequently of loss of balance, dry mouth, pain in the arms, loss of memory and dizziness than their respective controls (p < 0.05). We found no correlation between the presence of these signs and symptoms, quality of life, presence of anxiety and depression with S100B protein levels or with presence of injury in the cranial CT performed at hospital admission. Conclusion: MHT is associated with a higher incidence of post-concussion syndrome symptoms, lower quality of life and anxiety than their respective controls even 18 months after the trauma. (C) 2007 Elsevier Ltd. All rights reserved.

Managing the Brisbane River and Moreton Bay: an integrated research/management program to reduce impacts on an Australian estuary

The Brisbane River and Moreton Bay Study, an interdisciplinary study of Moreton Bay and its major tributaries, was initiated to address water quality issues which link sewage and diffuse loading with environmental degradation. Runoff and deposition of fine-grained sediments into Moreton Bay, followed by resuspension, have been linked with increased turbidity and significant loss of seagrass habitat. Sewage-derived nutrient enrichment, particularly nitrogen (N), has been linked to algal blooms by sewage plume maps. Blooms of a marine cyanobacterium, Lyngbya majuscula, in Moreton Bay have resulted in significant impacts on human health (e.g., contact dermatitis) and ecological health (e.g., seagrass loss), and the availability of dissolved iron from acid sulfate soil runoff has been hypothesised. The impacts of catchment activities resulting in runoff of sediments, nutrients and dissolved iron on the health of the Moreton Bay waterways are addressed. The Study, established by 6 local councils in association with two state departments in 1994, forms a regional component of a national and state program to achieve ecologically sustainable use of the waterways by protecting and enhancing their health, while maintaining economic and social development. The Study framework illustrates a unique integrated approach to water quality management whereby scientific research, community participation and the strategy development were done in parallel with each other. This collaborative effort resulted in a water quality management strategy which focuses on the integration of socioeconomic and ecological values of the waterways. This work has led to significant cost savings in infrastructure by providing a clear focus on initiatives towards achieving healthy waterways. The Study's Stage 2 initiatives form the basis for this paper.

Certification and integration of management systems: the experience of Portuguese small and medium enterprises

The purpose of this study was to characterize the situation of Portuguese Small and Medium Enterprises (SMEs) concerning the certification of their Quality Management Systems (QMS), Environmental Management Systems (EMS) and Occupational Health and Safety Management Systems (OHSMS), in their individually form, to identify benefits, drawbacks and difficulties associated with the certification process and to characterize the level of integration that has been achieved. This research was based on a survey carried out by the research team; it was administered to 46 Portuguese SMEs. Our sample comprised 20 firms (43%) from the Trade/Services activity sector, 17 (37%) from the Industrial sector, 5 (11%) from the Electricity/Telecommunications sector and 4 (9%) from the Construction area. All SMEs surveyed were certified according to the ISO 9001 (100%), a quarter of firms were certified according to the ISO 14001 (26.1%) and a few certified by OHSAS 18001 (15.2%). We undertook a multivariate cluster analysis, which enabled grouping variables into homogeneous groups or one or more common characteristics of the SMEs participating in the study. Results show that the main benefits that Portuguese SMEs have gained from the referred certifications have been, among others, an improvement of both their internal organization and external image. We also present the main difficulties in achieving certification. Overall, 7 of the Portuguese SMEs examined indicated that the main benefits of the IMS implementation management included costs reduction, increased employee training and easier compliance of legislation. The respective drawbacks and difficulties are also presented. Finally, we presented the main integrated items in the certified Portuguese SMEs we examined.

The estimation of the return on firms’ investments – as to ISO 9001

The aim of this paper was to estimate the return on investment in QMS (quality management systems) certification undertaken in Portuguese firms, according to the ISO 9000 series. A total of 426 certified Portuguese firms were surveyed. The response rate was 61.03 percent. The different payback periods were validated through statistical analysis and the relationship between expected and perceived payback periods was discussed. This study suggests that a firm’s sector of activity, size and degree of internationalization are related to the length of the investment in QMS certification recovery period. Furthermore, our findings suggest, that the time taken to obtain the certification is not directly related to the economic component of the certification. The majority of Portuguese firms (58.9%) took up to three years to recoup their investment and 35.5% of companies said they had not yet recovered the initial investment made. The recoup of investment was measured by the increase in the number of customers and consequent volume of deliveries, improved profitability and productivity of the company, improvement of competitive position and performance (cost savings), reduction in the number of external complaints and internal defects/scrap, achievement of some important clientele, among others. We compared our work to similar studies undertaken in other countries. This paper provides a contribution to the research related to the return on investment for costs related to the certification QMS according to ISO 9000. This paper provides a valuable contribution to the field and is one of the first studies to undertake this type of analysis in Portugal.

Certification and integration of environment with quality and safety – a path to sustained success

According to Wright [1] certification of products and processes began during the 1960’s in the manufacturing industry, as a tool to control and assure the quality/conformity of products and services provided by suppliers to customers/consumers. Thus, the series of ISO 9000 was published first time, in 1987 and it was been created with a flexible character, to be reviewed periodically. Later, were published others normative references, which highlight the ISO 14001 in 1996 and OHSAS 18001 in 1999. This was also, the natural sequence of the certification processes in the organizations, i.e., began with the certification of quality management systems (QMS) followed by the environmental management systems (EMS) and after for the Occupational Health and Safety Management System (OHSMS). Hence, a high percentage of organizations with an EMS, in accordance with the ISO 14001, had also implemented, a certified QMS, in accordance with ISO 9001. At first the implementation of a QMS was particularly relevant in high demanding activity sectors, like the automotive and aeronautical industries, but it has rapidly extended to every activity sector, becoming a common requisite of any company worldwide and a factor of competitiveness and survival. Due to the increasingly demanding environmental legislation in developed countries, companies nowadays are required to seriously take into consideration not only environmental aspects associated to the production chain itself, but also to the life cycle of their products.

Motivation and Benefits of Implementation and Certification according ISO 9001 – the Portuguese Experience

The aim of the research is to analyze the different aspects associated with the motivation and benefits of certified ISO 9001 companies in Portugal. A total of 426 certified Portuguese companies were surveyed. The response rate was equal to 61.03 percent. Our results suggest that the main motivation for certification were “improvement of quality”, “improvement of company image”, “marketing advantage”, “give empowerment to workers / capturing workers knowledge” and “cost reduction”. The main benefits that Portuguese companies have gained from the referred certification have been, among others, the improvement of “procedures”, beneficial effect on the “company’s image”, the improvement of quality products/services, increase of the “customer satisfaction”, improvement of “on-time delivery”; improvement the “morale” of workers’ increase in productivity and decrease of “production costs”, among others. The surveyed firms belong only to the Minho region of the north of Portugal. This paper aims to provide a contribution to the research related to the motivation and benefits associated to the quality management systems. The selection of the motives and benefits were validated through statistical analysis and the relationship between expected and perceived benefits was discussed.

Integration of Individualized Management Systems (MSs) as an Aggregating Factor of Sustainable Value for Organizations: An Overview Through a Review of the Literature

Nowadays, there exist various standards for individual management systems (MSs), at least, one for each stakeholder. New ones will be published. An integrated management system (IMS) aims to integrate some or all components of the business into one coherent and efficient MS. Maximizing integration is more and more a strategic priority in that it constitutes an opportunity to eliminate and/or reduce potential factors of destruction of value for the organizations and also to be more competitive and consequently promote its sustainable success. A preliminary investigation was conducted on a Portuguese industrial company which, over the years, has been adopting gradually, in whole or in part, individualized management system standards (MSSs). A research, through a questionnaire, was performed with the objective to develop, in a real business environment, an adequate and efficient IMS-QES (quality, environment, and safety) model and to potentiate for the future a generic IMS model to integrate other MSSs. The strategy and research methods have taken into consideration the case study. It was obtained a set of relevant conclusions resulting from the statistical analyses of the responses to the survey. Globally, the investigation results, by themselves, justified and prioritized the conception of a model of development of the IMS-QES and consequent definition and validation of a structure of an IMS-QES model, to be implemented at the small- and medium-sized enterprise (SME) where the investigation was conducted.

Dependence relationship between the critical quality factors and social impact

This paper shows the results of the empirical study conducted in 186 tourist accommodation businesses in Spain certified under the "Q for Tourist Quality", own System Quality Management. It was raised with the purpose of analyzing the structure of the relationship between critical quality factors and results-social impact, how they operate and the level of their influence on obtaining these results within the company. Starting from a deep theoretical revision we propose a theoretical model together with the hypotheses to be tested, and we proceed to validation using the technique of Structural Equation Models. The results obtained show that companies wishing to improve their social impact should take into account that leadership is the most important factor to achieve it. Leadership indirectly affects the social impact through its influence on alliances and resources, quality policy/planning, personnel management and learning.

Quality perception in research laboratories from Fiocruz after QMS implementation

Quality Management System has been implemented at the René Rachou Research Center since 2003. This study investigated its importance for collaborators (Cs) in laboratories. This was a quantitative and descriptive study performed in a group of 113 collaborators. It was based on the World Health Organization handbook: Quality Practices in Basic Biomedical Research. The questionnaires evaluated the parameters using the Likert scale. Biosafety, training and ethics were considered to be the most important parameters. Supervision and quality assurance, data recording, study plan, SOPs and file storage achieved intermediate evaluation. The lower frequency of responses was obtained for result report, result verification, personnel and publishing practices. Understanding the perception of the collaborators allows the development of improvement actions aiming the construction of a training program directing strategies for disseminating quality.

Fatores influenciadores da gestão da qualidade e independência do auditor: um estudo de caso

Dissertação apresentada ao Instituto Superior de Contabilidade para obtenção do Grau de Mestre em Auditoria Orientada por: Doutora Alcina Dias

Quality of life, life satisfaction and happiness in shift- and non-shiftworkers

OBJECTIVE: To investigate the quality of life, life satisfaction, happiness and demands of work in workers with different work schedules. METHODS: The survey was carried out on professional workers in social care. Some were shiftworkers whose schedule included night shifts (N=311), some were shiftworkers without night shifts (N=207) and some were non-shiftworkers (N=1,210). Surveys were mailed and the response rate was 86%. For the purpose of this study several variables were selected from the Survey: The Quality of Life Profile, which measures importance, satisfaction, control and opportunities in nine domains of life plus measures of happiness, life satisfaction and demands of work. RESULTS: While both groups of shiftworkers, compared to non-shiftworkers, reported needing more physical effort to complete their work, and reported 'being' more physically tired, no differences were found in reports of overall happiness, life satisfaction or total quality of life. However, night-shiftworkers reported greater percentage of time unhappy than the other two groups of workers. In analyses of the quality of life, night-shiftworkers were less satisfied with domains of spiritual 'being' and physical and community 'belonging' than day-shiftworkers and non-shiftworkers. They also reported having fewer opportunities to improve their physical 'being', leisure, and personal growth than the other two groups. CONCLUSIONS: Quality of life in specific domains in night-shiftworkers was rated worse than in other groups of workers. Domain-based quality of life assessment gives more information regarding the particular needs of workers than overall or global measures of well-being.