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

Quality improvement in professional local government services : a longitudinal study

This sustained longitudinal study, carried out in a single local authority, investigates the implementation of a Total Quality Management (TQM) philosophy in professional local government services. At the start of this research, a large majority of what was written about TQM was polemical and based on limited empirical evidence. This thesis seeks to provide a significant and important piece of work, making a considerable contribution to the current state of knowledge in this area. Teams from four professional services within a single local authority participated in this research, providing the main evidence on how the quality management agenda in a local authority can be successfully implemented. To supplement this rich source of data, various other sources and methods of data collection have been used: 1) Interviews were carried out with senior managers from within the authority; 2) Customer focus groups and questionnaires were used; 3) Interviews were carried out with other organisations, all of which were proponents of a TQM philosophy. A number of tools have been developed to assist in gathering data: 1) The CSFs (critical success factors) benchmarking tool; 2) Five Stages of Quality Improvement Model. A Best Practice Quality Improvement Model, arising from an analysis of the literature and the researcher's own experience is proposed and tested. From the results a number of significant conclusions have been drawn relating to: 1) Triggers for change; 2) Resistance of local government professionals to change 3) Critical success factors and barriers to quality improvement in professional local government services; 4) The problems associated with participant observation and other methodological issues used.

Power quality improvements for LV networks

In order to increase the capacity of the existing Low Voltage grid, one solution is to increase the nominal residential network voltage from 230 V to 300 V, which is easily accommodated within the voltage rating of existing infrastructure such as cabling. A power electronic AC-AC converter would then be used to step the voltage back down to 230 V at an individual property. Such equipment could also be used to provide power quality improvements on both the utility and customer side of the converter depending on its topology. This paper provides an overview of a project which is looking at the development of such a device. The project is being carried out in collaboration with the local UK, Distribution Network Operator (DNO).

Simulation of power quality issues in more electric aircraft actuator supplies

To examine the detailed operation of the power distribution network in a future more electric aircraft that employs electric actuation systems, a Micro-Cap SPICE simulation is developed for one of the essential buses. Particular attention is paid to model accurately the most important effects that influence system power quality. Representative system and flight data are used to illustrate the operation of the simulation and to assess the power quality conditions within the network as the flight control surfaces are deployed. The results illustrate the importance of correct cable sizing to ensure stable operation of actuators during transient conditions.

Quality Improvement through Experiments with Mixtures

Mixture experiments are typical for chemical, food, metallurgical and other industries. The aim of these experiments is to find optimal component proportions that provide desired values of some product performance characteristics.

Directing the Continuous Quality Improvement Effort

The continuous quality improvement (CQI) efforts at the Lodge and Conference Center at Grand National, Opelika, Alabama, involve a range of strategies, policies, and practices enacted by the current management team to lift the service game and enhance the overall quality and value for money appeal of the guest experience. The authors report findings of a recently conducted study on this issue.