Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this stud...Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.展开更多
Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and fnancing. Different tools have been developed, incl...Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and fnancing. Different tools have been developed, includ-ing incident analysis, health technology assessment and clinical audit. The clinical audit consist of mea-suring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the ef-fectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.展开更多
Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form th...Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.展开更多
University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development ...University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development of student Party branches and enhance the effectiveness of student Party member education and training.This paper summarizes and analyzes the issues in the construction of student Party branches in universities and explores strategies for improving their quality,aiming to provide a reference for relevant personnel.展开更多
Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for...Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for SLRT. However, making a large-scale and diverse sign language dataset is difficult as sign language data on the Internet is scarce. In making a large-scale and diverse sign language dataset, some sign language data qualities are not up to standard. This paper proposes a two information streams transformer(TIST) model to judge whether the quality of sign language data is qualified. To verify that TIST effectively improves sign language recognition(SLR), we make two datasets, the screened dataset and the unscreened dataset. In this experiment, this paper uses visual alignment constraint(VAC) as the baseline model. The experimental results show that the screened dataset can achieve better word error rate(WER) than the unscreened dataset.展开更多
The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective ...The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds.展开更多
The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention...The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.展开更多
To improve the quality of the illumination distribution,one novel indoor visible light communication(VLC)system,which is jointly assisted by the angle-diversity transceivers and simultaneous transmission and reflectio...To improve the quality of the illumination distribution,one novel indoor visible light communication(VLC)system,which is jointly assisted by the angle-diversity transceivers and simultaneous transmission and reflection-intelligent reflecting surface(STAR-IRS),has been proposed in this work.A Harris Hawks optimizer algorithm(HHOA)-based two-stage alternating iteration algorithm(TSAIA)is presented to jointly optimize the magnitude and uniformity of the received optical power.Besides,to demonstrate the superiority of the proposed strategy,several benchmark schemes are simulated and compared.Results showed that compared to other optimization strategies,the TSAIA scheme is more capable of balancing the average value and variance of the received optical power,when the maximal ratio combining(MRC)strategy is adopted at the receiver.Moreover,as the number of the STAR-IRS elements increases,the optical power variance of the system optimized by TSAIA scheme would become smaller while the average optical power would get larger.This study will benefit the design of received optical power distribution for indoor VLC systems.展开更多
High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 syst...High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 system. Mutation efficiency varied with genetic background in the T_0 generation, and GPC in the T_1 generation decreased significantly,owing mainly to a reduction in glutelin content. Amylose content was down-regulated significantly in some Osaap6 and all Osaap10 mutants. The increased taste value of these mutants was supported by Rapid Visco Analysis(RVA) profiles, which showed higher peak viscosity and breakdown viscosity and lower setback viscosity than the wild type. There were no significant deficiencies in agronomic traits of the mutants. Targeted mutagenesis of OsAAP6 and OsAAP10, especially OsAAP10, using the CRISPR/Cas9 system can rapidly reduce GPC and improve ECQ of rice, providing a new strategy for the breeding cultivars with desired ECQ.展开更多
This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improveme...This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improvement at a catchment scale. The experimental field-scale wetland systems （four sets, 0.88 ha each） have been in operation since 2002, where water depth was maintained at 30-50 cm and hydraulic loading rate was at 6.3-18.8 cm/day. The wetland system was found to be adequate for treating polluted stream water with stable removal efficiency even during the winter. The integrated modeling system （modified-BASINS） was applied to the Seokmoon estuarine reservoir watershed and calibrated with monitoring data from constructed wetland, stream, and reservoir. The calibrated integrated modeling system estimated that constructing wetlands on 0.5% （about 114 ha） of the watershed area at the mouth of reservoir could reduce 11.61% and 13.49% of total external nitrogen and phosphorus loads, respectively. It also might improve the nitrogen and phosphorus concentration of the reservoir by 9.69% and 16.48%, respectively. The study suggested that about 0.1%-1.0% of the watershed area should be allocated for constructed wetland to meet specified water-quality standards for the estuarine reservoir at the polder area where land use planning is relatively less complicated.展开更多
japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of ...japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.展开更多
The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes...The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes the effect of industrial big data and artificial intelligence in industrial energy system.The real-time data of blast furnace gas(BFG)generation collected in iron and steel sites are also of low quality.In order to tackle this problem,a three-stage data quality improvement strategy was proposed to predict the BFG generation.In the first stage,correlation principle was used to test the sample set.In the second stage,the original sample set was rectified and updated.In the third stage,Kalman filter was employed to eliminate the noise of the updated sample set.The method was verified by autoregressive integrated moving average model,back propagation neural network model and long short-term memory model.The results show that the prediction model based on the proposed three-stage data quality improvement method performs well.Long short-term memory model has the best prediction performance,with a mean absolute error of 17.85 m3/min,a mean absolute percentage error of 0.21%,and an R squared of 95.17%.展开更多
Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy stra...Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.展开更多
Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper ...Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.展开更多
To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base popula...To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base population, which fits to our ecology type was constructed by 6 years＇ gene enrichment through the introduction of new genes from 23 local varieties and recurrent selection. The LD-base populations were then improved by making crosses with high protein and high oil genotypes. As a result we obtained a high protein sub-population （db） and a high oil sub-population （gy）, For the db sub-population, the protein content is 1.18% higher than the base population, 22.38% of the individuals contain 45% or more of protein, which is 10.99% higher than the base population. For the gy sub-population, oil content is 0.24% higher than the base population. Individuals with oil content of 20% or more are 11.05% higher than the base population. The quantitative characters such as flowering date, mature date, pod habit, and hilum color, etc., all showed wide range of separation, and the segregation ratio approached balance. The c.v. of branch number of ms1 recurrent population （72.8%） is higher than general cross-population （57.3%）, and the c.v. of 100 seed weight of ms1 （18.1%） is higher than general cross population （16.5%）, the coefficient of variation of plant height, pods per plant, and seeds per pod were not significantly different. It was demonstrated in this paper that the quality character of ms 1 male sterile recurrent selection population was improved by adding new genes. And the segregation of other characters widened, making the populations suitable for the objective of soybean breeding. In this paper, we also discussed the breeding method, key technology, and selection effect of soybean ms 1 population.展开更多
BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for ...BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.展开更多
The dairy herd improvement data from Henan Province were analyzed statistically to establish screening criteria for relevant data, thereby laying a foundation for genetic evaluation of dairy cows. With the 2 152 451 t...The dairy herd improvement data from Henan Province were analyzed statistically to establish screening criteria for relevant data, thereby laying a foundation for genetic evaluation of dairy cows. With the 2 152 451 test-day records about 155 893 Chinese Holstein dairy cows collected by the Henan Dairy Herd Improvement Center from January 2008 to April 2016, the dynamics of test times during a complete lactation, test interval during a complete lactation, days in milk （DIM） of first test-day record, daughter descendant number and herd number of bull, age at first calving and pedigree integrity rate among different years and different herd sizes were analyzed by MEANS order of SAS 9.4. In addition, the data that were applicable to genetic evaluation were screened by SQL program. The results showed that during 2008-2015, the number of cow individuals participating in DHI in Henan Province increased from 7 379 to 93 706; the test-day milk yield increased from 19.91 to 24.05 kg; the somatic cell count reduced from 411.09×10^3 to 277.08×10^3 cells/ml; the percentage of cows with DIM ranging from 5-305 d reached 70.92%; the average test times increased from 3.20 to 6.31 times; the test interval decreased from 70.22 to 33.83 d; the dairy cows with age at first calving of 25 months were dominant, accounting for 12.57%; the bulls whose daughter descendant number was 20 or more and the daughters were distributed in 10 or more farms accounted for 6.05%; the one-generation pedigree integrity rate was 82.54%; the percentage of data that could be used for genetic evaluation was screened as 20.67%, which was lower than the results of other similar studies.展开更多
<b>Introduction:</b> Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression ...<b>Introduction:</b> Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. <b>Method:</b> Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. <b>Results:</b> The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. <b>Conclusion:</b> The use of quality improvement in addressing gaps in HIV service delivery is highly effective.展开更多
The relationship between major quality tools such as quality function development （QFD）, failure mode and effects analysis （FMEA）, design of experiments （DOE） and statistical process control （SPC） is analyzed ...The relationship between major quality tools such as quality function development （QFD）, failure mode and effects analysis （FMEA）, design of experiments （DOE） and statistical process control （SPC） is analyzed through an extensive review of the literature and the concurrent quality engineering philosophy, and a basic structure for the integration of quality tools is presented. An integrated quality management system （IQMS） is developed using C＋＋ Builder, running in the Windows 2000 Server environment with the basic internet connections, and SQL Server 2000 as the platform for developing the database, An illustrative example applying IQMS to the continuous quality improvement for a crane equipment manufacturing is reported. The result shows that the application of IQMS can optimize the process of design and manufacturing, shorten the cycle time of product, reduce the cost, and realize quality improvement continuously, The proposed integrated framework with IOMS is believed to be applicable to continuous quality improvement in many manufacturing companies.展开更多
BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to r...BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED.METHODS:In 2009,a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems.RESULTS:Responsible officers were assigned to look after seven error-prone areas.Strategies were proposed,discussed,endorsed and promulgated to eliminate the problems identified.A reduction of medication incidents(Ml) from 16 to 6 was achieved before and after the improvement work.CONCLUSION:This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.展开更多
文摘Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.
文摘Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and fnancing. Different tools have been developed, includ-ing incident analysis, health technology assessment and clinical audit. The clinical audit consist of mea-suring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the ef-fectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.
文摘Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.
文摘University student Party branches serve as the Party’s grassroots organizations within universities and act as a bridge and link between the Party and students.Therefore,it is essential to strengthen the development of student Party branches and enhance the effectiveness of student Party member education and training.This paper summarizes and analyzes the issues in the construction of student Party branches in universities and explores strategies for improving their quality,aiming to provide a reference for relevant personnel.
基金supported by the National Language Commission to research on sign language data specifications for artificial intelligence applications and test standards for language service translation systems (No.ZDI145-70)。
文摘Sign language dataset is essential in sign language recognition and translation(SLRT). Current public sign language datasets are small and lack diversity, which does not meet the practical application requirements for SLRT. However, making a large-scale and diverse sign language dataset is difficult as sign language data on the Internet is scarce. In making a large-scale and diverse sign language dataset, some sign language data qualities are not up to standard. This paper proposes a two information streams transformer(TIST) model to judge whether the quality of sign language data is qualified. To verify that TIST effectively improves sign language recognition(SLR), we make two datasets, the screened dataset and the unscreened dataset. In this experiment, this paper uses visual alignment constraint(VAC) as the baseline model. The experimental results show that the screened dataset can achieve better word error rate(WER) than the unscreened dataset.
文摘The efficiency of phytosynthetic bacteria (PSB) to improve the water quality in saline alkali ponds was studied, the result showed that (1) PSB application could increase the content of DO, NO\+-\-3\|N and effective phosphorus (EP) in ponds; (2) the changes of COD were not evident, just effective in later period after PSB application; (3) PSB application could decrease the contents of NH\+-\-4\|N (NH\-3\|N), NO\+-\-2\|N ; (4) PSB application could improve the structure of the effective nitrogen (EN) and EP, stimulate the growth of phytoplankton, and increase primary productivity, and finally increase the commercial profits of ponds because of the increase of EP and the decrease of EN contents; (5) the effect exerting speed of PSB was slower, but the effect sustaining time was longer; (6) the appropriate concentration of PSB application in saline alkali wetland ponds was 10×10 -6 mg/L, one time effective period was more than 15 days. So PSB was an efficient water quality improver in saline alkali ponds.
基金supported by the National Natural Science Foundation of China(No.41807386)Tianjin Financial Budget Project of 2018。
文摘The Yongding New River is essential for the water supplies of Tianjin.To date,there is no comprehensive report that assesses the year-round water quality of the Yongding New River Main stream.Moreover,little attention has been given to determining a combined weight for improving the traditional comprehensive water quality identification index(ICWQII)by the game theory.Seven water quality parameters were investigated monthly along the main stream of the Yongding New River from May 2018 to April 2019.Organic contaminants and nitrogen pollution were mainly caused by point sources pollution,and the total phosphorus mainly by non-point source pollution.Dramatic spatio-temporal variations of water quality parameters were jointly caused by different pollutant sources and hydrometeorological factors.In terms of this study,an improved comprehensive water quality identification index(ICWQII)based on entropy weight or variation coefficient and traditional CWQII underestimated the water qualities,and an ICWQII based on the superstandard multiple method overvalued the assessments.By contrast,water qualities assessments done with an ICWQII based on the game theory matched perfectly with the practical situation.The ICWQII based on game theory proposed in this study takes into account not only the degree of disorder and variation of water quality data,but also the influence of standard-exceeded pollution indicators,whose results are relatively reasonable.All findings and the ICWQII based on game theory can provide scientific support for decisions related to the water environment management of the Yongding New River and other waters.
基金supported by the National Natural Science Foundation of China(No.62071365)the Key Research and Development Program of Shaanxi Province(No.2017ZDCXL-GY-06-02).
文摘To improve the quality of the illumination distribution,one novel indoor visible light communication(VLC)system,which is jointly assisted by the angle-diversity transceivers and simultaneous transmission and reflection-intelligent reflecting surface(STAR-IRS),has been proposed in this work.A Harris Hawks optimizer algorithm(HHOA)-based two-stage alternating iteration algorithm(TSAIA)is presented to jointly optimize the magnitude and uniformity of the received optical power.Besides,to demonstrate the superiority of the proposed strategy,several benchmark schemes are simulated and compared.Results showed that compared to other optimization strategies,the TSAIA scheme is more capable of balancing the average value and variance of the received optical power,when the maximal ratio combining(MRC)strategy is adopted at the receiver.Moreover,as the number of the STAR-IRS elements increases,the optical power variance of the system optimized by TSAIA scheme would become smaller while the average optical power would get larger.This study will benefit the design of received optical power distribution for indoor VLC systems.
基金financially supported by National Key Research and Development Program of China(2016YFD0100501)the National Natural Science Foundation of China(31871241,31371233)+3 种基金the Natural Science Foundation of Jiangsu Province(BE2017345,PZCZ201702,BE2018351)the Research and Innovation Program of Postgraduate in Jiangsu Province(KYCX17_1886)the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Yangzhou University International Academic Exchange Fund。
文摘High grain protein content(GPC) reduces rice eating and cooking quality(ECQ). We generated OsAAP6 and OsAAP10 knockout mutants in three high-yielding japonica varieties and one japonica line using the CRISPR/Cas9 system. Mutation efficiency varied with genetic background in the T_0 generation, and GPC in the T_1 generation decreased significantly,owing mainly to a reduction in glutelin content. Amylose content was down-regulated significantly in some Osaap6 and all Osaap10 mutants. The increased taste value of these mutants was supported by Rapid Visco Analysis(RVA) profiles, which showed higher peak viscosity and breakdown viscosity and lower setback viscosity than the wild type. There were no significant deficiencies in agronomic traits of the mutants. Targeted mutagenesis of OsAAP6 and OsAAP10, especially OsAAP10, using the CRISPR/Cas9 system can rapidly reduce GPC and improve ECQ of rice, providing a new strategy for the breeding cultivars with desired ECQ.
文摘This article describes the integrated modeling approach for planning the size and the operation of constructed wetlands for maximizing retention of nonpoint source pollutant loads and reservoir water-quality improvement at a catchment scale. The experimental field-scale wetland systems （four sets, 0.88 ha each） have been in operation since 2002, where water depth was maintained at 30-50 cm and hydraulic loading rate was at 6.3-18.8 cm/day. The wetland system was found to be adequate for treating polluted stream water with stable removal efficiency even during the winter. The integrated modeling system （modified-BASINS） was applied to the Seokmoon estuarine reservoir watershed and calibrated with monitoring data from constructed wetland, stream, and reservoir. The calibrated integrated modeling system estimated that constructing wetlands on 0.5% （about 114 ha） of the watershed area at the mouth of reservoir could reduce 11.61% and 13.49% of total external nitrogen and phosphorus loads, respectively. It also might improve the nitrogen and phosphorus concentration of the reservoir by 9.69% and 16.48%, respectively. The study suggested that about 0.1%-1.0% of the watershed area should be allocated for constructed wetland to meet specified water-quality standards for the estuarine reservoir at the polder area where land use planning is relatively less complicated.
基金sponsored by the National Natural Science Foundation of China(31371587,31430062)the Cultivation Plan for Youth Agricultural Science Technology Innovative Talents of Liaoning Province,China(2015035,2015036)the Program for Changjiang Scholars and Innovative Research Team in University,China(IRT13079)
文摘japonica rice is mainly distributed in Northeast China and accounts for 44.6% of the total cultivated area of japonica rice in China. The comprehensive using of inter-subspecies heterosis is the main breeding mode of super japonica rice varieties in this region. Improving rice quality at relative high yielding level is the current research focus. Performing crosses between indica and japonica lines allows for the recombination of regulatory genes and genetic backgrounds, leading to complicated genetic rice quality characteristics, which can be used to explore patterns of quality improvement. In the present study, we utilize recombinant inbred lines （RILs） derived from indica-japonica hybridization to analyze the effect factors of rice quality derived from genetic factors, which contain both regulatory genes concerning rice quality and genetic backgrounds＇ random introduction frequency coming from indica （Di value）, and the improvement strategy was further discussed. The regulatory genes involved in amylase content （Wx） and nitrogen utilization efficiency （NRT1.1B） were the major factors affecting the amylose content （AC） and protein content （PC） in RILs, respectively. Both the Di value and the major grain width gene （GS5） had regulatory effects on milled rice width （MRW） in RILs, and their interaction explained the major variance of MRW in the RILs. With the mediation of MRW and chalkiness degree （C）, Di value had a further impact on head rice rate （HR）, which was relatively poor when the Di value was over 40%. In Northeast China, the Di value should be lowered by backcrossing or multiple crosses during the breeding of indica-japonica hybridization to maintain the whole better HR and further to emphasize the use of favorable genes in individual selection.
基金supported by the National Natural Science Foundation of China(51734004 and 51704069).
文摘The real-time energy flow data obtained in industrial production processes are usually of low quality.It is difficult to accurately predict the short-term energy flow profile by using these field data,which diminishes the effect of industrial big data and artificial intelligence in industrial energy system.The real-time data of blast furnace gas(BFG)generation collected in iron and steel sites are also of low quality.In order to tackle this problem,a three-stage data quality improvement strategy was proposed to predict the BFG generation.In the first stage,correlation principle was used to test the sample set.In the second stage,the original sample set was rectified and updated.In the third stage,Kalman filter was employed to eliminate the noise of the updated sample set.The method was verified by autoregressive integrated moving average model,back propagation neural network model and long short-term memory model.The results show that the prediction model based on the proposed three-stage data quality improvement method performs well.Long short-term memory model has the best prediction performance,with a mean absolute error of 17.85 m3/min,a mean absolute percentage error of 0.21%,and an R squared of 95.17%.
基金supported by Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY448).
文摘Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.
基金This work is supported by an unrestricted innovation research grant of the Amsterdam UMC,location Academic Medical Center in Amsterdam,the Netherlands
文摘Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.
文摘To solve the problem that soybean has narrow genetic base, we constructed a series of male sterile recurrent selection populations, and studied the effects of quality improvement and practical value. An LD-base population, which fits to our ecology type was constructed by 6 years＇ gene enrichment through the introduction of new genes from 23 local varieties and recurrent selection. The LD-base populations were then improved by making crosses with high protein and high oil genotypes. As a result we obtained a high protein sub-population （db） and a high oil sub-population （gy）, For the db sub-population, the protein content is 1.18% higher than the base population, 22.38% of the individuals contain 45% or more of protein, which is 10.99% higher than the base population. For the gy sub-population, oil content is 0.24% higher than the base population. Individuals with oil content of 20% or more are 11.05% higher than the base population. The quantitative characters such as flowering date, mature date, pod habit, and hilum color, etc., all showed wide range of separation, and the segregation ratio approached balance. The c.v. of branch number of ms1 recurrent population （72.8%） is higher than general cross-population （57.3%）, and the c.v. of 100 seed weight of ms1 （18.1%） is higher than general cross population （16.5%）, the coefficient of variation of plant height, pods per plant, and seeds per pod were not significantly different. It was demonstrated in this paper that the quality character of ms 1 male sterile recurrent selection population was improved by adding new genes. And the segregation of other characters widened, making the populations suitable for the objective of soybean breeding. In this paper, we also discussed the breeding method, key technology, and selection effect of soybean ms 1 population.
文摘BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.
基金Supported by Science and Technology Open Cooperation Project of Henan Province(162106000017)Science and Technology People-benefiting Plan Project of Henan Province(152207110004)Puyang Science and Technology Plan Project(150109)~~
文摘The dairy herd improvement data from Henan Province were analyzed statistically to establish screening criteria for relevant data, thereby laying a foundation for genetic evaluation of dairy cows. With the 2 152 451 test-day records about 155 893 Chinese Holstein dairy cows collected by the Henan Dairy Herd Improvement Center from January 2008 to April 2016, the dynamics of test times during a complete lactation, test interval during a complete lactation, days in milk （DIM） of first test-day record, daughter descendant number and herd number of bull, age at first calving and pedigree integrity rate among different years and different herd sizes were analyzed by MEANS order of SAS 9.4. In addition, the data that were applicable to genetic evaluation were screened by SQL program. The results showed that during 2008-2015, the number of cow individuals participating in DHI in Henan Province increased from 7 379 to 93 706; the test-day milk yield increased from 19.91 to 24.05 kg; the somatic cell count reduced from 411.09×10^3 to 277.08×10^3 cells/ml; the percentage of cows with DIM ranging from 5-305 d reached 70.92%; the average test times increased from 3.20 to 6.31 times; the test interval decreased from 70.22 to 33.83 d; the dairy cows with age at first calving of 25 months were dominant, accounting for 12.57%; the bulls whose daughter descendant number was 20 or more and the daughters were distributed in 10 or more farms accounted for 6.05%; the one-generation pedigree integrity rate was 82.54%; the percentage of data that could be used for genetic evaluation was screened as 20.67%, which was lower than the results of other similar studies.
文摘<b>Introduction:</b> Achieving viral load suppression among the adolescents living with HIV continues to hold back attainment of sustainable development goals. TASO Mbale realized a viral load suppression rate of 63.1% among the adolescents living with HIV in care in quarter 4 of 2016. We therefore, instituted a quality imrpovement project to improve Viral load suppression from 63.1% in quarter 4 2016 to 90% by the end of quarter 4 2017. <b>Method:</b> Baseline data from the Uganda viral load dashboard were analyzed, and fishbone diagram was utilized to provide root causes of low viral load suppression among the adolescents living with HIV at TASO Mbale. The identified barriers were Knowlegde gap, among the adolescents, on positive living, Missing clinic appointments, Sub-optimal adherence, Poorly planned adolescent HIV clinic, Inadequate follow-up and Low use of data for informed decisions. A plan-do-study-act (PDSA) model was applied to implement tested changes. Strategies that worked included introduction of appointment register to track appointment behaviour of the adolescents, generating lists of clients on appointment who were due for Viral Load bleeding, telephone calls for follow up, increasing the frequency of reviewing adolescents from once a month to twice a week, committing a dedicated team responsible for adolescent care. <b>Results:</b> The viral load suppression improved from 63.1% in quarter 4 of 2016 to 63.8% in the first quarter of 2017, to 87.5% in quarter 2 of 2017, 97.6% in the third quarter and 91.4% in quarter 4 of 2017. <b>Conclusion:</b> The use of quality improvement in addressing gaps in HIV service delivery is highly effective.
基金This project is supported by National Natural Science Foundation of China (No.70372062)Tianjin City Key Technologies R&D Program(No.04310881R)New Century Excellent Talent Program of Education Ministry of China(No.NCET-04-0240).
文摘The relationship between major quality tools such as quality function development （QFD）, failure mode and effects analysis （FMEA）, design of experiments （DOE） and statistical process control （SPC） is analyzed through an extensive review of the literature and the concurrent quality engineering philosophy, and a basic structure for the integration of quality tools is presented. An integrated quality management system （IQMS） is developed using C＋＋ Builder, running in the Windows 2000 Server environment with the basic internet connections, and SQL Server 2000 as the platform for developing the database, An illustrative example applying IQMS to the continuous quality improvement for a crane equipment manufacturing is reported. The result shows that the application of IQMS can optimize the process of design and manufacturing, shorten the cycle time of product, reduce the cost, and realize quality improvement continuously, The proposed integrated framework with IOMS is believed to be applicable to continuous quality improvement in many manufacturing companies.
文摘BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED.METHODS:In 2009,a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems.RESULTS:Responsible officers were assigned to look after seven error-prone areas.Strategies were proposed,discussed,endorsed and promulgated to eliminate the problems identified.A reduction of medication incidents(Ml) from 16 to 6 was achieved before and after the improvement work.CONCLUSION:This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.
