scholarly journals Documentation of Prognostication Discussion

2021 ◽  
Vol 27 ◽  
pp. 222-229
Author(s):  
Divakaran E. Edassery ◽  
Rajashree K. Chittezhathu ◽  
Jyothi Jayan Warrier
Keyword(s):  
Palliative Care ◽  
Statistical Analysis ◽  
Patient Encounter ◽  
Care Clinic ◽  
Cause Analysis ◽  
Root Cause ◽  
Ishikawa Diagram ◽  
Documentation Status ◽  
Key Drivers ◽  
A3 Method

Background: Our organization is a NGO that provides palliative and supportive care at outpatient (OP), home visits and inpatient (IP), and Hospice settings. During patient encounter at different settings, documentation of discussion on prognostication was not done on the patients’ case sheets. This had created communication gap between the professionals, the patients and their family members. Due to this, there was a mismatch between the patients’ expectations and the services provided. Aims: The aim of the study was to implement A3 protocol and to increase the documentation status from zero to 75% by the end of five months after the commencement of the project. Settings and Design: OP - Department of Palliative Care Clinic A3 method. Material and Methods: The process map of the newly registered patients was followed. Root cause analysis was done using the Ishikawa Diagram. The main cause was that there was no specific format for documentation of prognostication. The professionals also felt some difficulty in disclosing the information as they were not following any prognostication tools upon which such discussions can be made. The key drivers were identified. Interventions were focused with specific contributors. A run chart was maintained to assess the progress of the interventions Statistical Analysis Used: Percentage calculation. Results: This endeavor has resulted in raising the documentation status from 0 to 80%. Conclusion: A3 protocol has been successful in developing the format for documentation of prognostication. Our team has gained confidence in implementing the A3 in other domains too.

scholarly journals Proposed Production Process Standardization at Function ART Indonesia to Reduce Waste of Production

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Demara Bijak Kurniawan ◽  
Sonny Rustiadi
Keyword(s):  
Production Process ◽  
Small Businesses ◽  
Communication Process ◽  
Process Standardization ◽  
Cause Analysis ◽  
Foreign Companies ◽  
Root Cause ◽  
Ishikawa Diagram ◽  
Expert Interview ◽  
Space Saving

The growth of the property business goes hand in hand with the furnishing industry in Indonesia. The construction of apartments, minimalist houses which adjust to the limitations of land in Indonesia creates changes in furnishing designs which are minimalist, simple, and multifunctional that support, such as space saving models. In Indonesia, many space saving products are introduced by foreign companies such as IKEA and Informa. Function.id is one of the small businesses that has a goal to fulfill the needs of space saving product in Indonesia. With some limitations, Function.id does the production process using the makloon / outsource method. However, because the concepts applied are not standardized and well-structured, instead it creates a problem in the production process. Therefore, the purpose of this research is to identify the problem and to standardize the makloon production process of Function.id to be implemented in Function ART Indonesia. The approach of this research is qualitative with expert interview, then continued to define the production process and communication process of Function.id and its vendor to ease the analysis of this research. After that do a root cause analysis to map the problems of Function.id with ishikawa diagram as a framework. The main causes of problems faced by Function.id are no designer specialist, limited source of vendor, lack of supplier source, having no a precise and measurable product design for vendor, having no clear letter of agreement, unstructured communication process, unstable ordering pattern, and having no standardization guidelines. Solutions and improvements that can be applied to develop Function.id into Function ART Indonesia in its production process are creation of a structured and create an SOP for production process with instruments of communication to vendor and supplier with implementation of heijunka. Also, some requirements that needs to be prepared before the production process could be implemented, such as do a collaboration with designer, design maximizing, letter of agreement and survey for supplier and vendor.

Nodal screw compressor failure analysis using data analytics—CSG application

2015 ◽  
Vol 55 (1) ◽  
pp. 59
Author(s):  
Prashant Parulekar
Keyword(s):  
Statistical Analysis ◽  
Data Analytics ◽  
Screw Compressor ◽  
Cause Analysis ◽  
Root Cause ◽  
Statistical Measures ◽  
Using Data ◽  
Filter Signal ◽  
Data Analytic ◽  
Insight Into

An engine-driven oil-injected screw compressor in CSG service failed catastrophically. Instrumentation provided on the package was ineffective in predicting or detecting the failure. As part of the Root Cause Analysis (RCA) process, a statistical analysis of the logged instrument data, as measured across a period of six months prior to the failure, was carried out. This paper uses data analytic methods to process instrument data, data visualisation techniques, advanced statistical analysis of the instrument data, and techniques to filter signal noise. The analysis recognised the multivariate behaviour and interrelationships between various operating parameters. The paper further provides insight into the interpretation of statistical measures and how to draw conclusions that explain the failure mechanism. The outcomes of the analysis presented in this paper then provided insights into establishing operating envelopes, proposed instrumentation upgrades to be provided in future and helped establish an operation and maintenance regime that should assist in preventing such failures in future.

Preventing 30-day readmissions for patients with cancer: A root-cause analysis.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 226-226
Author(s):  
Manan P Shah ◽  
Irena Tan ◽  
Sarah K. Garrigues ◽  
Jennifer Hansen ◽  
Douglas W. Blayney ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Academic Medical Center ◽  
Root Cause Analysis ◽  
Urgent Care ◽  
Cancer Center ◽  
Cause Analysis ◽  
Patients With Cancer ◽  
Root Cause ◽  
Timely Access ◽  
Key Drivers

226 Background: The high rate of unplanned 30-day readmissions for patients with cancer is a significant driver of costs and a marker of poor quality. In this study, we analyzed 30-day readmissions at our cancer center to determine causality and propose key drivers to prevent them. Methods: Patients with known cancer who were readmitted to our academic medical center within 30 days of a previous hospitalization were identified in our electronic health record by a third-party algorithm. Among patients with hematologic malignancies, only those undergoing bone marrow transplant care were included. Surveys querying causality and preventability of the readmissions were sent to the patients’ attending oncologists. Electronic chart documentation of readmissions were reviewed by two investigators to assess causality and preventability of each readmission. Results were discussed in focus groups to determine key drivers to prevent 30-day readmissions. Results: 437 readmissions were identified between 9/1/19 and 8/31/20, and 182 readmissions with corresponding surveys completed by their oncologists were identified (Table). Based on survey responses, 30 (16%) of the 182 readmissions were preventable, whereas based on our review, 56 (31%) were preventable. The top three causes of the 56 preventable readmissions were: underutilized ambulatory care (43%), premature discharge (23%), and goals of care discordance (16%). For underutilized ambulatory care, the primary treatments provided during those readmissions were: procedures such as thoracentesis and paracentesis (42%), medication administration for pain or nausea (33%), and infusions or transfusions (25%). Notably, most of these patients either did not attempt to seek outpatient care (42%) or were not able to secure an ambulatory appointment (29%) prior to their readmission. Through focus group discussions, we found that the key drivers to reduce preventable 30-day readmissions at our institution are (1) timely access to outpatient pleural effusion and ascites management, (2) timely access to ambulatory management of cancer-related symptoms (e.g., pain, nausea, weakness), (3) increased systems-wide awareness and utility of avenues of urgent care, and (4) increased palliative care efforts in patients with readmissions. Conclusions: Systematic review of 30-day readmissions revealed a greater than anticipated portion of preventable readmissions. Root-cause analysis yielded key drivers to reduce 30-day readmissions at our cancer center.[Table: see text]

Root Cause analysis of SG tube ODSCC indications within the tube sheets of NPP biblis unit A

2011 ◽  
pp. 78-86
Author(s):  
R. Kilian ◽  
J. Beck ◽  
H. Lang ◽  
V. Schneider ◽  
T. Schönherr ◽  
...  
Keyword(s):  
Root Cause Analysis ◽  
Cause Analysis ◽  
Root Cause

Rule Construction and its Execution for Root Cause Analysis

2012 ◽  
Vol 132 (10) ◽  
pp. 1689-1697
Author(s):  
Yutaka Kudo ◽  
Tomohiro Morimura ◽  
Kiminori Sugauchi ◽  
Tetsuya Masuishi ◽  
Norihisa Komoda
Keyword(s):  
Root Cause Analysis ◽  
Cause Analysis ◽  
Root Cause

Root Cause Analysis Techniques Using Picosecond Time Resolved LADA

2014 ◽  
Author(s):  
Dan Bodoh ◽  
Kent Erington ◽  
Kris Dickson ◽  
George Lange ◽  
Carey Wu ◽  
...  
Keyword(s):  
Integrated Circuits ◽  
Picosecond Laser ◽  
Root Cause Analysis ◽  
Fault Isolation ◽  
Time Resolved ◽  
Cause Analysis ◽  
Root Cause ◽  
Design And Manufacturing ◽  
Multiple Interactions ◽  
Established Technique

Abstract Laser-assisted device alteration (LADA) is an established technique used to identify critical speed paths in integrated circuits. LADA can reveal the physical location of a speed path, but not the timing of the speed path. This paper describes the root cause analysis benefits of 1064nm time resolved LADA (TR-LADA) with a picosecond laser. It shows several examples of how picosecond TR-LADA has complemented the existing fault isolation toolset and has allowed for quicker resolution of design and manufacturing issues. The paper explains how TR-LADA increases the LADA localization resolution by eliminating the well interaction, provides the timing of the event detected by LADA, indicates the propagation direction of the critical signals detected by LADA, allows the analyst to infer the logic values of the critical signals, and separates multiple interactions occurring at the same site for better understanding of the critical signals.

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