scholarly journals Conclusion: the road ahead: where should we go now to improve healthcare quality in acute settings?

2019 ◽  
Vol 32 (Supplement_1) ◽  
pp. 99-103 ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Natalie Taylor ◽  
Robyn Clay-Williams ◽  
Hsuen P Ting ◽  
Gaston Arnolda
Keyword(s):  
Quality Improvement ◽  
Healthcare Quality ◽  
Quality And Safety ◽  
Future Studies ◽  
The Road ◽  
The Core ◽  
Depth Analysis ◽  
No Gold Standard ◽  
Main Message ◽  
Over Time

Abstract This final article in our 12-part series articulating a suite of quality improvement studies completes our report on the Deepening our Understanding of Quality in Australia (DUQuA) program of work. Here, we bring the Supplement’s key findings and contributions together, tying up loose ends. Traversing the DUQuA articles, we first argued the case for the research, conducted so that an in-depth analysis of one country’s health system, completed 5 years after the landmark Deepening our Understanding of Quality Improvement in Europe (DUQuE), was available. We now provide a digest of the learning from each article. Essentially, we have contributed an understanding of quality and safety activities in 32 of the largest acute settings in Australia, developed a series of scales and tools for use within Australia, modifiable for other purposes elsewhere, and provided a platform for future studies of this kind. Our main message is, despite the value of publishing an intense study of quality activities in 32 hospitals in one country, there is no gold standard, one-size-fits-all methodology or guarantee of success in quality improvement activities, whether the initiatives are conducted at departmental, organization-wide or whole-of-systems levels. Notwithstanding this, armed with the tools, scales and lessons from DUQuA, we hope we have provided many more options and opportunities for others going about strengthening their quality improvement activities, but we do not claim to have solved all problems or provided a definitive approach. In our view, quality improvement initiatives are perennially challenging, and progress hard-won. Effective measurement, evaluating progress over time, selecting a useful suite of quality methods and having the persistence to climb the improvement gradient over time, using all the expertise and tools available, is at the core of the work of quality improvement and will continue to be so.

Towards a Functional Model of Quality Improvement Collaboratives

2007 ◽  
Vol 51 (11) ◽  
pp. 707-711
Author(s):  
Emily S. Patterson ◽  
Sharon Schweikhart ◽  
Shilo Anders ◽  
Suzanne Brungs ◽  
Marta L. Render
Keyword(s):  
Quality Improvement ◽  
Functional Model ◽  
Healthcare Quality ◽  
Quality And Safety ◽  
Critical Elements ◽  
Quality Improvement Collaboratives ◽  
Support Research

Quality improvement collaboratives (QIC) are widely used for seeking improvements in healthcare quality and safety. Nevertheless, the effectiveness of QICs is variable. In order to support research that identifies critical elements in running a successful collaborative, we fill a conceptual gap by moving towards a functional model of QICs. Specifically, we define how QICs are distinct from traditional quality improvement teams, conceptualize how primary and secondary functions are accomplished in a means-ends framework, and illustrate how the functions are dynamically accomplished in a series of meetings by nested teams within a collaborative. Finally, we discuss distinctions among QICs.

scholarly journals The inside of me: interoceptive constraints on the concept of self in neuroscience and clinical psychology

2021 ◽  
Author(s):  
Alessandro Monti ◽  
Giuseppina Porciello ◽  
Maria Serena Panasiti ◽  
Salvatore Maria Aglioti
Keyword(s):  
The Self ◽  
Physiological Signals ◽  
Self Concept ◽  
Abstract Concept ◽  
Future Studies ◽  
The Core ◽  
The Stability ◽  
Bodily States ◽  
Over Time ◽  
Core Features

AbstractHumans are unique in their ability to think about themselves and carry a more or less clear notion of who they are in their mind. Here we review recent evidence suggesting that the birth, maintenance, and loss of the abstract concept of ‘self’ is deeply tied to interoception, the sense of internal physiological signals. Interoception influences multiple facets of the self-concept, cutting across its material, social, moral, and agentive components. Overall, we argue that interoception contributes to the stability of the self-concept over time, unifying its layers and constraining the degree to which it is susceptible to external influences. Hence, the core features of the self-concept are those that correlate more with inner bodily states. We discuss the implications that this may have for theories of embodied cognition as well as for the understanding of psychiatric disorders in which the concept of self appears fragmented or loose. Finally, we formulate some empirical predictions that could be tested in future studies to shed further light on this emerging field.

Pengelolaan Data Terintegrasi Berdasarkan Instrumen Akreditasi Perguruan Tinggi 3.0 Menggunakan Zachman Framework

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Ardhin Primadewi ◽  
Mukhtar Hanafi
Keyword(s):  
Higher Education ◽  
Self Evaluation ◽  
The Core ◽  
Depth Analysis ◽  
Performance Report ◽  
Total Data ◽  
Zachman Framework ◽  
The Government ◽  
Data Gap ◽  
Education Performance

Higher education in Indonesia is regulated by the government with the Higher Education Accreditation (APT). In APT 3.0, Higher Education is required to be able to present performance data in the form of a Higher Education Performance Report (LKPT) as a reference in making a Self-Evaluation Report (LED). However, it is necessary to have an in-depth analysis to determine the gaps in the data required by Higher Education according to the APT 3.0 standard. The process of integrating the samples refer to the Zachman Framework (ZF). The results of this simplification that the data is available in support of APT 3.0 approximately 79% of the total data both inside and outside the core business of Higher Education and is well managed in an integrated database. The remaining 21% of the data that are not available is spread across several information systems, especially SIMMawa, SIMHumas and Cooperation, and SIMAKU. This shows that the change in accreditation standards that have been in effect since April 2019 has created a significant data gap for Higher Education. This research also produced an alternative model of integrated data management that can be used as input for Information System developers in the Higher Education scope.

scholarly journals Hospital managers’ perspectives with implementing quality improvement measures and a new regulatory framework: a qualitative case study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042847 ◽  
Author(s):  
Sina Furnes Øyri ◽  
Geir Sverre Braut ◽  
Carl Macrae ◽  
Siri Wiig
Keyword(s):  
Quality Improvement ◽  
Adaptive Capacity ◽  
Qualitative Content Analysis ◽  
Regulatory Framework ◽  
Local Context ◽  
Quality And Safety ◽  
Hospital Practice ◽  
Hospital Managers ◽  
Safety Improvement

A new regulatory framework to support local quality and safety efforts in hospitals was introduced to the Norwegian healthcare system in 2017. This study aimed to investigate hospital managers’ perspectives on implementation efforts and the resulting work practices, to understand if, and how, the new Quality Improvement Regulation influenced quality and safety improvement activities.DesignThis article reports one study level (the perspectives of hospital managers), as part of a multilevel case study. Data were collected by interviews and analysed according to qualitative content analysis.SettingThree hospitals retrieved from two regional health trusts in Norway.Participants20 hospital managers or quality advisers selected from different levels of hospital organisations.ResultsFour themes were identified in response to the study aim: (1) adaptive capacity in hospital management and practice, (2) implementation efforts and challenges with quality improvement, (3) systemic changes and (4) the potential to learn. Recent structural and cultural changes to, and development of, quality improvement systems in hospitals were discovered (3). Participants however, revealed no change in their practice solely due to the new Quality Improvement Regulation (2). Findings indicated that hospital managers are legally responsible for quality improvement implementation and participants described several benefits with the new Quality Improvement Regulation (2). This related to adaptation and flexibility to local context, and clinical autonomy as an inevitable element in hospital practice (1). Trust and a safe work environment were described as key factors to achieve adverse event reporting and support learning processes (4).ConclusionsThis study suggests that a lack of time, competence and/or motivation, impacted hospitals’ implementation of quality improvement efforts. Hospital managers’ autonomy and adaptive capacity to tailor quality improvement efforts were key for the new Quality Improvement Regulation to have any relevant impact on hospital practice and for it to influence quality and safety improvement activities.

scholarly journals Enhancing the healthcare quality improvement storyboard using photovoice

2020 ◽  
Vol 9 (4) ◽  
pp. e001104
Author(s):  
Pamela Mathura ◽  
Miriam Li ◽  
Natalie McMurtry ◽  
Narmin Kassam
Keyword(s):  
Quality Improvement ◽  
Healthcare Quality ◽  
Healthcare Quality Improvement

Equality and Equity in Chinese Higher Education in the Post-massification Era: An Analysis Based on Chinese Scholarly Literature

2021 ◽  
pp. 1-22
Author(s):  
Qiang Zha
Keyword(s):  
Higher Education ◽  
Literature Review ◽  
Bibliometric Analysis ◽  
Chinese Higher Education ◽  
Scholarly Literature ◽  
The Core ◽  
Research Questions ◽  
Changes Over Time ◽  
Core Issues ◽  
Over Time

Abstract This paper examines several research questions relating to equality and equity in Chinese higher education via an extended literature review, which in turn sheds light on evolving scholarly explorations into this theme. First, in the post-massification era, has the Chinese situation of equality and equity in higher education improved or deteriorated since the late 1990s? Second, what are the core issues with respect to equality and equity in Chinese higher education? Third, how have those core issues evolved or changed over time and what does the evolution indicate and entail? Methodologically, this paper uses a bibliometric analysis to detect the topical hotspots in scholarly literature and their changes over time. The study then investigates each of those topical terrains against their temporal contexts in order to gain insights into the core issues.

scholarly journals Isolation and Molecular Characterization of the Romaine Lettuce Phylloplane Mycobiome

2021 ◽  
Vol 7 (4) ◽  
pp. 277
Author(s):  
Danny Haelewaters ◽  
Hector Urbina ◽  
Samuel Brown ◽  
Shannon Newerth-Henson ◽  
M. Catherine Aime
Keyword(s):  
Lactuca Sativa ◽  
New Combinations ◽  
Food Spoilage ◽  
Human Pathogens ◽  
Plant Leaves ◽  
Romaine Lettuce ◽  
Future Studies ◽  
The Core ◽  
American Agriculture

Romaine lettuce (Lactuca sativa) is an important staple of American agriculture. Unlike many vegetables, romaine lettuce is typically consumed raw. Phylloplane microbes occur naturally on plant leaves; consumption of uncooked leaves includes consumption of phylloplane microbes. Despite this fact, the microbes that naturally occur on produce such as romaine lettuce are for the most part uncharacterized. In this study, we conducted culture-based studies of the fungal romaine lettuce phylloplane community from organic and conventionally grown samples. In addition to an enumeration of all such microbes, we define and provide a discussion of the genera that form the “core” romaine lettuce mycobiome, which represent 85.5% of all obtained isolates: Alternaria, Aureobasidium, Cladosporium, Filobasidium, Naganishia, Papiliotrema, Rhodotorula, Sampaiozyma, Sporobolomyces, Symmetrospora and Vishniacozyma. We highlight the need for additional mycological expertise in that 23% of species in these core genera appear to be new to science and resolve some taxonomic issues we encountered during our work with new combinations for Aureobasidiumbupleuri and Curvibasidium nothofagi. Finally, our work lays the ground for future studies that seek to understand the effect these communities may have on preventing or facilitating establishment of exogenous microbes, such as food spoilage microbes and plant or human pathogens.

Value-based dentistry: Putting the patient first

2016 ◽  
Vol 7 (3) ◽  
pp. 126-129 ◽  
Author(s):  
Sreenivas Koka ◽  
Galya Raz
Keyword(s):  
Risk Management ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Dental Care ◽  
Time Cost ◽  
Safety Risk ◽  
The Cost ◽  
Over Time

What does ‘value’ mean? In the context of dental care, it can be defined as the quality of care received by a patient divided by the cost to the patient of receiving that care. In other words: V =Q/C, where Q equals the quality improvement over time, which most patients view in the context of the outcome, the service provided and safety/risk management, and C equals the financial, biological and time cost to the patient. Here, the need for, and implications of, value-based density for clinicians and patients alike are explored.

scholarly journals What is special about L3 processing?

2013 ◽  
Vol 18 (2) ◽  
pp. 130-144 ◽  
Author(s):  
KEES DE BOT ◽  
CAROL JAENSCH
Keyword(s):  
Second Language ◽  
Language Processing ◽  
Language Use ◽  
Fundamental Question ◽  
Third Language ◽  
The Core ◽  
Dynamic Perspective ◽  
Core Issue ◽  
The Brain ◽  
Over Time

While research on third language (L3) and multilingualism has recently shown remarkable growth, the fundamental question of what makes trilingualism special compared to bilingualism, and indeed monolingualism, continues to be evaded. In this contribution we consider whether there is such a thing as a true monolingual, and if there is a difference between dialects, styles, registers and languages. While linguistic and psycholinguistic studies suggest differences in the processing of a third, compared to the first or second language, neurolinguistic research has shown that generally the same areas of the brain are activated during language use in proficient multilinguals. It is concluded that while from traditional linguistic and psycholinguistic perspectives there are grounds to differentiate monolingual, bilingual and multilingual processing, a more dynamic perspective on language processing in which development over time is the core issue, leads to a questioning of the notion of languages as separate entities in the brain.

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