The Annual Institutional Review—Key Performance Measures and Processes

ABSTRACT Background The Accreditation Council for Graduate Medical Education (ACGME) requires sponsoring institutions to demonstrate effective oversight through an annual institutional review (AIR). The ACGME only requires 3 elements to be reported, and it is up to the discretion of the designated institutional official (DIO) whether other supporting information should be included. This leads to uncertainty and inconsistency for DIOs as they decide what to report. Objective We surveyed DIOs in an effort to provide national data on key performance indicators and other relevant components of the AIR process. Methods In July 2019, we conducted a national survey of 847 DIOs. The survey had 16 questions that explored basic institutional demographics, timelines, and processes for the AIR and key performance indicators. Written answers were grouped by similar responses, and we performed descriptive statistics on all variables to assess distributions of responses. We also explored associations between variables using cross-tabulation and chi-square statistics. Results A total of 267 DIOs responded to the survey (32% response rate). There were 7 institutional performance measures that achieved over 50% consensus. These reviews required the majority of DIOs (62%, 167 of 267) 5 to 20 hours to complete. Less than one-third of sponsoring institutions reported diversity data. The majority of DIOs (68%, 182 of 267) felt the AIR process added substantial value. Conclusions This survey reports key performance measures and processes included by DIOs in the AIR. Our results show a wide range of institutional responses though consensus was achieved on 7 key performance measures.

Safety Precuations and Tools Examination for Employees of Power Plant

Employee welfare and safety has been seen as one of an organization's key performance measures. Changes in employees ' working life and changes in both the internal and external business environment have brought tremendous transformation in organizational behaviour. Globalization, innovation and other aspects of work-design compelled companies to focus on the safety and welfare of workers.

Performance measurement system for a lean manufacturing setting

Purpose The purpose of this paper is to propose a performance measurement system for a lean manufacturing environment, which assesses the multi-dimensional performance of lean manufacturing. Design/methodology/approach Following a case study approach, structured interviews were conducted to identify the parameters to measure the performance of a lean manufacturing apparel company. A model was developed with the analytical hierarchical process to assess the performance. Findings The proposed model consists of three levels: first level (overall manufacturing performance), second level (criteria that represent the stakeholders’ view of manufacturing performance) and third level (sub-criteria for the criteria which represent the areas affected by lean manufacturing). The model connects indicators that measure manufacturing performance with the areas required improvements, according to their relative importance to stakeholders. Research limitations/implications The interviewers’ perspectives were used to determine the importance of each manufacturing area for stakeholders. Key performance measures can vary from company to company. Practical implications Managers can use this model to identify important areas for manufacturing performance and the performance improvements driven by different types of lean practices. The results revealed that identifying stakeholders’ requirements was an important aspect of evaluating manufacturing performance. Social implications The model embeds a stakeholder approach in performance measurement, thereby providing a comprehensive model to assess performance. Originality/value This study applies the stakeholder view to identify the multi-dimensional nature of performance in a lean manufacturing setting. It also defines the key performance measures using lean practices.

Key performance measures for colonoscopy in the Polish Colonoscopy Screening Program

Background The European Society of Gastrointestinal Endoscopy (ESGE) has published guidelines on key performance measures for colonoscopy. We analyzed whether those standards were met in the Polish Colonoscopy Screening Program (PCSP) and whether the monitoring was feasible. Methods We analyzed database records for 43 277 PCSP participants (25 PCSP centers) for the years 2014 – 2015. We used the guideline definitions to calculate values for all key performance measures and compared these with the proposed standards at individual, center, and program level. All data were acquired from the PCSP database, apart from complication data which was assessed from external registries. Results At the program level, four of five minimum standards and one of two target standards (no set minimum standard) were met. Adequate bowel preparation rate was 91.3 % for the whole program (range among individual centers 79.2 % – 99.2 %). Cecal intubation rate was 97.4 % (93.4 % – 99.4 %). Adenoma detection rate was 29.8 % (19.1 % – 39.1 %). An appropriate polypectomy technique was applied in 62.7 % of cases (0.4 % – 97.8 %). Regarding complications, 7-day hospitalization rate after screening colonoscopy was 0.3 % (n = 127), and 30-day all-cause mortality was 0.02 % (n = 9). Patient feedback was assessed in 66.2 % of colonoscopies (7.6 % – 81.8 %). Appropriate post-polypectomy surveillance was proposed in 95.4 % of cases (range 84.9 % – -99.7 %). It was easy to monitor 6 of 7 key performance measures within the PCSP database, but monitoring complications required the additional effort of data extraction from external registries. Conclusions The PCSP meets most proposed minimum standards at program level. Some centers need additional interventions to meet the complete set of quality standards. Use of ESGE performance measures for monitoring colonoscopy is generally feasible in the setting of the colonoscopy screening program.

Performance measures for endoscopy services: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a list of key performance measures for endoscopy services. We recommend that these performance measures be adopted by all endoscopy services across Europe. The measures include those related to the leadership, organization, and delivery of the service, as well as those associated with the patient journey. Each measure includes a recommendation for a minimum and target standard for endoscopy services to achieve. We recommend that all stakeholders in endoscopy take note of these ESGE endoscopy services performance measures to accelerate their adoption and implementation. Stakeholders include patients and their advocacy groups; service leaders; staff, including endoscopists; professional societies; payers; and regulators.