How to build a quality-related documentary system

A project quality assurance organization (QAO) assigns project quality responsibilities and relationships, both for design and construction. In the highway sector, all project quality roles and responsibilities have historically been assigned to the state highway agency (SHA), an accepted and well-understood industry practice. However, increasing use of alternative project delivery methods and reductions in SHA staffing are having an impact on traditional QAO practices. SHAs are increasingly selecting alternative QAOs, but they are making these selections in an ad hoc manner because of limited staff knowledge and experience, and a lack of guidance from the research community. Highway design and construction quality research focuses almost exclusively on inspections, observations, corporate quality, warranties, and materials testing, resulting in a gap in the research about shifts in project quality roles and responsibilities. This research extends the civil engineering quality management body of knowledge by identifying factors that influence the selection of QAOs and rating the appropriateness of the QAOs for each selection factor. Because of the complexity of the topic, scope of the decision process, and the limited project data available, structured interviews and the Delphi method were chosen to explore the selection factors. The research discovered 10 factors: project size, project complexity, project delivery method, project schedule sensitivity, availability of agency project staff, agency project staff experience, agency culture, industry ability to manage their own quality, trust between agency and industry, and amount of quality risk to shift away from the agency. The research provides the highway industry with new understanding of the effects that each selection factor has on the fundamental QAOs. This fundamental knowledge will allow SHAs to make more informed QAO selections.

Starting from the year 2000, some Arab countries began focusing on quality assurance in the education field. Currently, 19 of the 22 Arab countries have developed good quality assurance systems in education. Most of these quality assurance organizations in the Arab world include higher education, pre-university education, and vocational education in their mandates. The idea of networking between quality assurance organizations started to develop and flourish in 2008 with the launch of the Global Initiative for Quality Assurance Capacities (GIQAC) project, managed by UNESCO, which was born out of an initiative created by the World Bank. The World Bank then corresponded with all the quality assurance organizations to develop networks and encouraged them to communicate among each other. At that time there were at least seven quality assurance networks engaged in this vital initiative. A part of this chapter is dedicated to the networks and initiatives that had remarkable influence on higher education in the Middle East and Arab region, with a focus on the Arab Network of Quality Assurance in Higher Education (ANQAHE). The relationship between quality standards and academic integrity is discussed in this chapter, with an analysis of the way quality standards are used by different Arab external quality assurance agencies (EQAAs) to promote academic integrity.

<p>In formal education and training, internal assessment (in which assessor judgements are made within education organisations) is widely used for summative purposes to contribute to the award of qualifications. In many jurisdictions including New Zealand, organisations that conduct these high-stakes internal assessments are required by regulation to engage in moderation within the organisation and with external quality assurance bodies to quality-assure those assessments. However, policies are rarely implemented directly as intended. Instead, they are enacted by organisations, that is, policies are interpreted and translated, with multiple factors influencing this process. One such factor is the person who takes the role of ‘policy narrator’ and leads the policy interpretation and translation within the organisation. In New Zealand there is further potential for enactment variation because education organisations are largely self-governing, and thus have substantial freedom regarding organisational systems and practices. Moderation is commonly held to have both accountability and improvement purposes. However, it is unknown what policy narrators within New Zealand organisations consider the functions of moderation to be. This study sought to explore what the academic leaders who are responsible for moderation in New Zealand secondary and tertiary organisations (i.e., those likely to be policy narrators) perceive as the functions of internal moderation and national moderation conducted by the New Zealand Qualifications Authority (NZQA moderation). Further, the study sought to ascertain whether there are any observable differences in perceptions according to organisation type. A pragmatic mixed methods sequential research design was implemented. An online survey instrument was developed informed from interview findings, and then administered using a census approach to collect data (n = 221). Both qualitative and quantitative data analyses were conducted. Academic leaders were found to believe that moderation functions across multiple embedded contexts, from the immediate assessment event, to organisational and societal contexts. Internal and NZQA moderation were seen to work in the narrowly-focused area of assessment quality, and the broader areas of professional learning, organisational quality assurance, maintaining public and stakeholder confidence, and educational quality (internal moderation only). Instead of subscribing to the dominant improvement and accountability discourses, for the most part academic leaders tended think of moderation in more encompassing ways than the literature suggests. Respondents from Private Training Enterprises (PTEs) tended to see the organisational quality assurance and educational quality functions as being more important or having a stronger emphasis, and to hold a broader view of moderation functions, than those from schools. These findings could assist those in organisations to recognise and examine the influence of their own perceptions on practice, and identify opportunities to optimise how their organisations use moderation. The findings enable policy makers to ascertain the degree of alignment between policy intent and enactment, and could inform policy development and communication to the sector. Further, the potential for NZQA to increase the broader and improvement-focused aspects of moderation practice, while maintaining—and enhancing—its accountability focus is highlighted.</p>

<p>In formal education and training, internal assessment (in which assessor judgements are made within education organisations) is widely used for summative purposes to contribute to the award of qualifications. In many jurisdictions including New Zealand, organisations that conduct these high-stakes internal assessments are required by regulation to engage in moderation within the organisation and with external quality assurance bodies to quality-assure those assessments. However, policies are rarely implemented directly as intended. Instead, they are enacted by organisations, that is, policies are interpreted and translated, with multiple factors influencing this process. One such factor is the person who takes the role of ‘policy narrator’ and leads the policy interpretation and translation within the organisation. In New Zealand there is further potential for enactment variation because education organisations are largely self-governing, and thus have substantial freedom regarding organisational systems and practices. Moderation is commonly held to have both accountability and improvement purposes. However, it is unknown what policy narrators within New Zealand organisations consider the functions of moderation to be. This study sought to explore what the academic leaders who are responsible for moderation in New Zealand secondary and tertiary organisations (i.e., those likely to be policy narrators) perceive as the functions of internal moderation and national moderation conducted by the New Zealand Qualifications Authority (NZQA moderation). Further, the study sought to ascertain whether there are any observable differences in perceptions according to organisation type. A pragmatic mixed methods sequential research design was implemented. An online survey instrument was developed informed from interview findings, and then administered using a census approach to collect data (n = 221). Both qualitative and quantitative data analyses were conducted. Academic leaders were found to believe that moderation functions across multiple embedded contexts, from the immediate assessment event, to organisational and societal contexts. Internal and NZQA moderation were seen to work in the narrowly-focused area of assessment quality, and the broader areas of professional learning, organisational quality assurance, maintaining public and stakeholder confidence, and educational quality (internal moderation only). Instead of subscribing to the dominant improvement and accountability discourses, for the most part academic leaders tended think of moderation in more encompassing ways than the literature suggests. Respondents from Private Training Enterprises (PTEs) tended to see the organisational quality assurance and educational quality functions as being more important or having a stronger emphasis, and to hold a broader view of moderation functions, than those from schools. These findings could assist those in organisations to recognise and examine the influence of their own perceptions on practice, and identify opportunities to optimise how their organisations use moderation. The findings enable policy makers to ascertain the degree of alignment between policy intent and enactment, and could inform policy development and communication to the sector. Further, the potential for NZQA to increase the broader and improvement-focused aspects of moderation practice, while maintaining—and enhancing—its accountability focus is highlighted.</p>

This research aims to evaluate the differences in the use of the English language in electronic and manual documentation in nursing practice. Documentation is a crucial element in patient care, and with technological advancements, many healthcare institutions are transitioning from manual records to electronic documentation systems. The focus of this study is to identify variations in clarity, accuracy, and efficiency of nurse communication using both documentation methods.The research methodology involves surveys and document analysis on a sample of nurses engaged in both types of documentation. Surveys will assess nurses' perceptions regarding the clarity of documented information, the accuracy of information, and the efficiency of usage. The analyzed documents will include patient records, care plans, and incident reports.The research outcomes are expected to provide insights into the strengths and weaknesses of each documentation method, aiding healthcare organizations in decision-making regarding the implementation or development of documentation systems. The practical implications of this research can enhance nurse communication effectiveness and the quality of patient care, especially in the continually evolving healthcare information technology era.

Adverse outcomes, preventable or otherwise, are a reality of medical care. Most importantly, adverse events affect patients, but they also affect health care practitioners. Disclosing information about adverse events has benefits for the patient and the physician and, ideally, strengthens the patient-physician relationship and promotes trust. Studies show that after an adverse outcome, patients expect and want timely and full disclosure of the event, an acknowledgment of responsibility, an understanding of what happened, expressions of sympathy, and a discussion of what is being done to prevent recurrence. Surveys have shown that patients are less likely to pursue litigation if they perceive that the event was honestly disclosed. Barriers to full disclosure are many and include fear of retribution for reporting an adverse event, lack of training, a culture of blame, and fear of lawsuits. To reduce these concerns, it is recommended that health care facilities establish a nonpunitive, blame-free culture that encourages staff to report adverse events and near misses (close calls) without fear of retaliation. Health care institutions should have written policies that address the management of adverse events. Having a responsive process to inform and aid the patient, loved ones, and practitioners is required. A commitment on the part of all health care practitioners and institutions to establish programs and develop the tools needed to help patients, families, health care practitioners, and staff members deal with adversity is essential.

<strong>Introduction: </strong>Rice milling often carried out in the informal work sector generates paddy dust which is a hazard to the respiratory health of mill workers. Sri Lankan rice mill workers have shown reluctance in using respiratory protective apparatus during rice milling. <strong> </strong> <strong>Objectives: </strong>To describe the barriers for the use of respiratory protective devices during rice milling <strong> </strong> <strong>Methods: </strong>A qualitative study was conducted in the divisions of Ampara and Uhana in Ampara District in Sri Lanka during February 2016. Twenty-two in-depth interviews were conducted among rice mill workers, health professionals and government officers related to rice milling industry. Data were analysed using content analysis method. <strong> </strong> <strong>Results: </strong>The rice mill workers’ non-use of respiratory protective methods was mainly due to their negligence in personal respiratory health care and lack of support from the employer, health care institutes and other related institutes. Low level of comprehension of workers and less manpower in health care and other institutions were other contributing factors. <strong> </strong> <strong>Conclusions: </strong>Low priority given for respiratory health care by the workers, poor work environment and less support from the mill owner and relevant government authorities have resulted in non-use of respiratory protective devices among rice mill workers. Improving unhealthy work behaviour such as non-use of respiratory protective devices of the informal work sector is recommended using industry-based health education programs.

Medical Imaging & Informatics has become a fast‐growing market field in the medical private industry. It is driven mostly by health care institutions' desire to provide better quality service in decreasing turnaround time of diagnosis. In addition, Imaging and Informatics is moving from a purely Radiology product to an Enterprise‐wide product. With these forces driving the market forward, there is an apparent lack of resources both in the private industry as well as in health care institutions to properly address each of their needs. Because the clinical environment is a high‐demand, 24/7 operation, it presents a unique set of factors that other Information Technology (IT)‐related fields may not encounter. In addition, the image data that is involved can be very large in size in comparison to conventional, mostly text‐based IT‐related data. Traditionally, private industries have hired personnel with an IT background to lead the medical imaging & informatics product roadmap development and implementation. However, most people in the IT field lack the experience or knowledge of the clinical environment where the products will be embedded. This is crucial for the success of both the health care institution and the vendor. As for a health care institution, most personnel hired to manage, support, and implement a medical imaging & informatics product (eg, Picture Archive Communication System, or PACS) have a clinical background with limited experience in large‐scale IT system design and implementation which again, is crucial for success. The Medical ImagingInformatics field bridges the gap between private industry and the health care institution. It leverages the knowledge and expertise of IT‐related skills (eg, large‐scale system design, system uptime, acceptance testing, disaster recovery, etc) with the experience of how these medical imaging and informatics applications are utilized within the clinical environment. Because there is a constant flow of research within this unique relationship with the clinical environment, medical imaginginformatics also drives research and development of new products to remain on the leading edge of technology as well as determining the current market demands and trends. With these strengths, the Biomedical Engineering Master's Program in Medical Imaging and ImagingInformatics, Viterbi School of Engineering, University of Southern California draws course attendees from medical industry corporations already heavily involved in medical imaging and informatics products. Personnel from other IT‐related corporations looking for a career change into the medical arena are potential attendees as well. Clinical staff in a health care institution who are interested in branching out of their own respective clinical environments into the new arena of designing, implementing, and managing medical imaging and informatics systems such as PACS would also be ideal course attendees. One of the challenges is the uniqueness of this particular field of Medical ImagingInformatics is the lack of courses offered across the country. Therefore, the two courses offered in Medical ImagingInformatics are also taught through the Distance Education Network for students who are offsite from the USC campus. The following presentation will discuss course content, tools, and challenges/pitfalls that accompany distance education and learning specifically in the area of Medical ImagingInformatics. The following are learning objectives for the following presentation: 1. Learn about distance education network at USC 2. Learn about course content for Medical ImagingInformatics 3. Challenges in disseminating course content and student feedback 4. Learn what tools are helpful to facilitate distance learning for medical ImagingInformatics 5. See a demonstration of what a DEN classroom looks like from the off‐campus student perspective

Using the example of four regions of the Near North of Russia, the prevalence of educational and health care institutions in 22 thousand settlements (SS) of different status and size is analysed. The proportion of the population that has access to comprehensive or at least basic services at their place of residence is estimated. The dynamics of the population size is analysed depending on the provision of settlements with these institutions during the last intercensal period. The article is based on data collected from open sources on the availability of educational and health care institutions, as well as on population data based on the results of the All-Russian Census of Population of 2010 and 2020. In spite of the fact that educational institutions are available in 7.4% of populated areas, and health care institutions in 14%, the majority of the population (even without considering those living in large cities) is provided with basic services at their place of residence. Calculations are given for the provision of settlements of different sizes and administrative status with all types of educational and health care institutions. Despite the optimisation of the network of institutions, the provision of the population with them did not decrease during the 2010s, as the process of population decline and its concentration in larger settlements proceeded at an equally rapid pace. Regardless of the provision of settlements with educational and health care organisations, the reduction in their population was very significant.

PurposeHealth care is a complex system, mandating adoption of unrelenting updates of guidelines and best practices. Securing a balanced system of current practice and matching documentation has always been a challenge due to impaired connection between traditional forms of documentation (e.g. policies, procedures, and guidelines) and users. Departmental manuals always find their way back to shelves away from the workplace, and continuous interaction with customers and complexity of business processes hinder timely update and consequently sustainable improvement. The paper aims to discuss this issue.Design/methodology/approachIn late 2014, the corresponding author visited Japan as part of Kaizen benchmark tour that introduced the concepts and applications of “Kaizen,” the Japanese word for continuous improvement, in Toyota factory and health care institutes in Fukuoka, Nagoya, and Tokyo. Soon thereafter, the authors adopted Kaizen to be the organizational theme for improvement. QPS team launched several initiatives throughout 2015 to improve the quality of documentation. Documents submitted had one thing in common, all participants used flowcharts, diagrams, and even drawings to simplify hard-to-understand processes. This challenge highlighted the utilization of diagrams, well-organized forms, infographics, and other methods to simplify processes and to vitalize documents.FindingsSince the hospital utilizes the paper-form prescribing system, prescription errors lead to delays in dispensing time, affecting patient satisfaction in emergency room’s pharmacy. Pharmacy team launched a project using document vitalization as an improvement strategy. Aggregate results showed 16.7 percent reduction in average time per prescription in inpatient pharmacy and 20.0 percent reduction in emergency room pharmacy. Although measurements did not continue over a longer period or were statistically analyzed, they provide a crude indication of possible improvement using document vitalization.Research limitations/implicationsLack of a sound measurement system with proper statistical analysis prevented the provision of reliable evidence of improvement. Moreover, lack of previous case studies has been an obstacle. It is the authors’ plan to provide measurable evidence of improvement for multiple projects through measurement of process time, customer and employee satisfaction, the number of process errors, etc. Nevertheless, feedback from users provides a rough indication of possible improvement using document vitalization. It is the authors’ aim to incorporate “document vitalization” into the fabric of documentation process and SFHPM culture.Practical implicationsEmpowerment creates an energy-filled work environment where staff members feel they are the real change factors and are actively contributing to the advancement and success of their organizations (Taylor 2013). This does not mean allowing chaos and unplanned changes to disrupt process flow but rather to leave room for trial and error in a controlled environment and pilot-testing significant changes before generalization.Originality/valueThe term vitalization itself is a brand new one used in this field, and the authors introduce it for the first time to be a solution that comes from frontliners and can bridge the gap between document and practice. If all document vitalization successes were a tribute to one factor, it would be “empowerment.” Once leaders have the courage to listen to frontline staff voice and allow them to do things differently, the staff members will surprise their organizations with the marvels of their creations.

Purpose: The aim of the study was to assess the impact of data governance on data quality in healthcare institutions. Materials and Methods: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: The study found that institutions with robust data governance protocols experience fewer instances of data inconsistency and errors. This, in turn, improves the reliability of clinical decision-making processes and patient outcomes. Moreover, compliant data governance practices contribute to better data integration across various healthcare systems and departments, facilitating comprehensive patient care and longitudinal health monitoring. By promoting transparency and accountability in data management, healthcare institutions can mitigate risks associated with data breaches and ensure compliance with regulatory standards, thereby fostering trust among patients and stakeholders alike. Implications to Theory, Practice and Policy: Control theory, information theory and agency theory may be used to anchor future studies on assessing the impact of data governance on data quality in healthcare institutions. Healthcare institutions should prioritize the adoption of comprehensive data governance frameworks that integrate policy development, stakeholder engagement, and technological infrastructure. Policymakers should align regulatory frameworks with evolving data governance standards to promote interoperability and data exchange across healthcare networks.

The purpose of the article is to substantiate the theoretical and methodological foundations of the study, to determine the specifics, as well as to build a system of management elements for the systemic development of health care facilities. The urgency of the problem of development of theoretical and methodological bases of research of management of system development of health care institutions is revealed. Scientific approaches to the essential interpretation of development management at the micro level are generalized. The specifics and features of the management of systemic development of health care enterprises are identified. The system of principles of management of systemic development of health care institutions is identified and their essential and content characteristics are revealed. The structural elements and the algorithm of management of system development of the enterprise which specialize in rendering of services in the field of public health services are defined. The semantic characteristics of such elements as economic interests of business management entities (owners, investors, founders, managers, personnel, external contractors, consumers), principles, functions, methods, strategy and tactics, management mechanisms and tools, management objects, implemented measures, and their results. The applied significance of the research results is to build a system (and its structure) of elements that together provide management of systemic development of health care facilities. The scientific novelty of the research results is the identification of such specific features of the management of systemic development of health care enterprises as principles (emphasis on the formation of a management culture focused on quality satisfaction of medical and diagnostic needs of clients (human-centeredness), focus of management actions on increasing quantitative and improving the structural and qualitative results of medical and diagnostic services (synergy), parity attention to the implementation of the policy of external social responsibility, including the education of a healthy society (external social responsibility), methods (traditionally, administrative management methods are preferred, while as the health care system is reformed, the role of economic and socio-psychological) and tools (mechanisms and tools for management and decision-making should be based on modern information technologies through the automation of medical records and medical information management; transformation of classical management mechanisms towards market on the basis of development of contractual relations (health care institution – client; state – health care institution)) for development.

Irrational pharmacotherapy is a widespread health care problem, and knowing the prescription practices of physicians at an institutional level can present solutions. This study aimed to investigate whether physicians' prescribing patterns showed differences at the level of the health care institution. Photocopies of 3201 prescriptions written at primary health care centers (PHCs), public hospitals, private hospitals, and university hospitals (UHs) were collected from 10 provinces in Turkey. The prescriptions were evaluated according to prescribing indicators, and the details of drug utilization were compared for different health care institutions. The average number of medicines per prescription was 2.83, and the highest average was noted in PHCs (2.96). The average cost per prescription was US $51.57, and the highest average cost was found in UHs (US $166.10). The most frequently prescribed drug group was different among health care institutions. With the exception of UHs, the "cold-cough medicines" were the most frequently prescribed medicines at all of the institutions. Thirty-nine percent of the prescriptions included antibiotics. Despite the similarities between the distributions of diagnoses on prescriptions by health care institutions, the contents of the prescriptions showed differences. The high levels of prescriptions for "cold-cough medicines," whose use is widely debated, and the widespread tendency of physicians to prescribe antibiotics suggest that there is a growing need for disseminating the principles of rational pharmacotherapy. Furthermore, institutional differences must be considered when conducting rational pharmacotherapy programs.

This chapter addresses complaints, grievances, and ombudsman schemes, which are designed to provide effective and speedy relief where problems arise between a customer and an organization. It has become increasingly common for government agencies, companies, and organizations to have internal complaints and grievance procedures to look into and respond to any problems raised by their customers of a formal nature. It is seen to be good for customer relations for problems to be investigated by someone within the organization and for the problem to be resolved with the customer quickly and before it escalates into a contentious dispute. Efficient and effective complaints and grievance procedures also form part of an organization's quality control or quality assurance procedures, which are aimed at ensuring that high levels of service are maintained, with any weaknesses being addressed swiftly before other customers are affected by similar problems. Meanwhile, ombudsmen act like umpires in complaints brought against public or private organizations.

In this work, a novel and an innovative method for identifying blood groups using fingerprint images with deep learning is introduced. Additionally, this new technique can be used immediately to address situations where blood needs to be drawn from a patient. Blood grouping, which identifies blood groups such as A+, A-, B+, B-, AB+, AB-, O+, and O-, is a very important medical task in healthcare institutes, blood banks, forensic analysis, among other medical institutions, where methods have proven to be rather tedious. Based on existing correlations with fingerprint ridge detail analysis, this work incorporates state-of-the-art deep learning models such as ResNet50, VGG16, AlexNet, GoogleNet, and LeNet models for efficient fingerprint analysis. Moreover, this work proposes a novel design model of a CNN network outperforming all existing models in accuracy and model efficacy. Furthermore, this work proposes a pre-processing stage of fingerprint images with enhanced ridge detail analysis before analysis using fingerprint optimized parameters based on existing fingerprint datasets. Additionally, this work incorporates a systematic evaluation analysis of accuracy, precision, recall, and F1-score analysis to quantify model efficacy and accuracy. Moreover, this work incorporates a developed graphical interface platform using a web browser platform for immediate identification of blood groups based on image uploads.