Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics

Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.

Performance of a Horizontal Flow Constructed Reed Bed Filter for Municipal Wastewater Treatment: The Case Study of the Prototype Installed at Gaston Berger University, Saint-Louis, Senegal

In Saint-Louis, Senegal, a constructed wetland with horizontal flow reed beds (FHa and FHb) has demonstrated significant efficacy in treating municipal wastewater. Analyzing various treatment stages, the system showed only a slight temperature variation, from an influent average of 26.3°C to an effluent of 24.7°C. Electrical conductivity decreased from 1331 mS/cm to 974.5 mS/cm post-primary treatment, with suspended solids (SS) dramatically reduced from 718.9 mg/L to 5.7 mg/L in the final effluent. Biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) saw a notable decrease, from initial levels of 655.6 mg/L and 1240 mg/L to 2.3 mg/L and 71.3 mg/L, respectively. Nitrogenous compounds (N-TN) and phosphates () also decreased significantly, indicating the system’s nutrient removal capacity. Microbiological analysis revealed a reduction in fecal coliforms from 7.5 Ulog/100ml to 1.8 Ulog/100ml and a complete elimination of helminth eggs. The presence of Phragmites and Typha was instrumental in enhancing these reductions. The system’s compliance with the Senegalese standards for disposal into natural environments, WHO recommendations for unrestricted water reuse in irrigation, and the European legislation for water reuse was established. The effluent quality met the stringent criteria for various classes of agricultural reuse, illustrating the system’s potential for sustainable water management. This wetland model presents a robust solution for water-stressed regions, ensuring environmental protection while supporting agricultural needs. The study calls for ongoing research to further refine the system for optimal, reliable wastewater treatment and water resource sustainability.

Environmental Anthropological Study of Watershed Management‐Water Quality Conservation of Forest as a Catchment Area in the Southern Part of Australia

Authors have conducted an experiment of irradiation using sound waves (frequency) including ultrasonic waves into water such as drinking water, sea water and forest water and wastewater so far. As a result, almost the same effect of improvement of water quality was confirmed for each sound wave. Then, an environmental anthropological study of watershed management based on the sound was carried out assuming that a water quality management using the sound could be possible. The Goulburn River basin in the southern part of Australia in which indigenous peoples (Yorta Yorta) have been concerned with the management for a long time so far was selected as an objective drainage basin this time. As a result, a couple of environmental anthropological perspectives on watershed management were proposed.

Target Entities of Total Quality Management Based on the New TQM and Three-Dimensional Unification Value Models

In recent years, the method of TQM (Total Quality Management) is widely recognized. However, contents of target entities for assessment are various, and it is very difficult to define the whole scope of TQM. On the other hand, it is very important to define the whole target entities of quality management about the TQM because lack of important target entities may cause significant risk of loss in future. Furthermore, target entities of TQM should correspond to needs and priority of an objective requirement and that should be based on the consideration of basic principle of quality management. In the previous study, we have proposed the “framework of new TQM” of assessment for a total quality management of organizations based on the original concept of “TQM matrix”. On the other hand, we have proposed the view point of “Three-Dimensional Unification Value Models” for an evaluation of system product. Therefore, in this paper, we propose the target entities of whole assessment of quality management of organization totally based on the consideration of “New TQM framework” and the view point of “Three-Dimensional Unification Value Models”. Also, this paper proposes the result of verification based on the result of comparison between proposed target entities of assessment and American Malcolm Baldrige Prize for Performance Excellence.

Improving Clinical Laboratory Quality through Reduction of Tests’ Turnaround Time in Democratic Republic of the Congo: Key Strategies

In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

HONG KONG HOUSING AUTHORITY ——THE EVOLUTION OF QUALITY

The Hong Kong housing authority houses a half po pulation of Hong Kong. It constructs and manages pro perty on a massive scale. In 1989, the housing authority makes the decision that by 1993, its construction project management arm, and all construction companies working for the Housing Authority would be certified to the ISO 9000 standard. This decision is to have a profound and lasting impact on the construction industry in Hong Kong. In 1996, a management enhancement programme is launched. Targeting all 15 000 staff in the housing department, the programme aims at changing the culture of the organization and its partners in delivering high calibre services to customers. This paper examines the motivation and reasons behind the initiatives. It outlines the approach and framework used as the authority changes the mindset of a large department of the civil service.

Common Management Process Model of New TQM Based on the Situation Analysis

In the previous study, we suggested the concept of new TQM based on the consideration of basic concept of Quality Control. Also, in the previous study, we suggested the target domains and entities of product and process based on the TQM Matrix and view point of Three Dimensional Unification Value Models for managing quality of organization systems. Furthermore, in the previous study, we suggest the Common Management Process of organizations. Based on the above suggestion, in this paper, we would like to propose the Common Management Process Model of Total Quality Management based on the consideration of situation analysis and more precise definition of TQM Matrix and Three Dimensional Unification Value Model of “Product and Process”. Improvement of quality and efficiency of organization management can be expected by the integration of conventional different management such as quality assurance, quality improvement, risk management, investment individually from the view point of common management process.

Using quality improvement methods to increase use of pain prevention strategies for childhood vaccination

AIM To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.METHODS Specific intervention strategies(i.e.,comfort positioning,nonnutritive sucking and sucrose analgesia,distraction) were identified,selected and introduced in three waves,using a Plan-Do-Study-Act framework.System-wide change was measured from baseline to post-intervention by:(1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and(2) caregiver satisfaction ratings following the visit.Additionally,self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention to assess for possible long-term cultural shifts.RESULTS Significant improvements were noted post-intervention.Use of at least one pain prevention strategy was documented at 99% of patient visits and 94% of caregivers were satisfied or very satisfied with the pain prevention care received.Parents/caregivers reported greater satisfaction with the specific pain prevention strategy used [t(143) = 2.50,P ≤ 0.05],as well as greater agreement that the pain prevention strategies used helped their children's pain [t(180) = 2.17,P ≤ 0.05] and that they would be willing to use the same strategy again in the future [t(179) = 3.26,P ≤ 0.001] as compared to baseline.Staff and caregivers also demonstrated a shift in attitudes from baseline to 1-year post-intervention.Specifically,staff reported greater agreement that the pain felt from vaccinations can result in harmful effects [2.47 vs 3.10; t(70) =-2.11,P ≤ 0.05],less agreement that pain from vaccinations is "just part of the process" [3.94 vs 3.23; t(70) = 2.61,P ≤ 0.05],and less agreement that parents expect their children to experience pain during vaccinations [4.81 vs 4.38; t(69) = 2.24,P ≤ 0.05].Parents/caregivers reported more favorable attitudes about pain prevention strategies for vaccinations across a variety of areas,including safety,cost,time,and effectiveness,as well as less concern about the pain their children experience with vaccination [4.08 vs 3.26; t(557) = 6.38,P ≤ 0.001],less need for additional pain prevention strategies [3.33 vs 2.81; t(476) = 4.51,P ≤ 0.001],and greater agreement that their doctors' office currently offers pain prevention for vaccinations [3.40 vs 3.75; t(433) =-2.39,P ≤ 0.05].CONCLUSION Quality improvement methodology can be used to help close the gap in implementing pain prevention strategies during routine vaccination procedures for children.

Strong Seedlings of Improved Varieties and High-efficiency Cultivation of Artificial Forests Promotes the Early Realization of"Carbon Neutrality"

China is striving to achieve"carbon dioxide peaking"in 2030 and"carbon neutrality"in 2060.In addition to optimizing and upgrading the industrial structure and increasing industrial emission reduction,afforestation is an important way to increase forest carbon sinks and achieve carbon dioxide peaking and carbon neutrality.Improved seedlings are significantly better than general seedlings in terms of afforestation adaptability,growth and stress resistance.The use of improved varieties for afforestation can improve the quality of afforestation from the source.Although the growth cycle of economical tree species is short,and the carbon storage does not increase after directional cultivation,they significantly improve the quality and yield,and indirectly reduce carbon emissions compared with ordinary seedlings.Therefore,in agricultural and forestry production,the transformation and utilization efficiency of improved varieties should be improved and the planting structure should be optimized to improve the quality and efficiency and significantly improve the yield and carbon storage,and the management of plantations should be strengthened to help achieve the goal of"carbon neutrality"as soon as possible.This paper analyzed the current situation of improved varieties and plantation management in China,and put forward corresponding countermeasures.

CONTINUOUS IMPROVEMENT THROUGH INTEGRATION OF QUALITY TOOLS

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.

Procedure Design to Fulfill Quality Management System

With the application of the principle of PDCA, and dr awing on the experience of the process methods of the ISO9000 and the system met hods of management, the author analyses the basic requirement to fulfill quality management system in enterprises. Then the author inquires into the procedure t o establish the efficiency quality management system. Finally four stages (plan, do, check, action) and eight steps (decision, plan, analyze, design, do, check, improve, fulfill) are put forward to fulfill quality management system.

Study on Technical Schemes for Major Pollutants Emission Reduction in Beijing North Canal River Basin Based on Watershed Water Quality Target Management

Water quality target management in watershed is the fundamental choice of city rivers suffering both serious pollution and severe water shortage. In this study, we performed a case study regarding river pollution control plan based on water quality target management in the North Canal River catchment of Beijing section, in order to obtain effective water quality improvement programs. The ammonia nitrogen (NH3-N) and chemical oxygen demand (COD) were taken as the main controlling pollutants. Water quality targets and basic water quality improvement scenarios were set up considering different intensities of population regulation scenarios and gradually strengthening emission control measures. The MIKE11 model was adopted to simulate the effects of a range of water quality improvement scenarios. Results indicated that the basic scenarios could dramatically improve the surface water environment. However, additional intensive and combined measure programs should be implemented to ensure that the water quality would basically meet the targets of corresponding water function zones. The results highlight the need to implement water conservation in water shortage urban river basin and show the importance of enhancing drainage communication and conducting ecological water replenishment in such kind basins. It is expected to provide a reference for the water environment management practice of other metropolis in the world facing both crisis of water resource shortage and water environment pollution.

AN ORGANIZATIONAL CULTURE FOR QUALITY THROUGH EMPOWERMENT MANAGEMENT

Total quality management (TQM) is of strategic significance in winning the required edge for manufacturers in Hong Kong to survive in the ever increasingly competitive market. Mere capitalization on the cheap availability of labour and land in the China's Mainland for competitiveness is no longer viable because of the emergence of new competitors in particular those in Asia countries. TQM aiming for continuous improvements is the key for profitability growth and long run competitiveness. Over emphasis in the “hardware” for quality improvement without the complementation of it with the cultivation of the “software” for its implementation will not only delay the real implementation of real TQM but may also result in catastrophic failure of the organization in the face of rapid changes in demand and expectations of customers. An organizational culture for quality improvement through management empowerment is believed to be fruitful in helping the Hong Kong manufacturers to win the uphill battle for their well being and even survival in the world competition.

General Frame Work of New TQM Based on the ISO/IEC25000 Series of Standard

Generally, for quality improvement of an organization management, TQM (Total Quality Management) is used worldwide and recognized. However, contents of activity are various, and it is difficult for organization to define the whole scope of TQM. It is very important that the activity theme about the TQM is based on the consideration of the needs and priority from the objective requirement, which should correspond to the basic consideration of quality management. If we have selected the wrong theme, and missed understanding about importance and priority of target for TQM, it may cause a significant risk in the organization management. For example, the company which got a high evaluation about the quality of management has poor management and disgraceful affair after several years, and it is a case reaching the bankruptcy. We worked on a study for improvement of technique for quality requirement and evaluation of system for many years, and have participated in the development of international standard for supporting the quality requirements and evaluation of system in ISO/IECJTC1/SC7. The organization having a specific purpose is a kind of system. It is thought that evaluation technique of the system quality is adaptive for a quality evaluation of the organization management. Therefore, this study suggests the new framework of TQM from the view point of the general framework of management defined in ISO/IEC25040 and TQM matrix. Furthermore, this paper presents the result of comparison between proposed action theme derived from a framework of new TQM and the example of existing TQM, and reports an inspection result of the effectiveness.

Determination of Factors and Quality Control of Car Painting Based on FMEA and SPC.V2

The global automotive industry demands world-class levels of product quality, productivity, and competitiveness as well as continual improvement. To achieve this goal,?many vehicle manufacturers companies use?quality control tools to improve the quality of the product with zero defects and highly satisfied to the customer. Nowadays, there are a lot of quality tools applied to solve the problem quickly but it’s still the fact to find out good and efficient solving way. The study emphasizes the identification of potential failure which failures may have encountered in the production process and it will lead to car scrap, rework and influence of the internal production and quality target. After the complete study of the manufacturing process and production data-failure causes, failure rate and data etc. FMEA discover the weak processes in the form of higher risk priority number in the manufacturing of the car painting process, which required reducing by identifying and implementing of the defects and this will improve the process quality of the painting surface of the car. To analysis, the improvement of the car surface defects SPC (Statistical Process Control) tools are more efficient where can easily visible the defects trends. SPC chart is chronological graphs of process data that are used in manufactures industries to help understand, control and improve the process and that although based on statistical theory area easy for practitioners to use and interpret. In order to orient goal of zero defects of the car, surface uses the PFMEA technique to prioritize?the defects and statistically analyze the roots cause of the defect and control the defects through continues improvements process.

职能部门多学科联合诊疗提升医疗质量的实践路径——以浙江大学医学院附属儿童医院为例

医疗质量安全是公立医院高质量发展的基础和前提,多学科联合诊疗(multi-disciplinary treatment,MDT)理念对于医院职能部门协同开展医疗质量管理实践具有重要价值。浙江大学医学院附属儿童医院创新探索符合儿童医院自身特色的质量管理模式,构建职能部门医疗质量MDT实践路径,形成临床科室主动发起会诊,各职能部门多方协同双向互动,精准发现并解决问题,持续追踪并反馈改进的闭环管理流程。该模式实施后,全院医疗质量安全水平全面提升,主要表现为科室一级质控能力增强,绩效考核核心指标优化,患者满意度显著提升,对促进医院高质量发展具有深远意义。

数字化校园环境下提升高校教学管理质量的研究

党的“二十大”报告提出,全面贯彻党的教育方针,落实立德树人根本任务,深化教育领域综合改革,建设高质量教育体系,办好人民满意的教育。随着“新医科”理念的提出,扎实推进学科课程思政教学建设以及国家教育数字化战略行动,完善教育信息化标准体系,适应新的教育发展过程,教学管理工作就显得尤为重要。基于此,文章主要阐述了高校教学管理的意义和内涵,就教学管理工作中发现的主要问题进行分析讨论,探究高校教学管理水平的路径和方法,用以支持教学管理工作的科学发展。

土木工程学科博士研究生培养质量提升的体系构建研究

高层次人才培养和创新创造是研究生教育的重要使命。近期,多部门联合发文要求加快新时代研究生教育改革。只有按照“四个面向”为国家破解“卡脖子”技术,取得原创新科技成果才能成为国家战略科技力量。围绕“立德树人、服务需求、提高质量、追求卓越”的新发展思路,结合同济大学深化综合改革方案和建设世界一流大学的总体需要,对于土木工程学科博士研究生培养质量提升体系的构建进行研究,进一步突显人才培养的质量与内涵,着重强调课程和培养中间环节的质量保证和过程监督、研究生培养分流退出机制、学院和导师的主体责任,构建闭环管理体系以提升博士研究生培养质量。

持续质量改进管理对降低产妇自然分娩后尿潴留发生率的效果研究

目的探讨持续质量改进对降低产妇自然分娩后尿潴留发生率的效果。方法本研究为临床观察研究,选取2021年1月至12月于广东省妇幼保健院自然分娩的产妇作为研究对象,其中将产一区3062例产妇作为试验组、产二区3112例产妇作为对照组。试验组产妇年龄(29.52±4.25)岁;会阴伤口情况:无伤口266例,Ⅰ度裂伤2152例,Ⅱ度裂伤、侧切644例。对照组产妇年龄(29.68±4.09)岁;会阴伤口情况:无伤口244例,Ⅰ度裂伤2179例,Ⅱ度裂伤、侧切689例。对照组实施常规尿潴留护理措施,试验组在常规护理基础上给予持续质量改进管理措施。观察试验组及对照组尿潴留发生率、留置尿管率、尿潴留产妇护理单使用规范率,对比改进前后尿潴留发生率、留置尿管率、尿潴留产妇护理单使用规范率。采用χ^(2)检验、秩和检验、独立样本t检验。结果试验组与对照组尿潴留发生率、留置尿管率、尿潴留产妇护理单使用规范率对比差异均有统计学意义[3.20%(98/3062)比4.45%(139/3112),1.40%(43/3062)比2.80%(87/3112),88.78%(87/98)比56.12%(78/139)](χ^(2)=6.702、14.354、29.988,均P<0.05)。改进前后对比发现,产妇尿潴留发生率、留置尿管率、尿潴留产妇护理单使用规范率对比差异均有统计学意义(均P<0.05)。结论持续质量改进能够有效降低产妇自然分娩后尿潴留发生率及提高护理质量水平。