Minnesota 4-H Youth Program Quality Improvement Model

The University of Minnesota Extension Center for Youth Development made an organizational decision in 2011 to invest in a system-wide approach to implement youth program quality into the 4-H program using the Youth Program Quality Assessment (YPQA) tool. This article describes the four key components to the Minnesota Youth Program Quality Improvement model, the reasons for investing in this work, and recommendations for other states that may build youth program quality improvement models

Introduction of a Spinal Care Pathway Triage Protocol in the Secondary Care Setting

Background: Back pain is considered the leading cause of disability worldwide. Providing effective multidisciplinary care for clients with chronic back pain (CBP) has been an ongoing issue globally. Improper care management of CBP creates personal, economic, and societal burdens that significantly affect patients, their families, and the healthcare system. Purpose: This quality improvement project aimed to successfully integrate a spinal care pathway (SCP) electronic decision support tool (e-tool) into a multidisciplinary spinal care program, to improve providers’ satisfaction with care delivery and their satisfaction with CBP patient outcomes. Methods: This DNP project used an evidence-based quality improvement (EBQI) design to introduce an SCP e-tool into a multidisciplinary spinal care program, a secondary healthcare setting. The Institute for Healthcare Improvements’ Plan-Do-Study-Act cycle was used as the pilot change process to evaluate the effects of an SCP use on CBP patients’ delivery of care and healthcare providers’ satisfaction rates. Results: Of the NSI staff who participated in the surveys, 57.14% agreed, and 42.86% highly agreed that the SCP e-tool is and will be helpful in collaboratively triaging their CBP patients to the most appropriate care modalities to decrease pain and increase functionality, which is a critical metric indicator. (N=7). Conclusion: The SCP e-tool is a novel electronic clinical decision support tool that will provide an evidence-based method to improve the quality and delivery of care for CBP patients. The results of this EBQI project revealed clinical relevance to support the integration of the SCP e-tool into the NSI’s secondary clinical practice setting

A decision support system for drinking water production integrating health risks assessment

The issue of drinking water quality compliance in small and medium scale water services is of paramount importance in relation to the 98/83/CE European Drinking Water Directive (DWD). Additionally, concerns are being expressed over the implementation of the DWD with respect to possible impacts on water quality from forecast changes in European climate with global warming and further anticipated reductions in north European acid emissions. Consequently, we have developed a decision support system (DSS) named ARTEM-WQ (AwaReness Tool for the Evaluation and Mitigation of drinking Water Quality issues resulting from environmental changes) to support decision making by small and medium plant operators and other water stakeholders. ARTEM-WQ is based on a sequential risk analysis approach that includes consideration of catchment characteristics, climatic conditions and treatment operations. It provides a holistic evaluation of the water system, while also assessing human health risks of organic contaminants potentially present in treated waters (steroids, pharmaceuticals, pesticides, bisphenol-a, polychlorobiphenyls, polycyclic aromatic hydrocarbons, petrochemical hydrocarbons and disinfection by-products; n = 109). Moreover, the system provides recommendations for improvement while supporting decision making in its widest context. The tool has been tested on various European catchments and shows a promising potential to inform water managers of risks and appropriate mitigative actions. Further improvements should include toxicological knowledge advancement, environmental background pollutant concentrations and the assessment of the impact of distribution systems on water quality variation

The effects of ISO 9001 quality management system on innovation and management capacities in the Malaysian furniture sector.

Although the ISO 9001 quality management system is often perceived to be a marketing tool within the manufacturing industry, its implications on the innovation and management capacities of the furniture industry remain unknown. A survey of furniture manufacturers in Malaysia revealed that lack of innovation and ineffective management were among the main problems faced within the industry. Using a structured questionnaire, a survey of the ISO-certified manufacturers revealed that the ISO 9001 quality management system has a positive correlation on process innovation but not on product innovation. Therefore, ISO-certification would be beneficial for productivity improvement and identifying cost-cutting measures in furniture manufacturing enterprises. On the other hand, ISO-certification has a significant influence on the management of furniture enterprises, especially with regards to systematic decision-making and boosting the level of professionalism. Therefore, ISO-certification may be a useful tool to enhance the management competency and also improve the productivity within the furniture manufacturing sector

Screening and Ranking Methodology Applied to Biochars Aimed at Acidic and Calcareous Sandy Soil Improvement

The application of biochar (the by-product of biomass pyrolysis), as a soil amendment has been accepted as a sustainable solution to improve soil quality. The current study aims to establish a decision support tool for characterizing, ranking, and selecting biochars of different origins for soil improvement, thereby contributing to the development of a systematic approach, which lacks in the existing literature.The development of a Multi-Criteria Decision Support Approach applying a banded and weighted rating and scoring system allowed the selection and ranking of various biochars suitable for improving sandy soils before application. First, 14 selected, different biochar products (produced from industrial by-products, herbaceous, wood-based and manure-based feedstocks) were characterized with several physicochemical, biological and ecotoxicological methods taking into account both the technological and the environmental efficiency aspects of biochar utilization. Then, a system for the assessment and ranking of biochars for acidic, and calcareous neutral sandy soil improvement was developed, which could be flexibly adapted to different soil problems as well. Based on their performance in the tests, scores from (−5) to (+5) were assigned to each biochar. As a result, the grain husks and paper fiber sludge biochar was ranked as the most suitable for both acidic and neutral calcareous sandy soil improvement, with 55 and 43 scores, respectively (from the maximum 100). The applicability of this innovative multicriteria scoring-ranking system, as a tool for potential biochar users, was verified in microcosms and field-scale experiments, demonstrating the positive influence of this biochar on the acidic sandy soil

Assessment of river water quality using an expert system

This study is to develop an expert system to assess water quality for user to derive at a decision equivalent to an expert decision. The ES-RWQ was developed as simple yet reliable tool to assist user in assessing the status of the water quality and relating it to the source contributing to the water quality problem. The main objective is to build a prototype of ES-RWQ with an assessment method, and the ability to derive to a recommendation on the water quality problem. While the conventional models can provide an inside to the quality problem but being complex issue in itself, an effective method of extracting value added information from all sources to facilitate decisions on the implementation of cost-effective pollution prevention and control measurements still requires expert consultation. Therefore a re-look at the process of managing water quality are critical and timely to ensure the strategies and actions planned will lead to measurable water quality improvement. Reliable assessment tools are needed to effectively communicate the water quality data so that the data become an important part of finding solutions and decision making process. Expert system (ES-RWQ) aim to assist decision maker and water quality managers to decide on the most appropriate decision/action to be taken when confronting a situation which requires immediate action. ES-RWQ was developed using the visual basic programming language as the tool that consists of user interface, knowledge engine, and inference engine. The user interface can be construct using menu driven or natural language as the communication mode between user and the system. Load duration curve has been identified as one of the assessment tool that offers a practical approach to watershed management. The duration curve has an added value due to its ability to perform a quick and reliable statistical analysis of data targeting the sources as well as linking it to the potential implementation efforts to the hydrologic condition of the watershed. The assessment of water quality was based on pollutant loading model establishing the load capacity of the river to determine specific limit for thr river in receiving pollutant. Selection of tools was based on the combination of prediction reliability with ease of use and reduced requirement of field data. A prototype developed using Microsoft Visual Basic and validated by selecting two sub-catchment from Melaka and one sub-catchment of upper Sungai Langat, Selangor. Four variables Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), Ammoniacal Nitrogen (AN) and Total Suspended Solid (TSS) of different river classification standard were also selected to validate the ES-RWQ. The 20 years of flow data, the variables, and other information on the sub catchment were input into the prototype, for it to execute the knowledge and the inferences engine to ensure the system produced the expected result. ES-RWQ, produced an output of a load duration curve as the assessment for the water quality status, with it graphical representation, map extract from the geographical information system and recommendation to control pollution source identified. When the information of sub-catchments were executed by the system the output perform as per the specification design for the system to function. Test run with the user agencies was conducted with three rivers; Sg. Pinang, Pulau Pinang, Sg. Jelai, Pahang and Sg. Kanowit, Sarawak. The ES-RWQ was agreed by user agencies as an assessment tool and loading capacity as new approach to determine the status of water quality and identify sources of pollution. With effective knowledge management tool such as ES-RWQ will enhance decision making process and employing computer based-technology to capture knowledge and human expert knowledge as an added toolfor river water quality management

Perancangan Sistem Pendukung Keputusan Dalam Penilaian Kinerja Guru Dan Pegawai Menggunakan Metode Vikor (Studi Kasus : SMP Negeri 1 Kota Tebing Tinggi)

Having teachers, teaching staff and professional staff is a must for schools in carrying out a quality education process, as is the case with SMP Negeri 1 Kota Tebing Tinggi. For this reason, schools always encourage the improvement of teacher professionalism by monitoring teacher performance in implementing their duties so that they can achieve predetermined competency standards. The creation of a decision support system is one way to assist in determining teacher performance assessments at SMP Negeri 1 Kota Tebing Tinggi and is expected to The system is able to determine the best teacher or employee based on ranking. Decision Support System (DSS) is a system that produces an alternative decision that can be used as a tool in making a decision. The VIKOR method was chosen because this method determines the weight value for each attribute, then proceeds with a ranking process that will select the best alternative from a number of alternatives, in this case the alternative in question is the teacher who has the highest teacher performance assessment (PKG) based on the criteria specified. determined and questionnaires filled out by students and school principal

A novel decision making approach for benchmarking the service quality of smart community health centers

The purpose of this research is to develop a novel approach to benchmark smart community health centers in order to achieve continuous improvement of service quality. Three methods are presented: the fuzzy DEMATEL method is used to determine the criteria weights, the fuzzy ELECTRE III method is employed to obtain the ranking of smart community health centers, and IPA (Importance-Performance Analysis) is employed to formulate improvement strategies. The proposed approach clearly identifies the strengths and weakness of each smart community health center by ranking its performance with respect to a system of five service quality criteria. In addition, IPA is able to develop the most effective improvement strategies for each smart community health center. The proposed approach was applied to five smart community health centers in Beijing and service strengths and weakness are discussed. The proposed approach has three notable advantages. First, the novel approach can address ambiguity and uncertainty in the process of decision making. Second, interdependent relationships among the evaluation criteria are analyzed by the fuzzy DEMATEL method, so that the weights obtained are more in line with reality. Third, the fuzzy ELECTRE III method considers non-compensatory behavior for service quality comparisons among smart community health centers. The novel fuzzy-based approach presented in this paper is a powerful and highly effective tool to benchmark smart community health centers and develop successful improvement strategies of service quality

Development of a Decision Support System for Drought Characterization and Management: Application to Lexington, Kentucky

This report presents the results of an investigation into the potential use of expert system technology as an effective tool for drought forecasting and management. Historical data derived from the Kentucky River Basin was used to test the resulting decision support system. This study has demonstrated that expert system technology can serve as an effective platform for use in assisting the decision maker in both characterizing the nature of an existing drought and in selecting and implementing the required management policy. The success of any decision making process will of course be dependent upon the quality of the data upon which those decisions are made. In the current study, the critical data were the forecasted streamflow and the forecasted system demand for the coming week. Several different model structures were investigated for use in forecasting both streamflow and system demand. While a reasonable level of accuracy was obtained for the demand forecasts, only limited success was obtained in forecasting future weekly average streamflows. As a result, a probabilistic model structure was developed for use with streamflow forecasts that allowed more interaction with the decision maker. Although the resulting model evaluations failed to produce what may be considered satisfactory results, the developed model structure does provide a flexibility that may lead to improved performance by augmentation with additional rule based heuristics. Although not fully explored, several potential heuristic structures are identified. Additional model improvement can be expected by further refinement of the underlying deterministic streamflow forecast model structure

Improving the Coordination of Care for Periprocedural Antithrombotic Medication Management in Patients Undergoing Elective Surgery

Background: Arranging periprocedural antithrombotic medication (ATM) management is a frequently encountered complex clinical challenge. Often, there is limited time between the pre-admission clinic visit and the surgical date to coordinate ATM management and communicate the plan to the patient. This increases the risk of perioperative adverse events, case delays and cancellations, and is a patient safety concern. A quality improvement project was undertaken to address improving ATM periprocedural care coordination for patients taking ATM undergoing elective surgery. A review of the literature found clinical decision support system (CDSS) alerts to be an effective strategy. The aim of the project was to improve the quality and safety of ATM by optimizing the care coordination pathway for periprocedural ATM management. Methods: A multidisciplinary team was formed to collaborate on the project aims,intervention, and implementation plan. The intervention was a computer application for auto-identification and flagging of ATM to deploy a CDSS alert for referral to an online workflow organization tool (list manager) to coordinate ATM periprocedural management. Current state analysis was conducted. Results. Qualitative and quantitative evidence demonstrated variation across surgical services in coordinating periprocedural ATM management. This data supported project approval by senior leadership. Request for programming was submitted. Planning for piloting the intervention in two clinical areas where bleeding is of critical concern continues. Conclusion. The project was complex in both scope and design, affecting multiple stakeholders with competing concerns. In the first iteration, the request for programming the CDSS alert was denied. This required the project team to pivot to an alternative solution, an online workflow organization tool (list manager) and extended the project timeline. Recommendations: This quality improvement project demonstrates the need for further quality improvement initiatives and research on improving the coordination of periprocedural ATM management. It highlights the complexity of this care coordination process