Exploring Quality Challenges and the Validity of Excellence Models

\ua9 2016, \ua9 Emerald Group Publishing Limited. Purpose: The purpose of this paper is to identify and explore important quality-related challenges facing organizations, and investigate how current excellence models incorporate these challenges. Design/methodology/approach: The paper is based on a Delphi study of Swedish organizations. Forty-nine challenges were generated and ranked according to importance and the ten top-ranked challenges were compared to the principles of four excellence models. Findings: The excellence models still seem to be relevant since their content matches many of the identified challenges. The Malcolm Baldrige National Quality Award and the Swedish Institute for Quality models were found to have the most comprehensive coverage, while the International Organization for Standardization model had limited coverage. Research limitations/implications: Three areas for further research were identified: first, how quality management (QM) can evolve in different contexts that have varying needs in terms of adaptive and explorative capabilities; second, the interfaces of QM and sustainability, and ways to understand how customers and stakeholders can be active contributors to improvements; and third, the roles of the owners and board of directors regarding QM, and how to organize and distribute responsibilities of the QM work. Practical implications: There are three important challenges that future revisions of excellence models could address: first, making QM a strategic issue for company owners; second, involving customers in the improvement activities; and third, developing processes that are robust yet still easily adaptable. Originality/value: The Delphi study identified upcoming challenges in the QM area based on input from 188 quality professionals

Alive and kicking–but will Quality Management be around tomorrow? A Swedish academia perspective

The purpose of this article is to describe how Quality Management (QM) is perceived today by scholars at three Swedish universities, and into what QM is expected to develop into in twenty years. Data were collected through structured workshops using affinity diagrams with scholars teaching and performing research in the QM field. The results show that QM currently is perceived as consisting of a set of core of principles, methods and tools. The future outlook includes three possible development directions for QM are seen: [1] searching for a “discipline X” where QM can contribute while keeping its toolbox, [2] focus on a core based on the traditional quality technology toolbox with methods and tools, and [3] a risk that QM, as it is today, may seize to exist and be diffused into other disciplines

Impaired Antibody Response Is Associated with Histone-Release, Organ Dysfunction and Mortality in Critically Ill COVID-19 Patients

Purpose: the pathophysiologic mechanisms explaining differences in clinical outcomes following COVID-19 are not completely described. This study aims to investigate antibody responses in critically ill patients with COVID-19 in relation to inflammation, organ failure and 30-day survival. Methods: All patients with PCR-verified COVID-19 and gave consent, and who were admitted to a tertiary Intensive care unit (ICU) in Sweden during March-September 2020 were included. Demography, repeated blood samples and measures of organ function were collected. Analyses of anti-SARS-CoV-2 antibodies (IgM, IgA and IgG) in plasma were performed and correlated to patient outcome and biomarkers of inflammation and organ failure. Results: A total of 115 patients (median age 62 years, 77% male) were included prospectively. All patients developed severe respiratory dysfunction, and 59% were treated with invasive ventilation. Thirty-day mortality was 22.6% for all included patients. Patients negative for any anti-SARS-CoV-2 antibody in plasma during ICU admission had higher 30-day mortality compared to patients positive for antibodies. Patients positive for IgM had more ICU-, ventilator-, renal replacement therapy- and vasoactive medication-free days. IgA antibody concentrations correlated negatively with both SAPS3 and maximal SOFA-score and IgM-levels correlated negatively with SAPS3. Patients with antibody levels below the detection limit had higher plasma levels of extracellular histones on day 1 and elevated levels of kidney and cardiac biomarkers, but showed no signs of increased inflammation, complement activation or cytokine release. After adjusting for age, positive IgM and IgG antibodies were still associated with increased 30-day survival, with odds ratio (OR) 7.1 (1.5-34.4) and 4.2 (1.1-15.7), respectively. Conclusion: In patients with severe COVID-19 requiring intensive care, a poor antibody response is associated with organ failure, systemic histone release and increased 30-day mortality

Impaired Antibody Response Is Associated with Histone-Release, Organ Dysfunction and Mortality in Critically Ill COVID-19 Patients.

PURPOSE: the pathophysiologic mechanisms explaining differences in clinical outcomes following COVID-19 are not completely described. This study aims to investigate antibody responses in critically ill patients with COVID-19 in relation to inflammation, organ failure and 30-day survival. METHODS: All patients with PCR-verified COVID-19 and gave consent, and who were admitted to a tertiary Intensive care unit (ICU) in Sweden during March-September 2020 were included. Demography, repeated blood samples and measures of organ function were collected. Analyses of anti-SARS-CoV-2 antibodies (IgM, IgA and IgG) in plasma were performed and correlated to patient outcome and biomarkers of inflammation and organ failure. RESULTS: A total of 115 patients (median age 62 years, 77% male) were included prospectively. All patients developed severe respiratory dysfunction, and 59% were treated with invasive ventilation. Thirty-day mortality was 22.6% for all included patients. Patients negative for any anti-SARS-CoV-2 antibody in plasma during ICU admission had higher 30-day mortality compared to patients positive for antibodies. Patients positive for IgM had more ICU-, ventilator-, renal replacement therapy- and vasoactive medication-free days. IgA antibody concentrations correlated negatively with both SAPS3 and maximal SOFA-score and IgM-levels correlated negatively with SAPS3. Patients with antibody levels below the detection limit had higher plasma levels of extracellular histones on day 1 and elevated levels of kidney and cardiac biomarkers, but showed no signs of increased inflammation, complement activation or cytokine release. After adjusting for age, positive IgM and IgG antibodies were still associated with increased 30-day survival, with odds ratio (OR) 7.1 (1.5-34.4) and 4.2 (1.1-15.7), respectively. CONCLUSION: In patients with severe COVID-19 requiring intensive care, a poor antibody response is associated with organ failure, systemic histone release and increased 30-day mortality