A Quality Protocol for a Federally Qualified Health Center: A Pilot Project

Federally Qualified Health Centers (FQHCs) have become a vital part of access to care for low socioeconomic status individuals. The federal government has allocated funds to be distributed to FQHCs via Medicare and Medicaid reimbursement based on insurance claims and through the Health Resources and Service Administration (HRSA) via grants and incentives based on Uniform Data System (UDS) reporting. Federally Qualified Health Centers must complete annual uniform data system (UDS) reporting on quality indicator metrics to receive grants and incentives from HRSA. The Health Resources and Service Administration (HRSA) funded health centers are expected to have ongoing quality assurance and improvement programs to improve patient care and outcomes. A local West Michigan clinic is one of a group of five clinics that qualified for FQHC status based on serving the homeless population in the area. They have been operating as a FQHC for several years, but updated to a new EHR platform in January 2016, utilizing the Athena Health EHR. The completion of an organizational assessment assisted in identifying a problem in the level of training staff members receive on the Athena Health EHR, quality indicator documentation, and UDS reporting. Creating a quality protocol that includes staff education regarding UDS reporting and electronic health record functionality has the potential to improve compliance with HRSA reporting. The Donabedian Model was utilized to view the phenomenon of interest regarding quality indicator metrics, documentation and reporting. The PARiHS framework guided the implementation of the quality indicator protocol that incorporated staff education and increased utilization of EHR functionality for improved quality documentation and reporting at this West Michigan FQHC

The Optimization of Efficiency and Infrastructure for Modern Potable Water Treatment Plants

The USDOE Industrial Assessment Centers (IACs) is a program that is designed to help small and medium-sized manufacturing facilities reduce their overall costs and improve energy efficiency. This includes improving potable water treatment plants which supply water throughout the country. This thesis covers the process of how IAC branches and water treatment facilities generally operate, as well as several assessment recommendations that have been developed by a branch of the IAC for several water treatment plants based in the Rio Grande Valley of Texas. The steps of the assessment and water treatment process are described, and several cost saving measures that were developed are discussed at length. These include updating lighting equipment, utilizing improved components in various machinery, updating fenestration, using novel evaporation preventing devices as well as installing renewable energy devices and other energy efficiency measures all showing millions of dollars in potential savings in total

Space charge enhanced plasma gradient effects on satellite electric field measurements

It has been recognized that plasma gradients can cause error in magnetospheric electric field measurements made by double probes. Space charge enhanced Plasma Gradient Induced Error (PGIE) is discussed in general terms, presenting the results of a laboratory experiment designed to demonstrate this error, and deriving a simple expression that quantifies this error. Experimental conditions were not identical to magnetospheric conditions, although efforts were made to insure the relevant physics applied to both cases. The experimental data demonstrate some of the possible errors in electric field measurements made by strongly emitting probes due to space charge effects in the presence of plasma gradients. Probe errors in space and laboratory conditions are discussed, as well as experimental error. In the final section, theoretical aspects are examined and an expression is derived for the maximum steady state space charge enhanced PGIE taken by two identical current biased probes

Genesis of an Expert System For UMR Degree Auditing

This paper describes the features, design, and development of an expert system for degree auditing at the University of Missouri--Rolla. It summarizes artificial intelligence as it is known today while specifically addressing expert systems. It describes selected expert systems currently in existence. The present audit procedure utilized at the University of Missouri--Rolla is discussed. A description is given of the design and development of an expert system, written in LISP, to conduct a degree audit. Finally there are concluding remarks which include an analysis of the system and a discussion of possible system enhancement

A Representation for Serial Robotic Tasks

The representation for serial robotic tasks proposed in this thesis is a language of temporal constraints derived directly from a model of the space of serial plans. It was specifically designed to encompass problems that include disjunctive ordering constraints. This guarantees that the proposed language can completely and, to a certain extent, compactly represent all possible serial robotic tasks. The generality of this language carries a penalty. The proposed language of temporal constraints is NP-Complete. Specific methods have been demonstrated for normalizing constraints posed in this language in order to make subsequent sequencing and analysis more tractable. Using this language, the planner can specify necessary and alternative orderings to control undesirable interactions between steps of a plan. For purposes of analysis, the planner can factor a plan into strategies, and decompose those strategies into essential components. Using properly normalized constraint expressions the sequencer can derive admissible sequences and admissible next operations. Using these facilities, a robot can be given the specification of a task and it can adapt its sequence of operations according to run-time events and the constraints on the operations to be performed

Data Structure for the Use of Patterns in the Perceptual Ordering of the Game of Chess

It is well known that the way one perceives a problem can influence the difficulty of solving the problem in a profound way. In the case of computer chess playing programs, one finds that most programs perceive the game in much the same way. They are all based on Shannon\u27s original proposal for chess playing programs. His approach was to generate all of the possible combinations of moves up to a certain number of plays and then a subset of all combinations to a deeper level thereafter. Each of these moves would then be evaluated as to its relative worth. This paper lays the foundation for research in an alternate method of approaching the game based on how human experts perceive the board initially. A suitable data structure for this is then proposed and discussed

A Computerized Audio-Visual Speech Model

This thesis describes an expert system able to animate (graphically) and reproduce (acoustically) a text in any language which uses the Latin alphabet. A rule editor has been developed to create and modify the set of letter-to-sound rules of the target language. A parser has been implemented to apply the set of rules and translate text-to-speech. Each phoneme has a unique sound and thus requires its particular positioning of the vocal organs which are displayed in two different projections: a front view and a profile cross view of a human face in synchronization with the output sounds of the speech synthesizer

CIEGEN: A System for Testing Knowledge Base Compilation Heuristics on a Microcomputer

The expert system has proven itself to be a valuable aid in diagnosing and treating problems in domains requiring expertise. The commercial world has been alerted to this fact and the thrust is to make the expert system portable and available on small computers. The goal of this research has been to lay the groundwork for a domain independent expert system builder on a microcomputer. The result of this effort was CIEGEN, a system consisting of a rule compiler, inference engine, and rule generator developed on the IBM PC. It is domain independent, responsible for transforming a knowledge base of rules into heuristic based decision trees, and capable of performing backward chaining consultations. The system is also heuristic independent, allowing a knowledge base to be compiled by different heuristics and compared using the log created by the inference engine. A subgoal of the development of CIEGEN has been to study the heuristics used to compile a knowledge base because the efficiency of the expert system is based on the intelligence of the heuristic. The heuristic used by EMYCIN was implemented and compared with a heuristic developed by the author. For the six types of knowledge based generated by CIEGEN\u27s rule generator, EMYCIN\u27s heuristic, on the average, executed more quickly

The Optimal Trajectory Modelling of Robot Manipulators

Greater robot capability can be achieved through the use of robot manipulator control systems. Crucial to the success of these control systems is the optimal trajectory modelling of the path traced by the end- effector. To create this optimal path the utilization of B-Spline curve functions will be investigated, and compared to Cubic Spline curve functions

An Experimental Study of the Effects of Modularity on Resource Consumption in Software Development

Many authors have encouraged the use of modular programming techniques in software development. In fact, there is almost total agreement within industrial and academic circles that modularity is a desirable feature of any software package. Unfortunately, the desirability of modular design is almost always voiced without support from experimental evidence. This paper consists of an experiment comparing the resource consumption of programmers based on the modularity practices employed during the design and programming phases of software development. The experiment tests the effectiveness of modularity in reducing psychological complexity of software. The results of the research show that in some cases there is indeed a difference in resource consumption between the modularity practices tested. However, the stated benefits of modularity did not carry over to the design and programming phases of software development. The use of modularity seemed, in fact, to increase development costs in some cases