An intraorganizational model for developing and spreading quality improvement innovations

BACKGROUND Recent policy reforms encourage quality improvement (QI) innovations in primary care, but practitioners lack clear guidance regarding spread inside organizations. PURPOSE We designed this study to identify how large organizations can facilitate intraorganizational spread of QI innovations. METHODOLOGY/APPROACH We conducted ethnographic observation and interviews in a large, multispecialty, community-based medical group that implemented three QI innovations across 10 primary care sites using a new method for intraorganizational process development and spread. We compared quantitative outcomes achieved through the group's traditional versus new method, created a process model describing the steps in the new method, and identified barriers and facilitators at each step. FINDINGS The medical group achieved substantial improvement using its new method of intraorganizational process development and spread of QI innovations: standard work for rooming and depression screening, vaccine error rates and order compliance, and Pap smear error rates. Our model details nine critical steps for successful intraorganizational process development (set priorities, assess the current state, develop the new process, and measure and refine) and spread (develop support, disseminate information, facilitate peer-to-peer training, reinforce, and learn and adapt). Our results highlight the importance of utilizing preexisting organizational structures such as established communication channels, standardized roles, common workflows, formal authority, and performance measurement and feedback systems when developing and spreading QI processes inside an organization. In particular, we detail how formal process advocate positions in each site for each role can facilitate the spread of new processes. PRACTICE IMPLICATIONS Successful intraorganizational spread is possible and sustainable. Developing and spreading new QI processes across sites inside an organization requires creating a shared understanding of the necessary process steps, considering the barriers that may arise at each step, and leveraging preexisting organizational structures to facilitate intraorganizational process development and spread.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially

The LHC Inverse Problem, Supersymmetry and the ILC

We address the question whether the ILC can resolve the LHC Inverse Problem within the framework of the MSSM. We examine 242 points in the MSSM parameter space which were generated at random and were found to give indistinguishable signatures at the LHC. After a realistic simulation including full Standard Model backgrounds and a fast detector simulation, we find that roughly only one third of these scenarios lead to visible signatures of some kind with a significance {ge} 5 at the ILC with {radical}s = 500 GeV. Furthermore, we examine these points in parameter space pairwise and find that only one third of the pairs are distinguishable at the ILC at 5{sigma}

Dark Matter in the MSSM

We have recently examined a large number of points in the parameter space of the phenomenological MSSM, the 19-dimensional parameter space of the CP-conserving MSSM with Minimal Flavor Violation. We determined whether each of these points satisfied existing experimental and theoretical constraints. This analysis provides insight into general features of the MSSM without reference to a particular SUSY breaking scenario or any other assumptions at the GUT scale. This study opens up new possibilities for SUSY phenomenology both in colliders and in astrophysical experiments. Here we shall discuss the implications of this analysis relevant to the study of dark matter.Comment: 27 pages, 19 figs; Journal version in NJP issue "Focus on Dark Matter and Particle Physics". Previous version had 26 pages, 19 figures. Text and some figures have been update

Higgs After the Discovery: A Status Report

Recently, the ATLAS and CMS collaborations have announced the discovery of a 125 GeV particle, commensurable with the Higgs boson. We analyze the 2011 and 2012 LHC and Tevatron Higgs data in the context of simplified new physics models, paying close attention to models which can enhance the diphoton rate and allow for a natural weak-scale theory. Combining the available LHC and Tevatron data in the ZZ* 4-lepton, WW* 2-lepton, diphoton, and b-bbar channels, we derive constraints on the effective low-energy theory of the Higgs boson. We map several simplified scenarios to the effective theory, capturing numerous new physics models such as supersymmetry, composite Higgs, dilaton. We further study models with extended Higgs sectors which can naturally enhance the diphoton rate. We find that the current Higgs data are consistent with the Standard Model Higgs boson and, consequently, the parameter space in all models which go beyond the Standard Model is highly constrained.Comment: 37 pages; v2: ATLAS dijet-tag diphoton channel added, dilaton and doublet-singlet bugs corrected, references added; v3: ATLAS WW channel included, comments and references adde

Improving the sensitivity of Higgs boson searches in the golden channel

Leptonic decays of the Higgs boson in the ZZ* channel yield what is known as the golden channel due to its clean signature and good total invariant mass resolution. In addition, the full kinematic distribution of the decay products can be reconstructed, which, nonetheless, is not taken into account in traditional search strategy relying only on measurements of the total invariant mass. In this work we implement a type of multivariate analysis known as the matrix element method, which exploits differences in the full production and decay matrix elements between the Higgs boson and the dominant irreducible background from q bar{q} -> ZZ*. Analytic expressions of the differential distributions for both the signal and the background are also presented. We perform a study for the Large Hadron Collider at sqrt{s}=7 TeV for Higgs masses between 175 and 350 GeV. We find that, with an integrated luminosity of 2.5 fb^-1 or higher, improvements in the order of 10 - 20 % could be obtained for both discovery significance and exclusion limits in the high mass region, where the differences in the angular correlations between signal and background are most pronounced.Comment: 31 pages, 8 figures. v2: Minus signs in definitions of angles corrected. Typos fixed. Reference added. Cosmetic changes to Figure 4. Additional sentence added for clarificatio

The Universal One-Loop Effective Action

We present the universal one-loop effective action for all operators of dimension up to six obtained by integrating out massive, non-degenerate multiplets. Our general expression may be applied to loops of heavy fermions or bosons, and has been checked against partial results available in the literature. The broad applicability of this approach simplifies one-loop matching from an ultraviolet model to a lower-energy effective field theory (EFT), a procedure which is now reduced to the evaluation of a combination of matrices in our universal expression, without any loop integrals to evaluate. We illustrate the relationship of our results to the Standard Model (SM) EFT, using as an example the supersymmetric stop and sbottom squark Lagrangian and extracting from our universal expression the Wilson coefficients of dimension-six operators composed of SM fields.Comment: 30 pages, v2 contains additional comments and corrects typos, version accepted for publication in JHE