A Practical Guide to Performance Improvement: Tools and Tips to Sustain and Control Project Improvements

AORN Journal ◽  
2019 ◽  
Vol 110 (5) ◽  
pp. 510-515
Author(s):  
Anthony Dawson
Keyword(s):  
Performance Improvement ◽  
Practical Guide ◽  
And Control

Approach and Effect Analysis of Amplitude Frequency Performance Improvement in Metal Bar Cropping with Variable Frequency Vibration

2012 ◽  
Vol 152-154 ◽  
pp. 770-774
Author(s):  
Li Jun Zhang ◽  
Jie Qiong Xue ◽  
Sheng Dun Zhao ◽  
Yong Rui Zhao
Keyword(s):  
Performance Improvement ◽  
Cross Section ◽  
Narrow Range ◽  
Experimental Results ◽  
Variable Frequency ◽  
Structure Model ◽  
Effect Analysis ◽  
Steel Bar ◽  
Different Types ◽  
And Control

In order to solve the narrow range and control difficulties of the excited frequency in metal bar cropping with variable frequency vibration, the structure of the eccentric block in cropping machine was improved on in the paper and a new structure model of changing the integral eccentric block into one of main eccentric block and some small adjustable eccentric blocks, was also proposed. The key parameters of the cropping machine in the action of two different types of eccentric blocks were analyzed theoretically in detail. At the same time, the corresponding amplitude frequency characteristics of the cropping machine were also obtained. The cropping experimental results of 45 steel bar show that the cross-section quality and the cropping time are improved remarkably in the action of one main eccentric block and four adjustable eccentric blocks, comparing with the cropping results in the action of the whole eccentric block.

Increasing the percentage of advance directives in patient medical records.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 226-226
Author(s):  
Christopher A. Waynick ◽  
Jan Conwill ◽  
Victor Gian
Keyword(s):  
End Of Life ◽  
Performance Improvement ◽  
Medical Records ◽  
End Of Life Care ◽  
Process Change ◽  
High Resource ◽  
Performance Metric ◽  
Fishbone Diagram ◽  
Advance Care ◽  
And Control

226 Background: Advance care planning is often initiated too late, which leads to added stress and high resource utilization at the end of life which is contrary to many patients’ wishes. Ideally, discussing patient’s wishes should start early. An advance directive (AD) documents patient preferences for end-of-life care. Methods: In order to improve this process, the team used the DMAIC process: Define, Measure, Analyze, Improve, and Control. In the define phase, 79 new cancer diagnosis patients’ medical records were reviewed and completed. This revealed that 25.58% of these patients claim to have an AD, but only 5% have an AD documented in their record within 30 days of their first visit. Upon further discussion with staff, there was no standard process. The focus performance metric for the project was to have the AD in the chart within 30 days of their first visit. Goal was set at 20%. Analyzing the process was as follows: Process map, Fishbone diagram to determine potential improvements. Priority pay-off matrix. The most effective process change would be to add a notice in the new patient packet for the patient to bring their AD with them to their first visit. Results: The first iteration of the improve phase included the notice created in the analyze phase. After completion, 60% of patients had an AD in their chart within 30 days of their first visit. For the second iteration, the team worked with psychology staff to create a letter to the patient explaining the advantages of having an AD in the chart. Results were 100% of the performance improvement metric. Controlling this process change is simple, but continuing a 100% target is difficult. Some patients who do not have an AD in their chart feel uncomfortable with it or do not understand what it is. Future improvements include patient education processes and provider discussions with the patients to ensure an 80% target is maintained. Conclusions: The team learned developing and communicating a formal process is imperative to achieving the target. Also important is to communicate clearly with the patients, enabling them to understand what (and why) their provider needs from them.

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