This paper describes the different methodologies which can be used to deal with the technological impact of deteriorated beet on processing. The procedure developed by EU sugar beet research institutes to protect long-term stored beet against the outside weather conditions is considered a necessary preventive measure to limit beet deterioration. In addition, a wide range of process measures is available to handle incoming deteriorated beet material in beet sugar manufacture. The specific dextran processing problems associated with frost-damaged beet cannot normally be solved by the usual process measures and require the addition of the rather expensive enzyme dextranase. A few alternative processes which could either improve or even enable the processing of deteriorated beet are briefly discussed. The financial consequences of processing deteriorated beet on the manufacturing costs of white sugar are outlined. Finally, the point is explained at which processing of very badly affected beet is supposed to be technologically as well as economically unacceptable.
BACKGROUND: Dedicated quality-improvement (QI) initiatives within health care systems are of clear benefit, and physicians respond to financial incentivization. The Canadian health care system often lacks this lever, and many financially incentivized QI programs rely on traditional economic principles. We describe our evaluation of financial incentivization for the implementation of QI process metrics in a department of surgery at a Canadian academic hospital system and its impact over a 4-year period. METHODS: Quality-improvement processes informed by extant QI incentivization literature and guided by the principles of behavioural economics were implemented within our institution's Department of Surgery. Disbursement of supplemental government funding was modified to be contingent on the ability of divisions within the department to meet predefined QI metrics, including regular multidisciplinary meetings, morbidity and mortality rounds with documented feedback of systemic issues to division members, reviews of adverse events, and implementation of annual patient experience projects. We evaluated the effect of the QI processes from 2015/16 to 2018/19. RESULTS: There was a significant increase in the number of divisions that satisfied all the QI metrics over the study period, from 2 (28%) in 2015/16, to 5 (71%) in 2016/17, to 7 (100.0%) in 2017/18 and 2018/19 (p < 0.01). The application of behavioural economics principles, such as reward versus penalty payoff, loss aversion, payment separation, aligning of values, and relative social ranking, was important to the outcome of the study. CONCLUSION: Incentivizing QI activities in the Canadian health care system is possible and led to improvement in QI processes as a whole in our department. This paper lays out a method of financial reimbursement to facilitate engagement of physicians and establishment of a foundation of important QI processes and measures within a department.
Prior research suggests hospital quality of care is multidimensional. In this study, the authors jointly examine patient experience of care and clinical care measures from 2,583 hospitals based on inpatients discharged in 2006 and 2007. The authors use multinomial logistic regression to identify key characteristics of hospitals that perform in the top quartile on both, either, and neither dimension of quality. Top performers on both quality measures tend to be small (<100 beds), large (>200 beds) and rural, located in the New England or West North Central Census divisions, and nonprofit. Top performers in patient experience only are most often small and rural, located in the East South Central division, and government owned. Top performers in clinical care only are most often medium to large and urban, located in the West North Central division, and non—government owned. These findings provide an overview of how these dimensions of quality vary across hospitals.
Objective In the context of anesthesiology, we investigated whether the salience effort expectancy value (SEEV) model fit is associated with situation awareness and perception scores. Background The distribution of visual attention is important for situation awareness—that is, understanding what is going on—in safety-critical domains. Although the SEEV model has been suggested as a process situation awareness measure, the validity of the model as a predictor of situation awareness has not been tested. Method In a medical simulation, 31 senior and 30 junior anesthesiologists wore a mobile eye tracker and induced general anesthesia into a simulated patient. When inserting a breathing tube into the mannequin's trachea (endotracheal intubation), the scenario included several clinically relevant events for situation awareness and general events in the environment. Both were assessed using direct awareness measures. Results The overall SEEV model fit was good with no difference between junior and senior anesthesiologists. Overall, the situation awareness scores were low. As expected, the SEEV model fits showed significant positive correlations with situation awareness level 1 scores. Conclusion The SEEV model seems to be suitable as a process situation awareness measure to predict and investigate the perception of changes in the environment (situation awareness level 1). The situation awareness scores indicated that anesthesiologists seem not to perceive the environment well during endotracheal intubation. Application The SEEV model fit can be used to capture and assess situation awareness level 1. During endotracheal intubation, anesthesiologists should be supported by technology or staff to notice changes in the environment.
We meta-analytically synthesized the intergroup variability literature (177 effect sizes, from 173 independent samples, and 12,078 participants) to test the potential moderating effect of 11 measures of perceived variability. Aggregating across the measures, we detected a small but reliable tendency to perceive more variability among ingroup than outgroup members and such outgroup homogeneity was stronger among non-minimal than minimal groups. Furthermore, analyses that distinguished among the 11 measures revealed systematic discrepancies among the patterns of perception detected by those measures. Those systematic discrepancies further varied across social contexts defined by relative group status, with some measures yielding ingroup homogeneity and others outgroup homogeneity. We discuss the possibility that the measures of variability require different mental activities that interact with contextually induced cognitive and motivational processes to yield disparate intergroup perceptions.
Purpose:The purpose of the research is to explore a practical method of measuring the implementation of lean in a process. The method will be based on examining the abilities of a group. At this scale the ability to work standardized and solve problems is important. These two abilities are dependent of each other and are fundamental for the group's ability to create a stable result. In this context the method of standardized work (SW) is define to be the methods used in a process to generate stable results. Problem solving (PS) is defined as the methods used to return a process to a condition where SW is possible.
Methodology /approach: The research is conducted in a multiple case study in four large global manufacturing companies. The order of the data collection is: Firstly, interviews with the individuals that are centrally responsible for overall implementation of lean in the organization. Secondly, observe the implementation of SW and PS at the group level. In total 7 groups have been studied and 19 respondents interviewed.
Findings: Results show that the central definition of the methods for standardized work does not by itself have a direct impact on success of implementation of SW at group level. The method of SW where similar on a general level in the different cases, but with varying levels of implementation at group level was applied. Results also show that key factors for a successful implementation of standardized work on group level are: Ownership of the process, Direct connection to result of process, Correct workload and Leader demand. Methods of PS at group level where dissimilar despite a superficially similar approach. The evaluation method used was successful in providing comparable results between the cases.
Research limitations: A limitation of this research is within the scale of the measurement, as it only examines the group level. The research is further limited to four companies and seven groups.
Originality/value of paper: This paper aims to fill a gap in the established measurement methods of lean, as it examines the abilities of SW and PS at the group level of a process. These abilities are often referred to as essential in lean theory. However, there has been little scholarly work in defining the methods of SW and PS or the key factors affecting the methods at an operational level.
The European Union and its member states are investing in ambitious programmes for?better regulation? and targets of regulatory quality. This book lifts the veil of excessively optimistic propositions covering the whole better regulation agenda. It provides an innovative conceptual framework to handle the political complexity of regulatory governance. It approaches better regulation as an emerging public policy, with its own political context, actors, problems, rules of interaction, instruments, activities and impacts. Focusing on the key tools of impact assessment, consultation, simplificati
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