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Results for “Performance benchmarking”

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PubMed1998

Designing and implementing an outcomes-based performance improvement project: behavioral health care.

1. All performance measurement and improvement initiatives should be planned. Planning should reveal the origins of the project, define and validate the project purpose, specify the desired effect of the project, develop project success measures, specify necessary resources, describe any constraints, anticipate problems, and specify milestones and deadlines. 2. An interdisciplinary team is usually created to implement the improvement project. This team is generally composed of staff from different disciplines, organizational entities, and levels throughout the facility. 3. Am improvement team typically consists of an executive coach, a team leader, a facilitator, and multiple team members. Sometimes a measurement specialist is included in the team. Additional subject matter experts serve as ad hoc team members as needed. 4. Data management is a process comprising the following discrete activities: determination of data needs, specification of indicators, definition of data elements, specification of data sources, creation of data collection instruments, determination of data analysis strategies, completion of a data collection plan, pilot testing of data collection and analysis, and modification of data management tactics based on the results of the pilot test. 5. There are two fundamental kinds of studies: quantitative and qualitative. Quantitative studies present numeric performance data, such as averages, correlations,and variation. Qualitative studies provide narrative data, such as content and theme analyses, and individual quotes. 6. Effective data collection requires valid and reliable data collection instruments and trained data collectors. 7. Analysis of performance data may be quantitative or qualitative and may compare an organization's performance to itself over time, as well as to external benchmarks. 8. Root cause analysis is based on tools such as the process flow diagram, cause-effect diagram, scatter diagram, Pareto analysis, and repetitive why to determine the causes of achieved performance. 9. Improvement ideas should be tested on a small scale by using a systematic approach such as the PDCA cycle. 10. Findings and results of performance measurement and improvement initiatives should be communicated to internal and external audiences via a variety of approaches.

Behavior Therapy↗

PubMed1999

A national day only surgery benchmarking basket.

The efficient management of day surgery facilities benefits both patients and health administrators. Patients can benefit through minimisation of hospital stay while day surgery has the potential to increase elective surgery throughput and to reduce waiting times. This paper explores whether routinely collected morbidity data from Queensland public hospitals can be used to benchmark levels of day only surgery between hospitals. Thirteen procedures were identified that met criteria for inclusion in a day only surgery benchmarking basket. Queensland public hospitals and individual procedures were benchmarked against one another and analysed to determine whether hospitals performing the 13 procedures demonstrate the same rates of day only surgery. With the development of a clinically meaningful and administratively simple tool for comparing hospital day surgery rates using routinely collected morbidity data, the opportunity now exists for health services to compare the performance of clinical services both within and between hospitals. It is also suggested that the basket of procedures identified in this study could form the basis of a national day only surgery benchmarking process.

Ambulatory Surgical Procedures↗

PubMed2005

Benchmark studies of induced radioactivity produced in LHC materials, Part II: Remanent dose rates.

A new method to estimate remanent dose rates, to be used with the Monte Carlo code FLUKA, was benchmarked against measurements from an experiment that was performed at the CERN-EU high-energy reference field facility. An extensive collection of samples of different materials were placed downstream of, and laterally to, a copper target, intercepting a positively charged mixed hadron beam with a momentum of 120 GeV c(-1). Emphasis was put on the reduction of uncertainties by taking measures such as careful monitoring of the irradiation parameters, using different instruments to measure dose rates, adopting detailed elemental analyses of the irradiated materials and making detailed simulations of the irradiation experiment. The measured and calculated dose rates are in good agreement.

Benchmarking↗

PubMed2000

Benchmarking in health-system pharmacy: experience at Glens Falls Hospital.

The experience of Glens Falls Hospital (GFH) with the Benchmarking Program coordinated by The Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital is described. GFH, a community hospital in upstate New York with 442 licensed beds, serves a patient population drawn from a five-county area. In 1998, GFH developed a multidisciplinary pharmacy task force charged with generating strategic initiatives for curtailing drug costs. Proposals for various programs, including specific goals, were developed with the aid of trends reported in the individual hospital reports provided by the Benchmarking Program. The data obtained through these reports helped GFH's pharmacy staff establish goals for the appropriate use of many agents, including vancomycin, and allowed GFH to assess the impact of its initiatives through comparisons with similar hospitals across the United States. In 1995, vancomycin expenditures at GFH substantially exceeded those for benchmark hospitals of similar types, but, with the implementation of new vancomycin guidelines aimed at reducing inappropriate use in 1996, the difference was eliminated. The individual hospital reports generated by the Benchmarking Program provide valuable data that can be used to assess pharmacy performance, set drug expenditure goals, and design programs to reduce antimicrobial resistance.

Benchmarking↗

PubMed2004

A particle swarm optimizer with passive congregation.

This paper presents a particle swarm optimizer (PSO) with passive congregation to improve the performance of standard PSO (SPSO). Passive congregation is an important biological force preserving swarm integrity. By introducing passive congregation to PSO, information can be transferred among individuals of the swarm. A particle swarm optimizer with passive congregation (PSOPC) is tested with a set of 10 benchmark functions with 30 dimensions and compared to a global version of SPSO (GSPSO), a local version of SPSO (LSPSO), and PSO with a constriction factor (CPSO), respectively. Experimental results indicate that the PSO with passive congregation improves the search performance on the benchmark functions significantly.

Algorithms↗

PubMed1998

1998 benchmarking guide. Data with destiny.

Numbers seldom tell the whole story, but they certainly point out the direction you're going. Our 1998 Benchmarking Guide to Managed Care gives you the lowdown on top performers in markets already dominated by managed care and those yet to turn the corner.

Ambulatory Care↗

PubMedDate not supplied

Surgical benchmarks for the treatment of invasive bladder cancer.

Radical cystectomy is the gold standard for treatment of localized invasive bladder cancer in the United States. In recent years, there has been increasing focus on the importance of surgical technique as a factor that may influence the clinical and oncologic outcome of the operation, beyond the classically recognized patient and tumor-related factors. There is still insufficient high-quality evidence to support the absolute standardization of the surgical technique or the establishment of firm benchmarks by which the individual surgeon can measure performance. However, there is considerable evidence suggesting that 3 aspects of surgical technique have an impact on outcome: (1) Positive surgical margins nearly always result in ultimate cancer death. The rate of positive margins varies with surgeon experience as well as with cancer-specific variables. (2) The extent of lymphadenectomy has a significant impact on recurrence rates of the cancer, regardless of whether the lymph nodes are pathologically positive or not. (3) Higher volume surgeons have lower operative mortality and fewer positive surgical margins than low-volume surgeons. Higher volume hospitals also have lower operative mortalities and shorter hospital stays for patients who have undergone radical cystectomy. In this review, the authors evaluate the evidence supporting each of these statements and suggest potential areas of standardization of surgical technique that could translate into improved patient outcomes.

Benchmarking↗

PubMed1998

Community pharmacist interventions in a capitated pharmacy benefit contract.

Documented interventions associated with processing prescriptions in a managed care environment were analyzed, and a bench-mark for interventions was proposed. A retrospective analysis of documented interventions by 31 pharmacies contracted by a managed care organization to serve 22,000 Medi-Cal patients was undertaken. An intervention consisted of identifying any problem related to a prescription, taking action, and recording the problem, action, and outcome on a form. Problems were categorized as drug selection issues, clinical issues, errors in prescription writing, and patient education issues. A similar process was followed for describing actions and outcomes. The data were used as an indicator of prescription-related problems in contemporary pharmacies in a managed care environment; data from another study were used as an indicator of "ideal" pharmacist performance in detecting and resolving problems. The estimated intervention rate when pharmacists meeting ideal performance expectations worked in a managed care environment was set as a benchmark. The economic impact of drug selection interventions was determined as well. Data were retrieved and compiled from 595 (93.4%) of 637 interventions performed in 1995, when 93,483 contract-related prescriptions were processed by the 31 pharmacies. Fifty percent of problems related to drug selection issues. The most frequent action was contacting the presciber (56.1%). The overall intervention rate was 0.7% (range, 0-4.1%). It was estimated that 4% of prescriptions would require an intervention; two pharmacies met this level. Interventions resulting in prescription change realized an average decrease in cost of 65.8%. Community pharmacies under contract with a managed care organization intervened on 0.7% of prescriptions, but the rate of intervention across pharmacies was inconsistent, ranging from 0% to 4.1%; a benchmark of 4% would be reasonable.

California↗

PubMed2005

Improving the performance of SOMFA by use of standard multivariate methods.

Self-Organizing Molecular Field Analysis (SOMFA) comes with a built-in regression methodology, the Self-Organizing Regression (SOR), instead of relying on external methods such as PLS. In this article we present a proof of the equivalence between SOR and SIMPLS with one principal component. Thus, the modest performance of SOMFA on complex datasets can be primarily attributed to the low performance of the SOMFA regression methodology. A multi-component extension of the original SOR methodology (MCSOR) is introduced, and the performances of SOR, MCSOR and SIMPLS are compared using several datasets. The results indicate that in general the performance of SOMFA models is greatly improved if SOR is replaced with a more sophisticated regression method. The results obtained for the Cramer (CBG) dataset further underline the fact that it is a very poor benchmark dataset and should not be used to evaluate the performance of QSAR techniques.

Multivariate Analysis↗

PubMed2000

Internet-based monitoring and benchmarking in ambulatory surgery centers.

BACKGROUND: Each year the number of surgical procedures performed on an outpatient basis increases, yet relatively little is known about assessing and improving quality of care in ambulatory surgery. Conventional methods for evaluating outcomes, which are based on assessment of inpatient services, are inadequate in the rapidly changing, geographically dispersed field of ambulatory surgery. Internet-based systems for improving outcomes and establishing benchmarks may be feasible and timely. METHODS: Eleven freestanding ambulatory surgery centers (ASCs) reported process and outcome data for 3,966 outpatient surgical procedures to an outcomes monitoring system (OMS), during a demonstration period from April 1997 to April 1999. ASCs downloaded software and protocol manuals from the OMS Web site. Centers securely submitted clinical information on perioperative process and outcome measures and postoperative patient telephone interviews. Feedback to centers ranged from current and historical rates of surgical and postsurgical complications to patient satisfaction and the adequacy of postsurgical pain relief. RESULTS: ASCs were able to successfully implement the data collection protocols and transmit data to the OMS. Data security efforts were successful in preventing the transmission of patient identifiers. Feedback reports to ASCs were used to institute changes in ASC staffing, patient care, and patient education, as well as for accreditation and marketing. The demonstration also pointed out shortcomings in the OMS, such as the need to simplify hardware and software installation as well as data collection and transfer methods, which have been addressed in subsequent OMS versions. DISCUSSION: Internet-based benchmarking for geographically dispersed outpatient health care facilities, such as ASCs, is feasible and likely to play a major role in this effort.

Benchmarking↗

PubMedDate not supplied

Performance measurements in emergency medical services.

With the strong encouragement of leading health care agencies, business principles are being implemented throughout health care, including emergency medical services (EMS). The reason is simple--quality of care can be enhanced by incorporating the management concepts of continuous quality improvement (CQI). The CQI process couples carefully identified, measurable performance indicators with information systems to monitor, analyze, and trend data. Benchmarking outcomes with other EMS systems allows the identification of "best practices" and the evolution of standards. Emergency medical services professionals must actively participate with the broader health care community in creating performance measurements to ensure that high-quality care is delivered consistently.

Benchmarking↗

PubMed2006

Benchmarking pK(a) prediction.

BACKGROUND: pKa values are a measure of the protonation of ionizable groups in proteins. Ionizable groups are involved in intra-protein, protein-solvent and protein-ligand interactions as well as solubility, protein folding and catalytic activity. The pKa shift of a group from its intrinsic value is determined by the perturbation of the residue by the environment and can be calculated from three-dimensional structural data. RESULTS: Here we use a large dataset of experimentally-determined pKas to analyse the performance of different prediction techniques. Our work provides a benchmark of available software implementations: MCCE, MEAD, PROPKA and UHBD. Combinatorial and regression analysis is also used in an attempt to find a consensus approach towards pKa prediction. The tendency of individual programs to over- or underpredict the pKa value is related to the underlying methodology of the individual programs. CONCLUSION: Overall, PROPKA is more accurate than the other three programs. Key to developing accurate predictive software will be a complete sampling of conformations accessible to protein structures.

Catalysis↗

PubMed2004

Optimization and dynamics of protein-protein complexes using B-splines.

A moving-grid approach for optimization and dynamics of protein-protein complexes is introduced, which utilizes cubic B-spline interpolation for rapid energy and force evaluation. The method allows for the efficient use of full electrostatic potentials joined smoothly to multipoles at long distance so that multiprotein simulation is possible. Using a recently published benchmark of 58 protein complexes, we examine the performance and quality of the grid approximation, refining cocrystallized complexes to within 0.68 A RMSD of interface atoms, close to the optimum 0.63 A produced by the underlying MMFF94 force field. We quantify the theoretical statistical advantage of using minimization in a stochastic search in the case of two rigid bodies, and contrast it with the underlying cost of conjugate gradient minimization using B-splines. The volumes of conjugate gradient minimization basins of attraction in cocrystallized systems are generally orders of magnitude larger than well volumes based on energy thresholds needed to discriminate native from nonnative states; nonetheless, computational cost is significant. Molecular dynamics using B-splines is doubly efficient due to the combined advantages of rapid force evaluation and large simulation step sizes. Large basins localized around the native state and other possible binding sites are identifiable during simulations of protein-protein motion. In addition to providing increased modeling detail, B-splines offer new algorithmic possibilities that should be valuable in refining docking candidates and studying global complex behavior.

Algorithms↗

PubMedDate not supplied

A status report on the characterization of the microgravity environment of the International Space Station.

A primary objective of the International Space Station is to provide a long-term quiescent environment for the conduct of scientific research for a variety of microgravity science disciplines. Since continuous human presence on the space station began in November 2000 through the end of Increment-6, over 1260 hours of crew time have been allocated to research. However, far more research time has been accumulated by experiments controlled on the ground. By the end of the time period covered by this paper (end of Increment-6), the total experiment hours performed on the station are well over 100,000 hours (Expedition 6 Press Kit: Station Begins Third Year of Human Occupation, Boeing/USA/NASA, October 25, 2002). This paper presents the results of the on-going effort by the Principal Investigator Microgravity Services project, at NASA Glenn Research Center, in Cleveland, Ohio, to characterize the microgravity environment of the International Space Station in order to keep the microgravity scientific community apprised of the reduced gravity environment provided by the station for the performance of space experiments. This paper focuses on the station microgravity environment for Increments 5 and 6. During that period over 580 Gbytes of acceleration data were collected, out of which over 34,790 hours were analyzed. The results presented in this paper are divided into two sections: quasi-steady and vibratory. For the quasi-steady analysis, over 7794 hours of acceleration data were analyzed, while over 27,000 hours were analyzed for the vibratory analysis. The results of the data analysis are presented in this paper in the form of a grand summary for the period under consideration. For the quasi-steady acceleration response, results are presented in the form of a 95% confidence interval for the station during "normal microgravity mode operations" for the following three attitudes: local vertical local horizontal, X-axis perpendicular to the orbit plane and the Russian torque equilibrium attitude. The same analysis was performed for the station during "non-microgravity mode operations" to assess the station quasi-steady acceleration environment over a long period of time. The same type of analysis was performed for the vibratory, but a 95th percentile benchmark was used, which shows the overall acceleration magnitude during Increments 5 and 6. The results, for both quasi-steady and vibratory acceleration response, show that the station is not yet meeting the microgravity requirements during the microgravity mode operations. However, it should be stressed that the requirements apply only at assembly complete, whereas the results presented below apply up to the station's configuration at the end of Increment-6.

Acceleration↗

PubMed2006

Direct descent curvature optimal control with a modification algorithm and its application to nonlinear process.

This paper presents a direct descent second order or direct descent curvature algorithm with some modifications for the optimal control computations. This algorithm is compared with Hamiltonian methods in the literature. The proposed algorithm has generated numerically robust solutions with respect to conjugate points. The weighting matrix updating scheme was developed to improve the second-order optimal control algorithm, tested the performance of the algorithm, and shown on the benchmark and industrial process. The time-varying optimal feedback (TVOFB) gains are also generated along the trajectory as byproducts. If the trajectory deviates from the optimal trajectory for any reason (i.e., changing of system parameters, step disturbance into the plant, changing of initial conditions), it is held on the optimal trajectory by means of the optimal feedback. Simulations have been given for controlling the Van der Pol and bioreactor system, which are nonlinear benchmark systems.

Journal Article↗

PubMed2003

Diagnosis of the industrial systems by fuzzy classification.

The aim of this paper is to present a classifier based on a fuzzy inference system. For this classifier, we propose a parametrization method which is not necessarily based on an iterative training. This approach can be seen as a pre-parametrization which allows the determination of the rules base and the parameters of the membership functions. We also present a continuous and derivable version of the previous classifier and suggest an iterative learning algorithm based on a gradient method. An example using the learning basis IRIS, which is a benchmark for classification problems, is presented showing the performances of this classifier. Finally this classifier is applied to the diagnosis of a dc motor showing the effectiveness of this method.

Algorithms↗

PubMed1997

Investigation of the CasCor Family of Learning Algorithms.

Six learning algorithms are investigated and compared empirically. All of them are based on variants of the candidate training idea of the Cascade Correlation method. The comparison was performed using 42 different datasets from the PROBEN1 benchmark collection. The results indicate: (1) for these problems it is slightly better not to cascade the hidden units; (2) error minimization candidate training is better than covariance maximization for regression problems but may be a little worse for classification problems; (3) for most learning tasks, considering validation set errors during the selection of the best candidate will not lead to improved networks, but for a few tasks it will. Copyright 1997 Elsevier Science Ltd.

Journal Article↗

PubMed2000

Steady neutron source measurement method for sigma(a) and sigma(s) in geological samples

An improved experimental method, using a steady neutron source in a moderating medium, has been developed to determine thermal neutron absorption and scattering cross sections for bulk geological media using discrete samples. The system design has been optimized and experimental results have been benchmarked using Monte Carlo simulation. Studies have been performed to improve the measurement sensitivity and reproducibility over previous designs. A semi-empirical model has been developed for determining both absorption and scattering cross sections of the sample.

Journal Article↗