In the dynamic environment of increasing regulations, increasing patient demand, decentralization of budgets and enforcement of efficiency, small sized healthcare institutions in the Netherlands are having a difficult time. Although these service providers are usually capable of flexibly delivering healthcare, the investment and overhead for implementing and executing on required quality management standards like ISO 9001 is difficult. In this paper we construct a method for the implementation of an IT-enabled quality management system for small sized healthcare institutions, which is applied through case study. The case organisation provides intra- and extramural care for mentally handicapped persons and young adults with a psychiatric disorder. The quality management system implementation is based on 1) a lightweight IT infrastructure (based at a secure data centre and accessible through remote login) implying secure storage of patients' medical and personal information. Furthermore, the Deming (Deming, 1982) cycle enabled processes and protocols are 2) described in an e-handbook and prototyped via an open source process management system which supports the quality regulation demanded for providing care to patients. The case study supports the validity of our method and the fact that small sized healthcare institutions are able to execute their care while adhering to ISO 9001-like standards, with limited initial costs and relatively low cost of ownership
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Experts like Jouslin de Noray, Shiba and Hardjono discern three paradigms in quality management: control, continuous improvement and breakthrough. Van Kemenade argues that before being able to reach breakthrough you need another paradigm: commitment.
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Climate change and urbanization will increase the frequency and magnitude of urban flooding and water quality problems in many regions of the world. In coastal and delta areas like The Netherlands and the Philippines, where urbanization is often high, there has been an increase in the adoption of sustainable urban drainage systems (SUDS). SUDS are installed around the world with the expectation to reduce urban flooding and reduce the pollution impact on receiving waters. Most cities in Asia are starting to implement SUDS as their strategy to make their cities sustainable and resilient.The combination of SUDS with appropriate wastewater treatment and management systems have the potential to be multifunctional in alleviating flood run-off, improving water quality, alleviating heat stress and as a source for reusing the stormwater and wastewater.Since the earliest SUDS are implemented in Europe decades ago it is advised to use the lessons learnt in this process. International knowledge exchange is promoted in projects as IWASTO where several organisations from the Philippines and The Netherlands join forces on a specific region as the Pateros riverin Manila with the aim to minimise the pollution impact on this receiving water. The first findings of this project related to storm water and wastewater management are presented in this paper. In this stage of the project high level support models that map the challenges in the city (such as flooding and heatstress) arevaluable tools for implementing cost effective sustainable drainage for improving water quality.
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OBJECTIVE: To conduct a randomized controlled trial and compare the effects on cancer survivors' quality of life in a 12-week group-based multidisciplinary self-management rehabilitation program, combining physical training (twice weekly) and cognitive-behavioral training (once weekly) with those of a 12-week group-based physical training (twice weekly). In addition, both interventions were compared with no intervention.METHODS: Participants (all cancer types, medical treatment completed > or = 3 months ago) were randomly assigned to multidisciplinary rehabilitation (n = 76) or physical training (n = 71). The nonintervention comparison group consisted of 62 patients on a waiting list. Quality of life was measured using the RAND-36. The rehabilitation groups were measured at baseline, after rehabilitation, and 3-month follow-up, and the nonintervention group was measured at baseline and 12 weeks later.RESULTS: The effects of multidisciplinary rehabilitation did not outperform those of physical training in role limitations due to emotional problem (primary outcome) or any other domains of quality of life (all p > .05). Compared with no intervention, participants in both rehabilitation groups showed significant and clinically relevant improvements in role limitations due to physical problem (primary outcome; effect size (ES) = 0.66), and in physical functioning (ES = 0.48), vitality (ES = 0.54), and health change (ES = 0.76) (all p < .01).CONCLUSIONS: Adding a cognitive-behavioral training to group-based self-management physical training did not have additional beneficial effects on cancer survivors' quality of life. Compared with the nonintervention group, the group-based self-management rehabilitation improved cancer survivors' quality of life.
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There are lots of definitions of quality, and also of quality in education. Garvin (1984)discerns five approaches: the transcendental approach, the product-oriented approach, the customeroriented approach, the manufacturing-oriented approach and the value-for-money approach. Harvey and Green (1993) give five interrelated concepts of quality as: exceptional, perfection (or consistency), fitness for purpose, value for money and transformative. A new definition of quality is needed to explain recent quality issues in higher education. This article describes a quality concept with four constituents: object, standard, subject and values. The article elaborates on the values. Four value systems derived from Beck and Cowan (1996) are transformed into four value systems on quality and quality management: control, continuous improvement, commitment and breakthrough. These value systems make it possible to explain some recent developments in quality management in higher education.
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Legal management is een nieuw vakgebied, dat de praktijkvan juridische professionals vanuit een organisatiekundigperspectief benadert. Binnen organisaties heeft legalmanagement het doel de kwaliteit van de juridische functiete optimaliseren. In deze unieke uitgave schetsen experts deontwikkeling van dit nieuwe vakgebied en gaan zij in op destand van zaken van het legal management in verschillendesectoren van de Nederlandse rechtspraktijk: de centrale endecentrale overheid, het bedrijfsleven en de advocatuur.Voor iedereen die geïnteresseerd is in de organisatie vanjuridische dienstverlening en juridische processen.
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How to design and implement a system of Total Quality Management in education
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BackgroundThe challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work.MethodsWe conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017).ResultsThe LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace.ConclusionsThe availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.
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Purpose - This paper aims to explain the influence of facility design on urban quality of life from the perspective of students' research. The outcome of this paper is to determine the influence of facility management (FM) on the quality of life to citizens in the city of The Hague by actively using facility design to positively influence the liveability. Methodology - This current explorative study has been qualitative in nature, including desk research, literature study in relation to urban environment, walk through, observations and interviews with local residents and officials from the local government. This paper indicates how urban FM is defined based on the student perspective. Findings - More than 2000 FM students of The Hague University of Applied Sciences have been conducting research on urban facility management over the last 15 years. This educational module have provided data on changes at neighbourhood level resulting in numerous small-scale improvements initiated by the department of Urban Development, Housing, Sustainability and Culture of The Hague. Intended impact - A better understanding of urban facility management and integration of people, places and processes within the urban environment, improving liveability in neighbourhoods and an entrance into global citizenship for young professionals. This study will support The Hague University of Applied Sciences in the evolving field of urban FM. It provides the school of Facility Management with the opportunity to perform additional research in order to deliver evidence to society on the influence and impact of urban FM.
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A baseline study was performed to characterize the stormwater quality from the upstream roofs and road areas. Results showed variations in stormwater quality. This may inhibit single-step treatment performance. Therefore, a ‘treatment train’ of several SUDS measures was developed in order to achieve high pollutionremoval rates and to help prevent loss of valuable archaeological deposits and thereby reduce subsidence.
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