在知識經濟發展的21世紀，高等教育的需求是世界性的趨勢。台灣在過去20年中，高等教育有急速的膨脹，因此高等教育的品質管制也成為重要的議題。高等教育評鑑中心 (HEEACT) 目前在台灣針對各類別的系所進行評鑑，其他非政府機構例如中華工程教育學會 IEET) ，以及國際機構AACSB也在台灣進行教育認證，目前教育部正擬定有關高等教育評鑑的國家政策。 　　國際化的衝擊，也是促進高等教育評鑑或認證的驅動力量。高等教育評鑑不僅提昇教學品質，也促進專業人員的國際流動性。在過去數年之中，對於高教評鑑中心執行之結果，各方有許多不同的觀點、爭議以及抱怨。本研究的目的，在於選擇高教評鑑相關之主要議題，收集專家學者的意見，並且討論受訪者對於這些議題具有共識或不同意見的結果。 　　本研究採取深度訪談的研究方法，獲取專家們對於高等教育評鑑或認證的看法。本研究共有15位專家學者參與訪談，由訪談結果顯示，受訪者在三分之一的議題方面具有較明顯的共識。本研究將訪談結果整理分析，並與文獻上所取得的資料相互對應比較。本研究結果對於政府制訂未來高等教育品質管制的政策提供有用的資料。 / The demand of higher education is a worldwide trend in the knowledge based economy of the 21st century. Taiwan has a rapid higher education expansion during the past two decades, and the quality control is becoming a highly concerned issue. The Higher Education Evaluation & Accreditation Council (HEEACT) is conducting general evaluations for higher education programs in Taiwan. Non-governmental commissions like the Institute of Engineering Education Taiwan (IEET) and the Association to Advance Collegiate Schools of Business (AACSB) are also conducting accreditations in Taiwan. A national policy for the effective evaluation of higher education is currently formulating by the Ministry of Education. The impact of globalization is another driving force for the evaluation and accreditation of higher education programs. Higher education evaluation and accreditation not only enhance the teaching quality, but also promote professional mobility. During the last several years, there were different opinions, arguments and complains for the evaluation conducted by HEEACT. The aim of this study was to select major issues of higher education evaluation, to find out opinions from related experts, and to discuss the differences and similarities of interview results. This research applied the in-depth interview method to collect the comments for higher education evaluation and accreditation in Taiwan. Fifteen professionals and administration leaders have been interviewed. The interviewees showed consensus on one third of the interview questions. Their opinions on various interview topics have been recorded, analyzed, and compared with literature evidences. The results of this study provide useful information to the future policy and improvement.

Objective: determine whether accreditation through Accreditation Canada is associated with more favorable resident safety in Ontario LTC homes and which facility characteristics are predictive of accreditation. Methods: logistic regression was used to determine predictors of accreditation. To examine the association between accreditation and safety, safety was operationalized as five MDS-RAI quality indicators: prevalence of falls, restraints, catheters, pressure ulcers, and infections. Separate multivariable models were developed for each indicator. Results: the odds of accreditation were approximately six times smaller for municipal (p < 0.001) and non-profit facilities (p < 0.001) relative to for-profits; three times greater for chains relative to non-chains (p < 0.001); and twice as large for urban relative to rural facilities (p = 0.04). Of the five quality indicators examined, only one (falls) was associated with accreditation. After adjusting for confounders, accredited homes were estimated to have 8% lower fall rates than non-accredited homes (p = 0.01).

The core of biotechnological industry is biomedical products which are related to health and life and need clinical trial. Laboratory data are collected during different stages of clinical trial. Laboratory data are provided by laboratories which are accreditated internationally. Most of medical laboratories in Taiwan are not accreditated. This exploratory research is to understand the change of healthcare envirovement and the stratege of accreditation to be taken when we develop the biotechnological industry which needs to be accreditated. We used questionare as a tool and mailed 616 and received 152. The statistical methods are descriptive and nonparametrical statistics. The results show as following: 94.7% of the responders agreed to have Taiwanese own medical laboratory accreditation system which should be approved by the Department of Health. The surveyors of hospital accreditation are appraised. Most of the responders (89.5%) did not agree the replacement of professional peer review by physicians without clinical laboratory training. The quality and quantity of CNLA surveyors need to be improved. Continous quality improvement gets concensus of the responders. The certification of accreditation shall connect to the payment system of national health insurance but does not equal to good clinical laboratory. Most of the responders (88.8%) recognized that implementing medical laboratory accreditation system is a part of organization learning. ISO 15189 medical laboratory accreditation is the first choice of the responders (50.7%) and CAP-LAP is the second (28.3%). The reasons for implementing and not implementing medical laboratory accreditation system are improving quality and the change of hospital accreditation, and just applying hospital accreditation and not required by law. Key words¡Ghospital accreditation, ISO 15189:2003, CAP-LAP, program for improving biotechnology industries, contract research organization, business strategy, organization learning.

HAVEN FOR ALL HUNGRY SOULS: THE INFLUENCE OF THE AFRICAN METHODIST EPISCOPAL CHURCH AND THE SOUTHERN ASSOCIATION OF COLLEGES AND SCHOOLS ON MORRIS BROWN COLLEGE By Serena Celeste Wilson Morris Brown College is a small, private historically Black college located near downtown Atlanta, Georgia. The College is the only post-secondary institution in Georgia founded by Blacks for the purpose of educating Blacks. The relationship between Morris Brown College, and the African Methodist Episcopal Church and the Southern Association of Colleges and Schools presents an untapped area of research regarding the how external regulatory and fiscal contributing bodies influence the internal mission, culture and management of an institution of higher education. Morris Brown College presents a unique case because, since its founding, it has maintained a close affiliation with the Church that established it. Yet, in recent years, its financial existence has been dependent upon the receipt and use of public funding—which is intricately tied to accrediting standards and oversight. In 2003 the College lost its accreditation. This study employs an ethnographic case-study qualitative research design to explore how the College’s relationship with these bodies influenced the institution’s organizational structure, fiscal management, and administrative culture and identity. The study’s findings indicate that the College’s relationship with the Southern Association of Colleges and Schools was largely reflective of the values, ideals, and perspectives of who represented the College at any given time. The College’s relationship with its founding body, the African Methodist Episcopal Church, was primarily maintained through the placement of Church members (largely clergy) on the College’s board of trustees, and evidenced in the College’s ideology and mission. Although an autonomous operating body, the College’s relationships with these two bodies are complicated by the institution’s reliance on continued financial support from the Church, and validation (in the form of accreditation) from SACS. While healthy working relationships with both bodies are not mutually exclusive, the internal planning, governance, and evaluation of the College must necessarily consider the values and expectations of these (and other) external entities.

Disertacinio tyrimo objektas – universitetinių studijų akreditavimo procesas. Nagrinėjant šį objektą, sprendžiama tyrimo problema – universitetinių studijų kokybės vertinimo sistemoje nėra suformuoto visuotinai priimto akreditavimo proceso modelio. Tyrimo problema konkretizuojama probleminiu klausimu – kokia turėtų būti universitetinių studijų akreditavimo proceso modelio struktūra, kad būtų užtikrinta vieša universitetų atskaitomybė ir sudarytos prielaidos palyginamų vertinimo metodologijų formavimui? Tyrimo tikslas – sukurti teorinį universitetinių studijų akreditavimo proceso modelį ir empiriškai patikrinti jo pagrįstumo vertinimą. Šio darbo rezultatų naujumą atskleidžia sukurtas ir teoriškai pagrįstas universitetinių studijų akreditavimo proceso modelis, kuris europinėje studijų kokybės vertinimo sistemoje siūlomas palyginamoms metodologijoms formuoti ir universitetų atskaitomybei užtikrinti. Teoriniu atžvilgiu disertacinis tyrimas atskleidžia universitetinių studijų akreditavimo proceso kompleksiškumą ir išryškina esmines atskirų šio proceso etapų charakteristikas. Praktinis rezultatų reikšmingumas: siūlomas universitetinių studijų akreditavimo proceso modelis bei atskiri jo elementai gali būti sėkmingai taikomi aukštojo mokslo institucijose, siekiant užtikrinti aukštą studijų kokybę; tyrimo procese išryškėjo tobulintini universitetinių studijų akreditavimo proceso aspektai, kuriais remiantis pateikiamos rekomendacijos šiam studijų kokybės vertinimo procesui gerinti. / The object of the research is the accreditation process of university studies. While analysing this object, the problem of the research is being solved – the system of quality assessment of university studies lacks a universally accepted model of accreditation process. The object of the research is made more explicit by the following problematic question: what structure of the university studies accreditation process model should there be to ensure public accountability of universities and to create the background for the formation of comparable evaluation methodologies. The aim of the research is to create a theoretical model of university studies accreditation process and to test its validity assessment empirically. The novelty of the results of this work is evidenced by the worked out and theoretically substantiated model of university studies accreditation process. The model is recommended for the formation of comparable methodologies and university accountability assurance in the European system of study quality assessment. From the theoretical point of view, this doctoral thesis research reveals the complexity of university studies accreditation process and highlights the main characteristics of separate stages of this process. Practical significance: the proposed model of university studies accreditation process and its separate elements can successfully be applied in higher education institutions to ensure high quality of studies; in the course of the research some... [to full text]

Cette recherche évalue si l’intégration du programme d’agrément MIRE (Mesures implantées pour le renouveau de l’évaluation) d’Agrément Canada, anciennement Conseil canadien d’agrément des services de santé, engendre du changement et de l’apprentissage organisationnel. Elle étudie le cas de deux organismes de santé, la Health Authority of Anguilla (HAA) et la Ca’ Foncella Opetale de Treviso (CFOT). La recherche comporte trois niveaux d’analyse pour lesquels des données qualitatives et quantitatives ont été recueillies : 1) les membres des équipes d’agrément; 2) les équipes d’agrément; 3) l’organisme dans son ensemble. Des questionnaires individuels administrés aux membres des équipes, des entretiens semi-structurés avec les chefs des équipes et les coordonnateurs de la qualité, une revue de documentation et plusieurs mesures périodiques du niveau de compliance aux normes MIRE ont été les techniques de collecte de données utilisées. Les résultats indiquent que les organismes ont opéré des transformations : 1) stratégiques; 2) de l’organisation; 3) des relations avec son environnement. Ils ont amélioré leurs systèmes et leurs pratiques de gestion de même que leurs communications internes et externes. Il y a eu aussi des apprentissages utiles par les individus, les équipes et les organismes. Les apprentissages individuels concernaient les programmes qualité, l’approche centrée sur la clientèle, la gestion des risques, l’éthique professionnelle, la gestion participative et l’évaluation des services. Les étapes « autoévaluation » et « apporter des améliorations et donner suite aux recommandations » du cycle d’agrément ont contribué le plus au changement et à l’apprentissage organisationnel. Les équipes interdisciplinaires d’agrément ont été le véhicule privilégié pour réaliser ces changements et ces apprentissages. La HAA et la CFOT ont amélioré progressivement leur niveau de compliance aux normes dans toutes les dimensions de la qualité, au niveau des équipes d’agrément et pour l’ensemble de l’organisation. Néanmoins, l’amélioration du niveau global de compliance était en deçà de la limite minimum des exigences du programme pour l’obtention d’un statut d’agrément sans restrictions importantes. L’envergure des changements et des apprentissages réalisés soulève la question de la capacité des organismes d’institutionnaliser ces nouvelles connaissances. La CFOT pourrait y arriver étant donné les ressources et les compétences à sa disposition. / This research assesses whether integration of Accreditation Canada’s (previously known as Canadian Council on Health Services Accreditation) AIM (Achieving Improved Measurement) accreditation program brings about change and organizational learning. It studies the case of two health organizations: the Health Authority of Anguilla (HAA) and the Ca’ Foncella Opetale de Treviso (CFOT). The research consists of three levels of analysis for which qualitative and quantitative data were gathered: (1) members of the accreditation teams; (2) the accreditation teams; (3) the organization as a whole. The techniques used to collect data consisted of individual questionnaires administered to team members, semi-formal interviews with team leaders and quality coordinators, a review of documentation and several periodic measurements of compliance with the AIM standards were the techniques used. The findings indicate that the organizations made strategic, organizational and relational changes. They improved their systems and management practices as well as their internal and external communications. There was also useful learning by individuals, teams and the organizations. Individual learning involved quality programs, the client-focused approach, risk management, professional ethics, participatory management and assessment of services. The “self-assessment” and “make improvements and implement the recommendations” stages of the accreditation cycle contributed the most to change and organizational learning. The interdisciplinary accreditation teams were the preferred vehicle for achieving these changes and this learning. The HAA and CFOT have gradually improved their level of compliance with the standards in all quality dimensions, both at the accreditation team level and throughout the organization. However, improvement in the overall compliance level was below the program’s minimum requirements to obtain accreditation status without major restrictions. The scope of the changes and learning achieved raises the issue of the capacity of organizations to formalize this new knowledge throughout the organization. CFOT might achieve this given the resources and skills available to it

As part of the transformation agenda of education and training policy, the main thrust of Recognition and Prior Learning (RPL) in the South African policy context was to contribute to addressing social justice issues such as equity, redress and access of the majority of adult learners, who were historically denied access to formal learning. The study focuses on the following critical questions: What are the official policy claims of the assessment and recognition of prior learning at the national and sectoral level? How do assessors mediate official policy in recognising and assessing prior learning of adult learners in an institutional context? What are the experiences and engagements of adult learners in having their prior learning assessed? This research responds to the conceptual gaps in the study of RPL policy and practice and the National Qualifications Framework. The study examines epistemological issues such as: what and whose knowledge is considered as valid; the relationship between knowledge and experience; the relationship between different types of knowledge and learning; and the relationship between knowledge and access to power. The study also addresses a contextual gap: very limited research exists on the RPL experiences of societies in transition with similar transformational agendas as South Africa. The present research study also examines the implementation process in a transitional context, exploring the gap that develops between intended policies and actual practice. This is a qualitative study using the case study approach to examine the complexities of the assessment and recognition of prior learning process in a Technical College Institution located in the Further Education and Training Band. The analysis of selected international case studies of RPL contributed to identifying and exploring conceptual gaps in RPL policy and practice. These conceptual issues provided the first set of preliminary lens for the production, description and analysis of data in the research study. The preliminary lens were then re-interpreted and elaborated in relation to Bernstein 's theory (1996) of symbolic control and cultural production. reproduction and change. The synthesised conceptual framework provided a theoretical vocabulary to redescribe and reinterpret data at deeper levels of abstraction. The key findings of the research were as follows: The undertheorisation of RPL in policy circles and the ways in which policy has tended to gloss over issues such as "equivalence", "integrated competence", knowledge-power dynamics and the differences between mainstream and outsider knowledge; The gap between policy rhetoric and sectoral practice. The sector advocated a technicist approach to RPL that was preoccupied with matching adult experiential learning against prescribed standards. The sector practice marginalized or even excluded adult learners who had acquired their knowledge and learning in non-formal and informal contexts; Nevertheless, assessors who were socially and culturally sensitive to the RPL process had an implicit understanding of the different types of knowledge and knowers. Their developmental approach to RPL provided an enabling environment for adult learners to demonstrate their learning and knowledge from experience. Adult learners without high levels of formal literacy were able to demonstrate their ability to reflect on their experiential learning to transfer their abstract and critical thought processes to solve new problems in the assessment context. The research highlights the commensurability between informal and formal knowledge and the ability of workers who have learnt their skills informally to demonstrate high levels of conceptual and transferable skills. The present research makes the following theoretical contributions: Firstly , Bernstein's theory was extended to examine policy formulation and the policy process. Within the framework of critical policy analysis, a new construct: "relations outside" was created as an analytical tool to examine the nuances of the macro-contexts (historical, political, social, economic) which shape the meaning and significance of policy. Secondly, the research study produces a new conceptual framework to analyse the complex and dynamic nature of RPL policy and practice in a transformational context. The present study advocates a critical and holistic approach to RPL that interrogates how power-relations within and across contextual, epistemological and pedagogical issues reproduce or challenge the existing patterns of inequalities in society. / Thesis (Ph.D.) - University of Durban-Westville, 2004.

Objective: determine whether accreditation through Accreditation Canada is associated with more favorable resident safety in Ontario LTC homes and which facility characteristics are predictive of accreditation. Methods: logistic regression was used to determine predictors of accreditation. To examine the association between accreditation and safety, safety was operationalized as five MDS-RAI quality indicators: prevalence of falls, restraints, catheters, pressure ulcers, and infections. Separate multivariable models were developed for each indicator. Results: the odds of accreditation were approximately six times smaller for municipal (p < 0.001) and non-profit facilities (p < 0.001) relative to for-profits; three times greater for chains relative to non-chains (p < 0.001); and twice as large for urban relative to rural facilities (p = 0.04). Of the five quality indicators examined, only one (falls) was associated with accreditation. After adjusting for confounders, accredited homes were estimated to have 8% lower fall rates than non-accredited homes (p = 0.01).

Situado no contexto da qualidade em saúde, este estudo versa sobre a decisão clínica e autonomia do paciente. Parte-se da premissa que, demais da competência técnica profissional e utilização de tecnologia adequada, o respeito aos direitos dos pacientes é atributo essencial à boa qualidade do atendimento médico. Tomando como exemplo a abordagem terapêutica do climatério, foi feita análise qualitativa do processo de decisão clínica, com base nas informações obtidas através de entrevistas semi-estruturadas com médico ginecologistas e com pacientes em fase de climatério. O propósito foi buscar apreender os valores dos médicos e dos pacientes e tentar compreender a lógica de seus comportamentos e atitudes, no que se refere especificamente aos papéis desempenhados por eles nesse processo. Com base nos resultados da análise, discute-se a complexidade da aplicação do princípio da autonomia na prática clínica e apresenta-se uma reflexão sobre a acreditação, como estratégia possível de contribuição a esse processo e à melhoria da qualidade do atendimento médico, por sua grande identificação como os aspectos relativos aos direitos dos pacientes, aos processos de educação permanente e à melhoria contínua da qualidade. / This research is set in the context of quality in health care. The object of the study was the patients role in clinical decision-making, considering that assuring good quality of clinical care requires respect to patients rights, as much as good technology. In order to study the decision process, we chose hormonal replacement therapy in the climacteric through qualitative analysis, based on non-structured interviews with gynecologists and postmenopausal women. The main purpose was the understanding of the values, attitudes and the reasoning employed by physicians and patients. The complexity of application of the bioethical principal of autonomy in daily clinical practice is discussed. The contribution of accreditation to these processes is examined, stressing the relevance of the functions related to patients rights, continuous education and continuous quality improvement.

Medical Laboratories Accreditation is covered by ISO 15189:2012 - Medical Laboratories — Requirements for Quality and Competence. In Portugal, accreditation processes are held under the auspices of the Portuguese Accreditation Institute (IPAC), which applies the Portuguese edition (NP EN ISO 15189:2014). Accordingly, Medical Laboratories accreditation processes now require the estimate of measurement uncertainty (MU) associated to the results. The Guide to the Expression of Uncertainty in Measurement (GUM) describes the calculation of MU, not contemplating the specific aspects of medical laboratory testing. Several models have been advocated, yet without a final consensus. Given the lack of studies on MU in Portugal, especially on its application in the medical laboratory, it is the objective of this thesis to reach to a model that fulfils the IPAC’s accreditation regulations, in regards to this specific requirement. The study was based on the implementation of two formulae (MU-A and MU-B), using the Quality Management System (QMS) data of an ISO 15189 Accredited Laboratory. Including the laboratory’s two Cobas® 6000–c501 (Roche®) analysers (C1 and C2) the work focused three analytes: creatinine, glucose and total cholesterol. The MU-B model formula, combining the standard uncertainties of the method’s imprecision, of the calibrator’s assigned value and from the pre-analytical variation, was considered the one best fitting to the laboratory's objectives and to the study's purposes, representing well the dispersion of values reasonably attributable to the measurand final result. Expanded Uncertainties were: Creatinine - C1 = 9,60%; C2 = 5,80%; Glucose - C1 = 8,32%; C2 = 8,34%; Cholesterol - C1 = 4,00%; C2 = 3,54 %. ...[cont.].