Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-02-22T13:16:36Z No. of bitstreams: 1 cinthiapratesvigna_dissert.pdf: 1669342 bytes, checksum: ba9ea8e5f3663ead4ae548054ee31890 (MD5) / Made available in DSpace on 2017-02-22T13:16:36Z (GMT). No. of bitstreams: 1 cinthiapratesvigna_dissert.pdf: 1669342 bytes, checksum: ba9ea8e5f3663ead4ae548054ee31890 (MD5) Previous issue date: 2016-01-29 / Introduction: The search for Accreditation is a growing reality in hospitals and recently in Health Plan Operators (OPS), through the program established by Normative Resolution 277. The use of indicators is one of the most used forms of assessment quality in health services. Objectives: To build and measure quality indicators for nursing audit in the accreditation process. Propose actions to improve the network of hospitals and the audit service of the OPS. Compare the use of lancing technologies and securing peripheral intravenous catheter (CIP) and the length of time consumption and cost. Update and analyze the impact of equipo exchange protocol used in intravenous therapy based on best practices. Build and measure the quality indicator related to central venous catheter. Method: a descriptive exploratory study, quantitative and retrospective itself (2013), conducted in six hospitals linked to an OPS in which the data were obtained from the Nursing Audit service. They were constructed and validated care indicators and management by the audit team and quality OPS for compliance with the dimensions 1 and 2 of RN 277. Results: From the OPS Accreditation process indexes were created and performed protocol update. of service quality indicators, peripheral intravenous catheter time, care incidents related to central venous catheter and equipo exchange time protocol infusion based on scientific evidence, have been based in "second dimension" which It comes to the quality and dynamic performance of the hospital network that provides services to OPS. Quality indicators management were drawn from the "size 1" which evaluates the most common business processes and critical of the audit service. The equipo exchange protocol deployed in hospitals showed a reduction in consumption and cost, and improved safety to the customer. Subsequently, assistance with improvement proposals were presented to hospitals and management to OPS. Conclusion: This study showed the building, measuring six indicators of quality care, four in management and material consumption protocol update the audit nursing. In addition, proposals to hospitals focused on patient safety assurance and the audit service of the OPS to improve the processes and results were presented. There was a new performance audit of nursing through quality indicators in order to encourage continuous improvement of the assistance provided by hospitals and the management of the OPS audit service. It also contributes to the auditor nurse seek new practices, assuming his role as responsible for the pursuit of customer service quality. / Introdução: A busca pela Acreditação é uma realidade crescente em instituições hospitalares e, recentemente, em Operadoras de Planos de Saúde (OPS), por meio do programa instituído pela Resolução Normativa 277. A utilização de indicadores é uma das formas mais utilizada de avaliação da qualidade nos serviços de saúde. Objetivos: Construir e mensurar indicadores de qualidade pela auditoria de enfermagem no processo de acreditação. Propor ações de melhorias à rede de hospitais e ao serviço de auditoria da OPS. Comparar a utilização de tecnologias de punção e fixação de cateter intravenoso periférico (CIP) quanto ao tempo de permanência, consumo e custo. Atualizar e analisar o impacto do protocolo de troca de equipo utilizado na terapia intravenosa com base nas melhores práticas. Construir e mensurar o indicador de qualidade relacionado ao cateter venoso central. Método: Estudo exploratório-descritivo, quantitativo e retrospectivo propriamente dito (2013), realizado em seis hospitais vinculados a uma OPS, no qual os dados foram obtidos junto ao serviço de Auditoria de Enfermagem. Foram construídos e validados indicadores assistenciais e de gestão pela equipe de auditoria e qualidade da OPS para o cumprimento das dimensões 1 e 2 da RN 277. Resultados: A partir do processo de Acreditação da OPS foram construídos indicadores e realizada atualização de protocolo. Os indicadores de qualidade assistencial, tempo de permanência do cateter intravenoso periférico, incidentes assistenciais relacionados ao cateter venoso central e o protocolo de tempo de troca de equipo de infusão com base em evidência científica, foram elaborados com base no item “dimensão 2”, que trata da dinâmica da qualidade e desempenho da rede hospitalar que presta atendimento a OPS. Os indicadores de qualidade na gestão foram elaborados a partir da “dimensão 1”, que avalia os processos operacionais mais frequentes e críticos do serviço de auditoria. O protocolo de troca de equipo implantado nos hospitais apresentou uma redução no consumo e custo, e maior segurança ao cliente. Posteriormente, os assistenciais, com propostas de melhoria, foram apresentados aos hospitais e os de gestão à OPS. Conclusão: Este estudo mostrou a construção, mensuração de seis indicadores de qualidade assistencial, quatro em gestão e da atualização de protocolo de material de consumo pela auditoria de enfermagem. Além disso, foram apresentadas propostas aos hospitais voltadas a garantia da segurança do paciente e ao serviço de auditoria da OPS para a melhoria dos processos e resultados. Houve uma nova atuação da auditoria de enfermagem por meio de indicadores de qualidade com objetivo de incentivar a melhoria contínua da assistência realizada pelos hospitais e na gestão do serviço de auditoria da OPS. Também contribui para que o enfermeiro auditor busque novas práticas, assumindo seu papel como responsável pela busca da qualidade da assistência ao cliente.

Esse estudo teve por objetivo analisar as dinâmicas de mudanças organizacionais transcorridas em um estabelecimento de saúde. Conduzido através metodologia de estudo de caso descritivo, teve como campo de pesquisa o Instituto de Hematologia do Estado do Rio de Janeiro. Buscando conhecer o papel da preparação para acreditação na dinâmica da mudança em uma organização de saúde essa pesquisa foi assim estruturada: abordagem dos problemas encontrados nas mudanças organizacionais em estabelecimentos de saúde; quadro teórico estruturado com uma revisão de literatura; embasamento da metodologia aplicada, com definição de instrumentos de coletas de dados, de material e atores implicados no levantamento para realização da análise qualitativa. O estudo analisou as seguintes variáveis: a natureza da mudança focalizando a extensão, ritmo e trajetória; as estratégias de ação, contemplando as situações de adesões e resistência e a concepção, verificando se as mudanças foram indutivas ou dedutivas. O resultado demonstrou que a preparação para acreditação naquele hospital, proporcionou mudanças com movimentos lentos, mas com continuidade em todos os setores do estabelecimento. Foi identificada participação mais ativa de um grupo de profissionais identificados como facilitadores, funcionando como multiplicadores. A abrangência das estratégias aplicadas foram desde as reuniões em assembléias gerais, á formação de grupos de estudo por setores para entendimento do manual de padrões de acreditação. Foram realizados processos internos de auto-avaliação com base no manual de acreditação. Em relação á concepção, o processo de mudança foi motivado pela determinação da direção do hospital para obtenção do certificado de acreditação internacional. Quanto á resistência e adesão, o estudo demonstrou que a participação de uma grande maioria dos profissionais foi motivada pelo desejo de aprender e desenvolver novas práticas que proporcionasse a melhoria da qualidade da assistência. A análise de dados aponta certa resistência da categoria médica no início do processo. Do ponto de vista organizacional, foram criadas novas estruturas. A conclusão do estudo: O processo de preparação para acreditação na unidade de saúde estudada demonstrou ser um instrumento capaz de promover mudanças em organizações de saúde. / This study it had objective to analyze the dynamic ones of which elapsed organizational changes in a health establishment. Lead through methodology study of descriptive case, the Institute of Hematology of the State of Rio de Janeiro had as research field. Searching this research to know the paper of the preparation for accreditation in the dynamics of the change in a health organization thus was structured: boarding of the problems found in the organizational changes in health establishments; structured theoretical picture with a literature revision; basement of the applied methodology, with definition of instruments of collections of data, material and actors implied in the survey for accomplishment of the qualitative analysis. The study it analyzed the changeable following: the nature of the change focusing the extension, rhythm and trajectory; the action strategies, contemplating the situations of adhesions and resistance and the conception, verifying if the changes were inductive or deductive. The result demonstrated that the preparation for accreditation in that hospital, provided changes with slow movements, but with continuity in all the sectors of the establishment. It was identified to more active participation of a group of identified professionals as providers, functioning as multiplying. They comprehensives, was applied strategies was since the meetings in general meetings, the training of groups of study for sectors for agreement of the manual of accreditation standards. Internal processes of autoevaluation on the basis of the accreditation manual were accomplished. In respect to conception, the change process was motivated by the determination of the direction of the hospital for attainment of the certificate of international accreditation. How much the resistance and adhesion, the study demonstrated that the participation of a great majority of the professionals was motivated by the desire to learn and to develop new practices that the improvement of the quality of the assistance provided. The analysis of data points certain at the beginning resistance of the medical category of the process. Of the point of view organizational, structures were new servants. The conclusion of the study: The process of preparation for accreditation in the unit of studied health demonstrated to be an instrument capable to promote changes in health organizations.

Na perspectiva de contribuir para a melhoria da qualidade, os serviços de saúde precisam desenvolver e aprimorar seus processos internos para melhoria de seus resultados assistenciais. A adoção de programas para a melhoria contínua da qualidade, como a acreditação, é uma maneira de avaliar se esses processos promovem, de fato, a segurança e a qualidade do atendimento. Este estudo, de delineamento metodológico, objetivou adaptar e validar, para uso no Brasil, instrumentos que possibilitem mensurar aspectos destes programas de melhoria da qualidade. Para tanto optou-se pelo questionário Quality Improvement Implementation Survey II (QIIS) e pelas subescalas do Preparation of Health Services for Accreditation (PHSA), analisando as suas propriedades psicométricas para profissionais que atuam nas áreas assistenciais, administrativas e de apoio de hospitais acreditados. O QIIS é divido em duas seções, denominadas A e B. A primeira mensura e classifica o tipo de cultura na qual se enquadra o hospital; as respostas são obtidas em escores entre 0 e 100 pontos e integra cinco subescalas e vinte itens analisados em quatro categorias: Cultura de Grupo; de Desenvolvimento; Hierárquica e Racional. A seção B destaca as ações do hospital para a melhoria da qualidade; apresenta sete subescalas com cinquenta e oito itens: Liderança, Informação e Análise, Planejamento Estratégico da Qualidade, Utilização de Recursos Humanos, Gestão da Qualidade, Resultados da Qualidade e Satisfação do Cliente. As subescalas denominadas Acreditação e Benefício da Acreditação foram adotadas do PHSA. A primeira subescala possui quatro itens e a segunda, oito. Tanto para a seção B do QIIS e subescalas do PHSA, as respostas foram medidas por meio de escalas do tipo Likert. O delineamento metodológico seguiu os seguintes passos: tradução e síntese das traduções, avaliação por comitê de especialistas, retrotradução, pré-teste e análise das propriedades psicométricas. Os dados foram coletados em sete hospitais 8 acreditados, no período de junho de 2016 a agosto de 2017. Participaram do estudo 581 profissionais. A validade de face e conteúdo dos instrumentos foi avaliada pelo comitê de especialistas, tradutores, respondentes do pré-teste e pelas pesquisadoras que conduziram este estudo. Quanto à análise das propriedades psicométricas, realizou-se a Análise Fatorial Exploratória e Análise Fatorial Confirmatória. Em termos de resultados, o delineamento do perfil da amostra apresentou-se de maioria feminino (68,2%), com idade média de 35,4 anos e cerca de 8 anos de atuação nos hospitais, sendo que a maioria das respostas eram de sujeitos que atuavam em hospitais com fins lucrativos (66,4%), 19% de respostas foram de hospitais públicos e 14,2% de filantrópicos. Após ajustes do modelo, a seção A da versão final do QIIS passou a ter quatro subescalas e treze itens; já a seção B, o mesmo número de subescalas, porém com quarenta e um itens. Quanto às subescalas do PHSA, houve mudança apenas na segunda (Benefício da Acreditação), com a exclusão de dois itens. Com relação à confiabilidade, obteve-se valor adequado para a consistência interna das seções A e B da versão adaptada do QIIS e subescalas do PHSA, tendo os Alphas de Cronbach variando de 0,64 a 0,94; exceto na categoria \"Cultura Racional\", que não apresentou medidas de ajustes adequadas (Alpha 0,53). Diante dos resultados, conclui-se que, apenas na categoria \"Cultura Racional\" não houve medidas adequadas para a sua aplicabilidade. A versão adaptada do QIIS e escalas do PHSA atenderam aos critérios de validade e confiabilidade na amostra estudada. Acredita-se que a utilização possibilitará um diagnóstico situacional dos hospitais brasileiros que adotaram a acreditação como estratégia para a melhoria contínua da qualidade / In order to contribute to the improvement of the quality of health services need to develop and improve their internal processes to improve their care results.. The adoption of programs for continuous quality improvement, such as accreditation, is one way to assess whether these processes actually promote safety and quality of care. The purpose of this study was to adapt and validate the Quality Improvement Implementation Survey II (QIIS) and subscales of the Preparation of Health Services for Accreditation (PHSA) for use in Brazil, as well as to analyze its psychometric properties for professionals working in care areas , administrative and support services of accredited hospitals. The QIIS is divided into two sections, named A and B. The first measures and classifies the type of culture in which the hospital fits; the answers are obtained in scores between zero and 100 points and integrates five subscales and twenty items analyzed in four categories: Group Culture; Hierarchical and Rational; of Development. Section B highlights the hospital\'s actions to improve quality; presents seven subscales with fifty-eight items: Leadership, Information and Analysis, Quality Strategic Planning, Use of Human Resources, Quality Management, Quality Results and Customer Satisfaction. The Accreditation and Accreditation Benefit subscales were adopted from the PHSA, used to measure the results of the implementation of an accreditation program under the nurses\' perspective. The first subscale has fourth items and the second, eight. For both section B of QIIS and PHSA, responses were measured using the Likert scale. The methodological design followed the following steps: translation and synthesis of translations, evaluation by expert committee, back-translation, pre-test and analysis of psychometric properties. Data were collected from seven accredited hospitals from June 2016 to August 2017. A total of 581 professionals participated in the study. The face and content validation of the instruments was evaluated by the committee of experts, translators and researchers who conducted this study. Regarding the analysis of the psychometric 10 properties, the Exploratory Factor Analysis and Confirmatory Factor Analysis were performed. In terms of results, the outline of the sample profile was female (68.2%), with an average age of 35.4 years and and about 8 years old in hospitals, with the majority of responses being from subjects who worked in for-profit hospitals (66.4%), 19% from public hospital responses and 14.2% from philanthropists. After adjustments of the model, section A of the final version of QIIS, now has four subscales (thirteen items); already section B, the same number of subscales, but with forty-one items. As for the subscales of the PHSA, there was change only in the second subscale (Benefit of Accreditation), with the exclusion of two items. Regarding reliability, an adequate value for the internal consistency of section A and B were obtained, of the adapted version of the QIIS and subscales of the PHSA with the alphabets of Cronbach varying from 0.64 to 0.94; except in the \"Rational Culture\" category, which did not present adequate adjustment measures (Alpha 0.53). In the light of the results, it is concluded that, only in the category \"Rational Culture\" there were no adequate measures for its applicability. The adapted version of the QIIS and PHSA scales met the criteria of validity and reliability in the sample studied. It is believed that the use will enable a situational diagnosis of Brazilian hospitals that have adopted accreditation as a strategy for the continuous improvement of quality

Post apartheid South Africa saw the introduction of many policies and legislations that were to meet the goals of democracy, social redress, equity and development. One of the crucial legislations that guided the restructuring of higher education was the South African Qualifications Authority Act (SAQA) of 1995. Within this SAQA Act (1995) is the issue of quality assurance. Through a system of quality assurance and through processes such as the registration of higher education practices and programmes such as the Education and Training Quality Assurance Bodies (ETQA), the National Standards Body (NSB), the Standards Generating Bodies (SGB), the Council of Higher Education and the Higher Education Quality Committee (HEQC) within the SAQA Act mandate. The higher education sector is been guided to offer relevant and responsive needs that meet the needs of learners, employers and other stakeholders. Quality Assurance could relate to greater accountability and efficiency in respect of education or higher standards of education provision. It is within the expression of higher standards and comparability of quality assurance that through the SAQA Act (1995) all providers of higher education, whether public higher education providers of private higher education providers, are required to register as providers of higher education programmes and to register its programmes been offered. It is within this expression of quality assurance that this study is located. This study examined the impact of the Quality Assurance Legislation on programme design of the Information Technology (IT) Department within the School of Technology at Anchorlite College, which is a private higher education institution (PHEI). The Study focused on two critically questions, viz: i. Did the PHEI use a quality assurance system before the quality assurance legislation? ii. What impact did the quality assurance legislation have on pedagogy, resources and content of programme design of a PHEI A case study method was used on a purposeful sampled PHEI to illuminate the impact of the quality assurance legislation on programme design at Anchorlite College. Data was obtained through an interview with the Head of Department. The institution's records were used to retrieve data. Also a questionnaire was administered to the IT staff The findings indicate that there are both positive and negative aspects concerning the impact of the quality assurance legislation on programme design. The SAQA Act (1995) did impact on the IT programme pertaining to staffing, physical resources, assessment, programme design and learners. The findings indicate that the quality assurance legislation within the' Requirements for Learning Programmes' (SAQA, 1998) influenced and impacted the IT programme. This impact was indicated by appropriate and adequate staff have been employed to support the learning programme, the physical resources have increased, a more informed assessment strategy has been implemented and the learners admission requirements into the IT programme has changed by introducing aptitude testing. The findings did indicate that some staff was aware of the quality assurance before the SAQA Act (1995) The recommendations of this study indicate that the staff aligns themselves with the needs of the industry by internships or forming partners with industrial organizations. The IT programme will have to be reviewed and adapted to include the needs of the industry. The system of staff development programmes is implemented so that the staff becomes familiar with the new skills and techniques of industry. The SAQA Act (1995), the quality assurance legislation did impact on the programme design of the IT programme at Anchorlite College. / Thesis (M.Ed.) - Educational Management)-University of Durban Westville, 2002.

This thesis attempted to develop insight into why, contrary to expectation and predictions, learners in Rundu obtained better scores in a standardised English comprehension test than learners in Katima Mulilo, given that the conditions of teaching and learning were judged to be least favourable in Rundu.

Thesis (MSc)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: With the inception of precision farming techniques during the last decade, agricultural efficiency has improved, leading to greater productivity and enhanced economic benefits associated with agriculture. The awareness of health risks associated with food borne diseases has also increased. Systems such as Hazard Analysis and Critical Control Points (RACCP) in the USA and Good Agricultural Practices (GAP) in Europe are trying to ensure that no food showing signs of microbial contamination associated with production techniques are allowed onto the export market. Growers participating in exporting are thus being forced to conform to the requirements set by international customers. The aim of this study was to compile a computerized record keeping system that would aid farmers with the implementation of GAP on farms, by making use of GIS capabilities. A database, consisting of GAP-specific data was developed. ArcView GIS was used to implement the database, while customized analyses procedures through the use of Avenue assisted in GAP-specific farming related decisions. An agricultural area focusing on the export market was needed for this study, and the nut producing Levubu district was identified as ideal. By making use of ArcView GIS, distinct relationships between different data sets were portrayed in tabular, graphical, geographical and report format. GAP requirements state that growers must base decisions on timely, relevant information. With information available in the above-mentioned formats, decisions regarding actions taken can be justified. By analysing the complex interaction between datasets, the influences that agronomical inputs have on production were portrayed, moving beyond the standard requirements of GAP. Agricultural activities produce enormous quantities of data, and GIS proved to be an indispensable tool because of the ability to analyse and manipulate data with a spatial component. The implementation of good agricultural practices lends itself to the use of GIS. With the correct information available at the right time, better decisions can promote optimal croppmg, whilst rmmrrnzmg the negative effects on the consumer and environment. / AFRIKAANSE OPSOMMING: Gedurende die afgelope dekade het die gebruik van presisie boerderytegnieke tot verbeterde gewasverbouing gelei, wat verhoogde produktiwiteit en ekonomiese welvarendheid tot gevolg gehad het. 'n Wêreldwye bewustheid ten opsigte van die oordrag van siektekieme geasosieer met varsprodukte het ontstaan. Met die implementering van Hazard Analysis and Critical Control Points (HACCP) en Good Agricultural Practices (GAP), poog die VSA en Europa om voedsel wat tekens van besmetting toon van die invoermark te weerhou. Buitelandse produsente en uitvoerders word dus hierdeur gedwing om by internasionale voedselstandaarde aan te pas. Hierdie navorsing het ten doel gehad om 'n gerekenariseerde rekordhouding stelsel daar te stel wat produsente sal bystaan tydens die implementering van GAP, deur gebruik te maak van GIS. 'n Databasis gerig op die implementering van GAP is ontwerp. ArcView GIS is gebruik word om die databasis te implementeer, waarna spesifieke navrae die data ontleed het om sodoende die besluitnemingsproses te vergemaklik. 'n Landbou-area wat aktief in die uitvoermark deelneem was benodig vir dié studie, en die Levubu distrik was ideaal. Verwantskappe tussen datastelle is bepaal en uitgebeeld in tabel-, grafiek- en verslag vorm. Die suksesvolle implementering van GAP vereis dat alle besluite op relevante inligting gebaseer word, en met inligting beskikbaar in die bogenoemde formaat kan alle besluite geregverdig word. Deur die komplekse interaksie tussen insette en produksie te analiseer, was dit moontlik om verwantskappe uit te beeld wat verder strek as wat GAP vereistes stipuleer. Deur die gebruikerskoppelvlak in ArcView te verpersoonlik is die gebruiker nie belaai met onnodige berekeninge nie. Aktiwiteite soos landbou produseer groot datastelle, en die vermoë van GIS om die ruimtelike verwantskappe te analiseer en uit te beeld, het getoon dat GIS 'n instrumentele rol in die besluitnemingsproses speel. Deur middel van beter besluitneming kan optimale gewasverbouing verseker word, terwyl die negatiewe impak op die verbruiker en omgewing tot 'n minimum beperk word.

Thesis (MPhil)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The practice of medicine has always been a big area of interest as a profession. The focus ranges depending on issues at hand - it may be on the educational, training, humanistic, economic, professional ethics and legal aspects. One area of medicine that is under the spotlight around the world is that of the maintenance of clinical competency, followed very closely and almost linked to professional ethics. This study follows the introduction of a system of Continuing Professional Development (hereinafter also referred to as CPD), in South Africa and an overview of how it has been introduced in a few other countries. The main areas of focus being the extrication of inherent values of CPD, relating this aspect to quality improvement in medical health care. The medical profession as well as most of the interested parties, has different perspectives regarding the fact that the system is regulated through legislation. There is also the doubt whether the CPD system will be effective in achieving the goals that it has been set to achieve. Although a system of Continuing Medical Education has been a tradition in all countries, which implies that the CPD system is not totally new as far as the educational principles are concerned, the values accruable need to be exploited. It is the possible success of this kind of evaluations that may foster more understanding of the inherent values in this CPD system. / AFRIKAANSE OPSOMMING: Beroepsgewys het die praktyk van geneeskunde nog altyd groot belangstelling gelok. Die fokus verskuif na gelang van die onderwerpe ter sprake. Dit wissel van opvoedkunde, opleiding, humanisme, ekonomie, en professionele etiek tot regsaspekte. Dwarsoor die wêreld word daar gefokus op die handhawing van kliniese vaardighede, gevolg deur professionele etiek wat ook daarin verweef is. Hierdie studie bespreek die instelling van 'n stelsel van Voortgesette Professionele Ontwikkeling (hierna verwys na as VPO) in Suid-Afrika asook oorsig oor die wyse waarop dit in 'n paar ander lande ingestel is. Die klem lê op die inherente waardes met betrekking tot die verbetering gehalte in mediese gesondheidsorg. Die mediese beroep, asook meeste van die belangegroepe het verskillende opvattings oor die feit dat die stelsel deur wetgewing gereguleer word. Daar is ook twyfel of die VPO-stelsel in sy vooropgestelde doelwitte sal slaag. Wat die opvoedkundige beginsels betref, is die VPO-stelsel nie totaal en al nuut nie. Alhoewel VPO in ander lande tradisie is, is dit nodig om die totstandkoming van waardes te ontgin. Die moontlike sukses van hierdie tipe van evaluasies mag dalk beter begrip ten opsigte van die inherente waardes in die VPO-stelsel bevorder.

Made available in DSpace on 2016-06-02T20:37:48Z (GMT). No. of bitstreams: 1 5175.pdf: 1937380 bytes, checksum: c74ac55f5059fbe2d78f9dabe02dc226 (MD5) Previous issue date: 2013-06-07 / The tests and/or study laboratories have sought the implementation of Quality Management Systems (QMS) in order to obtain a differential, which is the greater reliability and acceptance of their results. The two main systems adopted in laboratories are the Good Laboratory Practices (GLP), which guidelines are defined in NIT-DICLA-035, and ISO/IEC 17025, according to NBR ISO/IEC 17025. Comparatively, the guidelines of both standards, in respect to the experimental stage of laboratory, have the same goal, to guarantee the quality of the results. The systems differ in that the ISO/IEC 17025 operates in the laboratory routine activities as a whole, in contrast GLP focus is to serve as a base to a study that is accomplished. An analysis of the elements of the standards shows that there is substantial overlap in both of the requirements, which makes it possible to maintain a single and integrated system. Thus, this paper aims to analyze critically the implementation and maturation process of an integrated QMS according to GLP and ISO/IEC 17025 implemented in a Laboratory that performs tests of pesticides and veterinary products residues using chromatography. The system implementation was done in stages, and the activities performed in each one were evaluated. The first step consisted in defining the quality assurance team. Next it was defined the work scope, followed by the steps: analysis of the similarities between the standards and structuring of a system; adaptation and elaboration of documentation to comply with the integrated system, with emphasis on the methods validation and uncertainty estimation procedures; training; audits; critical analysis meeting by management and finally organize the documentation for submission to INMETRO. During the implementation process it was conducted a survey among collaborators about the difficulties and benefits of the process. In addition, it was evaluated the time required to implement the system, the period to get the formal recognition and audit data, such as noncompliance highlighted and corrective actions taken. These data were compared with those obtained in Brazil and the USA laboratories. / Os laboratórios de estudo e/ou ensaios tem buscado a implementação de Sistemas de Gestão da Qualidade (SGQ) como forma de obter um diferencial, que reside na maior confiabilidade e aceitação de seus resultados. Os dois principais sistemas adotados em laboratórios são as Boas Práticas de Laboratório (BPL), cujas diretrizes são definidas na NIT-DICLA-035, e a ISO/IEC 17025, conforme NBR ISO/IEC 17025. Comparativamente, as diretrizes de ambas as normas, no que se refere à etapa experimental do laboratório, possuem o mesmo objetivo, a garantia da qualidade dos resultados obtidos. Os sistemas se diferem na medida em que a ISO/IEC 17025 atua nas atividades rotineiras do laboratório como um todo, já o foco das BPL é dar embasamento a um estudo realizado. Uma análise dos elementos das normas evidencia que há grande sobreposição dos requisitos exigidos em ambas, o que torna possível manter um sistema único e integrado. Assim, o presente trabalho tem como objetivo analisar criticamente o processo de implementação e amadurecimento de um SGQ integrado conforme as BPL e a ISO/IEC 17025 implementado em um Laboratório que realiza análises de resíduos de agrotóxicos e produtos veterinários por cromatografia. A implementação do sistema foi realizada em etapas, sendo que as atividades realizadas em cada uma delas foram avaliadas. A primeira etapa consistiu na definição da equipe de garantia da qualidade. Na sequência foi definido o escopo de trabalho, seguida das etapas: análise das similaridades entre as normas e estruturação de um sistema; adaptação e elaboração de documentação para atendimento ao sistema integrado, com destaque para os procedimentos de validação de métodos e estimativa da incerteza; treinamentos; auditorias; reunião de análise crítica pela direção e por fim a montagem da documentação para envio ao INMETRO. Durante o processo de implementação foi feita uma pesquisa entre os colaboradores a respeito das dificuldades e benefícios do processo. Além disso, foi avaliado o período necessário para implementar o sistema, o período para obter o reconhecimento formal e dados das avaliações, tais como as não conformidades evidenciadas e as ações corretivas tomadas. Esses dados foram comparados com os de laboratórios no Brasil e nos EUA.

Made available in DSpace on 2010-04-20T20:15:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-04-05T00:00:00Z / A presente dissertação é um estudo de caso sobre as mudanças organizacionais ocorridas em hospital como conseqüência da implantação dos padrões da Joint Commission on Accreditation of Healthcare Organizations - JCAHO (Comissão Conjunta de Acreditação de Organizações de Assistência à Saúde) / Case Study on organizational changes that took place in a tertiary healthcare facility located in São Paulo, Brazil, as a result of the adoption of a comprehensive quality model, the implementation of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards for hospitals. Quality initiatives within the referred hospital are identified. The changes that ocurred due to this implementaion process are presented and discussed, as well as the organizational change estimulating and limitating factors. The main challenges faced are the development of the medical staff organization, the medical record improvement and the management of the environmente of care.

Arising from a literature study, the notions of quality and quality assurance (QA) were described. A literature study was undertaken regarding the current South African national QA policies on teacher education. A case study was conducted at Tshiya College of Education, which merged with the University of the North: Qwaqwa Branch during the rightsizing of higher education in 2001. The establishment of a QA system for teacher education, on micro level, was critically described. Action research was used to investigate the process of QA. A steering committee was established. Two QA seminars contributed toward an awareness campaign. A SWOTanalysis was done. A QA policy was designed, including a framework-for-action which was action researched by volunteers. Researchers developed their own improvement plans by: compiling their job descriptions; rating their effectiveness of task execution; and attending to emerging quality gaps to determine focus areas. Professional development was emphasised. Improvement plans for Micro Teaching and Media were action researched. Taxing circumstances, resulting from the higher education transformation and its effect on the research, were reported. Data emerged from describing the action research phases: planning, implementation, observation, and reflection for re-planning. Self-, peer-, and student-assessments were utilised. Apart from discussions and meetings, the researchers kept diaries and forms were designed for assessments. In both improvement plans, reflection-in-action led to identification of unforseen weaknesses which were addressed as side-spirals of the original plans. Reflection-on-action took place at a formal meeting to which external evaluators were invited. Strengths and weaknesses were determined and findings corroborated and clustered toward final recommendations. Intrinsic motivation was described as a precursor to involvement in QA. Leadership/management/planning was seen as creating infrastructure to encourage employees to focus on quality and movement toward the institution's vision. Implementation was described as taking action to put a realistic plan into practice. Teamwork was identified as a hallmark of action research and emphasis was placed on collective wisdom. It was concluded that meritorious modelling meant that educators should lead by example / Educational Studies / D.Ed.(Education Management)