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The management of quality is a consideration in all industries. The ISO 9000 standard defines a management system framework which includes the necessary and sufficient elements for the systematic management of quality. Some organizations experience positive results from implementing an ISO 9000 based quality management system while others do not. Given its widespread use and the economic implications of ineffective implementation, this study analyzes the implementation process steps, the performance of system elements after certification and organization performance metrics. The methodology combines publicly available financial data and survey results to characterize the determinants of success for ISO 9000 quality management system implementation.

Small warm-water streams in the southeastern United States experience significant differences in temperature, as well as changes in physical parameters due to seasonal fluctuations. It has been generally thought that fish assemblage patterns change as a direct result of these seasonal variations. This study was designed to determine the effects of variable flow regimes on fish species composition, diversity, and abundance. Eight small warm-water streams in four national parks (Chickamauga and Chattanooga National Military Park, Fort Donelson National Battlefield, Abraham Lincoln Birthplace National Historic Site, and Russell Cave National Monument) were sampled May-June 2005 for the summer trials, October-November 2005 for the fall trials, and April 2006 for the spring trials. All trials were conducted when water levels and flows were at normal seasonal stages. Fish populations were determined by electrofishing a 100-m reach at each site. Physical parameters including temperature, dissolved oxygen, conductivity, pH, and flow rate were also measured at each site. From summer to fall, the majority of the streams decreased in flow until temporary pools were formed. The lack of flow caused increased temperatures, decreased dissolved oxygen, and increased conductivity levels. As a direct result, overall fish abundance and diversity values decreased. From fall to spring, all the streams increased in flow, which brought back the riffle to pool habitat sequences. Dissolved oxygen levels increased, conductivity levels decreased, and temperatures became more stable. As a result, overall fish abundance and diversity values increased. Results indicated that fish assemblage patterns in the four parks did change as a direct result of the seasonal variations in habitat and water quality.

Thesis (Ph.D.)--University of Delaware, 2006. / Principal faculty advisor: James Raths, School of Education. Includes bibliographical references.

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 104-115).

The aim of this thesis was to identify important aspects of surgical nursing care, designing strategic and clinical quality indicators in postoperative pain management, investigate content validity, develop and evaluate psychometric properties of an instrument to measure the indicators, test the applicability of the instrument and investigate patient and nurse assessment. To identify the important aspects of nursing care which might impact on quality of care in surgical wards, it was conducted 4 focus group interviews with clinical nurses (n=20). A tentative model with 15 categories in 2 dimensions, elements of performance and prerequisites, emerged from the data analysis. The categories were, e.g. detecting and acting on signs and symptoms, informing and educating, promoting relationships, responsibility and attitudes. The model was used as a foundation for developing indicators in postoperative pain management, one in each category, each supported by a literature review. To assess the content validity of the indicators, a questionnaire was compiled and sent to registered nurses with a special interest in pain (n=210) and to a random sample of clinical nurses working in surgical wards (n=321). The groups assessed the indicators as essential for achieving high quality, realistic to carry out and possible for nurses to influence management. The first group validated 14 of the 15 indicators and the second group validated 12 as “major” factors in terms of being essential to achieve high quality of care. The remaining factors were classified as “supportive”. No indicator was discarded. To measure the indicators, an instrument was developed and psychometric properties were evaluated. The indicators were converted to statements suitable for a patient questionnaire and were scored on a 5-point scale with higher values indicating higher quality of care. Patients (n=198) answered the questionnaire on their second postoperative day. The inter-item and item-total correlation coefficients were in a satisfactory range, and Cronbach’s coefficient alpha (0.84) supported internal consistency reliability. Four sub-scales, entitled communication, action, trust and environment emerged from the factor analysis with a total variance of 61.4%. The total scale correlated (rs=0.53) with the single item pain-relief-satisfaction question. The patients who reported more pain than expected scored lower on the total scale and the patients who received epidural analgesia reported higher scores on the total scale. A nurse questionnaire, similar to the patient questionnaire, was compiled. The responsible nurse at the time (n=63) answered 196 questionnaires paired with the individual patient. The new instrument appeared to be useful in identifying important areas for improvement both from the patients’ and nurses’ perspectives, based on the number of disagreements (1 and 2). Differences were found among departments. The patients’ assessments on the environment sub-scale and the overall satisfaction question were higher than the nurses’ assessments. The findings suggest initial support for the instrument as a means to measure the quality of nursing care in postoperative pain management. Key words: quality indicators; health care, pain; postoperative, focus groups, psychometrics, questionnaires, nursing care. / On the day of the public defence of the doctoral thesis the status of the articles III was: Accepted; article IV and V was: Accepted for publishing.

This thesis suggests a method for measurement of corporate contribution to sustainable development, looking at how well a company stands up to its policies and commitments regarding sustainable development. A sustainability index is developed and calculated for ITT Flygt AB over a three years period (2002-2004). The index structure is based on scientific literature and interviews with ITT Flygt and four other engineering companies. The purpose of the index is to support corporate sustainability-management. The index is calculated by aggregating some forty sustainability-indicators. These indicators are individual to each company and are designed to measure the significant sustainability aspects of the company. Besides from providing one aggregated sustainability-value of the company, the index also provides sub-indices, which support the interpretation of the index result.

Accelerating the introduction of basic, clean energy services is seen as a key strategy for promoting sustainable development in rural areas. Still, many people worldwide lack access to modern energy such as electricity, and Africa lags behind other developing regions of the world. Support to rural electrification is therefore given high priority by the national governments and donor organisations. There is a trend to encourage the involvement of other actors than national utilities for implementation of rural electrification. At the same time, it is required that the activities shall contribute to sustainable development. The objective of the work presented in this thesis has been to reach increased knowledge on the impact from organisational factors on project sustainability, and to examine whether rural electrification implemented by private entrepreneurs or other non-governmental organisations contribute more effectively to sustainable development than the conventional approach where rural electrification is the responsibility of a government utility. A key activity of the research work has been to improve and develop the present methodologies used for evaluations, as to attain a more functional in-field evaluation method. The thesis presents findings from seven rural electrification cases in Eastern and Southern Africa and shows how these can be used to illustrate different dimensions of sustainability by means of indicators. The evaluation indicates that the national utilities perform better from a social/ethical perspective, whereas the private organisations and the community-based organisations manage their client-relation issues in a more sustainable way. In addition, a literature survey shows that among stakeholders there are a number of “concepts-taken-for-granted” as regards to rural electrification. These are not supported by the findings from the seven cases. The observed deviations between expectations and realities can obstruct the development as decision-makers may have unrealistic expectations when planning for new electrification activities. Instead, activities have to be implemented with the empirical reality in mind. By doing so the ambiguities, complexities and all the paradoxes of rural electrification can hopefully be better managed. The study has been funded by The Swedish International Development Agency, Department for Research Cooperation (SAREC), and Ångpanneföreningen’s Foundation for Research and Development (ÅFORSK). / QC 20100812

The purpose of this paper was, on the basis of the association’s annual reports, to describe appropriate key performance indicators for non-profit associations. The purpose was furthermore to study how the associations show their goal-attainment.   The research was delimited to contain the second category of non profit associations, which include sports associations. The authors choose three non profit associations, which according to the law, shall draw up annual reports. The three ice hockey associations HV71, MODO Hockey and Frölunda Hockey Club, were thereafter chosen on the basis of those delimits. The research was furthermore delimited to include the parent associations only.     The authors obtained the basis of the paper through studies of literature and annual reports and via an interview. The authors described different key performance indicators based on these studies and analytical assumptions.   In the study it appeared that all of the three studied associations largely present their goal-attainment in the statement of activity, which is a part of the annual report. The financial key performance indicators that appeared were “the equity ratio” and “the gross profit margin”, which are considered to be appropriate for these three sport associations. It also appeared that the described appropriate non financial key performance indicators could be used as statistical measures to show the three studied association’s goal-attainments and with that consolidate the credibility in their annual reports.

Bakgrund: Schizofreni är en sjukdom som drabbar cirka 1 % av befolkningen, men en evidensbaserad, effektiv behandling med få biverkningar saknas. Denna litteraturstudie syftar till att kartlägga kvalitetsindikatorer som utgör grunden för en god omvårdnad av patienter med schizofreni. Syfte: Att sammanställa och belysa kvalitetsindikatorer som förväntas säkerställa en god kvalitet i omvårdnad och bemötande av patienter med schizofreni. Design: Litteraturstudie Metod: Litteraturstudie av 17 vetenskapliga artiklar, en review-artikel samt fyra debattartiklar om behandling av schizofreni, som analyserats och kvalitetsgranskats för att kunna belysa vilka faktorer som utgör kvalitetsindikatorer vid omvårdnad av patienter med schizofreni. Resultat: Kvalitetsindikatorer vid omvårdnad av patienter med schizofreni är ett holistiskt synsätt där patienten står i centrum och vården ges av välutbildade vårdgivare. Patienten ska erbjudas möjlighet att vara aktiv i sin behandling. Behandlingsmetod ska väljas och/eller kombineras efter patientens individuella behov och önskemål samt syfta till att involvera anhöriga i vårdprocessen. Slutsats: Det finns många omvårdnadsmetoder för schizofreni, vilken som ger bäst effekt varierar då diagnosen är mycket individuell. Det är viktigt att vårdgivare i samråd med patienten anstränger sig för att finna den metod som passar individen bäst. / Background: Schizophrenia is a psychiatric diagnosis which affects about 1 % of the population. However, there is no evidence based effective treatment with limited side-effects available. This literature review seeks to clarify quality indicators which constitute the basis for a good treatment and care for patients with schizophrenia. Aim: To compile and illuminate quality indicators expected to guarantee good quality of the care and treatment received by patients with schizophrenia. Design: Literature study. Methods: For this review 17 scientific articles, one review and four papers on the subject of treatment of schizophrenia were analyzed and quality examined in order to illuminate the factors which constitute the basis of quality indicators for good treatment and care for patients with schizophrenia. Results: Quality indicators in caring for patients with schizophrenia constitute a holistic, patient centered approach. The caregivers are well educated and the patient is encouraged to take an active part in the treatment. The method of treatment should be chosen and/or combined in accordance with the patient’s individual needs and wishes. It also aims to include close relations in the caring process. Conclusion: There are many methods of treatment available for schizophrenia. It is however a very individual diagnosis, and which treatment gives the best effect varies from case to case. It is important that caregivers, while including the patient in the process, strive to find the method most suited to the individual.