This thesis explored healthcare quality improvement, considering the general question of why the last decade's worth of quality improvement (QI) had not significantly improved quality and safety. The broad objective of the thesis was to explore how hospitals perform when completing QI projects and whether any organizational characteristics were associated with that performance. First the project evaluated a specific QI collaborative undertaken in the Veterans Affairs (VA) healthcare system. The goal of the collaborative was to improve patient flow throughout the entire care process leading to shorter hospital length of stay (LOS) and an increased percentage of patients discharged before noon. These two goals became the primary outcomes of the analysis, which were balanced by three secondary quality check outcomes: 30-day readmission, in-hospital mortality, and 30-day mortality. The analytic model consisted of a five-year interrupted time-series examining baseline performance (two-years prior to the intervention), the year during the QI collaborative, and then two-years after the intervention to determine how well improvements were maintained post intervention. The results of these models were then used to create a novel 4-level classification model. Overall, the analysis indicated a significant amount of variation in performance; however, sub-group analyses could not identify any patterns among hospitals falling into specific performance categories. Given this potentially meaningful variation, the second half of the thesis worked to understand whether specific organizational characteristics provided support or acted as key barriers to QI efforts. The first step in this process involved developing an analytic model to describe how various categories of organizational characteristics interacted to create an environment that modified a QI collaborative to produce measureable outcomes. This framework was then tested using a collection of variables extracted from two surveys, the categorized hospital performance from part one, and data mining decision trees. Although the results did not identify any strong associations between QI performance and organizational characteristics it generated a number of interesting hypotheses and some mild support for the developed conceptual model. Overall, this thesis generated more questions than it answered. Despite this feature, it made three key contributions to the field of healthcare QI. First, this thesis represents the most thorough comparative analysis of hospital performance on QI and was able to identify four unique hospital performance categories. Second, the developed conceptual model represents a comprehensive approach for considering how organizational characteristics modify a standardized QI initiative. Third, data mining was introduced to the field as a useful tool for analyzing large datasets and developing important hypotheses for future studies.

The papers in this portfolio are part of the author's efforts to 'make things better' in education, and are the products of over a decade's thinking and research. While most of the papers are written from within the context of the state school system in NSW, their messages apply equally well to school systems elsewhere. The papers reflect an eclectic mix of research perspectives and methodological paradigms. It is suggested that student learning outcomes may be improved if schools specify goals and objectives, make the necessary resources available and establish accountability mechanisms for monitoring and measuring performance. The analysis and synthesis generates critical knowledge, that is, knowledge which is explanatory and interpretive. The desire to assist schools to achieve a position where they are able to (firstly) assemble their own data systems, and secondly to conduct their own analysis of this data and report this to the school community has been the common theme underpinning all the professional work of the author. The works evolved in this portfolio document an evolving process, and one which is far from concluded. There is much further work that could be done. An analysis of the macro and micro-politics of school improvement processes, for example, would be a useful contribution to the literature. For the present purposes, there is a practical need to limit the scope and number of the works presented. The works included all address, in some way, the common theme of improving school and systemic effectiveness through better information management. Hopefully, they have made some small contribution to better understanding the phenomenon, and will in turn positively impact on the performance of schools and school systems / Doctor of Education

Doctor of Education (EdD) / Increasingly the Australian educational environment in which schools find themselves is one where schools are expected to achieve successes for their students and furthermore allow their successes or lack thereof to be compared with ‘transparency’ against the successes of other schools. The overriding principle expected from the politicians and society in general is one of providing parents with the best information possible on which they will be able to base their decision as to which school will be the best for their children. This notion is noble and honourable, one at which little criticism can be levelled. However, as researchers in the ‘Effective Schools’ and ‘Improving Schools’ research fields have discussed for decades, measuring the effectiveness of schools is not an easily achievable goal. It is far too easy to fall into the trap of using simplistic and narrow measures that supposedly allow easy comparisons. This study takes the view, as does most research to date, that univariable measures of school effectiveness are fatally flawed. The current trend in many western nations to simply compare the academic success of schools, however that might be measured, does little to measure the effectiveness of schools. What is most concerning is the growing trend of creating league tables of comparison and in some educational systems to use such tables to determine school funding. Equally disturbing is the amount of research that seeks to examine what students consider important in an effective school. There is a great deal of research on what characteristics parents, teachers, politicians and other key stakeholders consider an effective school to have but extraordinarily there is comparably very little research on what students consider important. This study seeks to somewhat address this inadequacy by measuring what students in their senior years of schooling in a single independent school in New South Wales, Australia perceive to be appropriate and useful measures of effective schooling. In so doing this research also examined if in the students’ minds their current school is effective and most significantly examines why students hold the views they have concerning effective schools. In order to achieve this aim, this study took a qualitative research approach to discover Student Perceptions of Effective Schooling. The theoretical orientation adopted was to both verify current theory of effective schooling as well as suggest possible developments, modifications and improvements to current theory in light of the students’ perceptions. As such both inductive and deductive analysis of the data took place. The data was collected using a range of methods from traditionally quantitative research tools, such as surveys, through to the qualitative research tool of focus groups. The results of this study demonstrated that while the current research has developed a good multivariable approach to measuring school effectiveness there were significant areas the students believed needed greater or lesser emphasis. The importance of technically good teachers, separate from the need for good and caring teachers, as well as the need for schools to be safe places were all important measures of effective schools. The ability of the school to engage students outside the classroom and provide a relevant and diverse academic curriculum was also considered essential for effective schooling.

Graduation date: 1997

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 200-209).

Project Management is the primary key to successful software development. In 1995 Caper Jones stated that the failure or cancellation rate of large software systems was over 20% in his article on patterns of large software systems. More than two thirds of the projects fail due to improper management of skills, activities, and personnel. One main reason is that software is not a tangible entity and is hard to visualize and hence to monitor. A manager has to be skilled in different CASE tools and technologies to track and manage a software development process successfully. The volume of results produced by these CASE tools is so huge that a high level manager cannot look into all the details. He has to get a high level picture of the project, to know where the project is heading, and if needed, then look into the finer level details by drilling down to locate and correct problems. The objective of this thesis is to build an Advanced Charting System (ACS), which would act as a companion to PAMPA 2 (Project Attribute Monitoring and Prediction Associate) and help a manager visualize the state of a software project over a standard World Wide Web browser. The PAMPA 2 ACS will be responsible for visualizing and tracking of resources, tasks, schedules and milestones of a software project described in the plan. PAMPA 2 ACS will have the ability to depict the status of the project through a variety of graphs and charts. PAMPA 2 ACS implements a novel charting technique called as DOT Chart to track the processes and activities of a software project. PAMPA 2 ACS provides a multilevel view of the project status. PAMPA 2 ACS will be able to track any arbitrary plan starting from a collapsed / concise view of a whole project. This can be further drilled down to the lowest level of detail. The status can be viewed at the project version level, plan and workbreakdown levels, process, sub process, and activity level. Among all the process models, the DOT charts can be applied effectively to spiral process model where each spiral represents a project version.

Cost competitiveness is a major driving force in the semiconductor industry. The processing cost of an individual die is directly proportional to its size. Advances in processing technology have shrunk the device sizes in wire-bonded chips, resulting in a smaller die core size. However, the space below wire-bond pads remains relatively underutilized because of the reliability concern that electrical loads transmitted during bonding can cause failures in the underlying devices. Recently, studies have attempted to improve the use of space below wire-bond pads. Hence, the circuits under pads (CUP) structure modified layout rules to include circuits structure under pads, was developed, and extensive qualification work is required to meet reliability standards. The main purpose of this paper is to investigate the damage caused by the wirebonding process of CUP devices on the in-line assembly packaging manufacture. The root cause of wirebonding failures analyzed were based on the CUP structure and several wire bond parameters; such as bonding force, ultrasonic current, bonding time period, capillary type, machine, and wafer source, which were also confirmed with the DOE/JMP engineer technique. Finally, results were also used to implement the corrective action and the assembly yield of CUP Device has been improved, successfully.

The current project addresses the productivity improvement of a manual assembly line by making use of operations analysis in the framework of Lean production. A methodology is proposed that helps to improve the productivity of any production process. The methodology consists of selecting a product or product family to be studied followed by current process study. Once the existing process is documented, all the assembly tasks involved must be timed using time study techniques. Operations analysis enables the reduction of non-productive tasks and results in a set of standardized work elements along with the set of standard procedures for performing the operations. Assembly line balancing along with the associated operations analysis assists in constructing or re-configuring an assembly system, which is the key step in improving the overall performance of an assembly line. Following this approach, two manual assembly line configurations (single stage parallel line and five-stage serial line) are constructed for a case study. The results show that by changing over to the single stage assembly line configuration the operator productivity is doubled when compared to the existing assembly method.

Background: Low back pain (LBP) and low back related disorders are highly prevalent and associated with a considerable burden of pain, disability and work loss. People with a variety of low back-related complaints comprise a large proportion of referrals made to orthopedic surgeons and many of these patients are not considered to be surgical candidates or have not maximized their non-surgical options for managing their low back-related complaints. Objectives: We sought to evaluate the impact of a triage assessment program delivered by physiotherapists using a variety of approaches. Informed by a biopsychosocial model, the objectives of this dissertation were: 1) To determine the short term impact of a physiotherapy triage assessment for people with low back-related disorders on participant self-reported pain, function and quality of life and patient and referring practitioner satisfaction. 2) To determine which demographic, clinical, psychosocial and environmental factors are predictive of improved self-reported pain, function, quality of life and participant and referring practitioner satisfaction. 3) To determine the diagnostic and treatment recommendation concordance between physiotherapists and orthopaedic surgeons, using a newly developed clinical classification tool, for people presenting to a spinal triage assessment service with low back complaints. Methods: Two approaches were used to achieve the aforementioned objectives: a prospective observational study (n=115) to address the first two objectives and a sub-group reliability study (n=45) to address the third objective. Results: There was a mean overall significant improvement in the SF-36 Physical Component Summary at the 4-6 week post-test time point and relatively high satisfaction reported by participants and referring care providers. Qualitative analysis of comments revealed a variety of positive, negative and other contextual factors that may impact outcomes. A variety of different sociodemographic, psychological, clinical and other variables were associated with success or improvement in each respective outcome. There may be a potential mechanism of reassurance that occurs during the spinal triage assessment process as those with higher psychological distress were more likely to improve on certain outcomes. There was high diagnostic concordance between physiotherapists and an orthopaedic surgeon; however, there were more differences in management recommendations between the surgeon and a solo physiotherapist versus physiotherapists working in a collaborative team. Conclusions: A spinal triage assessment program delivered by physiotherapists has the potential to positively impact a variety of patient-related short term outcomes including satisfaction. Further study is needed to examine longer-term outcomes and which biopsychosocial factors may impact these outcomes.

Heritage assets and the values associated with their protection deserve recognition as they represent a reference point from which cities can look to their past, understand the present, and plan for the future. To strengthen our understanding, this research explores the relationship between Heritage Conservation District (HCD) designation and its effect on community improvement efforts. In doing so, it seeks to explore the reasons for and values associated with the desire for communities to conserve their architectural heritage. The concept of the HCD is also investigated as a mechanism for promoting heritage, and the role of the HCD in achieving revitalization goals is described. Multiple sources of evidence were analyzed to provide insight into these research objectives. Planning and policy documents and mapped census data were examined, and open-ended interviews, community surveys, and field observation were undertaken to investigate the effectiveness of policy implementation and its impact on communities. Markham Village and Unionville, two HCDs located in the Town of Markham, Ontario, serve as case studies and provide a focus on current experiences within a real-life setting. Community improvement indicators were devised to determine progress toward community improvement and to measure the success of these HCDs. This study attempts to provide a means by which to monitor and evaluate conservation and revitalization goals.