Orientador: Gláucia Maria Bovi Ambrosano / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T22:24:12Z (GMT). No. of bitstreams: 1 Goncalves_JulianaRocha_D.pdf: 1509889 bytes, checksum: e0e512f024362ace1e2869a3cf3438ab (MD5) Previous issue date: 2013 / Resumo: Pesquisas que trabalham com avaliação da qualidade tem recebido grande destaque devido sua importância na utilização na gestão dos serviços. Por outro lado as organizações que atuam na área odontológica não possuem padronização para avaliar sua atuação junto aos usuários e empresas-clientes. Em geral a avaliação é realizada com vistas à ampliação e à captação de negócios não estando diretamente relacionada à melhoria da saúde bucal da população atendida, que poderia ser o objetivo principal. Os objetivos deste trabalho foram: (1) desenvolver indicadores para avaliar a qualidade do serviço odontológico sob o ponto de vista dos usuários; (2) Estabelecer indicadores para a avaliação da qualidade da assistência odontológica; e (3) Estabelecer métodos estatísticos que serão utilizados na avaliação e gestão de serviços odontológicos. Participaram da pesquisa usuários com idade a partir de 18 anos e prontuários de usuários com tempo de alta inferior a seis meses. Para o calculo amostral os seguintes parâmetros foram utilizado, em um serviço de plano odontológico com uma média de 1200 atendimentos/mês realizados por dentistas credenciados foi estimada uma prevalência de 50% de satisfação do usuário. O nível de confiança foi de 95%, com margem de erro de 5%, estimando-se assim uma amostra de 291 indivíduos por meio do Epi Info 6.0. Considerando uma possível perda de 20% foram selecionados 355 prontuários. Na primeira fase do trabalho utilizando o questionário SERVQUAL com cinco dimensões e também do sociodemografico, foram avaliadas as expectativas sobre o serviço (antes de receberem o tratamento odontológico). Além disso, foi testada uma ferramenta de marketing IPA (Importance Performance Analysis) que permite o direcionamento de ações de acordo com os resultados obtidos. Trezentos e setenta e nove questionários foram preenchidos. Na segunda fase, onde os beneficiários tinham recebido o tratamento odontológico, 155 questionários foram preenchidos. A pesquisa foi realizada em quatro empresas clientes de um serviço de plano odontológico com questionários. Os dados foram tabulados e foram feitos os cruzamentos das variáveis. Após estes procedimentos foi criado um banco de dados para o desenvolvimento do software, utilizando as ferramentas da qualidade. Concluiu-se que Os homens tiveram expectativas mais elevadas do que as mulheres em três dimensões: presteza, segurança e empatia. A presteza foi à única dimensão que as expectativas do serviço oferecido, foram mais elevadas do que a percepção. Na dimensão tangibilidade e confiabilidade, as pacientes do gênero feminino mostraram mais insatisfeitos com o serviço do que os homens. Os mais velhos tiveram maior prevalência de insatisfação com o serviço na dimensão Empatia. E finalizando a ferramenta IPA se mostrou eficaz quando utilizada na gestão do serviço uma vez que destaca os pontos chaves a serem melhorados no serviço / Abstract: Researches that work with quality assessment have received great prominence due its importance in use in the management of services. Moreover organizations working in dentistry have no standardization to assess the performance with users and client companies. In general the evaluation is carried out in order to expand and capture business not directly related to improving the oral health of the population served, which could be the main objective. The objectives of this study were: (1) develop indicators to assess the quality of dental services from the point of view of users, (2) Establish indicators for assessing the quality of dental care, and (3) establish statistical methods that will be used in the evaluation and management of dental services. Participants were from users aged 18 years and records of users with high time less than six months. To calculate sample the following parameters were used in one service dental plan with an average of 1200 calls / month conducted by accredited dentists was estimated a prevalence of 50% user satisfaction. The confidence level was 95%, with a margin of error of 5%, estimating just a sample of 291 individuals using the Epi Info 6.0. Considering a possible loss of 20% were selected 355 charts. In the first phase of work using the SERVQUAL questionnaire with five dimensions and also the sociodemographic, were evaluated expectations about the service (before receiving dental treatment). In addition, we tested a marketing tool IPA (Importance Performance Analysis) which allows the targeting of actions according to the results. Three hundred and seventy-nine questionnaires were completed. In the second phase, where beneficiaries had received dental treatment, 155 questionnaires were completed. The research was conducted in four business customers a service dental plan with questionnaires. Data were tabulated and the crossings were made of variables. After these procedures has created a database for developing the software, using the tools of quality. It was concluded that men had higher expectations than women in three dimensions: responsiveness, assurance and empathy. The promptness was the only dimension that the expectations of the service offered, were higher than the perception. In size tangibility and reliability, the genre of female patients showed more dissatisfied with the service than men. The older had a higher prevalence of dissatisfaction with the service dimension in Empathy. And ending the IPA tool was effective when used in the management of the service once that highlights the key points to be improved in service / Doutorado / Saude Coletiva / Doutora em Odontologia

Submitted by Gabriela Lopes (gmachadolopesufpel@gmail.com) on 2016-09-13T18:41:25Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação_Cristiane Stöcker.pdf: 1279350 bytes, checksum: 3d6d0191f5ab1b919784bddc4279ed78 (MD5) / Made available in DSpace on 2016-09-13T18:41:25Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação_Cristiane Stöcker.pdf: 1279350 bytes, checksum: 3d6d0191f5ab1b919784bddc4279ed78 (MD5) Previous issue date: 2015-08-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Este trabalho foi desenvolvido em quatro vinhedos familiares localizados no Município de Pelotas, no Território Zona Sul do Rio Grande do Sul. O objetivo do presente estudo foi construir um diagnóstico, a partir da análise de indicadores da qualidade do solo, da folha e da fruta em propriedades agrícolas familiares produtoras de uva cultivar bordô. Este diagnóstico baseou-se em uma pesquisa descritiva a qual contribuirá para o estabelecimento de um modelo para posterior estudo sobre a dinâmica dos indicadores físicos, químicos e (micro)biológicos no sistema solo-planta-fruto em agroecossistemas com produção de uva. Os indicadores utilizados foram: densidade do solo, porosidade total, microporosidade, macroporosidade, diâmetro médio ponderado dos agregados, pH, matéria orgânica, capacidade de troca de cátions, macronutrientes (K, P, Ca, Mg, Al), micronutrientes (Fe, Mn, Zn, Cu e B), relação de ácaros/colêmbolos, Índice de Shannon, número de minhocas, respiração basal do solo, carbono da biomassa microbiana do solo, análises foliares de macronutrientes (N, P, K, Ca, Mg) e micronutrientes (B, Cu, Fe, Mn, Zn) e análises físico-químicas da fruta (°Brix, acidez, ratio, pH, antocianinas, atividade antioxidante e fenóis totais), os quais foram mensurados através de análises laboratoriais. Com a interpretação dos dados foi possível verificar que os solos avaliados apresentam condições físicas adequadas. Com relação aos indicadores químicos, os solos avaliados apresentam adequada fertilidade, e com relação às condições biológicas (meso e macrofauna), estão abaixo dos índices considerados como ideais. Levando-se em consideração a análise foliar podemos inferir que os vinhedos apresentam estado nutricional adequado. Os indicadores físico-químicos da uva estão dentro dos parâmetros esperados para a cultivar avaliada. / This study was conducted in four family vineyards located in the municipality of Pelotas, in the South Territory of the Rio Grande do Sul state. The aim of this study was to construct a diagnosis based on the analysis of soil quality indicators, leaf and fruit on family farms grape producers. This diagnosis was based on a descriptive research which will contribute to the establishment of a model for further study on the dynamics of physical, chemical and (micro) biological indicators in the soil-plant-fruit system. The indicators used were: bulk density, total porosity, microporosity, macroporosity, mean weight diameter of aggregates, pH, organic matter, cation exchange capacity, macronutrients (K, P, Ca, Mg, Al), micronutrients (Fe, Mn, Zn, Cu and B) ratio of mites/springtails, Shannon Index, number of earthworms, soil basal respiration, microbial biomass carbon, leaf analysis macronutrients (N, P, K, Ca, Mg) and micronutrients (B, Cu, Fe, Mn, Zn) and physical-chemical analysis of fruit (°Brix, acidity, ratio, pH, anthocyanins, antioxidant activity and phenolic compounds), which were measured by laboratory analysis. With the data interpretation was possible to verify that the soil physical indicators present adequate physical conditions. With respect to chemical indicators the vineyards evaluated have adequate soil fertility, but regarding the biological conditions (meso and macrofauna) the results were below the considered ideal. Taking into account the foliar analysis, the vineyards present adequate nutritional status. Lastly, the fruit physical and chemical indicators present expected parameters for this cultivar.

Depuis le début des années 2000, le secteur social et médico-social connait des évolutions et des mutations importantes. D’un côté, le nombre de personnes prises en charge est en perpétuelle augmentation. D’un autre côté, les finances et les budgets mis à disposition des établissements ne cessent de se réduire, ce qui oblige les décideurs à s’adapter et à trouver de nouvelles solutions pour faire plus avec moins de moyens. Dans cette thèse, nous étudions un problème pratique auquel sont souvent confrontés les directeurs des établissements qui est l’élaboration de plans d’actions optimaux. Un plan d’actions est un ensemble d’actions qui sont mises en place afin d’améliorer à la fois les performances de l’établissement et la qualité de prise en charge de ses résidents.Élaborer un plan d’actions optimal consiste à identifier et choisir les meilleures actions qui améliorent tous les objectifs du plan tout en respectant quelques contraintes. Après la présentation du contexte pratique et théorique, nous fournissons une modélisation formelle du problème sous forme d’un problème de sac-à-dos multi-objectif.Puis nous présentons quelques méthodes de résolution à base d’indicateurs de qualité et de la dominance de Lorenz. Nous montrons que la méthode IBMOLS combinée avec l’indicateur de qualité R2 permet d’obtenir des solutions efficaces et d’intégrer facilement les préférences du décideur. Nous montrons également que dans un contexte où les préférences du décideur sont inconnues ou les objectifs ont tous la même importance, la dominance de Lorenz est un outil très efficace qui permet, d’un côté, d’intégrer l’équité dans le processus de recherche et, d’un autre côté, de réduire le nombre de solutions non dominées ainsi que le temps d’exécution. / Since the early 2000s, the social and medico-social sector is experiencing significant evolutions and mutations. On the one hand, the number of persons taken over is constantly increasing. On the other hand, the finances and budgets available to the structures are constantly decreasing. This forces decision-makers to adapt and find new solutions to do more with fewer resources. In this thesis, we study a practical problem that is often faced by the decision-makers, which is the elaboration of optimal action plans. An action plan is a set of actions that are realized to improve both the performance of the structure and the quality of service offred to its residents. Elaborating an optimal action plan consists of identifying and selecting the best actions that improve all the objectives of the plan while respecting some constraints. After presenting the practical and theoretical context, we provide a formal modeling of the problem as a multi-objective knapsack problem. Then, we present a number of solution methods based on quality indicators and Lorenz dominance. We show that combining IBMOLS method with R2 indicator allows obtaining efficient solutions and easily integrating the decision-maker preferences. We also show that in a context where decision-maker preferences are not known or all the objectives are considered equals, Lorenz dominance is a very efficient tool to incorporate equity into the search process and reduce the number of non-dominated solutions as well as the algorithm runtime.

Within the DIECOFIS framework, ec3, the Division of Business Statistics from the Vienna University of Economics and Business Administration and ISTAT worked together to find methods to create a comprehensive database of enterprise data required for taxation microsimulations via integration of existing disparate enterprise data sources. This paper provides an overview of the broad spectrum of investigated methodology (including exact and statistical matching as well as imputation) and related statistical quality indicators, and emphasises the relevance of data integration, especially for official statistics, as a means of using available information more efficiently and improving the quality of a statistical agency's products. Finally, an outlook on an empirical study comparing different exact matching procedures in the maintenance of Statistics Austria's Business Register is presented.

Background, aim and objectives: Evaluating quality of care is essential when redesigning or improving practice. Medicines reconciliation (MR) on hospital admission is now policy in the UK. It is the process of obtaining an up-to-date and accurate medication list and documenting any discrepancies. The overall aim of this work was to develop quality indicators to evaluate MR on admission to hospital; the specific objectives include developing MR quality indicators, achieving consensus on their appropriateness and testing their feasibility by applying them in a hospital setting. Design: The study was designed in three parts, each consisting of three steps. In part I, ideas about potential indicators were obtained from two sources: a literature search and the nominal group technique. These ideas were converted to potential indicators using criteria for good indicators and then reviewed by nine reviewers. Part II was designed to achieve consensus on the appropriateness of the indicators to evaluate MR. It involved pre-piloting, piloting and conducting the main two-round online Delphi study. Several methods were used to approach predefined experts. Part III involved applying in hospital settings those MR indicators that had achieved consensus. It included developing operational definitions and directly observing the MR process as conducted by pharmacy staff in two hospitals. The indicators were further tested by collecting data about the MR process for all patients seen by pharmacy staff on one weekday in the two hospitals. Results: A systematic approach was followed to develop MR indicators. The idea generation step produced over 90 ideas about potential indicators, which were converted to 85 MR indicators. The assessment by the nine practicing hospital pharmacists discarded 29 of them and the remaining 56 MR indicators were carried forward to the Delphi study, during which 41 indicators achieved consensus as appropriate for evaluating MR on admission to hospital. In the feasibility study, 5 MR indicators were found not to be feasible and three not adequately assessed, while 33 indicators were considered feasible to be used in a hospital setting. Conclusions: This work provided a novel list of 33 indicators that achieved consensus and were found to be feasible to evaluate the MR process on admission to hospital. Further research should explore the use of these indicators, among others, to assess and improve the overall quality of care provided to patients on admission and throughout the hospitalization journey.

O presente trabalho tem por objetivo propor uma análise e melhoria de processos em uma Instituição Pública, de caráter militar do Exército Brasileiro, utilizando como base o Programa de Excelência Gerencial desenvolvido no Exército Brasileiro. Por meio de um estudo de caso foi elaborado um modelo de implantação da análise e melhoria de processos no setor de aquisição, recebimento e distribuição de materiais do Comando da 12 Brigada de Infantaria Leve (Aeromóvel). Esta dissertação teve início com uma pesquisa bibliográfica envolvendo os conceitos de sistema de gestão da qualidade, sua evolução, suas principais características relacionadas aos mapeamentos dos processos, seguido de uma abordagem sobre a série ISO 9000, sendo evidenciado também um breve histórico da qualidade no Exército Brasileiro e seu atual programa de gestão. Com base na revisão bibliográfica, desenvolveu-se um modelo de implantação da análise e melhoria de processos que tivesse como objetivo, agilizar os processos que envolvem o setor de aquisição, recebimento e distribuição da Organização em estudo. Após a implantação deste modelo, o estudo apresentou a situação da organização durante a implantação e suas principais melhorias. Por fim, conclui-se que os resultados verificados, através da análise dos indicadores, evidenciaram os benefícios que a análise e melhoria de processos ocasionaram para o Comando da 12 Brigada de Infantaria Leve (Aeromóvel). / This study aims to propose an analysis and process improvement in a Public Institution of military character of the Brazilian Army, using as basis the Management Excellence Program (PEG-EB) developed in the Brazilian Army. The model was initially developed to be applied in the acquisition, receipt and distribution of material sector, using as a case study, the 12th Light Infantry Brigade Division (Aeromóvel). The task began with a literature search involving the concepts of the quality management, its evolution, its main characteristics related to mapping of processes, followed by a discussion of the ISO 9000 series, also being shown a brief history of quality in the Army Brazil and its current management program. Based on literature review, developed a deployment model analysis and improvement of processes that have as their objective, streamline processes involving the acquisition sector, collection and distribution organization in the study. After the implementation of this model, the study showed the situation of the organization during the implantation and its main improvements. Finally, it is concluded that the results confirmed by analysis of the indicators showed the benefits of analysis and process improvement caused to the Command of the 12th Light Infantry Brigade (Aeromóvel).

Orientador: Wilza Carla Spiri / Banca: Silvana Andrea Molina Lima / Resumo: Introdução: a preocupação com a qualidade nas organizações de saúde tem se manifestado por meio da busca de melhores práticas para atender tanto o mercado competitivo, como os seus clientes. Portanto, torna-se necessário e urgente dispor de informações relevantes para planejar, desenvolver e avaliar as ações de modo a instrumentalizar os gestores para avaliarem seus processos com racionalidade e criticidade. A utilização de indicadores é uma forma adequada de mensurar, comparar e agregar o juízo de valor ante o encontrado e o ideal estabelecido. Para tanto, necessitam ter sua coleta e sistematização bem planejadas, como forma de facilitar o desempenho das atividades para melhoria dos processos de trabalho. O Centro Cirúrgico é considerado uma das unidades mais complexas e específicas do hospital, cujo desempenho está diretamente relacionado com a qualidade de seus próprios processos e com os processos dos serviços que o apoiam. Objetivo: implantar e analisar indicadores de qualidade no Centro Cirúrgico de um hospital especializado em dermatologia. Método: estudo descritivo, analítico, prospectivo e transversal com abordagem quantitativa. O cenário da pesquisa foi um hospital público, especializado em dermatologia, no interior do Estado de São Paulo. A primeira etapa do estudo foi a busca de indicadores adequados para uso no Centro Cirúrgico de acordo com as características do hospital estudado e segundo a literatura existente nessa área. A segunda etapa cons... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The preoccupation with the quality in health organizations has been manifested through the search for better practices to meet not only the competitive market but also its customers. Therefore, it is fundamental and immediate to gather relevant pieces of information to plan, develop and evaluate the practices that are proposed and provide managers with instruments to evaluate their processes rationally and critically. The use of indicators is an applicable way to measure, compare and provide value face what is found and the established ideal. For this purpose, the collection and systematization need to be well planned in a way to facilitate the development of activities in order to improve the processes of work. The Operating Room is considered one of the most complex and specific unit of a hospital, whose performance is straightforwardly related to the quality of its own processes and with those services that are supported by it. Objective: implement and analyze the indicators of quality of an Operating Room of a hospital specialized in dermatology. Method: it is a descriptive, analytical, prospective and cross-sectional study with a quantity approach. The venue of the research was a public hospital specialized in dermatology in a city of São Paulo state. In the first stage of the study, it was sought suitable indicators to use in the Operating Room, according to the characteristics of the chosen hospital and according to the literature found in the area. The next stage, the instrument was constructed in order to collect the selected indicators. The third stage was consisted of the implementation of indicators through an educative process that assessed the background knowledge and posterior knowledge after the training. The fourth stage was related to the survey and analyze of selected... (Complete abstract click electronic access below) / Mestre

Throughout human history, people have migrated from one area to another for many reasons, including searching for better economic, political or other conditions that are assumed to improve the human standard of living (Kotkin 2016:6; United Nations Department of Economic and Social Affairs 2014). Migration to urban areas has increased over the past century, and is only expected to continue doing so. In 2016, 54% of earth’s human population lived within urban areas, making it the largest urban population ever to occur on the planet (Brenner & Schmidt 2014:733; United Nations Population Fund 2014). A 2013 study by El Din, Shalaby, Farouh and Elariane states that, with more of the human population residing in urban areas than in the past, studies around human life in urban areas are more significant and necessary for the sake of increasing knowledge bases for the development of sustainable human environments (El Din et al. 2013:87, 88). Architects and urban planners focus on improving the quality of life of the end users of their designs at a contextual level, which in turn is beneficial as a good quality of life is considered to be one of the most important aspects for sustainable urban development (Othman, Aird & Buys 2015:22). Over the past 15 years there has been a knowledge shift towards global parameters for measurement of quality of life that are not uniform or based solely on economic indicators, but rather are developed so that these indicators can be used to measure quality of life at a contextual level in order to supply informative data and results (United Nations Population Fund 2016; Vermuni & Costanza 2006:124). There are contextual differences, similarities and variations for the definition of a good quality of life between the large urban areas in the developed world as well as in countries within the Global South, which contains the majority of the world’s Third World countries (Rigg 2007:8-10). With the global continuation of the urbanisation of the human population in different contexts, along with the migration of individuals between different parts of the world, urban planners and architects are challenged to design spaces that provide good quality of life within any urban context for an end user coming from any urban or rural context. This study seeks to investigate the means of assessing quality of life in residential spaces of end users who share similar values in terms of quality of life, but will be studied in three varied urban contexts, namely Zimbabwe, South Africa and the United Kingdom. Zimbabwe, is classified as a Low Income country by the United Nations Department of Economics and Social Affairs (2014), has experienced high levels of migration out of the country over the past 16 years (Humphris 2010), with the highest number of migrations into South Africa, which is classified as an Upper Middle Income Country, and the United Kingdom, classified as a High Income country (United Nations Department of Economics and Social Affairs 2014). This research paper seeks to measure and compare quality of life in the homes of Zimbabweans in the three contexts mentioned above, in order to gauge what aspects of residential design impact positively or negatively on the end user’s quality of life. / Mini Dissertation (MSc)--University of Pretoria, 2017. / Architecture / MSc Applied Sciences in Architecture / Unrestricted

BACKGROUND: Colonoscopy performance by gastroenterologists has been shown to be associated with lower rates of developing interval colorectal cancer. However, it is unclear if this difference among specialists stems from a difference in meeting colonoscopy quality indicators. OBJECTIVE: The purpose of this study is to determine and compare the rates of colonoscopy quality indicators between different specialties. DESIGN: This is a cohort study of patients undergoing screening colonoscopy investigating quality metrics as compared by the proceduralist specialty. SETTING: All screening colonoscopies performed at the Cleveland Clinic between 2012 and 2014 were followed by manual chart review. PATIENTS: Average-risk patients, ≥50 years of age, who had a complete screening colonoscopy were included. MAIN OUTCOME MEASURES: Adenoma detection rate, cecal intubation rate, withdrawal time, and other nonestablished overall and segment-specific rates were calculated and compared using t tests. RESULTS: A total of 4151 patients were included in the analysis. Colonoscopies were performed by 54 (64.3%) gastroenterologists, 21 (25%) colorectal surgeons, and 9 (10.7%) general surgeons. Gastroenterologists had the highest overall adenoma detection rate (28.6 ± 1.2; p < 0.001), followed by colorectal surgeons (24.3 ± 1.5) and general surgeons (18.4 ± 2.3), as well as the highest adenoma detection rate in men (34.7 ± 1.3; p < 0.001), followed by colorectal surgeons (28.2 ± 1.6) and general surgeons (23.7 ± 2.6). Similarly, gastroenterologists had the highest adenoma detection rate in women (24.3 ± 1.1; p < 0.001), followed by colorectal surgeons (21.6 ± 1.4) and general surgeons (12.9 ± 2.0). Withdrawal time was the longest among general surgeons (11.1 ± 5.5; p = 0.041), followed by colorectal surgeons (10.94 ± 5.2) and gastroenterologists (10.16 ± 1.26). LIMITATIONS: We could not adjust for some procedure-related details such as retroflexion in the right colon and the use of end-of-scope devices. CONCLUSIONS: In this study, only gastroenterologists met the currently accepted overall and sex-specific adenoma detection rate benchmarks. They also outperformed nongastroenterologists in many other nonestablished quality metrics. See Video Abstract at http://links.lww.com/DCR/B232.

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