The Benchmarking Effort for Networking Children's Hospitals (BENCHmark)

BACKGROUND: In 1992, 12 large children's hospitals established the Benchmarking Effort for Networking Children's Hospitals (BENCHmark). The goal was for the BENCHmark effort to supplement the hospitals' continuous quality improvement (CQI) programs and to speed adoption of best practices from peer institutions. For three years, the hospitals have been comparing data on cost, quality, and speed indicators. Also, "best practice" groups have met to share information on how processes can be improved. RESULTS: The BENCHmark hospitals have experienced significant process improvement in areas such as emergency department waiting time and admitting process time. EXAMPLE: The BENCHmark hospitals selected admitting as one of the first best practice groups to meet. Interdisciplinary staff from all BENCHmark hospitals met three times over the course of a year to define their indicator and share information on best practices. St Louis Children's Hospital, as a result, instituted a pre-arrival team and cross-trained staff, with the result being a reduction of admitting processing time from 58 minutes to 19 minutes. Same-day surgery patients now bypass the admitting department and go directly to the surgical floor. Patient and surgeon satisfaction has increased greatly. CONCLUSIONS: Hospitals that are planning to benchmark are encouraged to reach consensus on project goals and to focus on indicators that provide a clear business advantage. Physician involvement is key to improving performance and physicians will only be engaged if the hospitals against whom they are benchmarked are considered peers. Being willing to share initial data openly seems to be a key factor in determining successful integration of the BENCHmark process into hospital CQI efforts. The BENCHmark project has been so successful that a second group of 12 comparable pediatric institutions, known as the Network II, has been established.     

Pain threshold values during periodontal probing: assessment of maxillary incisor and molar sites

Probing pain threshold (PPT) assessments were conducted in the facial and oral sulci of maxillary central incisors and first molars of 10 periodontally healthy adults. All subjects were systemically healthy, free of pain, and reported no current medication usage. A computer-linked electronic probe, modified to deliver steadily increasing forces up to 200 grams, was used to collect the data. The system contained a subject operated "off-switch" which, upon activation, signaled the computer to record the subject's PPT. Assessments of each subject's PPTs were conducted on 3 separate occasions at 7-day intervals. Results indicated that the facial sulci of the incisors were the most pain sensitive. They displayed a mean PPT of 50.9 +/- 26.6 grams. The oral sulci of the incisors exhibited a mean PPT of 76.5 +/- 45.2 grams. Facial and oral sulci of the molars evidenced mean PPT values of 102.6 +/- 52.1 grams and 113.5 +/- 51.3 grams, respectively. These data suggest that sulci associated with incisor teeth are nearly twice as pain sensitive as sulci associated with molar teeth. In addition, facial sulci are significantly more pain sensitive than oral sulci. Data did not indicate a visit effect nor a side-of-mouth effect on PPT values.     

Scanning tunneling spectroscopy studies on YBa2Cu3O7−δ

Scanning Tunneling Spectroscopy (STS) measurements have been carried out on the high T_c superconductor (HTS) YBa₂Cu₃O_7– (YBCO). Using very high quality single crystals as well as hard tips, we obtained differential conductance spectra which showed various conductance features in agreement with other spectroscopic techniques. The reproducibility of our spectra allowed us to map for the first time the vortex lattice on a HTS using a STS technique¹. The vortices are arranged in a short range order oblique lattice, while the cores of the flux lines show an anisotropic shape. These observations can be related to the in-plane anisotropy of YBCO.     

Parameterization for reconstruction of 3D freeform objects from laser-scanned data based on a PDE method

Published online: 19 July 2001     

Community intervention with the elderly: a social network approach

A technique is described for using the advantages of a social systems approach when working with elderly persons in psychiatric distress. The technique is based on the assumption that the solution to a variety of human predicaments lies within the collective instrumental and affective resources of the client's social network. The vehicle for accomplishing this objective is the "Network Session" during which a mental health professional meets with the elderly person and members of his/her social network to help resolve the difficulty. A case report demonstrating use of the technique is included.     

Conservative availability analyses including dependent failures in redundant I&C-systems with recurrent tests

In this paper analytic formulae are derived to estimate conservatively the unavailability of a two out of four digital safety Instrumentation and Control (I&C) system with recurrent tests. The analytic formulae disclose the influence of the different parameters on the system’s unavailability. In particular, the choice of a proper test interval is essential to guarantee the required low unavailability. The extraordinary self-checking capabilities of digital systems are taken into account by use of an appropriate failure model together with the treatment of dependent failures of the integrated software–hardware system. The underlying methodology is approved by licensing experts of nuclear facilities in Germany.     

Path-based clustering for grouping of smooth curves and texture segmentation

Perceptual grouping organizes image parts in clusters based on psychophysically plausible similarity measures. We propose a novel grouping method in this paper, which stresses connectedness of image elements via mediating elements rather than favoring high mutual similarity. This grouping principle yields superior clustering results when objects are distributed on low-dimensional extended manifolds in a feature space, and not as local point clouds. In addition to extracting connected structures, objects are singled out as outliers when they are too far away from any cluster structure. The objective function for this perceptual organization principle is optimized by a fast agglomerative algorithm. We report on perceptual organization experiments where small edge elements are grouped to smooth curves. The generality of the method is emphasized by results from grouping textured images with texture gradients in an unsupervised fashion.