Program Performance Measures

At ORC, a study group with representation from 55 companies has been working on a publication pertaining to measurement systems. This is important work. Not since 1980 has a major, broad-ranged publication been issued pertaining to the measurement of safety performance. And the 1980 publication is out of print. Its title is The Measurement Of Safety Performance. William F. Tarrants was the editor. In 1995,/or its member companies only, the Chemical Manufacturers Association issued Program Performance Measures, about which more will be said later. 

Program Performance Measures. Washington, DC Chemical Manufacturers Association, 1995. 

Production Controls The nature of the produc tion control logic differs greatly between continuous and batch plants. A good example of produc tion control in a continuous process is refineiy optimization. From the assay of the incoming crude oil, the values of the various possible refined products, the contractual commitments to dehver certain products, the performance measures of the various units within a refinery, and the hke, it is possible to determine the mix of produc ts that optimizes the economic return from processing this crude. The solution of this problem involves many relationships and constraints and is solved with techniques such as linear programming. 

Although not as informative as past performance measures or hard evidence of good programs, the existence of a company policy stating a candidate toller s commitment to health, safety and environmental responsibility should be determined. These policies, typically signed and displayed prominently in the facility, help ensure management and company executives are fully aware of their commitment to workers and the public. 

Close tracking of data entry means that performance measures can be tracked and managed. Such measures typically include query rates (which can be tracked by site, investigator, quesiton, and any comparators), time to respond to queries, rate of query rejection, and the like, and they provide an opportunity to identify and correct performance issues, whether associated with an individual site or study or a program. This capability alone provides a powerful tool by which sites throughout the world can be closely monitored. 

The central computer is called the master terminal unit, or MTU. The MTU has two main functions to periodically obtain data from RTUs/PLCs and to control remote devices through the operator station. The operator interfaces with the MTU using software called human machine interface (HMI). The remote computer is called the program logic controller (PLC) or remote terminal unit (RTU). The RTU activates a relay (or switch) that turns mechanical equipment on and off. The RTU also collects data from sensors. Sensors perform measurement, and actuators perform control. 

Every employee is expected to comply with established rules and procedures as a condition of employment and to participate in the Safety, Loss Prevention and Security program. Safety performance and attitude shall be considered major and essential employee job performance measurement criteria. 

Step 9. Perform measurements of samples, duplicates, and blanks. Collect data. Plot peaks to confirm resolution and absence of interference by nearby peaks. Follow computer program instructions to terminate analysis. 

With simple probe molecules, such as H2, information about the number of surface metal atoms is readily obtained by using adsorption measurements. However, even with such simple probe molecules further information about the heterogeneity of a surface may be obtained by performing temperature-programmed desorption measurements. With probe molecules which are chemically more specific (e.g., NH3 and organic amines, H2S and organic sulfides) it may be possible to obtain information about the number and nature of specific types of surface sites, for example, the number and strength of Lewis or Bronsted acid sites on oxides, zeolites or sulfides. 

Early in a GP calculation the great majority of programs are very poor, and consequently it maybe helpful to use a multiobjective function,which takes into account the performance of the program as measured by several factors. This allows a distinction to be made between programs of modest ability, which are able to complete one or two tasks correctly, and those that are completely hopeless. 

A related initiative to provide ongoing measurement of the quality of care provided by health systems are the ORYX indicators. ORYX is intended to integrate the use of outcomes and other performance measurement data into the accreditation process. Performance measures are expected to be applicable across the accredited health care organizations with the evolution of core performance measures applicable to each accreditation program. The initial four core measurement areas will be for hospitals and will focus on acute myocardial infarction, heart failure, community-acquired pneumonia, and pregnancy and related conditions. Hospitals are expected to collect data that will allow assessment of patient care based on the standards. The ORYX standards for acute myocardial infarction in Table 21.3 reflect the focus on medications and how pharmacists can impact their organizations performance. ... 

However, it is still necessary to consider whether it is possible to perform easily all transport-property measurements that industry requires. Let us assume that we need to measure only three properties at just 10 temperatures and 10 pressures, for 15 pure fluids and all their possible multicomponent mixtures, at five compositions in the liquid and gas phases. Then, the total number of measurements required is of the order of 10 (3x10x10x32766x5x2). If one further assumes that one can perform three measurements per day, then it is obvious that even for the above program of measurements, 90.000 man-years will be required and it considered only 15 materials from among the set of several thousand involved routinely in industry. It is clear that measurement alone cannot serve the industrial appetite for transport property data. Nevertheless, accurate measurements will continue to be vital for the verification of theory and the validation of predication. 

Pharmaceutical outcome data are also used to improve the quality of care, identify potential problems, and improve patient outcomes. These data are often used within a continuous quality improvement (CQI) cycle, where rate-based performance measures are tracked over time and used in conjunction with control charts to show changes in quality and assess the impact of programs or changes in process. Information can be fed back to front line health care practitioners, areas for possible improvement identified, appropriate changes made, and reassessments initiated. 

David Eddy at Duke University has written extensively on the problems and potential solutions related to pharmaceutical performance measurement systems. According to a U.S. survey, the most commonly perceived problems with pharmaceutical performance measurement systems are limitations with billing and administrative databases, lack of time to review summary data by physicians, and incomplete data. Other limitations include risk adjustment (what if my practice has sicker patients), overreliance on administrative (claims) data rather than clinical data (therefore lacking key patient outcomes), patient individuality and variation in medical practice, and lack of capacity for taking into account a discipline-specific rather than a whole programs-oriented CQI approach. There has also been some debate on the reliability of performance measurement systems to assess the true impact of physician care on the quality of health care.t ... 

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