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The purpose of this paper is to describe the quality improvement project to increase the medical record documentation completion rate in a district hospital in Rwanda. Despite the importance of medical records to support high quality and efficient care, incomplete documentation is common in many hospitals.

The pre- and post-intervention record completion rate in the maternity unit was assessed. Intervention included assigned nurse to specific patients, developed guideline, provided trainings and supervisions.

The documentation completion rate significantly increased from 25 per cent pre-intervention to 67 per cent post-intervention, p < 0.001. The completeness of seven out of the ten elements of medical records also significantly increased.

The quality improvement project created a cost-effective intervention that successfully improved the documentation completion rate. Ongoing monitoring should be continued to learn sustainability.

The results are useful for hospitals with similar settings to improve completion of nursing documentation and increase nursing accountability on patient care.

Quality, an abstract concept, requires concrete definition in order to be actionable. This chapter moves the quality discussion from the theoretical to the workplace, building steps needed to manage quality issues.

The chapter reviews general data studies, web quality studies, and metadata quality studies to identify and define dimensions of data quality and quantitative measures for each concept. The chapter reviews preferred communication methods which make findings meaningful to administrators.

The chapter describes how quality dimensions are practically applied. It suggests criteria necessary to identify high priority populations, and resources in core subject areas or formats, as quality does not have to be completely uniform. The author emphasizes examining the information environment, documenting practice, and developing measurement standards. The author stresses that quality procedures must rapidly evolve to reflect local expectations, the local information environment, technology capabilities, and national standards.

This chapter combines theory with practical application. It stresses the importance of metadata and recognizes quality as a cyclical process which balances the necessity of national standards, the needs of the user, and the work realities of the metadata staff. This chapter identifies decision points, outlines future action, and explains communication options.

The research reported examines the role of service in manufacturing. Focuses on the degree to which Chase′s “Service Factory” concept is applicable in the UK. Also examines the role of service in four manufacturing companies. It was found that the roles reported by Chase in the USA are also used by a number of UK companies, and it is concluded that the service‐factory concept is robust and is not necessarily embedded in some of the cultural norms of the USA, as are some TQM practices. The case data indicated that the source of customer service may be in customers being served by various parts of the organization, that customer service is complex and that service levels are a function of both manufacturing and distribution. This would seem to point to the distribution view of customer service, the field‐service view and/or the service‐factory view being too narrow in terms of the company as a whole.

Complete health documentation during childbirth can reduce complications and improve maternal and foetal outcomes. One such document is the partograph which allows health workers to record and follow the labour progress. However, the completion rates of partograph remain low in some hospitals. This study describes the implementation of a quality improvement project to increase the completion rate of partograph in a district hospital in Rwanda.

The project team tackled the root cause of partograph incompletion by implementing a labour monitoring guideline, assigning patients and duties to midwives and by providing support and supervision.

The intervention successfully increased overall partograph completion rates from 11 to 61 per cent, p < 0.001. This study also showed that completeness of the partograph was statistically associated with a decrease in foetal deaths and higher Apgar score with p < 0.001 for both.

This study describes the establishment of a quality improvement project following the strategic problem solving approach to increase the completion rate of partograph documentation. The intervention was simple, data-driven and cost-neutral. The team achieved its objectives by integrating staff input, obtaining commitment from the multidisciplinary team and applying leadership skills.

The results are useful for hospitals in limited resources settings wishing to improve overall partograph completion and improve foetal and maternal outcomes during labour, in an efficient and cost-neutral way.

To remain sustainable, open source software (OSS) projects must attract new members—or newcomers—who make contributions. In this paper, the authors develop a set of hypotheses based on the knowledge barriers framework that examines how OSS communities can encourage contributions from newcomers.

Employing longitudinal data from the source code repositories of 232 OSS projects over a two-year period, the authors employ a Poisson-based mixed model to test how community characteristics, such as the main drivers of knowledge-based costs, relate to newcomers' contributions.

The results indicate that community characteristics, such as programming language choice, documentation effort and code structure instability, are the main drivers of knowledge-based contribution costs. The findings also suggest that managing these costs can result in more inclusive OSS communities, as evidenced by the number of contributing newcomers; the authors highlight the importance of maintaining documentation efforts for OSS communities.

This paper assumes that motivational factors are a necessary but insufficient condition for newcomer participation in OSS projects and that the cost to participation should be considered. Using the knowledge barriers framework, this paper identifies the main knowledge-based costs that hinder newcomer participation. To the best of the authors' knowledge, this is the first empirical study that does not limit data collection to a single hosting platform (e.g., SourceForge), which improves the generalizability of the findings.

Medical record represents the main information support used by healthcare providers. The purpose of this paper is to examine whether patient perception of hospital care quality related to compliance with medical-record keeping.

The authors merged the original data collected as part of a nationwide audit of medical records with overall and subscale perception scores (range 0-100, with higher scores denoting better rating) computed for 191 respondents to a cross-sectional survey of patients discharged from a university hospital.

The median overall patient perception score was 77 (25th-75th percentiles, 68-87) and differed according to the presence of discharge summary completed within eight days of discharge (81 v. 75, p=0.03 after adjusting for baseline patient and hospital stay characteristics). No independent associations were found between patient perception scores and the documentation of pain assessment and nutritional disorder screening. Yet, medical record-keeping quality was independently associated with higher patient perception scores for the nurses’ interpersonal and technical skills component.

First, this was a single-center study conducted in a large full-teaching hospital and the findings may not apply to other facilities. Second, the analysis might be underpowered to detect small but clinically significant differences in patient perception scores according to compliance with recording standards. Third, the authors could not investigate whether electronic medical record contributed to better compliance with recording standards and eventually higher patient perception scores.

Because of the potential consequences of poor recording for patient safety, further efforts are warranted to improve the accuracy and completeness of documentation in medical records.

A modest relationship exists between the quality of medical-record keeping and patient perception of hospital care.

The documentation provided with an automated system should outline all necessary procedures; answer questions; help with staff training; and provide a comprehensive and detailed view of the purchased system. Good documentation does not offer irrelevant information, nor does it present too much detail when inappropriate, or too little when required. The hazards of inadequate documentation are many—it can be misleading, erroneous, and confusing. Good documentation cannot make up for a poor system; and poor documentation is not likely to result in a good system being rejected by a potential purchaser. However, in addition to training staff and end‐users to effectively use a new system, good documentation can help decision‐makers understand the features, functionality, and advantages of a good system.

This study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.

An exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.

The results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.

The contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.

Practical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.

Since only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

Good system documentation is the backbone to the success of any automated system, for only through complete and thorough documentation can the user fully understand and utilize a system's capability. This symposium focuses on printed documentation and the many related applications that affect the daily lives of computer users. Printed documentation takes different forms, including user and reference manuals, tutorials, reference cards, and “cheat sheets.” The various forms are produced by both system vendors and system users, the latter frequently adapting and modifying vendor‐prepared documentation to reflect local practice and meet specialized training needs.

The purpose of this paper is to propose a model that allows analyzing exchange and use of fiscal information by the roles of actors involved in the budget process and to apply the proposed model to the 2018 Czech state budget debate. The aim is to identify approaches used by the members of the Chamber of Deputies (members of the parliament (MPs)) when gathering information to be used in their decision making on the state budget, and to evaluate usefulness of the information provided through the executive’s budget proposal.

This paper is the observatory study of the Czech 2018 state budget debate based on a set of unstructured interviews with newly elected MPs.

When it comes to the MPs deciding about the state budget the executive’s budget proposal seems to be an insufficient source of information as the MPs relied heavily on various information brokers during the budget debate. The use of information and communication technologies in the process of information provision lags behind its potential.

The authors suggest two possible ways to improve the effective transparency of the Czech state budget debate: standardization of the chapter books and making them available to every MP as well as to the general public, and adding the budget proposal to the Monitor budget explorer – a publicly available budget explorer provided by the Ministry of Finance.

The originality of this paper lies in the proposal of the Fiscal Information Ecosystem Model and its application to the 2018 Czech state budget debate which shows how the members of the Czech Chamber of Deputies gathered information they needed in their decision making.