Process Improvement Techniques Research Articles

The Use of Ubiquitous Computing for Business Process Improvement

Due to the cut throat competition among organizations, business process improvement is now an everyday activity. A relentless activity that makes business processes more complex than ever. As they get more complex, the improvement rounds become time-consuming, costly and the quality of each outcome is put into jeopardy, which is somehow paradoxical with the concept of improvement. In this paper, we propose a business process improvement technique based on ubiquitous computing. First, we couple business processes with ubiquitous computing and define a ubiquitous business process. Then, we explain how ubiquitous computing positively impacts the performance metrics of business processes. Afterwards, we set a specification for designing ubiquitous business processes by extending BPMN. Finally, we propose a concrete case study about time-banking to corroborate our theory. A comparative study of the same process, in ubiquitous and non-ubiquitous versions, is established. The results clearly illustrate that ubiquitous computing impacts positively the business process performance metrics. Still, the case study corroborates that ubiquitous computing not only improves a business process but also enables it to get improved with the least of human interventions.

Application of the Taguchi method to improve a medical device cutting process

Companies currently are immersed in a highly competitive world; therefore, they must adopt continuous process and product improvement techniques to remain in business and retain loyal customers. This paper presents the analysis of a medical device manufacturing company to determine what factors influence the length variation of plastic tubes in a cutting process. These tubes are part of intensive care sets; therefore, their length and diameter are critical features. Recently, products were rejected for not meeting the tube length specification, causing customer complaints regarding product quality. The Taguchi method was applied to find significant factors that determine the best configuration in the cutting process to approximate this quality characteristic to its desired target value. Important factors and their corresponding best levels were identified. After the proposed process adjustment was implemented, the process capability index (Cpk) increased from 0.90 to 1.58, which indicated a considerable reduction in customer complaints and corresponding costs.

Re-examining high reliability: actively organising for safety

In the 15 years since To Err is Human was published,1 the US healthcare industry has worked diligently to improve patient safety. Although progress has been made in reducing hospital-acquired...

An analysis of the application of process improvement techniques in business process outsourcing

Purpose – The purpose of this paper is to enhance the understanding of the application of process improvement techniques (PITs) in the business process outsourcing (BPO) process. The paper focuses on how PITs impact the BPO process, and identifies a number of key enablers of applying PITs in the BPO process. Design/methodology/approach – The paper employs a case study approach. In-depth case study analysis of a number of organisations that have employed a number of PITs in BPO is carried out. Findings – The findings support current literature that highlights the importance of formal contracting, relational contracting, and vendor capabilities for applying PITs in BPO. However, the findings also highlight the importance of additional factors, not widely considered in the current literature. The client must possess internal capabilities in PITs and change management to ensure process improvement occurs. Moreover, the findings here have shown that the client must invest in and develop the resources that enhance its capability to employ PITs in BPO. Originality/value – The findings highlight the importance and relevance of process improvement to BPO, and identify a number of important issues for further research in order to bridge the gap between these two complementary areas.

Elective chemotherapy admissions: An opportunity to improve wait times.

240 Background: Chemotherapy wait times are a well-recognized challenge facing cancer hospitals. Recent publications have stated that not only do wait times affect patients but they increase costs and consume hospital resources. Wait times lead to longer lengths of stay and require additional staff attention. Reducing chemotherapy treatment wait times has long been a priority of Sloan Kettering, with this study focusing on inpatient chemo processes. During October and November of 2014, 6 current state observations were performed in chemo nursing verification, chemo pharmacy and an inpatient chemo unit. Metrics measured included submission of electronic chemo orders, blood work availability, clearing for treatment, PICC line placement, bed availability and drug transport. All system components were analyzed from both a clinical and industrial engineering perspective. Future state analysis was conducted from December 2014 through April of 2015. Process improvement techniques including direct observation, process mapping, waste analysis and time studies were used to assess workflow. Methods: Prior to implementing performance improvement interventions, baseline data was compiled. 12% of electronic chemo orders were submitted 24 hours prior to admission, 36% of the time blood work was not available within 72 hours prior to patient arrival, 46% of treatments experienced pending delays due to ‘Proceed to Treat’ order, 0% of PICC lines were placed prior to admission, 34% of patients were discharged before 2pm and time for drug delivery averaged 1 hour and 47 minutes. The average time from patient admission to first chemotherapy treatment was 9.7 hours. Results: Following the rollout of a newly designed pilot unit in January 2015, data was collected for 192 chemo admissions in February through April of 2015. The use of electronic chemo orders rose to 84%, blood work was available 60% of the time, pending orders reduced to 0%, PICC placement occurred prior to day of admission 98% of the time, 46% of patients discharged before 2pm and drug delivery was reduced to 0 minutes. The time from admission to chemo treatment was reduced to 2.1 hours. Conclusions: The amount of patients treated after day of admission reduced from 17% to 8%, saving 18 patient days.

Health Services Research and Regionalization of Care-From Policy to Practice: the Ontario Experience in Head and Neck Cancer.

Patients being treated at higher case volume hospitals or by higher case volume physicians appear to have better outcomes. This volume-outcome relationship is reviewed for oncologic and non-oncologic surgery with a focus on head and neck oncology. The impact of these research findings on health policy and health-care organization in Ontario, Canada, is then outlined. Lastly, future directions for quality improvement in surgical oncology are reviewed in the context of a universal health-care system. These include surgeon report cards, pre-operative checklists, linking funding and remuneration to the quality of delivered care, and the use of process improvement techniques.

Applications of process improvement techniques to improve workflow in abdominal imaging

Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

Continuous improvement concepts as a link between quality assurance and implementation of cleaner production: Case study in the generic pharmaceutical industry

The subject and the research objective presented in this article is establishing of the relationship between quality assurance and implementation of cleaner production in the generic pharmaceutical industry through the comprehensive concept of continuous improvement. This is mostly related to application of Lean and Six Sigma tools and techniques for process improvement and their link to other known concepts used in the industrial environment, especially manufacturing of generic pharmaceutical products from which two representative case studies were selected for comparative analysis, also considering relevant regulatory requirements in the field of quality management, as well as appropriate quality standards. Although the methodology discussed in this conceptual and practice oriented article is strongly related to chemical engineering, the focus is mainly on process industry, i.e. production systems, rather than any specific technological process itself. The scope of this research is an engineering approach to evaluation of the production systems in terms of continuous improvement concepts application, considering both quality aspects and efficiency of such systems.

Variability patterns for business processes in BPMN

Many entities, both in academia and the business sector, urge an efficient improvement of business processes. However, when it comes to addressing this point, each slight disparity in the business rules and/or objectives translates into a separate model, which is neither practical nor acceptable as it burdens the host process-aware information system with repetitive and almost verbatim instances. To solve this issue, we propose considering variability. Variability will serve as a business process improvement technique to efficiently design and run a variable business process throughout different business situations that are similar to one another is some ways yet differ in others. First, we define variability within the context of business processes. Second, we present a set of variability patterns and explain how they are used. We validate our approach via the business process improvement patterns known and used by the community. The variability design patterns are a series of business process improvement patterns for building business process with variability and efficiently acting on the improved process performance metrics.

CT Dose Optimization in Pediatric Radiology: A Multiyear Effort to Preserve the Benefits of Imaging While Reducing the Risks.

The marked increase in radiation exposure from medical imaging, especially in children, has caused considerable alarm and spurred efforts to preserve the benefits but reduce the risks of imaging. Applying the principles of the Image Gently campaign, data-driven process and quality improvement techniques such as process mapping and flowcharting, cause-and-effect diagrams, Pareto analysis, statistical process control (control charts), failure mode and effects analysis, "lean" or Six Sigma methodology, and closed feedback loops led to a multiyear program that has reduced overall computed tomographic (CT) examination volume by more than fourfold and concurrently decreased radiation exposure per CT study without compromising diagnostic utility. This systematic approach involving education, streamlining access to magnetic resonance imaging and ultrasonography, auditing with comparison with benchmarks, applying modern CT technology, and revising CT protocols has led to a more than twofold reduction in CT radiation exposure between 2005 and 2012 for patients at the authors' institution while maintaining diagnostic utility.

Assessing Class Performance and Progress using Grade Self-Estimation in Undergraduate Embedded Systems Courses

Embedded systems courses are typically taught with a heavy emphasis on laboratory experience using sophisticated software development tools. There is a considerable mismatch between practical and theoretical knowledge associated with a steep initial learning curve, leading to an initial bi-modal grade distribution. We introduce a self-assessment philosophy to enable the students to use a process improvement technique in order to better understand how to connect their theoretical and applied knowledge, and identify areas for improvement. Students were found to over-estimate their performance early in the semester; a tendency that was considerably corrected by the term’s end. We evaluate student performance on a number of course components using student self-analysis during final exam questions, as well as progress throughout the term exams.

Surgical suite to pediatric intensive care unit handover protocol: implementation process and long-term sustainability.

The article reports the long-term sustainability of a standardized transfer protocol from cardiac surgical suite to the pediatric intensive care unit. Using rapid process improvement technique, the original mean defect rate per handover decreased from 13.2 to 0 and 0.3, 12, and 24 months postimplementation, respectively. This study stresses the importance of long-term assessment to control for possible observation biases; it also illustrates a successful implementation strategy that used video recording to engage staff in identifying solutions to the observed defects.

Reasons for Operational Excellence Deployment Failures and How to Avoid Them

Globalization of business accompanied with increased margin squeeze has been leading many companies in western Europe during the last decade to deploy substantial Operational Excellence (OPEX) programs to remain competitive. Mainly proven Six Sigma and Lean techniques for quality and process improvement have been adopted however with variable lasting success. What are the reasons for success or failure? Which are the applied approaches? What are the circumstances leading to the outcome? This paper shows that management competence as well as the selected approach is decisive for success or failure. In addition, an optimized deployment approach to achieve a sustainable implementation of the OPEX program is presented.

Internal purchase process: a study for setting improvement target

Purchasing is an essential activity in every business. A shorter lead time in purchase cycle can lead to competitive advantage and just in time purchases, leading to low inventory requirements at operation locations. The purchase cycle process has two parts, an internal process - purchase request to purchase order release and an external process - supply of material by vendor(s). There are possibilities of delays during the course of the internal process of the purchase cycle and hence needs improvement. In continuous improvement process techniques, a determination of the current process base line, i.e., current operations actual performance and thereupon the improvement goal needs to be identified. This paper presents a case study of a manufacturing industry purchase internal process lead time. This study would benefit purchasing managers/executives to design their purchase process base line and improvement targets, using statistical tools and techniques for an efficient process improvement.

Application of Moldflow and Taguchi technique in improving the productivity of injection moulded energy meter base

In injection moulding process, the productivity is largely dependent on the cycle time and its optimisation plays a vital role. Productivity improvement in injection moulding is possible by undertaking scientific moulding using the modern process improvement and statistical techniques. This paper describes the improvement in the productivity of injection moulded polycarbonate energy meter base wherein Moldflow software is used to predict the injection pressure, filling time, clamping force, etc. and the design of experiments is carried out to know the impact of various parameters on sink mark, cycle time and overall quality indexes. The experimentation is done using the predicted values obtained from Moldflow analysis and an orthogonal array is employed for optimising injection time followed by pack time and cooling time. Significant improvements are achieved in reducing the cycle time from 51.5 seconds to 42.0 seconds using the systematic optimised processing parameters and thus increasing productivity.

Improving the medical records department processes by lean management

Background:Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves.Aims:The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management.Materials and Methods:This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD.Statistical Analysis Used:The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions.Results:The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes.Conclusion:The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential.Originality/Value:The study represents one of the few attempts trying to eliminate wastes in the MRD.

Human resource management, Lean processes and outcomes for employees: towards a research agenda

Lean management or lean thinking is a process improvement technique that along with Six Sigma is used in an increasing range of workplaces. This special issue focuses on the use of Lean in developed countries. This increased usage reflects a growing propensity for managers to launch initiatives to upgrade the efficiency and productivity of the enterprises that they manage, usually in an attempt to enhance the cost-effectiveness of operations. This special issue of the IJHRM includes eight articles in addition to this one on various aspects of the connections between lean management, human resource management (HRM) and outcomes for employees. The present article reviews the context for the increasing popularity of lean ideas among managers. Drawing on research in a range of countries, the articles in the special issue provide interesting insights into the relationships between process improvement innovations and HRM, as well as raise further important questions for research, which enable us to suggest an agenda for future research. This includes asking: what are the differences in the ways that Lean is implemented, for example the differences that may reflect industry, regional and national variables?

Generation of Square Cavity Using Planetary EDM

The design and manufacturing of complex shaped 3D features have a wide range of applications in todays manufacturing industries. With machining of hard materials continues to attract much interest in this field, EDM remains an indispensable process to carry out this purpose despite its limitations compared to conventional machining processes in terms of material removal rate and surface quality. Many process improvement techniques have been reported by researchers to overcome these limitations and out of them, incorporation of tool electrode kinematics is observed to have a significant effect. In the present investigation, an attempt has been made to study the effectiveness of two different tool motions in the generation of non-circular cavities. Tool electrode is moved on planetary and diagonal paths during this study. Effects of various electrical and non-electrical parameters on EDM responses have been studied. Current, pulse ON time and voltage are considered as the electrical parameters while tool kinematics parameters like tool path offset and scanning speed have been selected as the non-electrical parameters. Experiments have been carried out the study the effect of tool movement on planetary and diagonal path on different response characteristics viz. Material removal rateand Wear Ratio. It has been observed that planetary motion is a better strategy than diagonal motion for the generation of non-circular cavities in terms of achievement of the response characteristics. The results observed are critically discussed.

Applying industrial process improvement techniques to increase efficiency in a surgical practice

The goal of this study was to examine how industrial process improvement techniques could help streamline the preoperative workup. Lean process improvement was used to streamline patient workup at an endocrine surgery service at a tertiary medical center utilizing multidisciplinary collaboration. The program consisted of several major changes in how patients are processed in the department. The goal was to shorten the wait time between initial call and consult visit and between consult and surgery. We enrolled 1,438 patients enrolled in the program. The wait time from the initial call until consult was reduced from 18.3±0.7 to 15.4±0.9days. Wait time from consult until operation was reduced from 39.9±1.5 to 33.9±1.3days for the overall practice and to 15.0±4.8days for low-risk patients. Patient cancellations were reduced from 27.9±2.4% to 17.3±2.5%. Overall patient flow increased from 30.9±5.1 to 52.4±5.8 consults per month (all P<.01). Utilizing process improvement methodology, surgery patients can benefit from an improved, streamlined process with significant reduction in wait time from call to initial consult and initial consult to surgery, with reduced cancellations. This generalized process has resulted in increased practice throughput and efficiency and is applicable to any surgery practice.

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Introduction: Aggressive efforts to improve situational awareness including identifying and predicting patients at risk of getting sicker, developing mitigation and escalation plans and the like have lead to a substantial decrease in actual code events outside our ICUs. This has lead to a greater dependence on in situ simulation to maintain the skills of our code team. Because we are a large institution that draws code team members from different disciplines and departments it is not uncommon that each subsequent shift's code team is a unique combination of practitioners. Novel interactions between code team members who were unfamiliar with other members had the potential to lead to elements of an optimal response being overlooked, or double covered. We therefore looked at process improvement techniques to implement several key goals for team improvement. Methods: We developed a core set of improvement goals for our code team response, including, but not limited to, team member identification, pre-defined roles for all responders, awareness of those specific roles, performance of a medication pause to assure dosing accuracy, sharing the mental model and consistent and complete documentation. Specific roles for the individual members were stressed between events through liaisons to the units, or by face-to-face communication with the carriers of the code pagers each shift. Key elements of code roles were also written on the armband used for team member identification. Documentation was modified to enhance our ability to track implementation. We then tracked performance through frequent, in-situ, randomly called simulations over a four-month period. Simulations were always followed by debriefings that reiterated goals, stressed the core improvements, and provided direct feedback. Results: Over the course of four months we were able to bring the rate of pre-defined critical process elements occurring during simulation from 40% to 100%. Two late failures were able be tracked to specific process misses, which allowed for focused education and refinement of the process with higher level of reliability interventions. Semi-qualitative observation at actual code events that occurred during this period showed similar presence of the process improvements. Conclusions: Systematic and reinforced practice of improvement processes can demonstrate real change in code team performance during in situ simulation. Sustaining these changes beyond the specific improvement period, and determining effect on outcome of true code events will be important follow up studies.