Process Redesign Research Articles

Web Accessibility Evaluation Using WCAG 2.0 and User-Centered Design Method

ITENAS e-learning has problems such as the flow of access to complex features, and the color of the display and buttons that overlap with the background color. The design of the web interface in this study uses the WCAG 2.0 standard. With the success points of Criterion 1.4.11 Non-text Contrast in the Produce Design Solution stage in the User-Centered Design method. The results of the WCAG 2.0 test show the highest contrast ratio of 15.16:1 which has met the required contrast ratio, the criteria are successfully applied. In the design evaluation stage, this study used SUS to test the usability of the prototype. User experience testing in this study uses UEQ. The results of the evaluation of the usability of the interface with SUS in the initial test resulted in a score of 38.93 which was in grade F or bad to grade B with a score of 74.38 or good after the redesign process. The results of user experience testing with UEQ obtained an average Efficiency scale of 1.875. The Attractiveness scale is 1.667, the Clarity scale is 1.750, the Accuracy scale is 1.375, the Stimulation scale is 1.525, the last is the Novelty scale of 1.350 according to the UEQ average scale which is at a positive level. From the results of the two SUS and UEQ tests, the Usability aspect and the User Experience aspect of the Itenas e-learning web can be said to have improved.

Improvement Of Maggot Drying Machine Using the Verein Deutsche Ingenieuer (VDI) 2222 Method

Maggots are the larvae of Black Soldier Flies (BSF) that consume organic waste and offer various benefits, one of which is using dried maggots as livestock feed, such as poultry and fish. Currently, maggots are dried using manual methods involving stoves and kettles, microwaves, and rotary maggot drying machines. However, each of these three methods has its own shortcomings. There is a need for the redesign of an effective and efficient maggot drying machine that produces high-quality maggots. The designed maggot drying machine combines principles of both rotary and oven drying. The redesign process of this maggot drying machine follows the Verein Deutsche Ingenieure (VDI) 2222 methodology. The research sequence includes problem formulation, literature review, data collection, improvement concepts, machine design, cost calculations, and analysis, which involves comparison with the previous machine, durability testing, and machine maintenance. The machine design utilizes the rotary principle to ensure even drying, while the oven principle allows for temperature control to obtain good-quality maggots that meet the needs of maggot enthusiasts.

First Phase of Integrated Care Initiative PAIK in Estonia: Lessons Learned

Background: Patients with chronic conditions often experience fragmented care and suboptimal health outcomes. Therefore, initiatives to improve the care-continuum of high-risk patients have emerged in Estonia. PAIK project was the first which tried to integrate social-services sector, specialist care and primary healthcare to co-ordinate the care for high-risk elderly patients with social health determinants. Although we measured improved perception of quality of care and level of integration, pragmatic analysis with matched controls failed to improve health outcomes and reduce costs.
 Aim: To analyse and describe lessons learned from PAIK initiative and if intervention or implementation failure explains the negative results of the project.
 Method: A qualitative analysis using focused interviews and expert opinion was used.
 Results: Firstly, the PAIK project was more a pragmatic service design and feasibility exercise than a full-fledged study designed to demonstrate better health outcomes. It was started without power analysis and analytical components were added later. No control arm was used and having social health determinants as inclusion criteria prevented retrospectively finding an unbiased propensity matched control group. Analysis showed that majority of the patients included, belonged to a very high-risk stratum (top 1%), where care-management is less effective. Also we found that not all components of the intervention were aligned with reducing hospitalisations and ER-visits.
 Another factor was that the healthcare sector lacked any prior experience with integrated care practice implementation and scaling, so the lack of existing workforce resulted in training activities continuing well into the duration of the project. Mid-study there was a change in clinical leadership, which also resulted in target population adjustment and process redesign.
 Thirdly we failed to identify and recruit champions from the primary care and social services sides, therefore engagement of these sectors was modest and the service was dominantly specialist care focused. The Covid pandemia also coincided causing resource conflicts in the sector both on hospital and primary care side. 
 Despite these above mentioned shortcomings, we consider the study generally a success, as we feel that focusing on social health determinants is important in such services and was very welcomed by both the social service providers and GP nurses. Also due to our project the role of care managers was defined in Estonia and educational programs implemented. Also, a functional care-management software module was developed and tested during the service. Finally our experience has been seen as valuable and has attracted specialist in several other counties to invest in integrated care efforts and there is greater readiness to change.
 Conclusions: Despite the PAIK intervention in Viljandi being well received by the patients and showed better patient reported outcomes, it failed to convincingly reduce health resource utilisation and hospitalisations. Both components of intervention failure and implementation failure are probably responsible. Experience from the project however might improve the success of future initiatives and be part of the foundation for care-delivery model innovation in Estonia.

​​VIRTUAL SIMULATION-BASED REFORM OF APPAREL CURRICULUM​

With the rapid development of modern science and technology, computer technology has been widely used in various industrial fields of society, and the education industry is no exception. The application of virtual reality technology in clothing design has greatly improved the efficiency of designers in the redesign process and perfected the wearing effect of clothing. In the face of the future demand for innovative design talents, cultivating talents who meet the requirements of clothing design is an important issue and task for university teaching. At present, there are problems in the teaching of clothing design profession such as single traditional teaching mode, weak creativity of students' works, disconnection between teaching content and practice, imperfect teaching resources and imperfect teaching details. In this paper, virtual reality technology is introduced to reform the curriculum system of the clothing profession through a mixed research approach, using experimental project-based teaching combined with quantitative research methods. Through practice, it is proven that the integration of virtual technology into apparel teaching creates a simulation effect for teachers and students that cannot be matched in the traditional apparel design teaching process and enhances students' interest in learning. The application of virtual reality technology is a new and efficient teaching method that has emerged in recent years with the development of computers, combining technology and art, and based on the teaching of clothing design projects, which greatly improves learning efficiency and teaching effectiveness and can effectively improve students' innovation ability, and has a broad development prospect.

Redesign User Interface Dengan Metode Design Thinking: Studi Kasus

Transformation of production and service processes is a form of change in the industrial revolution era that is supported by systems. One of the components in a company's information system is a web page or known as a website. User Interface in website design is a concern at the CV X company which operates in the interior contracting sector. This research aims to redesign the user interface to suit user needs on the CV X website using the design thinking method. The design thinking method has six stages, namely, empathize, define, ideate, prototype, test, and implement. This research carried out four of the six stages of design thinking. Several research results include a collection of companies' desires to change the layout, content and elements on the website, content regarding SVLK, the use of persuasive words, and navigation features in the website footer that are not yet available in the current design. Defining the problem at the define stage is the elimination of be spoke pages, the use of colors that match the characteristics of the company, the addition of interactive animations, and changes to all elements on the website. The results of collecting ideas at the ideate stage were 9 ideas. The realization of ideas at the prototype stage consists of 3 processes, namely the style guideline creation process, the redesign process, and a comparison of the current design with the redesign results. The process of creating a style guideline includes fonts, colors, button elements, website headers and footers. This research focuses on the website user interface only so that the test and implementation stages related to User Experience (UX) are not analyzed.

Occupational Stress Management Intervention: An Informative Perception

This article provides an overview of stress management interventions (SMIs) and the evidence that they improve employee well-being. The objective of this study is to identify the individual-level stress (personal) and stress at an organisational level (workplace) and to suggest certain intervention techniques at primary and secondary levels to reduce it. To begin, we create a classification system for SMI, as it is taught in accordance with degree (i.e., the personal stage or the organisational stage) and recognition (i.e., a ‘number one’ focus on changing the causes of stress or a ‘secondary’ or ‘tertiary’ attention on lowering stress itself). Relaxation methods, cognitive behavioural treatment (CBT) and mindfulness training are all examples of secondary character-stage SMI (such as implementing new organisational policies and procedures) and are subcategories of SMI based on how widely they have been proven to work (e.g., process redesign, adjustments to running time schedules). There is a lot of data to support these two SMI techniques, but the study concludes by strengthening the evidence base for SMI treatments requiring a good methodological design, as well as improved knowledge on the context and people in which SMIs are most successful, how SMIs are administered and long-term effects of SMIs. Therapy for mental health issues, stress management and CBT study was carried out from June to August 2022.

Why can't we improve turnover time? A systematic review.

Despite substantial efforts to reduce operating room (OR) turnover time (TOT), delays remain a frustration to physicians, staff, and hospital leadership. These efforts have employed many systems and human factor-based approaches with variable results. A deeper dive into methodologies and their applicability could lead to successful and sustained change. The aim of this study was to conduct a systematic review to evaluate relevant research focused on improving OR TOT and clearly defining measures of successful intervention. A systematic review of OR TOT interventions implemented between 1980 through October 2022 was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Research databases included: 1) PubMed; 2) Web of Science; and 3) OVID Medline. A total of 38 articles were appropriate for analysis. Most employed a pre/post intervention approach (29, 76.3%), the remaining utilized a control/intervention approach. Nine intervention methods were identified: the majority included a process redesign bundle (24, 63%), followed by overlapping induction, dedicated unit/team/space feedback, financial incentives, team training, education, practice guidelines, and redefinition of roles/responsibilities. Studies were further categorized into one of two groups: (1) those that utilized predetermined interventions based on anecdotal experience or prior literature (18, 47.4%) and (2) those that conducted a prospective analysis on baseline data to inform intervention development (20, 52.6%). There are significant variability in the methodologies utilized to improve OR TOT; however, the most effective solutions involved process redesign bundles developed from a prospective investigation of the clinical work-system.

Clinical and economic impact of partnered pharmacist medication charting in the emergency department.

Introduction: Partnered pharmacist medication charting (PPMC), a process redesign hypothesised to improve medication safety and interdisciplinary collaboration, was trialed in a tertiary hospital's emergency department (ED). Objective: To evaluate the health-related impact and economic benefit of PPMC. Methods: A pragmatic, controlled study compared PPMC to usual care in the ED. PPMC included a pharmacist-documented best-possible medication history (BPMH), followed by a clinical conversation between a pharmacist and a medical officer to jointly develop a treatment plan and chart medications. Usual care included medical officer-led traditional medication charting in the ED, without a pharmacist-obtained BPMH or clinical conversation. Outcome measures, assessed after propensity score matching, were length of hospital or ED stay, relative stay index (RSI), in-hospital mortality, 30-day hospital readmissions or ED revisits, and cost. Results: A total of 309 matched pairs were analysed. The median RSI was reduced by 15.4% with PPMC (p = 0.029). There were no significant differences between the groups in the median length of ED stay (8 vs. 10h, p = 0.52), in-hospital mortality (1.3% vs. 1.3%, p > 0.99), 30-day readmission rates (21% vs. 17%; p = 0.35) and 30-day ED revisit rates (21% vs. 19%; p = 0.68). The hospital spent approximately $138.4 for the cost of PPMC care per patient to avert at least one medication error bearing high/extreme risk. PPMC saved approximately $1269 on the average cost of each admission. Conclusion: Implementing the ED-based PPMC model was associated with a significantly reduced RSI and admission costs, but did not affect clinical outcomes, noting that there was an additional focus on medication reconciliation in the usual care group relative to current practice at our study site.

Improving complaint handling service with a qualitative approach: A public sector case

Public sector organisations must continuously improve the quality of their services. To do so, they must pay attention to their activities to provide value to citizens, that is, their business processes. A system redesign carried out with business process guides can provide more targeted results. This teaching case is based on the Surabaya City Office for Population Administration and Civil Registration (COPACR), an agency responsible for handling population administration and civil registration issues in the city of Surabaya, Indonesia. The case describes the problems in the complaint service business process and how to address them by redesigning the business process using a qualitative approach. The complaint service process redesign begins with an analysis of the existing (as-is) complaint service process. This is followed by documenting and identifying the root cause of the problems. Ideas were developed to redesign the complaint service process to solve the root cause of the existing problems. This case demonstrates the redesigning of business processes leading to improvements in the public sector.

A re-design process of an industrial centrifugal fan through CFD and rapid prototyping

Due to the ecological-green transition, it is fundamental to reduce the energy consumption of turbomachines in many fields. In particular, manufacturers of industrial fans are subjected to EU regulation N.327/2011, which indicates the limit for the absorbed power of this kind of machine. New design techniques allow to increase the overall efficiency satisfying the customer’s performance request. Recently, in order to reduce time to market, the manufacturers are very interested in using plastic materials in place of metal in the prototyping phase because they have higher formability, lower costs, and realization time. The aim of the authors is to present the re-design process of a commercial industrial centrifugal fan. The main goal was to change the shape and the number of the blades reducing the separation along the blade-to-blade channel, limiting the leakage flow, and increasing efficiency. Several modifications to the initial geometry were proposed and analyzed through numerical simulations. Three designs were then produced via a rapid prototyping process in plastic material and tested in a standardized rig. Moreover, a comparison between the experimental performances of the actual impeller made in metal sheets and the plastic one will be evaluated in order to view the effects of different roughness and deflation that characterize a plastic component realized using a 3D printing technique.

Advancing business process management lifecycle implementation through the integration of the design for Six Sigma method

Purpose This research proposes how Design for Six Sigma (DFSS) provides a complementary approach for business process management (BPM) lifecycle implementation in order to address gaps identified in the current literature.Design/methodology/approach The mandatory elements of a method (MEM) framework is used to illustrate DFSS's maturity as a process redesign method. The use of DFSS in a BPM context is described through several action research case examples.Findings This research specifies the procedure model (order of development activities), techniques, results, roles and information/meta model (conceptual data model of results) associated with using DFSS to address BPM-related challenges. The action research case examples provided discuss the details of implementing BPM using DFSS to design, implement and test redesigned processes to ensure they fulfill the needs of process participants.Research limitations/implications While the case examples discussed were performed in only a few settings, which limits the generalizability of their results, they provide evidence regarding the wide range of domains in which the proposed DFSS-BPM approach can be applied and how the tools are used in different contexts.Practical implications This research offers a road map for addressing the challenges practitioners often face with BPM lifecycle implementation.Originality/valueThis research provides the first attempt to integrate DFSS as a complementary method for BPM lifecycle implementation.

Rural modernization and the remaking of the rural citizen in China: Village redevelopment, migration and precarity

AbstractThe Chinese government's ambitious plans to modernize the countryside have significant impacts for rural populations. Upgrading or relocating villages is one component of this vision with profound implications for rural citizens. We use multiple social science research methods to investigate ongoing rural transformation in two villages designated for Village Redesign in Anhui Province, China. We show that the Village Redesign process is negatively impacting on the migration–development nexus and the resultant limbo deepens the precarity of high‐mobility, translocal households who already experience secondary forms of citizenship and limited social protections. This study raises further questions about the ongoing transformation of rural China and questions the modernizing rural agenda of the Chinese state.

Business Process Redesign: A Systematic Review of Evaluation Approaches

The continuous and systematic redesign of key business processes is very important for businesses and organizations that seek to achieve cost savings and efficiency enhancements. Selecting the most impactful processes and ensuring a successful redesign initiative remains an important topic that motivated the authors to conduct a Systematic Literature Review (SLR) on Business Process Redesign (BPR) Evaluation methodologies by applying an established eight-step SLR guide. The review sheds light on the current state of research and highlights the research gap by considering two dimensions of BPR artifacts: (a) the type of evaluation and (b) the generalizability of the existing approaches. The findings indicate that there is a lack of systematic methodologies in literature that properly evaluate the redesign capacity of models prior to implementation. Additionally, the existing methodologies do not cumulatively evaluate the quality characteristics that are necessary for BPR implementation or the applicability of BPR heuristics, and do not bear the generalizability to be readily used in a more general context. This paper aims to provide researchers with the necessary context and motivation to bridge this gap and further systematize BPR methodologies that can preselect the most suitable business processes for redesign.

Optimizing electronic blood ordering and supporting administration workflows to improve blood utilization in the pediatric hospital setting.

Red blood cell wastage occurs when blood is discarded rather than transfused, and ineffective ordering results in unnecessary crossmatch procedures. We describe how a multimodal approach to redesigning electronic ordering tools improved blood utilization in a pediatric inpatient setting and how using innovative application of time series data analysis provides insights into intervention effectiveness, which can guide future process improvement cycles. A multidisciplinary team used best practices and Toyota Production System methodology to redesign electronic blood ordering and improve administration processes. We analyzed crossmatch to transfusion ratio and red blood cell wastage time series data extracted from our laboratory information system and electronic health record. We used changepoint analysis to identify statistically discernible breaks in each time series, compatible with known interventions. We performed causal impact analysis on red blood cell wastage time series data to estimate blood wastage avoided due to the interventions. Changepoint analysis estimated an 11% decrease in crossmatch to transfusion ratio and a 77% decrease in red blood cell monthly wastage rate during the intervention period. Causal impact analysis estimated a 61% reduction in expected wastage compared to the scenario if the interventions had not occurred. Our results show that electronic health record design is an important factor in reducing waste and preventing unnecessary crossmatching, and that time series analysis can be a useful tool for evaluating the long-term impact of each stage of intervention in a longitudinal process redesign effort for the purpose of effectively targeting future improvement efforts.

The impact of partnered pharmacist medication charting in the emergency department on the use of potentially inappropriate medications in older people.

Introduction: A process redesign, partnered pharmacist medication charting (PPMC), was recently piloted in the emergency department (ED) of a tertiary hospital. The PPMC model was intended to improve medication safety and interdisciplinary collaboration by having pharmacists work closely with medical officers to review and chart medications for patients. This study, therefore, aimed to evaluate the impact of PPMC on potentially inappropriate medication (PIM) use. Methods: A pragmatic concurrent controlled study compared a PPMC group to both early best-possible medication history (BPMH) and usual care groups. In the PPMC group, pharmacists initially documented the BPMH and collaborated with medical officers to co-develop treatment plans and chart medications in ED. The early BPMH group included early BPMH documentation by pharmacists, followed by traditional medication charting by medical officers in ED. The usual care group followed the traditional charting approach by medical officers, without a pharmacist-collected BPMH or collaborative discussion in ED. Included were older people (≥65 years) presenting to the ED with at least one regular medication with subsequent admission to an acute medical unit. PIM outcomes (use of at least one PIM, PIMs per patient and PIMs per medication prescribed) were assessed at ED presentation, ED departure and hospital discharge using Beers criteria. Results: Use of at least one PIM on ED departure was significantly lower for the PPMC group than for the comparison groups (χ2, p = 0.040). However, PIM outcomes at hospital discharge were not statistically different between groups. PIM outcomes on ED departure or hospital discharge did not differ from baseline within the comparison groups. Discussion: In conclusion, PIM use on leaving ED, but not at hospital discharge, was reduced with PPMC. Close interprofessional collaboration, as in ED, needs to continue on the wards.

Development reference model to build management reporter using dynamics great plain aggregated

The digital technology transformation impacts changes in business patterns that require companies to innovate to act appropriately in making strategic decisions quickly, precisely, and accurately to increase efficiency, be practical company performance, and impacts changes in business patterns that require companies to innovate to act appropriately in making strategic decisions quickly to improve the performance. An enterprise resource planning (ERP) system is one step toward achieving performance. ERP system is one step to achieving performance. ERP system is essential for companies to automate the efficiency of business processes. The decisions from management in implementing the ERP system are necessary for ERP implementation to be successful. However, in practice, companies still experience complexity. For that, it needs to be considered related a business process reference model is essential to enhance efficiency in implementing the ERP used. This research discusses the business process reference model based on the ERP dynamics great plain (GP) application aggregated using management reporter (MR) to help users better understand the practical overview. The methodology utilizes a reference model based on Microsoft Dynamics GP guidelines with a business process redesign approach. This contributes to developing business processes to help users understand using the ERP dynamics GP application.

Development reference model to build management reporter using dynamics great plain aggregated

The digital technology transformation impacts changes in business patterns that require companies to innovate to act appropriately in making strategic decisions quickly, precisely, and accurately to increase efficiency, be practical company performance, and impacts changes in business patterns that require companies to innovate to act appropriately in making strategic decisions quickly to improve the performance. An enterprise resource planning (ERP) system is one step toward achieving performance. ERP system is one step to achieving performance. ERP system is essential for companies to automate the efficiency of business processes. The decisions from management in implementing the ERP system are necessary for ERP implementation to be successful. However, in practice, companies still experience complexity. For that, it needs to be considered related a business process reference model is essential to enhance efficiency in implementing the ERP used. This research discusses the business process reference model based on the ERP dynamics great plain (GP) application aggregated using management reporter (MR) to help users better understand the practical overview. The methodology utilizes a reference model based on Microsoft Dynamics GP guidelines with a business process redesign approach. This contributes to developing business processes to help users understand using the ERP dynamics GP application.

Performance and Emissions Benefits of Cooled Ceramic Matrix Composite Vanes for High-Pressure Turbines

Abstract Ceramic matrix composites (CMCs) offer great potential for developing lighter and more efficient aero-engines. Due to their high-temperature capability, CMCs are mainly used in the hot gas section in order to replace cooled metallic components and thus save cooling air. Especially CMC vanes for high-pressure turbines (HPTs) have been researched and tested in the past. A realistic design approach for cooled CMC vanes is the so-called shell and spar concept. The application of such vanes in HPTs as inlet guide vanes (IGVs) at constant rotor inlet temperature (T41) enables performance and emissions benefits which are assessed by means of a reference engine in this paper. Compared to metallic IGVs, more temperature-resistant CMC IGVs require significantly less cooling air and generate lower cooling losses. A quantitative comparison will be presented. Consequently, the redesign of the reference engine to the setting of a hybrid HPT leads to a reduction in thrust specific fuel consumption (TSFC) by 0.23% at cruise conditions. Additionally, there is potential to extract the IGV cooling air at a lower pressure level, increasing the cruise TSFC gain to 0.41%. In the course of the redesign process, the turbine inlet temperature (T4) is reduced by 50 K in order to reach the same T41 with a lower IGV coolant mass flow. Regarding emissions, this leads to a decreased production of nitrogen oxides (NOx). Hence, several NOx emissions parameters can be reduced by more than 4%.

Exploring topic modelling for generalising design requirements in complex design

As the redesign process progresses in product lifecycle management, effectively managing engineering changes becomes increasingly challenging, often leading to catastrophic and costly project failures. In response, the study provides a framework for generalising design requirements documents into topics that engineers can use to understand complex designs. Based on previous work, this study employs and compares four different models, including latent Dirichlet allocation (LDA), the collapsed Gibbs sampling algorithm for the Dirichlet multinomial mixtures model (GSDMM), LDA-BERT, and GSDMM-BERT to determine the appropriate representation of requirements documents. Both heatmaps and UMAPs are used to illustrate the correlation between topics and words. The results indicate that the combined vector representation of topic modelling and the sentence-BERT model outperforms single topic modelling. This combined model leverages the additional knowledge from a pre-trained sentence-BERT model, thereby improving model performance and word distribution in all three industrial projects. Through this proposed framework, engineers can potentially generalise high-quality requirements topics for large requirements documents.

The Road Ahead and Challenges of Revenue Cycle Management in Saudi Governmental Hospitals.

Healthcare providers use revenue cycle management (RCM) to track patient billing and revenue. The revenue cycle collects data from various systems and compiles it into a single RCM system connected to payers. Effective system integration improves revenue and financial stability. The aim is to assess RCM feasibility in Saudi Arabia's governmental hospitals, examine financial management, and recommend practical implementation. In this study, healthcare leaders were interviewed face-to-face and via audio recording to collect qualitative data in response to semi-structured questions. Key informants from seven main hospitals were interviewed. Respondents understood RCM and identified internal and external challenges in hospital financial management. Government hospitals face accountability obstacles. Two of the seven surveyed hospitals operate business clinics using a fee-for-service model. The billing system is not integrated with the information system. The RCM system faces challenges such as unclear vision, lack of accountability, staff resistance, process redesign, and importance of project management. Despite these challenges, respondents still value RCM and recognize its importance in improving hospital revenue management. Effective implementation of RCM requires significant transformational processes, including vision, governance, accountability, proper training, and effective monitoring and evaluation processes. Communication should also be emphasized, and the patient's perspective must be brought into focus. Involving all stakeholders can create direct and holistic patient benefits; therefore, bringing them on board is crucial. New approaches are required to enhance healthcare in Saudi Arabia, addressing gaps in revenue optimization and RCM. Future research should evaluate the move from government-funded to self-operated hospitals, providing a better understanding of the challenges and opportunities.