Reduction In Overtime Research Articles

Reducing the product defects using lean production perspective: a case study at CV Cita Nasional

This article discusses the issues of how to reduce pasteurized milk defects as part of waste in a lean production system. Product defects are the most important problem faced by the dairy enterprise daily. This problem makes production costs higher and decreases the profit. A set of seven tools and methods is used to identify and analyse the defect problem, and then make a solution plan. Value Stream Mapping is used to describe the current condition of the production system and make improvement planning. The lean production concept has been successfully used not only to find ways to reduce product defect, but also to plan and eliminate other wastes in the pasteurized-homogenized milk production process. Waste found and eliminated are production lead time, transportation, waiting time, defective products, and downtime machines. Overall, the research results in a reduction of overtime for 41 minutes, and make downtime on the packaging machine to become 0 minutes.

Designing a Direct Labor Planning Model for production management of pharmaceutical companies

In the pharmaceutical industry, production planning responds to changes in customer demand and internal company processes. Processes in this industry are not value-additive, although the industry does present opportunities for improvement, such as reducing overtime, which occurs more than 30% of the time; reducing production rescheduling, which reaches 40%; and improving level of customer service for state institutions, who represent 70% of purchase orders. These situations need to be improved within the company; and as a result, a sales and operations model that includes direct labor planning is designed. This model should enable a reduction of overtime and calculation of the amount of direct labor taking into account efficiency level. In practice, this is the expected outcome; it is achieved via the decisions made by the operations executive.

Optimization of Wood Supply: The Forestry Routing Optimization Model.

The main purpose of this paper was to present the Forestry Routing Optimization Model (FRoM) as a version of the classical Vehicle Routing Problem (VRP). This work approaches for wood logistic problems consisting of simple displacement and multiple displacements of trucks toward the stands. The FRoM encompasses both steps into one single integer mixed linear programming model, considering cranes and trucks schedule, fleet reduction, reduction of overtime, reduction of half-load transportation, and approaching the minimum distance traveled along a fixed planning horizon. Some technique constraints were implemented to provide accurate model function. An executed real problem data was used to compare the outcomes. The objective was to carry and transport 21,881.82 tons of lumber from 10 stands using a total of 48 trucks and 5 cranes in a planning horizon of 6 days, which each day has 20 hours of effective work. The FRoM has performed a fleet reduction of 72.92%, eliminating overtime. It has reduced the half-load trips to the order of 3.17% of all routes. The crane's analysis allowed catching points of inefficiency due to operational idleness. The FRoM provided savings of 49.12% at all logistic costs. FRoM has shown to be a good option as a route optimizer for forestry logistics.

INFEKSI MYCOBACTERIUM TUBERCULOSIS STRAIN H37RV TERHADAP EKSPRESI MATRIX METALLOPROTEINASE (MMP)-2 PADA OTAK

Background. Tuberculous infection in brain can cause microglia to secrete inflammatory factors like Tumor Necrosis Factor alpha (TNF-α) and Interleukin 1 beta (IL-1β) which will be shown as body immune respons. Those inflammatory factors eventually can trigger microglia to secrete Matrix Metalloproteinase-2 (MMP-2) which will regenerate necrotic or apoptosis cells because of inflammation process. MMP-2 has been proven to have important role in brain tuberculous infection.Objective. To ascertain MMP-2 expression in mus musculus brain tissue with no infection, infection for 8 weeks, and infection for 16 weeks.Methods. This research used semiquantitative method to compare MMP-2 expression in 3 samples group. Observation of MMP-2 expression in mus musculus brain tissue were made by using immunohistochemistry colouration method which then would be observed in microscope with 400x magnification. Brain cell which express MMP-2 will become brown in cell nucleus, cytoplasm, and wall.Results. The result which had be obtained was overtime reduction of MMP-2 expression.Conclusion. MMP-2 expression didn’t decrease after 8 weeks time of infection.

Feasibility and acceptability of the use of patient-reported outcome measures (PROMs) in the delivery of nurse-led supportive care to people with colorectal cancer

Logistical issues pertinent to the use of patient-reported outcome measures (PROMs) by colorectal cancer nurse specialists (CNS) to identify the needs of people with colorectal cancer (CRC) in acute care remain unknown. We explored the feasibility and acceptability of PROMs-driven, CNS-led consultations to enhance delivery of supportive care to people with CRC completing adjuvant chemotherapy. A systematic literature review and focus groups with patients and CNS (Phase 1) were followed by a repeated-measures, exploratory study (Phase 2), whereby pre-consultation PROM data were collected during three consecutive, monthly consultations, and used by the CNS to enable delivery of personalised supportive care. Based on Phase 1 data, the Supportive Care Needs Survey was selected for use in Phase 2. Fourteen patients were recruited (recruitment rate: 56%); thirteen (93%) completed all study assessments. Forty in-clinic patient-clinician consultations took place. At baseline, 219 unmet needs were reported in total, with a notable 21% (T2) and 32% (T3) over-time reduction. Physical/daily living and psychological domain scores declined from T1 to T3, yet not statistically significantly. In exit interviews, patients described how using the PROM helped them shortlist and prioritise their needs. CNS stressed how the PROM helped them tease out more issues with patients than they would normally. Nurse-led, PROMs-driven needs assessments with patients with CRC appear to be feasible and acceptable in clinical practice, possibly associated with a sizeable reduction in the frequency of unmet needs, and smaller decreases in physical/daily living and psychosocial needs in the immediate post-chemotherapy period.

Decreasing wait times for endobronchial ultrasound (EBUS).

192 Background: The department of pulmonary medicine evaluates manifestations of cancer and complications of therapy that affect the lungs. It is a procedurally oriented specialty with many diagnostic and therapeutic interventions. Endobronchial ultrasound with transbronchial fine needle aspiration (EBUS-TBNA) is a minimally invasive procedure that allows real time image guided sampling of tissue in the mediastinum. Current guidelines recommend use of EBUS for the initial test to diagnosis and stage lung cancer. It has a low complication rate, but needs specialized equipment as well as anesthesia support. Alternatives include CT-guided biopsy or surgery. The delay from time of referral to EBUS procedure has the potential to delay diagnosis and treatment, create patient anxiety, frustration and expense of travel for multiple appointments. The staff is under pressure to perform excessive cases on a daily basis resulting in overtime staffing costs. Our objectives were to reduce delays in diagnosis/treatment, improve patient satisfaction, improve referring services satisfaction and optimize the use of resources and improve staff working conditions. Methods: We used a Plan, Do, Study, Act process. Initially the process flow diagram was utilized along with a fishbone diagram to allow us to focus on the issues. The aim was to decrease EBUS wait time 20% by 7/2016. Our process flow sheet was arranged into swimlanes in order to identify focus areas. This allowed us to redesign the workflow to improve capacity and improve existing resources to be more efficient. Results: Working with anesthesia services and the cardiopulmonary center staff, we were able to open a second bronchoscopy suite 2 days a week for additional EBUS cases. We also had monthly meetings with issues and to monitor delays to other services. Conclusions: We were able to reduce our wait time from 7.5 days to 4.27 work days. The added capacity allows for surge in demand for EBUS. Our future studies will concentrate on patient and referring service satisfaction, cost savings with reduction in overtime, quantifying impact on decreasing delays in diagnosis and subsequent treatment.

Great Valley Root

The production supervisor of a global equipment supplier is facing two problems on the factory floor: excess overtime on the assembly line and unacceptable manufacturing lead times through the entire production process. After calculating the capacity and throughput time of the existing system, students must determine the best alternatives to realize the dual goals of 50% reduction in overtime and 50% reduction in throughput time. Excerpt UVA-om-1509 Rev. Mar. 24, 2014 GREAT VALLEY ROOT Great Valley Root (GVR) was a leading global supplier of fuel-dispensing equipment. One of its key products was the Echo line of fuel dispensers. The production process for the Echo product line consisted of three distinct stages: (1) molding plastic parts, (2) automated machining, and (3) assembly. The molding and machining stages were independent of each other. They both produced parts that were sent to the assembly stage. (See Figure 1 for a depiction of the Echo production process.) Figure 1. Echo production process. Notes: Triangles represent inventory and rectangles represent production stages. . . .

Optimization and Simulation of Orthopedic Spine Surgery Cases at Mayo Clinic

Spine surgeries tend to be lengthy (mean time of 4 hours) and highly variable (with some surgeries lasting 18 hours or more). This variability along with patient preferences driving scheduling decisions resulted in both low operating room (OR) utilization and significant overtime for surgical teams at Mayo Clinic. In this paper we discuss the development of an improved scheduling approach for spine surgeries over a rolling planning horizon. First, data mining and statistical analysis was performed using a large data set to identify categories of surgeries that could be grouped together based on surgical time distributions and could be categorized at the time of case scheduling. These surgical categories are then used in a hierarchical optimization approach with the objective of maximizing a weighted combination of OR utilization and net profit. The optimization model is explored to consider trade-offs and relationships among utilization levels, financial performance, overtime allowance, and case mix. The new scheduling approach was implemented via a custom Web-based application that allowed the surgeons and schedulers to interactively identify best surgical days with patients. A pilot implementation resulted in a utilization increase of 19% and a reduction in overtime by 10%.

Macroeconomic Implications of the German Short‐time Work Policy during the Great Recession

AbstractDespite a sharp fall in GDP, German employment in terms of employees stayed remarkably robust during the Great Recession. At the same time, hours worked per employee declined significantly. This is seen as the core of the German employment ‘miracle’. A general discussion arose about the reasons behind this astonishing labour market performance and the role of short‐time work (STW) as a kind of exportable panacea. In this article we look at the macroeconomic implications of STW and other measures of internal flexibility, in particular focusing on the quantification of safeguarded jobs during the crisis. We find that STW played an important role and helped to safeguard employment in Germany during the Great Recession. However, we show that other measures of internal flexibility (working time accounts, contractual arrangements on working time reductions, reduction of overtime) were equally important. Together with STW these instruments saved around 1 million jobs. To explain and understand the German success story, the features of the German core model – with a strong employer–employee relationship of mutual trust, strong employment protection, traditional standard working contracts and strong works councils at the firm level – are of key importance.

Value-Based Resource Management

With the health care environment shifting to a value-based payment system, Catholic Health Initiatives nursing leadership spearheaded an initiative with 14 hospitals to establish best nursing care at a lower cost. The implementation of technology-enabled business processes at point of care led to a new model for best value nursing care: Value-Based Resource Management. The new model integrates clinical patient data from the electronic medical record and embeds the new information in care team workflows for actionable real-time decision support and predictive forecasting. The participating hospitals reported increased patient satisfaction and cost savings in the reduction of overtime and improvement in length of stay management. New data generated by the initiative on nursing hours and cost by patient and by population (Medicare severity diagnosis-related groups), and patient health status outcomes across the acute care continuum expanded business intelligence for a value-based population health system.

The association between coronary artery calcification progression and loss of bone density in non-dialyzed CKD patients

Coronary artery calcification (CAC) and low bone density are coexisting deleterious conditions commonly shared by chronic kidney disease (CKD) patients. In the present study, we aimed to investigate whether the progression of CAC was associated with overtime reduction in bone density in non-dialyzed CKD patients. This is a prospective study of 24 months including 72 non-dialyzed CKD patients Stages 2 - 4 (age 57.6 ± 10.3 years, 62% male, 22% diabetics). CAC and vertebral bone density (VBD) were measured by computed tomography. At baseline, 46% of the patients had CAC (calcified group) and calcification was not identified in 54% of the patients (non-calcified group). The calcified group was older, predominantly male, and had lower VBD in comparison to non-calcified group. CAC progression was observed only in the calcified group (91% of the patients increased calcium score). The multiple regression analysis revealed loss of VBD as the independent determinant of CAC progression in these patients. CAC progression was associated with loss of VBD in non-dialyzed CKD patients.

The effects of overtime hour restrictions on hours and employment evidence from Taiwan ROC

Instead of the regulations on standard hours, those on overtime constitute a more significant aspect in the Labor Standards Law in Taiwan. The overtime hour restrictions lead to an exogenous reduction in overtime and affect on hours and employment. On the basis of Hart’s model (2004), a theoretical model was constructed to investigate overtime hour restrictions, and three possibilities are built. However, the empirical results in this study indicates that employers will hire more full-time employees relative to part-time employees and decline the working hours for full-timers and part-timers among the original covered sector after the enactment of LSL. After 1998, the empirical results in this study indicates that employers will hire less full-time employees relative to part-time employees and decline the working hours for full-timers and part-timers among the original uncovered sector in response to the LSL covered all sectors.

A Hierarchical Framework for Organizing a Software Development Process

Every year, companies that produce consumer tax preparation software struggle with a massive amount of work imposed by thousands of state and federal changes to tax laws and forms. With their release not even beginning before August, these changes still must be processed and incorporated into the application by mid-December. Three companies dominate this competitive market with its short selling season so that release delays create significant losses. Though systematic resource allocation and process management are crucial, the volume and complexity of the changes, the brief timeframe to implement them, and feedback loops built into the system for error resolution make it extremely difficult to analyze the process. One of the leading tax software providers tasked us with developing systematic approaches for managing the process flow and staffing each stage so that the company met the deadline at the lowest cost. Based on the characteristics of the process, we develop deterministic models that partition tax forms into groups and determine the staffing levels for each group. Partitioning the development process into groups has the benefit of simplifying workflow management and making it easier to find staffing levels. To provide the company with a range of resource configurations, we use two modeling approaches to obtain lower and upper bounds on the number of resources at each stage. Numerical experiments indicate that the models successfully capture the features of the process and the heuristics perform well. Implementing our models at the company has resulted in 31% reduction in overtime and 13% reduction in total resource costs.

Improving the efficiency of a chemotherapy day unit: Applying a business approach to oncology

Aim To improve the efficiency of a hospital-based chemotherapy day unit (CDU). Methods The CDU was benchmarked with two other CDUs to identify their attainable performance levels for efficiency, and causes for differences. Furthermore, an in-depth analysis using a business approach, called lean thinking, was performed. An integrated set of interventions was implemented, among them a new planning system. The results were evaluated using pre- and post-measurements. Results We observed 24% growth of treatments and bed utilisation, a 12% increase of staff member productivity and an 81% reduction of overtime. Conclusions The used method improved process design and led to increased efficiency and a more timely delivery of care. Thus, the business approaches, which were adapted for healthcare, were successfully applied. The method may serve as an example for other oncology settings with problems concerning waiting times, patient flow or lack of beds.

The wellbeing implications of a change in the sex-ratio of a population

It is often the case with socio-economic, or development-related, indicators that these are explicitly in the nature of ‘wellbeing’ or ‘illbeing’ indicators, such that increases in their values are routinely interpreted as reflecting ‘improvements’ or ‘deteriorations’, as the case may be. The sex-ratio of a population is one such indicator: an over-time reduction in the value of this statistic is generally regarded as pointing to a worsening in the relative wellbeing of women. This paper argues that summary real-valued socio-economic measures are largely in the nature of end-state descriptions, and not always completely reliable guides to the processes underlying their realization. This is also true for the sex-ratio measure. The paper points to the utility of decomposing a given change in the sex-ratio of a population into changes in its constituent and determining factors. In particular, the sex-ratio can be seen to be determined by the prior history of sex-ratios at birth and the prior history of the relative survival advantage of females. The magnitude and direction of changes in these determining factors are pointers to the processes that have mediated the change in the aggregate sex-ratio, and therefore pointers to whether the sex-ratio change—independently of the direction of change—may be interpreted in developmentally favourable or unfavourable terms. The issues underlying these considerations are illustrated through the use of relevant demographic data for India.

Steroids reduce local inflammatory mediator secretion and mucosal permeability in collagenous colitis patients

To study the effect of oral steroids upon clinical response and rectal mucosa secretion of eosinophil cationic protein (ECP), myeloperoxidase (MPO), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and albumin in patients with collagenous colitis (CC). A segmental perfusion technique was used to collect perfusates from rectum of CC patients once before and twice (one and four weeks) after the start of steroid treatment. Clinical data was monitored and ECP, MPO, bFGF, VEGF and albumin concentrations were analyzed by immunochemical methods in perfusates and in serum. Steroids reduced the number of bowel movements by more than five times within one week and all patients reported improved subjective well-being at wk 1 and 4. At the same time, the median concentrations of ECP, bFGF, VEGF and albumin in rectal perfusates decreased significantly. MPO values were above the detection limit in only 3 patients before treatment and in none during treatment. VEGF, bFGF, ECP and albumin concentrations correlated with each other with the exception of ECP and albumin. A decrease of serum ECP and VEGF concentrations was also seen even if the overtime reduction was not significant. Oral steroid treatment in CC patients induced a simultaneous reduction of bowel movements and rectal release of ECP, bFGF, VEGF and albumin, suggesting that these polypeptides and increased mucosal permeability are important components of the pathophysiology in collagenous colitis.

How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time.

We considered elective case scheduling at hospitals and surgical centers at which surgeons and patients choose the day of surgery, cases are not turned away, and anesthesia and nursing staffing are adjusted to maximize the efficiency of use of operating room (OR) time. We investigated scheduling a new case into an OR by using two patient-scheduling rules: Earliest Start Time or Latest Start Time. By using several scenarios, we showed that the use of Earliest Start Time is rational economically at such facilities. Specifically, it maximizes OR efficiency when a service has nearly filled its regularly scheduled hours of OR time. However, Latest Start Time will perform better at balancing workload among services' OR time. We then used historical case duration data from two facilities in computer simulations to investigate the effect of errors in predicting case durations on the performance of these two heuristics. The achievable incremental reduction in overtime by having perfect information on case duration versus using historical case durations was only a few minutes per OR. The differences between Earliest Start Time and Latest Start Time were also only a few minutes per OR. We conclude that for facilities at which the goals are, in order of importance, safety, patient and surgeon access to OR time, and then efficiency, few restrictions need to be placed on patient scheduling to achieve an efficient use of OR time. We showed how elective cases should be scheduled to maximize the efficiency of use of operating room time. The analysis applies to surgical suites at which surgeons and patients have access to operating room time every workday.

Overtime Work and Overtime Compensation in Germany

Sharing the available stock of work more fairly is a popular concern in the public policy debate. One policy proposal is to reduce overtime work in order to allow the employment of more people. This paper suggests that such a concept faces major problems. Using Germany as a case study, it is shown that the group of workers with the highest risks of becoming unemployed, namely the unskilled, also exhibit low levels of overtime work. Those who work overtime, namely the skilled, face excess demand on the labour market. Since skilled and unskilled workers are largely complements in production, a general reduction in overtime will lead to less production and hence also to a decline in the level of unskilled employment. The paper provides empirical support for this line of argument. It is also shown that paid overtime work has lost relative importance over time.

Overtime Work and Overtime Compensation in Germany

Sharing the available stock of work more fairly is a popular concern in the public policy debate. One policy proposal is to reduce overtime work in order to allow the employment of more people. This paper suggests that such a concept faces major problems. Using Germany as a case study, it is shown that the group of workers with the highest risks of becoming unemployed, namely the unskilled, also exhibit low levels of overtime work. Those who work overtime, namely the skilled, face excess demand on the labour market. Since skilled and unskilled workers are largely complements in production, a general reduction in overtime will lead to less production and hence also to a decline in the level of unskilled employment. The paper provides empirical support for this line of argument. It is also shown that paid overtime work has lost relative importance over time.

Overtime reductions: Negligible employment effects

Overtime hours were worked in Germany during the period 1990–1997 primarily by well-qualified blue-collar and white-collar workers. In addition, it is evident that overtime is increasingly being compensated by flexible leisure schedules. The scope for potential employment effects from a reduction of paid overtime is thus constantly decreasing and is much lower than the figures cited by unions in the current discussion. If the regulations to make working time more flexible being discussed in the “Alliance for Jobs’ were to be implemented, this would reinforce the observed trend towards compensation for overtime through leisure, further diminishing the potential employment effects. If the bargaining parties or the legislators would implement a reduction of overtime nonetheless, well-qualified blue-collar and white-collar workers in western Germany will suffer income losses.