Systematic Process Improvement Research Articles

Enhancement of Internal Business Process Using Artificial Intelligence

This research aims to explore the feasibility of Artificial Intelligence (AI) enabled process improvement systems to assist businesses in optimizing Internal Business Process (IBP) by making and adopting suggestions and improvements. Over the last two decades’ technological advances in the new generation have allowed us to use more sophisticated systems to speed up different tasks, as well as AI which has cognate from theory to something more efficient and applicable. This study confirms that a feasible AI-based system can provide benefits to companies in terms of increasing revenue. A mixed method was used; quantitative research was carried out through surveys to gather knowledge about the use of AI in the IBP, while qualitative research was carried out through interviews to obtain an overview of the use of AI in certain IBP. The results show that constructing AI in process optimization is a complicated task than one might expect.

A Resident-Led Quality Improvement Initiative to Increase End-of-Life Planning in Primary Care.

Background Despite many benefits of end-of-life (EOL) planning, only 1 in 3 adults has EOL documentation, with low rates in resident primary care clinics as well. Objective To increase clinic completion of life-sustaining treatment (LST) notes and advance directives (AD) for veterans at highest risk for death. Methods The setting was a Veterans Affairs (VA) internal medicine primary care clinic. All clinic residents in the 2021-2022 academic year and all clinic patients identified through a VA risk-stratification tool as highest risk for death were included. Baseline AD and LST completion rates were determined through manual chart review. Our interventions included 2 hours of teaching to increase resident knowledge of EOL planning and a systematic process improvement to complete EOL planning appointments. Outcomes assessed included anonymous resident pre- and post-surveys of self-assessed knowledge and comfort with EOL conversations, as well as rates of LST and AD completion determined through serial chart review. Results In the 2021-2022 academic year, 22 residents (100%) and 54 patients were included. Post-intervention surveys (n=22, 100%) showed improved self-assessed knowledge of EOL concepts and comfort with patient discussions (median Likert increase 3 to 4). The number of residents who completed an EOL planning visit increased from 9 of 22 (41%) to 15 (68%). LST completion increased from 9 of 54 (17%) to 29 (54%), and AD completion increased from 18 of 54 (33%) to 33 (61%). Conclusions A brief teaching intervention to prepare residents for comprehensive EOL visits combined with process improvement to offer EOL planning visits improved self-reported knowledge and comfort and completion of EOL visits.

Lessons in Manufacturing Efficiency: 12 by 12

In “Lessons in Manufacturing Efficiency: 12 by 12,” we explore how manufacturing efficiency principles can revolutionize operating room (OR) management. By addressing inefficiencies and adopting strategies like throughput accounting and the Theory of Constraints, this paper proposes a model for enhancing OR throughput, quality of care, and patient outcomes. Emphasizing technology integration and systematic process improvement, we offer a comprehensive framework for transforming surgical services into highly efficient, patient-centered operations, thereby setting a new standard for healthcare delivery.

Reducing The Number of Intermediate Stock by Implementing Just-In-Time & Pulling System

In tire manufacturing process in PT. XYZ, there is an area called the Intermediate Area in the Building - Curing area where WIP materials are temporarily stored before proceeding to the Curing process. The capacity of Intermediate Area is 15000 pcs, and the daily production volume approximately 20000 pcs. As a result, more space in the Intermediate Area is required to accommodate the increasing tire production planning. In this study, JIT & Pull system improvement process is carried out by following the PDCA cycle methodology. The implementation of the JIT done by determining standard for the number of intermediate stocks, whereas the Pull system implementation done by setting the standard material handling cycle time standard for one cycle. To keep the improvement runs according to the plan, the guidance sheet is made as the reference of the process. These improvements done to achieve the objective which is to reduce the number of stocks in the Intermediate Area by up to 834 pcs per day and reduce the total cycle time from 110 minutes to 90 minutes. Therefore, the main contribution of this research is to reduce the number of WIP materials in intermediate area and reduce the excessive transportation in the material handling process.

Barriers and Facilitators to Breast and Cervical Cancer Screenings for Hispanic Women in a Rural State

Abstract Introduction The Centers for Disease Control and Prevention (CDC) and the Division of Cancer Prevention of Control administer the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), designed to increase early detection of cancers among low-income uninsured and underinsured women. However, rates of cancer diagnosis and survivorship differ among women of different ethnicities. We investigated two questions: 1) what are the potential barriers and facilitators for women to complete recommended breast and cervical cancer screenings, and 2) are the barriers and facilitators different for Hispanic women when compared to non-Hispanic White women? Methods We used a community-based participatory research approach and mixed methods: qualitative interviews with women enrolled in the program and a systematic process improvement approach to identify root causes of completing or not completing screenings. We conducted semi-structured interviews in English (n = 11) and Spanish (n = 9) and analyzed responses using fishbone diagrams. Results We recruited 20 participants in four categories: (a) non-Hispanic White women who completed screenings (n = 9), (b) non-Hispanic White women who did not complete screenings (n = 2), (c) Hispanic women who completed screenings (n = 7), and (d) Hispanic women who did not complete screenings (n = 2). Among all women, facilitators included assistance from program staff with appointments and reminders. Hispanic women reported barriers including language difficulties and confusion about the program. Non-Hispanic White women identified barriers as confusion about the role of insurance. Conclusions We found that there are differences in barriers and facilitators for non-Hispanic White women and Hispanic women due to language, the role of insurance, and the level of trust in the program. Reasons for not completing screenings for Hispanic women were structural and systemic in nature; reasons for non-Hispanic White women were based on personal choices.

The better work, better care framework: 7 strategies for sustainable healthcare system process improvement

ABSTRACT Healthcare systems are under pressure to control costs and improve performance. Efforts to apply improvement trends such as “Lean” and other industrial engineering approaches have led to degradation of the working environment for healthcare professionals. Research is increasingly demonstrating how poor working environments contribute to declines in care quality and has led to calls for a “quadruple aim” with a focus on the working environment alongside quality, cost, and patient experience factors. This paper contributes to the debate by using a “systems” perspective to propose seven strategies by which healthcare systems might be improved without compromising the working environment. This article presents a rationale for these strategies based on current organisational psychology and human factors research and how these strategies might be deployed in practice. The authors argue that better working conditions leads to better care for patients and presents a viable approach for both practitioners and researchers to pursue the “Better Work, Better Care” agenda.

An Innovative and Integrative Approach to Breaking Down Barriers to Traditional Morbidity and Mortality Conference.

Children are vulnerable to medical errors. Adverse events are leveraged as educational tools in Morbidity and Mortality (M&M) Conference. Traditionally, M&M has brought angst when discussing adverse events. Our goal was to transition M&M to an educational environment highlighting system failures. A survey was created to capture data on satisfaction, education, and system process improvement. Feedback from the surveys led to several changes, including fostering a multidisciplinary forum, prioritizing educational topics, and emphasizing process improvement. In 5 years, satisfaction with M&M Conference has increased by 29%, with an increase by 50% when asked if process improvement issues were addressed adequately, and 100% of faculty incorporate what they learn from M&M into their practice. By developing a hands-on approach to M&M, we have improved satisfaction and focused on education and system process improvement. This design could be used throughout the medical community to improve discussion of adverse events which should improve patient safety.

Using FOCUS-PDSA Quality Improvement Methodology Model in Healthcare: Process and Outcomes.

Using FOCUS-PDSA Quality Improvement Methodology Model in Healthcare: Process and Outcomes.

Quality Control To Reduce Defects in Ceramic Production Using Six Sigma Method and Root Cause Analysis

PT. Kualimas Aditama is a company engaged in the manufacturing sector. This company has been a ceramics producer for 23 years. However, the problem faced in this company is that the level of product defects produced exceeds the company's tolerance limits. The company provides an acceptable tolerance for defective products of 3, but in fact the production of 60x60cm ceramics for 6 months in February 2023 had a product defect of 3.2% exceeding the tolerance limit which had a defect value of 1505 Pcs and a DPMO value of 8064.68899 with a sigma level of 3.9. In the define stage there were 4 product defects that occurred, namely ripe gupil of 2,668 pcs, raw gupil of 2,158 Pcs, ceramic scratched of 1,255 pcs and edge cracks of 586 Pcs. This study aims to determine damage to ceramics, determine the level of defects in ceramics and provide suggestions for improvements to reduce the number of defects. As an effort to reduce product defects that occur at PT.Kualimas Aditama, it is necessary to carry out quality control using the Six Sigma and RCA methods to improve production quality. From the results of the analysis, it is obtained that the triggering factors for product defects include human, machine, environmental factors.
 Highlights :
 
 Six Sigma Approach: Utilizing Six Sigma methodology for quality control allows for systematic problem-solving and process improvement.
 Root Cause Analysis (RCA): Identifying root causes of defects is crucial for implementing effective corrective measures.
 Human, Machine, Environmental Factors: Recognizing and addressing these factors are essential in reducing product defects and improving production quality.
 
 Keywords – Quality Control, Six Sigma, Root Cause Analysis

REDUCING INVENTORY LEVELS IN A SUPERMARKET BY THE SIX SIGMA METHOD

One of the most active sectors in an increasingly globalized world, retail sector has become a rapidly developing sector in Turkey as well. Companies in this sector must follow an inventory policy that provides them with minimum cost and maximum profit in order to compete and survive in market. For this reason, effective management of inventory is crucially important in the retail sector, as in other sectors. In this study, Six Sigma method was used in order to reduce the inventory levels in a large supermarket operating both wholesale and retail in Turkey. Six Sigma is a management tool that emphasizes continuous improvement as a culture and increases the efficiency of processes. In this study, the causes of high inventory levels were determined by following the steps of the Six Sigma method, and the collected data were analyzed. At the end of the implementation, some improvement actions were planned to reduce inventory levels, and a monitoring system was established to ensure sustainability. There was a deficiency in inventory tracking and demand forecasting processes. The main reason for this was seen to be the purchasing organization. It was determined that sometimes more than necessary purchases were made. Six sigma studies on supermarkets in Turkey are limited. This study sets an example for the use of the Six Sigma method, which is a systematic process improvement method for the retail industry.

ANALISA IMPLEMENTASI MANAJEMEN RANTAI PASOK BERBASIS ERP PADA SISTEM DISTRIBUSI PT SEMEN INDONESIA TBK

PT Semen Indonesia (Limited Company) is one of the largest companies in Indonesia that produces cement. The application of the ERP-based Supply Chain Management concept to the distribution system of PT Semen Indonesia is needed to fulfill the needs of end customers. This analysis aims to measure the performance of supply chain core processes in companies that have links ranging from the flow of raw materials from suppliers to the hands of final consumers, as well as ERP implementation in order to find out the positive and negative impacts of ERP implementation at PT Semen Indonesia in improving the distribution system. The research method used is qualitative by collecting related data and studies of documentation to map the ERP-based Supply Chain implementation at PT. Semen Indonesia, especially in the final product distribution process. The result achieved is to get a comparison between the positive and negative impacts of ERP implementation at PT Semen Indonesia in improving the distribution process. ERP implementation at PT Semen Gresik has a good impact on the effectiveness and efficiency of the distribution system improvement process, but also has consequences for the effectiveness and efficiency obtained. While the results of the analysis through business process modeling, the cement distribution process in the research object is included in the Supply Chain Operations Reference (SCOR) delivery process with the category of stocked product companies. Activities in the business process do not all follow the activities at SCOR, there is one activity that is not appropriate, namely providing proof of payment to customers, because the initial payment mechanism implemented by PT. Semen Indonesia.

Innovation in Chemical Reactor Engineering Practice and Science

Chemical engineering industrial practice has always forged ahead of chemical engineering science to create new processes and products driven mostly by the pull of society's desire for improved quality of life. The resulting processes have often left room for advances in process systems engineering and in chemical engineering science to explain subtle aspects of the chemical technologies, thereby leading the way to systematic process improvement. As process improvements move along the learning curve it raises the question, “what is the best process that can be achieved, and how close is the current process to that best case?” For reaction systems, Horn formulated this question in 1964, and Feinberg & Ellison answered it in 2001. In this article we state the method for calculating the ultimate productivity of a given reaction system and associated chemical kinetics and apply it to a simple industrial chemical process to make ethyl acetate from renewable bioethanol feedstock. The benchmarks provided by the method lead to useful practical pathways for driving innovation.

Exploring the Application of Lean Best Practices in Remanufacturing: Empirical Insights into the Benefits and Barriers

Remanufacturing processes have been widely identified as being important elements of a sustainable economy. However, the commercial viability of this product recovery route is significantly influenced by several operational challenges that are different from those that occur in conventional manufacturing. One of the most widely used systematic process improvement methods in conventional manufacturing is lean production, which seeks to minimize all forms of waste throughout an operation. As the academic study of lean best practices in remanufacturing processes is relatively new, there is a lack of knowledge regarding implementation and impact. As such, this paper presents multiple case studies investigating the application of lean methods in industrial remanufacturing operations. These studies focus on the automotive industry, where both conventional and remanufacturing operations have been the leading adopters of lean thinking and practice. The results of the investigation identify specific lean methods that help manage the inherent complexity of the remanufacturing processes, and consequently improve the overall productivity of the process. Similarly, factors that limit the application of lean practices within remanufacturing are also identified and discussed. Matrices for opportunities and threats are developed to enable the simple adoption of these findings. Overall, the research provides a more holistic understanding of the application of lean within a remanufacturing environment, with benefits for both academia and industry.

Reduction of Inventory Inaccuracy through Process Improvement and Information System Development of Xylem Water System International Inc., Calamba, Laguna, Philippines

Reduction of Inventory Inaccuracy through Process Improvement and Information System Development of Xylem Water System International Inc., Calamba, Laguna, Philippines

Is deployement of diagnostic test alone enough? Comprehensive package of interventions to strengthen TB laboratory network: three years of experience in Burkina Faso

BackgroundsThe laboratory plays a critical role in tuberculosis (TB) control by providing testing for diagnosis, treatment monitoring, and surveillance at each level of the health care system. Weak accessibility to TB diagnosric services still represents a big concern in many limited resources’ countries. Here we report the experience of Burkina Faso in implementing a comprehensive intervention packages to strengthen TB laboratory capacity and diagnostic accessibility.MethodsThe intervention lasted from October 2016 to December 2018 and focused on two main areas: i) development of strategic documents and policies; ii) implementation of TB diagnostic technology.National TB laboratory data were collected between 2016 and 2018 and evaluated according to five programmatic TB laboratory indicators: i) Percentage of notified new and relapse TB cases with bacteriological confirmation; ii) Percentage of notified new and relapse TB cases tested by Xpert MTB/RIF; iii) Percentage of notified, bacteriologically confirmed TB cases with a drug susceptibility testing (DST) result for rifampin; iv) Percentage of notified MDR-TB cases on the estimated number of MDR-TB cases; v) The ration between the number of smear microscopy and Xpert MTB/RIF tests. We compared these indicators between a 1 year (2016–2017) and 2 years (2016–2018) timeframe.ResultsFrom 2016 to 2018, the percentage of bacteriologically confirmed cases increased from 67 to 71%. The percentage of new and relapse TB cases notified tested by Xpert MTB/RIF increased from 18% in 2016 to 46% in 2018 and the percentage of bacteriologically confirmed cases with an available DST result for rifampicin increased from 27% in 2016 to 66% in 2018.. The percentage of notified MDR-TB cases on the estimated number of MDR-TB cases in 2018 increased from 43% in 2016 to 78% in 2018. In 2018, the ratio between the number of smear microscopy and Xpert MTB/RIF tests decreased from 53% in 2016 to 21% in 2018.ConclusionWe demonstrated that the implementation of a comprehensive package of laboratory strengthening interventions led to a significant improvement of all indicators. External technical assistance played a key role in speeding up the TB laboratory system improvement process.

Integrating Business Process Improvement and Information Systems to Improve Service Quality: A Conceptual Model

PT. X is a company that is engaged in testing telecommunications equipment. In its business activities there are some special problems in the current business processes and information systems that are not optimal. This research was conducted to examine the quality of services produced by business processes and information systems used today. The method used is to integrate Business Process Improvement with information systems to improve service quality. The results obtained from this study consist of a conceptual model for getting business processes and designing information systems that have accommodated business process and service improvements.

Modelling real contact areas caused by material straining effects in sheet metal forming simulation

Shortened product development processes in automotive industry combined with the upcoming lack of experts do challenge sheet metal part production fundamentally. Tryout time and manufacturing costs of large forming dies today are significantly influenced by their digitally supported engineering. The forming process by such tools is beside other influences is affected by elastic deformations of forming dies and press structure as well as contact areas between die and sheet metal part. In deep drawing such contact areas are influenced by the blank properties and the flange behavior in terms of thickening and thinning. Recent developments in sheet metal forming simulation do consider advanced friction models and structural modeling of die and press components improving simulation accuracy. Nevertheless thinning or thickening of sheet metal results into localized surface pressure distribution during deep drawing. For this reason, it is not sufficient to use the currently common practice of homogeneous surface pressure distribution in sheet metal forming simulation. In this respect, this paper presents a numerical approach for consideration of straining effects in the sheet metal part during forming operation. For this purpose, a systematic process improvement was developed in this paper to identify contact areas via a numeric simulation parameter. Validating the numerical investigation, a rectangle cup die is used, considering major strain. The main results of this contribution for that reason show how simulated contact areas can be estimated by reverse engineering of real forming parts. Hereby straining based contact areas lead to a novel contact area design in process planning, resulting in efficient die tryout.

Multivariate feed forward process control and optimization of an industrial, granulation based tablet manufacturing line using historical data.

The purpose of this work was to understand the variability in disintegration time and tableting yield of high drug load (>60%) tablets prepared by batch-wise high shear wet granulation. The novelty of the study is the use of multivariate methods (Batch Evolution Models - BEMs and Batch Level Models - BLMs) to enhance process control, with a feed forward component, using prediction models built from a historical dataset acquired for 95 industrial scale batches. Time dependent process variables and significant influences on investigated parameters were identified. Prediction of output from input was tested with Partial Least Squares (PLS) and Artificial Neural Network (ANN) modeling. A reliable prediction ability was achieved for granulation water amount (±2 kg in a 16-31kg range), tableting speed (±5000 tablets/h in a 23,000-72,500 tabl./h range) and disintegration time of cores (±100s; in a 250-900 s range). Offsets from the optimal process evolution and certain raw material properties were correlated with differences observed in the output variables. Improvement options were identified for 80% of the batches with high disintegration time. Hence, the trained models can be applied for systematic process improvement, enabling feed forward control.

Composite Technology Challenge System for Optimization in 5G Communications

The significance of approaches for improvement of systems/products has been increased. In the article, a modular technology challenge system is proposed as a basis for the system improvement process. The combinatorial framework for designing a modular technology challenge system is described: (1) collection of information items (literature sources on technology challenges/key technologies); (2) designing a hierarchy over the set of information items; (3) selection of the sub-hierarchy while taking into account the specified topic(s); (4) composition of a required information item configuration as technology challenge system. The composition stage is based on morphological design. An applied realistic numerical example illustrates the usage of the proposed framework to design a 5G technology challenge system as a set of the selected related optimization actions.

Organizational diagnostics: a systematic approach to identifying technology and workflow issues in clinical settings.

ObjectivesHealthcare organizations need to rapidly adapt to new technology, policy changes, evolving payment strategies, and other environmental changes. We report on the development and application of a structured methodology to support technology and process improvement in healthcare organizations, Systematic Iterative Organizational Diagnostics (SIOD). SIOD was designed to evaluate clinical work practices, diagnose technology and workflow issues, and recommend potential solutions.Materials and MethodsSIOD consists of five stages: (1) Background Scan, (2) Engagement Building, (3) Data Acquisition, (4) Data Analysis, and (5) Reporting and Debriefing. Our team applied the SIOD approach in two ambulatory clinics and an integrated ambulatory care center and used SIOD components during an evaluation of a large-scale health information technology transition.ResultsDuring the initial SIOD application in two ambulatory clinics, five major analysis themes were identified, grounded in the data: putting patients first, reducing the chaos, matching space to function, technology making work harder, and staffing is more than numbers. Additional themes were identified based on SIOD application to a multidisciplinary clinical center. The team also developed contextually grounded recommendations to address issues identified through applying SIOD.DiscussionThe SIOD methodology fills a problem identification gap in existing process improvement systems through an emphasis on issue discovery, holistic clinic functionality, and inclusion of diverse perspectives. SIOD can diagnose issues where approaches as Lean, Six Sigma, and other organizational interventions can be applied.ConclusionThe complex structure of work and technology in healthcare requires specialized diagnostic strategies to identify and resolve issues, and SIOD fills this need.