Workflow Reengineering Research Articles

Developing appropriate pricing models for workflow and workflow reengineering in case of federated ERP system

Developing appropriate pricing models for workflow and workflow reengineering in case of federated ERP system

Closing the Gap: Redesigning Data Capture to Support Both Clinical Operations and Outcomes Reporting

Background As HSCT outcomes data reporting demand and case management documentation grows with patient volume and associated long term survival, transplant centers are seeking opportunities to improve the quality and more readily access the large variety of data available. A transplant and cell therapies workflow reengineering approach was developed at Dana-Farber Cancer Institute (DFCI) to leverage the functionality of a new combined case management and outcomes reporting system. While the workflow redesign impacts many disciplines in the program, special attention is drawn to a key workflow change that moves the outcomes data reporting team members from delayed retroactive reporting to contemporaneous data capture that supports both optimal CIBMTR outcomes repository reporting and case management during and throughout phases of care. The goal of this project was to leverage timely data capture to better inform optimal patient management as well as improve the quality of outcomes data collected. Methods A detailed current state work flow mapping process of the HSCT and cell therapies program was completed in 2017 to serve as a baseline during a series of workshops that engaged key stakeholders from all disciplines involved in patient care, coordination, and outcomes reporting to identify inefficiencies, workarounds, and pain-points. The workflows were organized into segments so that each can be modified using the SIPOR method (Suppliers, Input, Process, Output, Recipients). This framework enabled the creation of future state maps for implementation to enable staff to tap into functionality of the new consolidated data repository, outcomes reporting and case management application. Outcomes The future state design project using the SIPOR method enabled the production of highly detailed workflows that align effectively with software configuration. A special workshop series focused on the specific problem of moving CIBMTR and other outcomes data reporting into the case management stages of the overall workflow. This includes pre-treatment evaluation, donor or collection evaluation and donor selection, active treatment period and acute post-treatment information, and long term follow-up outcomes. The SIPOR method allowed the workshops to quickly achieve key program goals to ensure ready access to currently available patient progress information that optimizes patient coordination, eliminate multiple and late data reporting, provide access to readily available data for analytics alongside all other clinical data, and improve accuracy and quality of reported data. A key human factor improvement includes the melding of data reporting staff into the clinical and coordination teams that allowed for quick access to providers and others for learning and timely resolution of data problems.

Implementation of Enterprise Imaging Strategy at a Chinese Tertiary Hospital.

Medical images have become increasingly important in clinical practice and medical research, and the need to manage images at the hospital level has become urgent in China. To unify patient identification in examinations from different medical specialties, increase convenient access to medical images under authentication, and make medical images suitable for further artificial intelligence investigations, we implemented an enterprise imaging strategy by adopting an image integration platform as the main tool at Xuanwu Hospital. Workflow re-engineering and business system transformation was also performed to ensure the quality and content of the imaging data. More than 54 million medical images and approximately 1 million medical reports were integrated, and uniform patient identification, images, and report integration were made available to the medical staff and were accessible via a mobile application, which were achieved by implementing the enterprise imaging strategy. However, to integrate all medical images of different specialties at a hospital and ensure that the images and reports are qualified for data mining, some further policy and management measures are still needed.

Workflow re-engineering of design-build projects using a BIM tool

The use of design-build delivery methods and building information modeling (BIM) tools in the construction industry has been growing rapidly in recent years due to the increasing demand for more efficient construction project management. The successful implementation of these tools by engineering firms on projects, however, is still not being achieved consistently. This paper shares the experiences of the implementation of an in-house BIM tool by a large engineering, procurement, and construction firm that has an extensive reputation for design-build projects. A new workflow was proposed that takes full advantage of the BIM tool to both enhance the construction management performance and to minimize the impact on the firm’s existing workflow. The development of a new workflow was conducted by interviewing key personnel in various departments of the firm and by carefully examining probable impacts of the BIM tool’s introduction into the firm’s business processes.

Evidence-Based Practice Implementation in Community Mental Health Settings: The Relative Importance of Key Domains of Implementation Activity

Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.

A three-stage framework for introducing a 4D tool in large consulting firms

The increase in the use of 4D management tools in recent years within the construction industry has been phenomenal, partly due to the increasing support available in commercial software packages, and partly in response to a greater demand for efficient construction management. However, successfully implementing a 4D management tool in an engineering firm for use in actual projects remains a challenging task. This paper presents the authors’ experiences of implementing an in-house 4D management tool at a large engineering, procurement and construction (EPC) firm with a long history of design–build projects. A three-stage consulting framework of system evaluation, usability study, and management plan (SUM) was proposed and implemented for a firm of this size, which included three parts: (1) System evaluation: requirement analysis and performance evaluation of both hardware and software components of the 4D tool; (2) Usability study: usability tests and improvement of the 4D tool; and (3) Management plan: workflow re-engineering for the firm to be able to successfully implement and apply the 4D management tool to actual projects. We found that the SUM framework was able to effectively identify major problems when introducing a 4D tool to a large design–build project and helped to minimize its own impact on the firm’s business processes.

Workflow structuring and reengineering method for design process

A short lead time for product commercialization is a critical advantage in the era of highly challenging competitions. It is more difficult, however, to shorten the design process rather than manufacturing process since the underlying design activities in process and related data are often interlinked and quite uncertain, and the attempts to perform the design activities concurrently increase the complexity of the design process. In case the targeting process is well-structured and easy to be managed, many approaches have been proposed and it is the best way to use the well-known reengineering method such as crashing the bottle-neck activity. However, they have only concerned mainly about well-defined procedures, not an operational-level sophisticated workflow. As a means to effectively manage and accelerate the design process, a process or workflow model needs to define complex relations such as iteration or coupled dependency in design process in order to coordinate the sophisticated process effectively. And, the acceleration approaches based on the operational-level information needs to be discussed. Firstly, in order to develop an appropriate model that effectively captures the operational-level characteristics in design process, we define the workflow including the control and data flow with an incidence matrix called Workflow Matrix (WfM). Secondly, a workflow structuring method is developed for identifying the reengineering issue and it also transform the complex design process into a well-structured workflow. Finally, we analyze the design process with WfM and suggest reengineering strategies to improve the design process.

Design requirements for radiology workstations.

This article stresses the importance of capturing feedback from representative users in the early stages of product development. We present our solution to producing quality requirement specifications for radiology workstations, specifications that remain valid over time because we successfully anticipated the industry trends and the user's needs. We present the results from a user study performed in December 1999 in a radiology clinic equipped with state-of-the-art Picture Archiving and Communications Systems (PACS) and imaging scanners. The study involved eight radiologists who answered questions and provided comments on three complementary research topics. First, we asked our subjects to enumerate the advantages and the disadvantages for both softcopy and hardcopy reading. We identified the two major factors for productivity improvement through the use of PACS workstations: workflow re-engineering and process automation. Second, we collected radiologist feedback on the use of hanging protocols (HPs). The results indicated the high importance of automatic image organization through HPs, with the potential effect of reducing the interpretation time by 10-20%. Our subjects estimated that 10-15 HPs would cover about 85%-95% of the regular radiological examinations. Third, we investigated the impact of the display devices on the radiologist's workflow. Our results indicated that the number and the properties of the monitors is a modality-specific requirement. The main results from this study on key functional requirements for softcopy interpretation only recently were incorporated in most of the current, successful PACS workstations.

The process specification language (PSL) theory and applications

The PROCESS SPECIFICATION LANGUAGE (PSL) has been designed to facilitate correct and complete exchange of process information among manufacturing systems, such as scheduling, process modeling, process planning, production planning, simulation, project management, work flow, and business-process reengineering. We give an overview of the theories within the PSL ontology, discuss some of the design principles for the ontology, and finish with examples of process specifications that are based on the ontology.

Using technology assessment as the picture archiving and communication system spreads outside radiology to the enterprise.

Picture archiving and communication systems (PACS) are being implemented within radiology departments, and many facilities are entering the next stage of PACS use by deploying PACS to departments outside of radiology and to other facilities located at a distance. Many PACS vendors and department administrators have based cost-justification analyses on the anticipated savings from expanding PACS to these areas. However, many of these cost-savings analyses can be highly suspect in their assumptions and findings. Technology assessment (TA) at the hospital/health system level is an organized, systematic approach to examining the efficacy of a technology in relation to the health system's mission and clinical needs. It can be an organized and unifying approach to aid in the distribution of limited capital resources. As extra-radiology PACS deployment is a costly endeavor, TA may be used to plan for PACS implementation throughout the enterprise. In many organizations, PACS is thought of as a radiology domain as its first uses were centered on this image-producing service. Now, as PACS technology spreads to other service areas, such as cardiology, dermatology, pathology, orthopedics, obstetrics, etc, the need to incorporate other viewpoints in a system-based PACS is necessary to avoid having independent PACS that may duplicate archives and may not communicate with each other. How to meet the diverse PACS needs of clinical services can be a challenging task; a TA program has been demonstrated to effectively handle the clinical needs, demands, and timeframes of PACS planning and support throughout hospitals and health systems. A hospital-based TA program can assist health care organizations to present PACS as a system-wide need and program rather than a radiology-based program gobbling up the capital budget. Submitting PACS to the TA review process can identify essential elements in planning and help avoid many of the pitfalls of PACS implementation and operations. Thorough cost and/or return on investment analyses, phasing decisions, workflow re-engineering, and outcomes assessment programs are a few of the issues that a TA program can address to help in the transition to a complete electronic image environment. The TA process includes clinician selection, evaluation criteria and their selection for technologies under review, a policy for review/authorization/denial, and measurement of expected outcomes.

Human and organizational error as a basis for process reengineering: with applications to systems integration planning and marketing

This paper presents the results of research on how assessment of the incidence and causes of human and organizational error in implementing processes can be utilized as a partial basis for the reengineering of organizational structures and processes. A systems integration environment was used as a site for empirical observation. A model was developed for the life cycle process of preparing a systems integration proposal involving integration of commercial-off-the-shelf (COTS) software and hardware, services, and value-added products. This model was used as a basis for analysis of errors committed during the life cycle process. From this analysis follows development of strategies for workflow and process reengineering. The identified approach can form part of a coordinated effort to reengineer vital processes within an organization with minimization of specific errors as a primary goal in efforts that involve the planning and engineering of systems.

Quantifying Process Benefits of Electronic Data Management Technologies

Establishing and maintaining a strategic advantage in a globally competitive business environment requires focus on electronic data management (EDM) technologies that facilitate work-flow automation and process reengineering. Effective implementation of EDM technologies requires a strategic, innovative, and cooperative approach to electronic document management. To date, a methodology for quantitative analysis of time and cost benefits attributable to EDM technologies has been difficult to structure due to the complexity of predicting the organizational changes resulting from their implementation. Additionally, implementation of EDM technologies will impact individual work task durations, work-flow precedence, and resource (labor) requirements. This is particularly true when multiple technologies are considered for concurrent implementation. This research developed a methodology for quantifying the time and cost benefits attributable to implementation of EDM technologies when applied to the major functional process of materials management. Data provided by leading engineering/construction companies were incorporated into four process models, each representing a distinct level of corporate information integration. The research shows that time and cost process benefits attributable to EDM technologies are significant.