...EXECUTIVE SUMMARY Trends come and go, and this is especially true in the healthcare industry where everything is currently constantly changing. It is always important to analyze pros and cons of business trends when deciding whether to implement them in an organization. While there are countless trends to consider, six in particular will be the topic of this discussion: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. In the ever-changing health care world, different business and finance trends come and go. In the midst of all the uncertainty, there is only one thing for certain and that is the goal of improving the bottom line. There are countless trends on the horizon for healthcare but there are six in particular that will be discussed: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. Careful consideration of the pros and cons of each trend can help determine whether implementing one or more of them is right for an organization. Mergers and acquisitions are expected to grow within the healthcare industry in the coming months and even years due to the Affordable Care Act. According to KPMG, 60 percent of the healthcare executives it recently polled said they plan to make more deals in 2013 than in 2012. Many of the deals are expected to be mid-market sized or smaller...
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...LEAN HOSPITALS “Mark Graban’s book has documented what is now happening in hospitals all across America as we learn to apply the Toyota Production System methodology to healthcare. This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins—these are the same type of wins that are happening at ThedaCare every day. I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.” — John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value “Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.” — Quint Studer, CEO, The Studer Group, author of Results that Last “Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standardized systems borrowed from reliable industries were implemented. Graban provides those trade secrets in an understandable and transparent fashion.” — Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman, Department of Medicine, University of Pennsylvania School of Medicine “There is an...
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...Case Study Report Historical background of 99 Cents Only Store - One of the leading retailers in the discount sales industry - Opened in 1982 - 232 retail locations in 31-3-2006 - Mostly 164 in California, 36 in Texas, 21 in Arizona, 11 in Nevada - Selling food and beverages, health and beauty aids, cleaning supplies, house wares, hardware, stationary, toys, gifts, pet products and clothing Sources of suppliers - Purchases from over a thousand suppliers - E.g. General Electronic, Colgate-Palmolive, General Mills, Johnsons & Johnson, Protector & Gamble, Kraft, Nabisco, Unilever, etc. Features and practices of the Store - Majority of the products can be restocked regularly. - Close out merchandise, not available for reorder - Special opportunity: cost below wholesale Strategies for keeping down costs of the Store - By using information technology to be enable to grow - Obviously require far more computing power - IT budget : still low level ( not surpass USD 5 million) - Using database management software licenses - Family oriented and run company (Weakness) - Actual cost vs. business value to the company - Change Programming background: programming system as better option - Close out items: 40 % of the product ( flow through the inventory only once) Greatest challenges - Launching the company's new distribution centre in Texas - Tight time constraint - revising the warehouse management system - aggressive growth plans of the company by developing...
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... 3-4 II- Introduction 4 III- Company Profile 4-5 IV- Problem and Processes Description 5-8 1- Problem definition 5-6 2- Patients flow model at hdf 6-8 V- patient Flow and Capacity Theories 9-12 3- Process mapping 10 4- theory of constraints 10-11 5- lean tools 11-12 VI- HDF processes evaluation from the capacity theories perspective 12-16 VII- Proposed changes and their effects on customer service 16-18 VIII- Final Recommendations and conclusion 19-21 IX- REFERENCE I- Executive Summary: Reducing operational inefficiencies is paramount to healthcare providers across the globes, who are exasperated with their self-defeating efforts to offer the best customer service to patients that balance between quality, cost efficiency, dependability and...
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...Ford, W. Edwards Deming, Frederick W. Taylor, Eli Whitney etc. Frank and Lillian Gilbert – Invented the Therbling method or method of measuring number of motions. Henry Ford – Was Irish and invented first moving assembly line where he started to build Mode-T. W. Edwards Deming – Credit for teaching Japan quality control methods in post-world war 2. Friday 27th September 2013 In Friday we continued with the topic Operations and Service Management. Operations Management in Germany is called Production management. Production is a process where there are inputs, transformation process and outputs. Transformation process for operations and service management is the main area what their concerned with. In transformations process managers drive productivity. The main task for managers is to get work done thru other people in an effective and efficient way. Operation management tend to have less workers than Service management because peoples work in Manufacturing is doing automated systems or assembly lines. Work/Consumer Experience That makes me think of when I was working in the furniture factory. In furniture factory...
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...Safe Staffing Examine Nurse-to-Patient Ratios Primary health care organizations such as New York Presbyterian (NYP) are impacted by low nurse-to-patient ratios. The recent implementation of the Patient Protection and Affordable Care Act (ACA) has required organizations such as NYP to explore many approaches to improve quality and patient outcomes that contain costs. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes” (www.nursingworld.org, 2015, para. 1). For this reason, nurse-to-patient ratios is an issue that needs to be addressed at NYP in order to improve quality healthcare within their organization. The acuity of the unit in which patient care is being provided, should determine the acceptable nurse-to-patient ratio. According to the American Nurses Association (ANA), factors that influence the nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; availability of or proximity to technological support or other resources ("Optimal Nurse Staffing," 2015). Currently, New York is one of only fourteen states that addresses the nurse staffing issue in hospitals. New York State requires organizations such as NYP to disclose their nurse-to-patient staffing ratios to the public; however the state does not require a minimum...
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...United States Environmental Protection Agency Solid Waste and Emergency Response (5302W) Policy, Economics & Innovation (1807T) EPA100-R-03-005 October 2003 www.epa.gov/ innovation/lean.htm Lean Manufacturing and the Environment: Research on Advanced Manufacturing Systems and the Environment and Recommendations for Leveraging Better Environmental Performance ACKNOWLEDGMENTS This report was prepared for the U.S. Environmental Protection Agency's Office of Solid Waste and Emergency Response (OSWER) and Office of Policy, Economics, and Innovation (OPEI). Ross & Associates Environmental Consulting, Ltd. prepared this report for U.S. EPA under contract to Industrial Economics, Inc. (U.S. EPA Contract # 68-D9-9018). DISCLAIMER The observations articulated in this report and its appendices represent Ross & Associates’ interpretation of the research, case study information, and interviews with lean experts and do not necessarily represent the opinions of the organizations or lean experts interviewed or researched as part of this effort. U.S. Environmental Protection Agency (EPA) representatives have reviewed and approved this report, but this does not necessarily constitute EPA endorsement of the observations or recommendations presented in this report. Lean Manufacturing and the Environment: Research on Advanced Manufacturing Systems and the Environment and Recommendations for Leveraging Better Environmental Performance Table of Contents Executive Summary...
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...Balanced Scorecard Introduction How can a balanced scorecard be utilized for optimum organizational performance in my organization – Cleveland Clinic? Within today’s complex environments many organization have pinpointed that an accurate understanding of their particular goals and the methods that they implement in order to achieve these goals is vital, this is also true with healthcare organizations. Organizations have come to the conclusion that no simple one measure can provide a clear performance target or focus attention on the critical areas of the business. Managers, today, want a balanced presentation of both financial and operational measures. Therefore, while they still require the financial measures, associated with the traditional approach, in order to assess the overall health of the organization, they also require measures that will allow them to concentrate more directly on their strategic performance and long term vision. The concept of the balanced scorecard was developed in order to provide managers with such a tool. The balanced scorecard can be described as a comprehensive framework that translates an organization mission and strategy into a comprehensive set of performance measures that provides the structure for creating a strategic measurement and management system. As a result the objectives and measures of the balanced scorecard are more than a collection of financial and non financial performance measures; they are derived from a...
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...Cardiac catheterization labs are one of the most significant capital investments for hospitals. However, in recent years, due to various changes in health care with regard to changes in Medicare reimbursement, it has become increasingly difficult for hospitals to maximize their cardiac cath lab’s potential economic return. In order to tackle the patient flow quandaries of delayed start times, physician unavailability, improper staffing, and excessive non-productive time in the cardiac catheterization lab, the implementation of the use of a combined Six Sigma and Lean System quality improvement methodology is suggested. Six Sigma’s focus on customers (in this case, patients) and quality improvement will be beneficial in identifying areas of concern and will provide a structure for the identification of and changes to poor patient flow in a cardiac catheterization lab. The call center on the other hand is an important operational center for management of an organization which calls for increased efficiency. The most important process in the call center, which needs most improvement, is an agent handling inbound or outbound call. Six-sigma methodologies can produce major breakthroughs in call handling providing improved results for employees, customers, and shareholders. The five step DMAIC project for both cases: Define. Defining the issues and their importance is not difficult. Since starting the first case of the day plays such an important role in the flow for the rest of...
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...plus residents—some 785,000 people—each year. A not-for-profit organization, Sharp has an annual net revenue of greater than $1.9 billion; employs a workforce of greater than 14,000 staff members and 2,600 affiliated physicians; operates four acute care hospitals, three specialty hospitals, three affiliated medical groups, and 19 outpatient medical clinics; and manages its own health insurance plan. This vertical integration enables Sharp to offer a full spectrum of health care services, from emergency, hospice, and mental health services to multiorgan transplants and hyperbaric treatment. Continuous Improvement Yields Quality Care, Financial Health In September 2001, the organization launched The Sharp Experience, a performance improvement initiative aimed at transforming the health care experience for caregivers, patients, and their families by reconnecting to purpose, worthwhile work, and making a difference. Today, all operations and activities are aligned under Sharp’s Six Pillars of Excellence—Quality, Service, People, Finance, Growth, and Community. Simply put, The Sharp Experience is the organization’s core competency and means for Sharp to achieve its vision to become “the best place for employees to work, the best place for physicians to practice medicine, and the best place for patients to receive care.” As a result of these efforts and the people of Sharp, the organization is thriving. For example, consider these key financial measures: ...
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...But today, Quality tools understanding and importance has grown among people and organizations. There are many tools that are used among the organizations that are classified as follows: 1. Cause Analysis Tools: includes Fishbone, Pareto, and Scattered Diagram. 2. Evaluation and Decision Making Tool: Decision Matrix, Multivoting. 3. Process Analysis Tool: includes Flow chart, Failure Mode Effects Analysis, Mistake-proofing and Spaghetti Diagram. 4. Data Collection and Analysis Tools: box and whisker plot, check sheet, control chart, Design of experiments, Histogram, Scatter Diagram, Stratification, and Survey. 5. Idea Creation Tools: Affinity Diagram, Benchmarking, Brainstorming, Nominal Group Technique. 6. Project Planning and Implementation Tool: Gantt Chart, Plan-Do-Check-Act (PDCA) Cycle or Plan-Do-Study-Act (PDSA) Cycle. 7. Seven New Management and Planning Tools: Affinity Diagram, Relations Diagram, Tree Diagram, Matrix Diagram, Matrix Data Analysis, Arrow Diagram, Process Decision Program Chart. Quality tools & techniques use statistical knowledge to accumulate data and analyze them. It serves diverse range of medical, computing, industrial, telecommunications and defense. These tools drive improvement throughout the organization. Employee has to at all levels has to master the fundamental Quality skills and advanced Quality tools. This is critical to improve the organization process. These tools helps to improve company’s business management, organization’s...
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...Idea behind the theory Muda is the Japanese term for waste and is a key concept in the Toyota Production System. The definition of waste is basically anything that does not add value. “Value and waste are opposites. "Value" is what the customer is actually willing to pay for the product or service. Economists define value as the ratio of the usefulness of a product or service to its costs. This includes the product's functions and features and it relates to the whole product, service or both. Costs include the price paid and also the cost in time and hassle in obtaining and using the product or service” (Sowards, 2005). “It is common to find that in a factory less that 5 per cent of activities actually add value, 35 per cent are necessary non-value-adding activities and 60 per cent add no value at all” (Jones, Hines, & Rich, 2006, pg. 154). To truly be able to eliminate waste from a process you need to know what wastes you are looking for. There are seven wastes that were identified by Toyota’s Chief Engineer, Taiichi Ohno as part of the Toyota Production System. 1. Overproduction. Producing items for which there are no orders, which generates such wastes as overstaffing and storage and transportation costs because of excess inventory. Ohno considered this to be the fundamental waste, since it causes most of the other wastes. 2. Waiting (time on hand). Workers merely serving to watch an automated machine or having to stand around waiting for the next processing step, tool, supply...
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...How can firms use models of analysis to understand their business environment? Discuss using appropriate examples. Organizations can use one business analysis model to analyse a section of its business or combine this with other business models to help them in the strategic planning process to gain a competitive advantage in today’s fast changing markets. SWOT and TOWS are acronyms for strengths, weaknesses, opportunities and threats. SWOT (internal-external) provides a checklist of strengths, weaknesses to minimize, uncover opportunities to take advantage of and identify threats to avoid. Whereas the TOWs matrix is (external-internal) matching internal strengths and weaknesses with external opportunities and threats provides a more in depth look at your company’s standing in its current market and gives an understanding of your competitors. External Opportunities (O) External Threats (T) Internal Strengths (S) (SO) Maxi-Maxi Strategy Use strengths to create opportunities (ST) Maxi-Mini Strategy Use strengths to minimise threats Internal Weaknesses (W) (WO) Mini-Maxi Strategy Minimize weaknesses to take advantage of opportunities (WT) Mini-Mini Strategy DEFENSIVE Minimize weaknesses and avoid threats It is important to use verifiable statements such as “Opportunities to save $10M in changing supplier” rather than “Opportunities to save will be good if we change supplier”. If the business is small it is important to know the risks and limitations in using...
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...STRATEGIC HRM AT THE MAYO CLINIC: A CASE STUDY Sunil Ramlall Hamline University Tripp Welch, Jennifer Walter, and Daniel Tomlinson The Mayo Clinic ABSTRACT For many decades, Mayo Clinic has been ranked as one of the top medical institutions in the world. The entire health care industry has been experiencing immense challenges. Given the current and historic success of Mayo, what does Mayo need to do from an HR perspective to maintain this standard of excellence? This case identifies the strategies used by Mayo to achieve excellence in employee and patient satisfaction. The case describes how this complex service organization fosters a culture that exceeds customer expectations and earns deep loyalty from both customers and employees. The role of HR is analyzed to explain how strategic HRM enables the organization to achieve its strategic business objectives. INTRODUCTION Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors of every medical specialty work together to care for patients, joined by common systems and a philosophy that "the needs of the patient come first." More than 3,300 physicians, scientists and researchers and 46,000 allied health staff work at Mayo Clinic, which has sites in Rochester, Minnesota, Jacksonville, Florida, and Scottsdale/Phoenix, Arizona. For many decades, Mayo Clinic has been ranked as one of the top medical institutions in the world. Over the past few years, the entire health care industry...
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...of existence” (p. 145). In fact, values are the foundation of a person’s understanding of the attitudes’ and motivation’s of others insomuch that his or her perceptions are influenced by the values he or she has (Robbins and Judge, 2011). Each person within an organization brings his or her own values to the organization, which contains individual interpretations of what is right and wrong implying a preference for certain behaviors and outcomes thereby influencing the attitudes and behaviors of an organization (Robbins and Judge, 2011). As noted by Yukl (2010), “[i]nfluence is the essence of leadership, and powerful leaders can have a substantial impact on the lives of followers and the fate of an organization” (p. 408). The personal values and ethics of the leaders of an organization often drive the values and ethical behavior of that organization (Yukl, 2010). Thus, it is paramount the values of organizational leaders are consistent and in line with the values of their organization (Yukl, 2010). Alignment of Personal and Organizational Values Our team researched and evaluated the organizational values and ethics of Sutter Health. Sutter Health is a not-for-profit network of physician organizations, hospitals and other health care providers (Sutter Health, 2008). Sutter Health focuses on enhancing the well-being of individual in the communities they serve through a not-for-profit commitment to compassion and excellence in health care services (Sutter Health, 2008). ...
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