Search results

To consider how information and information systems can be used to support improving patient flow in acute hospitals (a key target for the National Health Service in England), and the potential role of the National Programme for Information Technology currently being developed.

The literature plus past and present research, teaching and consulting experience with all levels of the National Health Service is drawn on to consider information provision and requirements.

The National Programme for Information Technology specifies many features designed to support improving patient flows, though timescales for implementation are longer than those for the pledged flow improvements, and operational use of this type of information system has been problematic in the National Health Service.

The work is limited to the National Health Service and information systems in use and planned for it. The National Health Service access targets, flow improvement initiatives and the National Programme for Information Technology apply primarily to England.

Some bed/flow management information systems currently in use incorporate tools and capabilities in advance of what is outlined in the National Programme for Information Technology, and some rare cases of culture changes in information system use have been achieved. One should learn from these to inform development and implementation of National Programme systems. These existing information systems and approaches may also be useful to hospitals considering systems prior to implementation of the National Programme for Information Technology.

There has been very little consideration of the use of operational information and information systems for bed/flow management in the literature. Development and implementation of National Programme for Information Technology systems should build from an understanding of the practice and context of bed/flow management.

Over the last several decades, lean thinking has been credited with several advancements in the practices of private sector organizations. Only recently have researchers begun to report on lean thinking as it applies to the public sector. For public procurement research, the concept remains largely unexamined. This research used the extant literature to identify preconditions that are required to successfully deploy lean thinking principles, tools, and techniques. Salient preconditions were organized into key categories. These categories provided the basis for a framework designed to assess public procurementʼs ability to adopt lean thinking, and aid in its implementation within this public sector environment. Questions suggested to guide future research, along with an approach intended to facilitate this work, are also presented.

Global competition and rapidly changing customer requirements are demanding increasing changes in manufacturing environments. Enterprises are required to constantly redesign their products and continuously reconfigure their manufacturing systems. Traditional approaches to manufacturing systems do not fully satisfy this new situation. Many authors have proposed that artificial intelligence (AI) will bring the flexibility and efficiency needed by manufacturing systems. This paper is a review of AI techniques used in manufacturing systems. The paper first defines the components of a simplified intelligent manufacturing systems (IMS), the different AI techniques to be considered and then shows how these AI techniques are used for the components of IMS.

This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.

The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.

The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.

Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.

Considerable amount of purchases in business-to-business (B2B) markets make through the tendering process. As technology keeps driving B2B procurement, both the supplier/contractor and buyer firms have settled down in their respective roles in the electronic-tendering environment. Researchers have ignored the supplier-side e-tender-driven marketing process that might lead to substantively successful financial performance. The purpose of this study is to improve the performance of an e-tender-driven marketing process of an original equipment manufacturer (OEM) incorporating the stakeholder's inputs.

Discrete event simulation modelling (DESM) has been used as a methodology to model, analyse and improve the process with the involvement of stakeholders at every stage of the study. Different scenarios are analysed to identify the near-optimal scenario based on agreed-upon key performance indicators.

Scenario that incorporated man-power sharing and eliminating avoidable activities gives the near-optimal solution for implementation.

This study highlights that better insights can be gained by adopting the process-oriented view of the marketing–operations interface. Embracing a stakeholder-based consultative approach gives research a more practical outlook and reduces the gap between theory and practice. Suggestions for further research are provided.

B2B organizations, where lines between marketing and operations are blurred, can improve their marketing processes by implementing operations research tools.

This study provides an attempt to improve the performance of a supplier-side e-tender-driven marketing process of an OEM using the DESM methodology incorporating stakeholder's inputs.

The purpose of this paper is to investigate the potentials of role-playing (RP) both in training healthcare (HC) professionals to implement tools and improvement actions based on Lean principles, and in supporting group discussion and the sharing of different competencies for the development of Lean HC.

The paper presents the case study of an RP simulation called LEAN HEALTHCARE LAB, which is used to train HC professionals at Siena University Hospital. The paper reports and discusses the results of a specific two-day simulation session and of a questionnaire that was distributed to gather feedback from the participants.

The paper verifies the potentials of RP to be a powerful educational and training tool that is able to stimulate the HC participants to apply Lean thinking principles and share their competencies in collaborative decision-making processes.

The study provides data in reference to one single simulation session, although the game has already been applied several times in different HC organizations with very similar outcomes. Moreover, a more in-depth analysis of players’ perceptions and decisions could be performed using different tools in addition to the adopted questionnaire.

RP games (RPGs) are effective training and educational tools for HC professionals. They offer benefits and learning conditions which are definitely different if compared with more conventional education programs for HC professionals.

While previous studies have extensively discussed the potentialities of RPG and simulations in training programs, only a few articles have discussed the RP adoption for Lean thinking and even less to educate HC professionals on Lean principles and tools.

The study aims to compare management practices in private and publicly owned elderly care homes. The demands for cost-effective care combined with emphasis on client experience highlights the importance of appropriate management practices.

The study utilises a survey of 500 homes covering management practices on monitoring, performance management and staff development. These are highly correlated, allowing for treating the practices both in aggregate and individually in the analysis. Additional questions capture information on site and management conditions.

Management practices employed at the elderly care homes vary greatly, with high and low individual scores found in most homes. But private homes consistently score higher than public homes, especially when it comes to incentive practices. Also, elderly care homes of both ownership forms score at the top and bottom of each management practice. But looking at the average management score, there are fewer private homes that score really low and more private homes that score really high.

The results identify given characteristics and maturity of the various management practices employed to plan and control operations in the elderly care homes and provides managerial and staff insights into their use.

The application and impact of standard management practices has previously been limited in publicly funded services. Little is known about management practices in elderly care and whether the practices are associated with better performance.

This paper aims to show that identification of expectations and software functional requirements via consultation with potential users is an integral component of the development of an emergency department patient admissions prediction tool.

Thematic analysis of semi‐structured interviews with 14 key health staff delivered rich data regarding existing practice and future needs. Participants included emergency department staff, bed managers, nurse unit managers, directors of nursing, and personnel from health administration.

Participants contributed contextual insights on the current system of admissions, revealing a culture of crisis, imbued with misplayed communication. Their expectations and requirements of a potential predictive tool provided strategic data that moderated the development of the Emergency Department Patient Admissions Prediction Tool, based on their insistence that it feature availability, reliability and relevance. In order to deliver these stipulations, participants stressed that it should be incorporated, validated, defined and timely.

Participants were envisaging a concept and use of a tool that was somewhat hypothetical. However, further research will evaluate the tool in practice.

Participants' unsolicited recommendations regarding implementation will not only inform a subsequent phase of the tool evaluation, but are eminently applicable to any process of implementation in a healthcare setting.

The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations.

The aim of this paper is to examine the introduction of innovation as part of a management development programme at a primary care organisation, a legal form known as a Primary Care Trust (PCT), in the UK.

The paper draws on experience of managing a successful management development programme for a PCT. The report of the case study analyses the key events that took place between 2008 and 2010, from direct observation, surveys, discussion and documentary evidence.

The Northern PCT has partnerships with a number of educational providers to deliver their leadership and management development programmes. A close working relationship had developed and the programme is bespoke – hence it is current and of practical use to the UK's National Health Service (NHS). In addition, there are regular meetings, with module leaders gaining a firsthand understanding of the organisation's needs and aspirations. This has resulted in a very focused and personalised offering and a genuine involvement in the programme and individuals concerned.

The research was conducted among a relatively small sample, and there is a lack of previous literature evidence to make significant comparisons.

The paper identifies key implications for practitioners and educators in this area.

This paper is one of few to investigate innovation and improvement in the NHS, and is unique in that it uses the lenses of a management development programme to explore this important, and under‐researched, topic.

The purpose of this study is to assess the state at which lean and six sigma (LSS) are used as a management system to improve the national health system national health system of Mexico.

Cross-sectional survey-research. The survey was administered at 30 different hospitals across six states in Mexico. These were selected using convenience sampling and participants (N = 258) were selected through random/snowball sampling procedures, including from top managers down to front-line staff.

Only 16 per cent of respondents reported participation in LSS projects. Still, these implementations are limited to using isolated tools, mainly 5s, failure mode and effects analysis (FMEA) and Fishbone diagram, with the lack of training/knowledge and financial resources as the top disabling factors. Overall, LSS has not become systematic in daily management and operations.

The sampling procedure was by convenience; however, every attempt was made to ensure a lack of bias in the individual responses. If still there was a bias, it is conjectured that this would likely be in overestimating the penetration of LSS.

The penetration of LSS management practices into the Mexican health system is in its infancy, and the sustainability of current projects is jeopardized given the lack of systematic integration. Hence, LSS should be better spread and communicated across healthcare organizations in Mexico.

This is the first research work that evaluates the use of LSS management practices in a Latin American country, and the first journal paper that focuses on LSS in healthcare in Mexico.