EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event

EPA Pesticide Factsheets

The submittal, review and approval process of the EPA–State process for developing and revising Water Quality Standards (WQS) was the focus of a Lean business process improvement kaizen event in June 2007.

Driving student-centred calculus: results of a comprehensive case study for Kaizen learning in the Sultanate of Oman

NASA Astrophysics Data System (ADS)

Heim, Bernhard; Rupp, Florian; Viet, Nils; Stockhausen, Paul v.; Gallenkämper, Jonas; Kreuzer, Judith

2015-04-01

The art of teaching freshmen students is undergoing a rapid paradigm change. Classical forms of teaching are not applicable any more and an unmanageable offer of new multimedia tools and concepts is glutting the market. Moreover, compared to previous courses, the class size triples. In view of these challenges, we implemented a new teaching concept best described as Kaizen learning. By Kaizen learning, we define a teaching philosophy that is based on a concise mix of short learning units (with feedback loops and tests) and of carefully chosen repetitions (also with feedback loops and tests) to calibrate a course for the students. Here, this intensive blended, student-centred learning paradigm is analysed together with its direct impact on the students' performance. This case study leads to easy-to-implement key drivers for successfully teaching science in Oman, such as (1) human-human interaction, (2) clearly communicated expectations, (3) avoidance of a short-term learning attitude, (4) a no-calculator policy, (5) continuous Kaizen learning, and (6) balanced combination of traditional teaching and e-learning.

Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

PubMed

Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

2011-04-01

The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

Kaizen and the Art of University Administration. AIR 1992 Annual Forum Paper.

ERIC Educational Resources Information Center

Muffo, John A.; Krallman, John D.

This paper examines how the concepts of strategic planning, assessment, and Total Quality Management fit together and relate to one another in the field of higher education. Central to the explanation of how these topics are related is the Japanese philosophy of Kaizen, a driving force behind the quality improvement movement in that country. The…

EPA Region 7 and Four States Water Quality Standards Review Process Kaizen Event Case Study

EPA Pesticide Factsheets

In June, 2007, participants from EPA headquarters, EPA Region 7, and the four States in EPA Region 7 (IA, KS, MO, and NE) conducted a Lean business kaizen event on the EPA–State process for developing and revising water quality standards (WQS).

"Kaizen" and Technology Transfer Instructors as Work-based Learning Facilitators in Overseas Transplants: A Case Study.

ERIC Educational Resources Information Center

Elsey, Barry; Fujiwara, Asahi

2000-01-01

A study of 240 instructors of kaizen (continuous quality improvement) and technology transfer in overseas assignments for Toyota found that commitment to work and corporate cultural values were significant. Instructors recognized the responsibility and challenges of communicating and transferring their know-how across cultures. (SK)

Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

PubMed

Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P < .001). Time spent on safety reviews remained the same (20% of the allocated interval), but the peer review component increased. The Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are

Ergonomics and Kaizen as strategies for competitiveness: a theoretical and practical in an automotive industry.

PubMed

Vieira, Leandro; Balbinotti, Giles; Varasquin, Adriano; Gontijo, Leila

2012-01-01

With increased international competitiveness in the automotive industry, came the concern of the companies save costs and lower production costs. For this purpose many ways are designed to reduce costs and waste of raw materials and reduce activities that do not aggregate value to manufacturing processes. In the early XVII appears the manufacturing system, which processes were hard with little concern for the health and safety of employees and conditions of the workplace. After the advent of the production system called lean manufacturing, a new paradigm in terms of production system capable of providing high levels of productivity and quality. It is based on waste elimination that occur during the production process. After began a new way of thinking, creating a culture of continuous improvement and lean process with no waste and reducing costs, without neglecting the welfare worker and improving the conditions of their work environment. This paper presents a reflection on the application of ergonomics in a lean production system of an automotive industry, using methodology based on the Kaizen (Continuous Improvement) to gain performance and improving the conditions of the workplace, also will be presented with positive and negative points in using this methodology in relation to ergonomics. The research will be conducted by collecting data 'in loco' and interviews with workers. Some studies show that in companies that are lean system and using the methodology of Kaizen, the results of product quality, levels of absenteeism and accidents are better than those obtained in companies that do not apply the same concept.

Development of the workflow kine systems for support on KAIZEN.

PubMed

Mizuno, Yuki; Ito, Toshihiko; Yoshikawa, Toru; Yomogida, Satoshi; Morio, Koji; Sakai, Kazuhiro

2012-01-01

In this paper, we introduce the new workflow line system consisted of the location and image recording, which led to the acquisition of workflow information and the analysis display. From the results of workflow line investigation, we considered the anticipated effects and the problems on KAIZEN. Workflow line information included the location information and action contents information. These technologies suggest the viewpoints to help improvement, for example, exclusion of useless movement, the redesign of layout and the review of work procedure. Manufacturing factory, it was clear that there was much movement from the standard operation place and accumulation residence time. The following was shown as a result of this investigation, to be concrete, the efficient layout was suggested by this system. In the case of the hospital, similarly, it is pointed out that the workflow has the problem of layout and setup operations based on the effective movement pattern of the experts. This system could adapt to routine work, including as well as non-routine work. By the development of this system which can fit and adapt to industrial diversification, more effective "visual management" (visualization of work) is expected in the future.

From Push to Pull: Barriers to MALSP Modernization

DTIC Science & Technology

2013-02-19

for the Japanese business model Kaizen . According to Hudgik (n.d.), “ Kaizen was created in Japan following World War II. The word Kaizen means... Kaizen business model seeks to maximize efficiencies of the manufacturer or company and challenge personnel to identify ways to increase productivity and...What is kaizen ? Retrieved from http://www.graphicproducts.com/tutorials/ kaizen /index.php Jabin, J. M. (2009, June 1). Evaluating alternative

Strategic Mobility 21: Baseline Joint Experimentation Campaign Plan

DTIC Science & Technology

2008-06-19

including energy. The Value Stream Analysis Future State then designed Kaizens (process optimizations) for an improved Future State to help drive waste...Recommended Improvements and Experimentation Opportunities Initial recommended Kaizens (improvement opportunities) for waste reduction, constraint...Trucking, Service Craft Logistics, BNSF, and Madison Warehouse, Inc. • Kaizen 1 (Figure 17): Full upload electronically of the Dole ANS files • Kaizen

6th Annual National Small Business Conference

DTIC Science & Technology

2009-06-03

Extension Partnership – MIT Lean Advancement Initiative – Customers • Lean Tools – Value Stream Mapping – Kaizen Events Center for Management...Blue denotes kaizen events Most suppliers did not have in-house lean capability therefore the OEM and customer facilitated the events 36 Center for...Management & Economic Research 37 Kaizen Events • Kaizen is the process of: – Identifying & eliminating waste – as quickly as possible – at the

Improving Fleet and Industrial Supply Center, Sigonella, Italy: Detachment Bahrain’s Ship Maintenance Contracts in Southwest Asia

DTIC Science & Technology

2011-05-16

Project Sponsor: CAPT Chris Ray Black/Green Belt: CDR Mike Ryan Business Impact ($) KAIZEN / Rapid Improvement Event The expected impacts of this...Availability Contracts Project Methodology: DMAIC DFSS Kaizen Project Plan—list planned dates for each DMAIC phase Kaizen start and end dates...Initial Plan of Action for Kaizen Week 1) List and quantify elements that make the Big X metrics; 2) Capture the current competition categories into which

Best Practices in Supplier Relationship Management and Their Early Implementation in the Air Force Materiel Command

DTIC Science & Technology

2012-01-01

information-sharing and through systematic efforts to develop the supplier. These efforts can be direct involvement activities, such as kaizen events,24 24...Womack and Jones (1996) define kaizen as “Continuous, incremental improvement of an activity to create more value with less muda. Also called point... kaizen and process kaizen .” They define muda as “any activity that consumes resources but creates no value,” i.e., waste. Figure 2.2 Krause and

Knowledge Sharing Mechanism: Enabling C2 to Adapt to Changing Environments

DTIC Science & Technology

2007-06-01

seeking to improve upon it. This refinement is called kaizen , the Japanese word for continuous improvement process. With each PDCA Cycle, we can either be...in a hoshin or a kaizen mode depending on our purpose. Additionally, a successful innovation achieved during a hoshin PDCA Cycle can directly lead to a...new kaizen PDCA Cycle because the innovation has allowed us to improve an existing process or artifact. A kaizen PDCA Cycle, likewise can directly

Achieving Success via Multi-Model Process Improvement

DTIC Science & Technology

2007-03-01

Mellon University page 19 Lean Tactics: Kaizen Events Kaizen - Make people’s jobs easier by taking them apart, studying them, and making improvements...KAI” - take apart and make anew • “ZEN” - think, make good the actions of others, do good deeds and help others Kaizen tips (VAL, M&A, QPM, CAR...business - Requires firm understanding of the “before” state - “Just do it” Projects - Kaizen event with rollout plan • required use of Six Sigma

From Push to Pull: Barriers to MALSP Modernization

DTIC Science & Technology

2013-03-01

gain efficiencies and/or effectiveness in the MALSP II processes” (p. 1). CPI is the English term for the Japanese business model Kaizen . According...to Hudgik (n.d.), “ Kaizen was created in Japan following World War II. The word Kaizen means ‘continuous improvement.’ It comes from the Japanese...words 改 (‘kai’), which means ‘change’ or ‘to correct,’ and 善 (‘zen’) which means ‘good.’” The Kaizen business model seeks to maximize efficiencies of

Diversifying the Department of Defense Network Enterprise with Linux

DTIC Science & Technology

2010-03-01

Cyberspace, Cyberwar, Legacy, Inventory, Acquisition, Competitive Advantage, Coalition Communications, Ubiquitous, Strategic, Centricity, Kaizen , ISO... Kaizen , ISO, Outsource CLASSIFICATION: Unclassified Historically, the United States and its closest allies have grown increasingly reliant...control through the use of continuous improvement processes ( Kaizen )34. In choosing the Linux client operating system, the move encourages open standards

Study on workloads of human care worker with the introduction of IT system - the characteristics of work loads by observational research and the suggestions for KAIZEN.

PubMed

Mizuno, Yuki; Yoshikawa, Toru; Matsuda, Fumiko; Takeuchi, Yuriko; Motegi, Nobuyuki; Ikegami, Thor; Sakai, Kazuhiro

2012-01-01

The purpose of this study was to clarify the characteristic of workloads on human care worker with the introduction of IT system, and suggested the support measures for KAIZEN in Japan. The investigation method is workflow line and hearing with a focus on work observation. The objects were 8 human care workers of the acute hospital that introduced an electronic system. By the introduction of the electronic chart, the nurse station sojourn time decreased, sickroom sojourn time increased, and time about direct nursing care to a patient increased. In addition, access to patient information became easy, and the offer of the health care service based on correct information came to be possible in real time. By The point of workflow line, it was effect that moving lengths decreased in order to install the electronic chart in patients' rooms. Though, it was a problem that it hasn't formed where to place the instruments such as sphygmomanometer, clinical thermometer and others.

The Perfect Process Storm: Integration of CMMI, Agile, and Lean Six Sigma

DTIC Science & Technology

2012-12-01

struggled over the past few decades with a blizzard of process improvement methodologies such as Total Quality Manage- ment (TQM), Kaizen , JIT...the Japanese Kaizen system, targeting quality, effort, employee involvement, willingness to change, communication, and elimina- tion of waste in...blizzard of process improvement methodologies such as Total Quality Management (TQM), Kaizen , JIT Production, and Re-Engineering. These operations are

U.S. Marine Corps Communication-Electronics School Training Process: Discrete-Event Simulation and Lean Options

DTIC Science & Technology

2007-12-01

acknowledged that Continuous Improvement (CI), or Kaizen in Japanese, is practiced in some way, shape, or form by most if not all Fortune 500 companies...greater resistance in the individualistic U.S. culture. Kaizen generally involves methodical examination and testing, followed by the adoption of new...or streamlined procedures, including scrupulous measurement and changes based on statistical deviation formulas. Kaizen appears to be a perfect fit

Supplier Relationship Management at Army Life Cycle Management Commands: Gap Analysis of Best Practices

DTIC Science & Technology

2012-01-01

307–308) define kaizen as “continuous, incremental improvement of an activity to create more value with less muda.” They define muda as “any activity...approaches, kaizen events, Six Sigma, total quality management (TQM) for continuous improvement, kaikaku,6 process reengineering for discontinuous...them fix problems and develop capabilities. These efforts may include kaizen (i.e., continuous, incremental improvement) events, process mapping, work

Annual Report to the Congressional Defense Committees: Status of the Department of Defense’s Business Transformation Efforts

DTIC Science & Technology

2007-03-15

it began employing LSS, the Department of the Navy (DON) has completed 1,700 Black Belt/Green Belt projects and over 2,000 Kaizen events (i.e...aircraft to an average of 210 days from 390 days. • An LSS Kaizen event for the Expeditionary Fighting Vehicle (EFV) program, focused on reducing...GB Belt projects and over 2,000 Kaizen events. Initial projects were designed to build confidence and gain momentum for success in more complex High

Human Systems Integration (HSI) Associated Development Activities in Japan

DTIC Science & Technology

2008-06-12

machine learning and data mining methods. The continuous effort ( KAIZEN ) to improve the analysis phases are illustrated in Figure 14. Although there...model Extraction of a workflow Extraction of a control rule Variation analysis and improvement Plant operation KAIZEN Fig. 14

Leader Development: The Importance of Communication, Trust, and Legacy

DTIC Science & Technology

2014-06-13

Toyota Way were the spirit of challenge, kaizen (constantly improve performance), genchi genbutsu (philosophy of how leaders make decisions...the results will follow. Take responsibility for helping people advance through self-developing learning cycle. 3. Support Daily Kaizen : learn how

Three Approaches to Space Systems Acquisitions and their Application to the Defense Department’s Weather Satellite Program

DTIC Science & Technology

2012-03-01

by Toyota in the manufacturing world, such as just-in-time, kaizen , one-piece flow, jidoka, and heijunka. These techniques helped spawn the “lean...relentless reflection (hansei) and continuous improvement ( kaizen ) Similar to Principle 2, this principle shares similarity with space program

An Analysis of Human Resource Officers in Support of MPT&E Enterprise Management: A Succession Management Plan for Human Capital Managers

DTIC Science & Technology

2007-09-01

creating incentives to motivate and cultivate an atmosphere of constant progress. This is often referred to as “ kaizen ,” the Japanese concept of...improvement, mainly to jumpstart the moribund Japanese industrial system. Eventually, this gave rise to the kaizen revolution and the concept was quickly

The Contest with Context: Theory and Military Innovation

DTIC Science & Technology

2009-04-01

willingness of all workers to push themselves beyond where they feel comfortable— kaizen in action.‖ 32 The idea that a peculiar organizational...Economist 374 (29 Jan 95): 73. The Japanese word kaizen is equivalent to the English concept of ―continuous improvement.‖ Similarly, recent research

A strategy for company improvement.

PubMed

Howley, L

2000-03-01

Strategies based on the kaizen methodology are designed to continuously improve company performance without the need for large capital investments. This article looks at how one company used simple kaizen principles to its advantage, achieving 67% increase in productivity and 10% reduction in the standard cost of product.

Asset Management Process (AMP) Improvement Project: Final Report of Findings and Recommendations

DTIC Science & Technology

2009-10-01

cannibalized components could no longer be sighted due to their re-use in other systems or equipment. Solution — A Rapid Improvement Event, or Kaizen , was...Property Loss Reporting domain’s lifecycle, the Green Belt recognized the opportunity for a Rapid Improvement Event (RIE), or Kaizen . A five-day RIE was

Leadership with a World View

ERIC Educational Resources Information Center

White-Hood, Marian

2004-01-01

As principal of Ernest Everett Just Middle School in Mitchellville, Maryland, the author has fostered a management philosophy that draws from the unity and simplicity of two different cultures: village life in Africa and the gemba kaizen business philosophy of Japan. Blended together, the African and gemba kaizen activities have transformed the…

Integrating health promotion with quality improvement in a Swedish hospital.

PubMed

Astnell, Sandra; von Thiele Schwarz, Ulrica; Hasson, Henna; Augustsson, Hanna; Stenfors-Hayes, Terese

2016-09-01

Integration of workplace employee health promotion (HP) and occupational health and safety (OHS) work into organizational quality improvement systems is suggested as a way to strengthen HP and OHS activities in an organization. The aim of this article was to study what consequences integration of HP, OHS and a quality improvement system called kaizen has on the frequency and type of HP and OHS activities. A quasi-experimental study design was used where an integration of the three systems for HP, OHS respectively kaizen, was performed at six intervention units at a Swedish hospital. The remaining six units served as controls. Document analysis of all employees' written improvement suggestions (kaizen notes) during 2013 was conducted. The findings show that the intervention group had more suggestions concerning HP and OHS (n = 114) when compared with the control group (n = 78) and a greater variety of HP and OHS suggestions. In addition, only the intervention group had included HP aspects. In both groups, most kaizen notes with health consideration had a preventive focus rather than rehabilitative. The intervention, i.e. the integration of HP, OHS and kaizen work, had a favourable effect on HP and OHS work when compared with the controls. The results of the study support that this system can work in practice at hospitals. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Impact of a poka-yoke device on job performance of individuals with cognitive impairments.

PubMed

Erlandson, R F; Noblett, M J; Phelps, J A

1998-09-01

Job performance and production related issues are important not only to successful vocational training and ultimate job placement for individuals with cognitive disabilities, but also for their ability to have expanded vocational options. This study hypothesized that the application of Kaizen philosophy, and poka-yoke techniques in particular, could create job opportunities and improve productivity of individuals with cognitive disabilities. Poka-yoke or error-proofing techniques are part of the collection of Kaizen techniques. Kaizen refers to continuous improvement in performance, cost/effectiveness, and quality. Kaizen strives to empower the worker, increase worker satisfaction, facilitate a sense of accomplishment, and thereby create pride-of-work. These techniques typically reduce the physical and cognitive demands of a task and thereby render the task more accessible. The job was a fuel clamp assembly. A redesigned assembly fixture was the poka-yoke intervention. Consistent with poka-yoke principles, the intervention improved the productivity of everyone attempting the assembly. In particular, the workers in this study showed an 80% increase in productivity and an average percent error drop from 52% to about 1% after the process redesign. Furthermore, the workers showed improved morale, self-esteem, and pride-of-work. Prior to the process redesign, only the higher functioning workers could successfully perform the assembly. After the redesign a greater number of workers could successfully perform the assembly. These results not only validated the study hypothesis, but demonstrated that the success facilitated by applying Kaizen techniques had similar results with individuals with cognitive disabilities as with nondisabled workers.

Ares Launch Vehicles Lean Practices Case Study

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv, N.; Self, Timothy A.

2008-01-01

This viewgraph presentation describes test strategies and lean philisophies and practices that are applied to Ares Launch Vehicles. The topics include: 1) Testing strategy; 2) Lean Practices in Ares I-X; 3) Lean Practices Applied to Ares I-X Schedule; 4) Lean Event Results; 5) Lean, Six Sigma, and Kaizen Practices in the Ares Projects Office; 6) Lean and Kaizen Success Stories; and 7) Ares Six Sigma Practices.

Kaizen newspaper

NASA Technical Reports Server (NTRS)

Shearer, Scott C. (Inventor); Proferes, John Nicholas (Inventor); Baker, Sr., Mitchell D. (Inventor); Reilly, Kenneth B. (Inventor); Tiwari, Vijai K. (Inventor)

2013-01-01

Systems, computer program products, and methods are disclosed for tracking an improvement event. An embodiment includes an event interface configured to receive a plurality of entries related to each of a plurality of improvement events. The plurality of entries includes a project identifier for the improvement event, a creation date, an objective, an action related to reaching the objective, and a first deadline related to the improvement event. A database interface is configured to store the plurality of entries in an event database.

The Application of Lean Thinking Principles and Kaizen Practices for the Successful Development and Implementation of the Ares I-X Flight Test Rocket and Mission

NASA Technical Reports Server (NTRS)

Askins, B. R.; Davis, S. R.; Heitzman, K. S.; Olsen, R. A.

2011-01-01

On October 28, 2009 the Ares I-X flight test rocket launched from Kennedy Space Center and flew its suborbital trajectory as designed. The mission was successfully completed as data from the test, and associated development activities were analyzed, transferred to stakeholders, and well documented. A positive lesson learned from Ares I-X was that the application of lean thinking principles and kaizen practices was very effective in streamlining development activities. Ares I-X, like other historical rocket development projects, was hampered by technical, cost, and schedule challenges and if not addressed boldly could have resulted in cancellation of the test. The mission management team conducted nine major meetings, referred to as lean events, across its elements to assess plans, procedures, processes, requirements, controls, culture, organization, use of resources, and anything that could be changed to optimize schedule or reduce risk. The preeminent aspect of the lean events was the focus on value added activities and the removal or at least reduction in non-value added activities. Trained Lean Six Sigma facilitators assisted the Ares I-X developers in conducting the lean events. They indirectly helped formulate the mission s own unique methodology for assessing schedule. A core team was selected to lead the events and report to the mission manager. Each activity leveraged specialized participants to analyze the subject matter and its related processes and then recommended alternatives and solutions. Stakeholders were the event champions. They empowered and encouraged the team to succeed. The keys to success were thorough preparation, honest dialog, small groups, adherence to the Ares I-X ground rules, and accountability through disciplined reporting and tracking of actions. This lean event formula was game-changing as demonstrated by Ares I-X. It is highly recommended as a management tool to help develop other complex systems efficiently. The key benefits for

The Application of Lean Thinking Principles and Kaizen Practices for the Successful Development and Implementation of the Ares I-X Flight Test Rocket and Mission

NASA Technical Reports Server (NTRS)

Askins, B. R.; Davis, S. R.; Heitzman, K. S.; Olsen, R. A.

2011-01-01

On October 28, 2009 the Ares I-X flight test rocket launched from Kennedy Space Center and flew its suborbital trajectory as designed. The mission was successfully completed as data from the test, and associated development activities were analyzed, transferred to stakeholders, and well documented. Positive lessons learned from Ares I-X were that the application of lean thinking principles and kaizen practices are effective in streamlining development activities. Ares I-X, like other historical rocket development projects, was hampered by technical, cost, and schedule challenges and if not addressed boldly could have resulted in cancellation of the test. The mission management team conducted nine major meetings, referred to as lean events, across its elements to assess plans, procedures, processes, requirements, controls, culture, organization, use of resources, and anything that could be changed to optimize schedule or reduce risk. The preeminent aspect of the lean events was the focus on value added activities and the removal or at least reduction in non-value activities. Trained Lean Six Sigma facilitators assisted the Ares I-X developers in conducting the lean events. They indirectly helped formulate the mission s own unique methodology for assessing schedule. A core team was selected to lead the events and report to the mission manager. Each activity leveraged specialized participants to analyze the subject matter and its related processes and then recommended alternatives and solutions. Stakeholders were the event champions. They empowered and encouraged the team to succeed. The keys to success were thorough preparation, honest dialog, small groups, adherence to the Ares I-X ground rules, and accountability through disciplined reporting and tracking of actions. This lean event formula was game-changing as demonstrated by the success of Ares I-X. It is highly recommended as a management tool to help develop other complex systems efficiently. The key benefits

Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency

EPA Pesticide Factsheets

Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

Promoting employee health by integrating health protection, health promotion, and continuous improvement: a longitudinal quasi-experimental intervention study.

PubMed

von Thiele Schwarz, Ulrica; Augustsson, Hanna; Hasson, Henna; Stenfors-Hayes, Terese

2015-02-01

To test the effects of integrating health protection and health promotion with a continuous improvement system (Kaizen) on proximal employee outcomes (health promotion, integration, and Kaizen) and distal outcomes (workability, productivity, self-rated health and self-rated sickness absence). Twelve units in a county hospital in Sweden were randomized to control or intervention groups using a quasiexperimental study design. All staff (approximately 500) provided self-ratings in questionnaires at baseline, and a 12- and 24-month follow-up (response rate, 79% to 87.5%). There was a significant increase in the proximal outcomes over time in the intervention group compared with the control group, and a trend toward improvement in the distal outcomes workability and productivity. Integration seems to promote staff engagement in health protection and promotion, as well as to improve their understanding of the link between work and health.

Total Quality Management Implementation Strategy: Directorate of Quality Assurance

DTIC Science & Technology

1989-05-01

Total Quality Control Harrington, H. James The Improvement Process Imai, Masaaki Kaizen Ishikawa , Kaoru What is Total Quality Control Ishikawa ... Kaoru Statistical Quality Control Juran, J. M. Managerial Breakthrough Juran, J. M. Quality Control Handbook Mizuno, Ed Managing for Quality Improvements

Model Development and Process Analysis for Lean Cellular Design Planning in Aerospace Assembly and Manufacturing

NASA Astrophysics Data System (ADS)

Hilburn, Monty D.

Successful lean manufacturing and cellular manufacturing execution relies upon a foundation of leadership commitment and strategic planning built upon solid data and robust analysis. The problem for this study was to create and employ a simple lean transformation planning model and review process that could be used to identify functional support staff resources required to plan and execute lean manufacturing cells within aerospace assembly and manufacturing sites. The lean planning model was developed using available literature for lean manufacturing kaizen best practices and validated through a Delphi panel of lean experts. The resulting model and a standardized review process were used to assess the state of lean transformation planning at five sites of an international aerospace manufacturing and assembly company. The results of the three day, on-site review were compared with baseline plans collected from each of the five sites to determine if there analyzed, with focus on three critical areas of lean planning: the number and type of manufacturing cells identified, the number, type, and duration of planned lean and continuous kaizen events, and the quantity and type of functional staffing resources planned to support the kaizen schedule. Summarized data of the baseline and on-site reviews was analyzed with descriptive statistics. ANOVAs and paired-t tests at 95% significance level were conducted on the means of data sets to determine if null hypotheses related to cell, kaizen event, and support resources could be rejected. The results of the research found significant differences between lean transformation plans developed by site leadership and plans developed utilizing the structured, on-site review process and lean transformation planning model. The null hypothesis that there was no difference between the means of pre-review and on-site cell counts was rejected, as was the null hypothesis that there was no significant difference in kaizen event plans. These

Quality in Teaching Laboratories.

ERIC Educational Resources Information Center

Stubington, John F.

1995-01-01

Describes a Japanese process-oriented approach called KAIZEN for improving the quality of existing teaching laboratories. It provides relevant quality measurements and indicates how quality can be improved. Use of process criteria sidesteps the difficulty of defining quality for laboratory experiments and allows separation of student assessment…

Organizational Change. Symposium 11. [Concurrent Symposium Session at AHRD Annual Conference, 2000.

ERIC Educational Resources Information Center

2000

This packet contains three papers from a symposium on organizational change. The first paper, "Kaizen Blitz: Rapid Learning to Facilitate Immediate Organizational Improvements" (Robert B. Gudgel, Fred C. Feitler), describes rapid and dramatic improvement in the organizational performance of a manufacturing firm after use of a series of…

National Education Standards: The Complex Challenge for Educational Leaders.

ERIC Educational Resources Information Center

Faidley, Ray; Musser, Steven

1991-01-01

National standards for education are important elements in the excellence process, but standards imposed by a central authority simply do not work in the Information Era. It would be wise to increase teachers' decision-making role in establishing and implementing local level excellence standards and train teachers to employ the Japanese "kaizen"…

Quest for Continual Growth Takes Root

ERIC Educational Resources Information Center

Surdey, Mary M.; Hashey, Jane M.

2006-01-01

In this article, the authors describe how the quest for continual growth has taken its root at Vestal Central School district. Located at the heart of upstate New York, educators at Vestal Central School district have created a spirit of "kaizen," a Japanese word meaning the relentless quest for continual improvement and higher-quality…

Lean sigma--will it work for healthcare?

PubMed

Bahensky, James A; Roe, Janet; Bolton, Romy

2005-01-01

The manufacturing industry has been using Lean Sigma for years in pursuit of continuous improvement to obtain a competitive advantage. The objectives of these efforts are to use the Lean techniques for reducing cycle times and the Six Sigma concepts for reducing product defects. The Iowa Business Council with several advocates worked with the University of Iowa Hospital and Clinics (UIHC) and two other Iowa hospitals to determine whether Lean Sigma is adaptable in healthcare. A team of 15 people at UIHC used the Kaizen Breakthrough Methodology over a five-day period in an aggressive identification and elimination of non-value added activities in Radiology CT scanning. The results exceeded the initial project objectives and indicated that Lean Sigma is applicable in healthcare. Overall, the Lean Sigma project increased revenue by approximately $750,000 per year. The Kaizen process proved to be successful and interesting. Within three days, the team installed new work flow processes. This implementation-oriented approach is what differentiates Lean Sigma from other quality improvement processes.

Schools of Quality: An Introduction to Total Quality Management in Education.

ERIC Educational Resources Information Center

Bonstingl, John Jay

This book offers an introduction to the basic ideas of Total Quality Management (TQM) in education. Chapter 1 contrasts the American model of the bell-shaped curve with the Japanese concept of "kaizen," which is personal dedication to mutual improvement and the heart of TQM philosophy. Chapter 2 provides an overview of the history of the TQ…

Improving the Transition of Care in Patients Transferred Through the Ochsner Medical Center Transfer Center

PubMed Central

Amedee, Ronald G.; Maronge, Genevieve F.; Pinsky, William W.

2012-01-01

Background Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. Methods We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. Results The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). Conclusions By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects. PMID:23267257

Improving the transition of care in patients transferred through the ochsner medical center transfer center.

PubMed

Amedee, Ronald G; Maronge, Genevieve F; Pinsky, William W

2012-01-01

Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects.

Total Quality Management Guide. Volume 2. A Guide to Implementation

DTIC Science & Technology

1990-02-15

Kaoru . Guide to Quality Control. Asian Productivity Organization. 1984. Ishikawa , Kaoru . What is Total Quality Control? The Japanese Way. Englewood...of the new Systems Age. The theories of Deming, Juran, Ishikawa , and other management methods that still predominate are pioneers of Systems Age...Feigenbaum, Armand V. Total Quality Control. New York: McGraw-Hill Book Company. 1983. bnai, Masaaki. Kaizen. New York: Random House. 1986. Ishikawa

How the Japanese work.

PubMed

Chambers, D W

1998-01-01

The Japanese do not work harder or even use different approaches so much as they aim for a different result--one that balances process and results and extends the definition of quality beyond the product itself to include cost and convenience to the customer as well. Ten methods of the Japanese kaizen culture of work are presented with applications and contrasts to American dentistry.

Total Quality Management: A Guide to Implementation

DTIC Science & Technology

1989-08-01

Kaizen. New York: Random House. 1986. Ishikawa , Kaoru . Guide to Quality Control. Asian Productivity Organization. 1984. Ishikawa , Kaoru . What is Total...with the problems and the new management principles are based on the complexities of the new Systems Age. The theories of Deming, Juran, Ishikawa , and...Progress. Jun 1985. Miller, Jeffery G. and Thomas E. Vollmann. "The Hidden Factory." Harvard Business Review. Sep-Oct 1985. Shimoyamada, Kaoru . "The

Towards a Cognitive Organisational Framework for Knowledge Management

DTIC Science & Technology

2001-09-01

of knowledge now exist only at the bottom of the organisation, with management uninformed on specific detail. For many knowledge- based ...the organisation’ s internal context - its internal management practices, learning culture and knowledge base . This has particularly been found to...of the process is based in ’Kaizen’. Within the Western culture we may well have ignored important insights in our own tradition. Traditionally, in

On-Site Construction Productivity Improvement Through Total Quality Management

DTIC Science & Technology

1991-12-01

morale of the work force. i Kaoru Ishikawa , Guide to Ouality Control, (2d ed; New York: Asian Productivity Organization, 1982), p. 45. ’"Ibid. 34...Curve Kaoru Ishikawa , Guide to Quality Control, (2d ed; New York: Asian Productivity Organization, 1982), p. 62. 54 For any normal distribution, 99.73...KAIZEN The Key to Japan’s Comoetitive Success. New York: Random House Business Division, 1986. Ishikawa , Kaoru , Guide to Ouality Control. 2d ed; New

[Development of analysis software package for the two kinds of Japanese fluoro-d-glucose-positron emission tomography guideline].

PubMed

Matsumoto, Keiichi; Endo, Keigo

2013-06-01

Two kinds of Japanese guidelines for the data acquisition protocol of oncology fluoro-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) scans were created by the joint task force of the Japanese Society of Nuclear Medicine Technology (JSNMT) and the Japanese Society of Nuclear Medicine (JSNM), and published in Kakuigaku-Gijutsu 27(5): 425-456, 2007 and 29(2): 195-235, 2009. These guidelines aim to standardize PET image quality among facilities and different PET/CT scanner models. The objective of this study was to develop a personal computer-based performance measurement and image quality processor for the two kinds of Japanese guidelines for oncology (18)F-FDG PET/CT scans. We call this software package the "PET quality control tool" (PETquact). Microsoft Corporation's Windows(™) is used as the operating system for PETquact, which requires 1070×720 image resolution and includes 12 different applications. The accuracy was examined for numerous applications of PETquact. For example, in the sensitivity application, the system sensitivity measurement results were equivalent when comparing two PET sinograms obtained from the PETquact and the report. PETquact is suited for analysis of the two kinds of Japanese guideline, and it shows excellent spec to performance measurements and image quality analysis. PETquact can be used at any facility if the software package is installed on a laptop computer.

Kennedy Space Center Orion Processing Team Planning for Ground Operations

NASA Technical Reports Server (NTRS)

Letchworth, Gary; Schlierf, Roland

2011-01-01

Topics in this presentation are: Constellation Ares I/Orion/Ground Ops Elements Orion Ground Operations Flow Orion Operations Planning Process and Toolset Overview, including: 1 Orion Concept of Operations by Phase 2 Ops Analysis Capabilities Overview 3 Operations Planning Evolution 4 Functional Flow Block Diagrams 5 Operations Timeline Development 6 Discrete Event Simulation (DES) Modeling 7 Ground Operations Planning Document Database (GOPDb) Using Operations Planning Tools for Operability Improvements includes: 1 Kaizen/Lean Events 2 Mockups 3 Human Factors Analysis

Care initiation area yields dramatic results.

PubMed

2009-03-01

The ED at Gaston Memorial Hospital in Gastonia, NC, has achieved dramatic results in key department metrics with a Care Initiation Area (CIA) and a physician in triage. Here's how the ED arrived at this winning solution: Leadership was trained in and implemented the Kaizen method, which eliminates redundant or inefficient process steps. Simulation software helped determine additional space needed by analyzing arrival patterns and other key data. After only two days of meetings, new ideas were implemented and tested.

[Comprehensive and competition-oriented quality management in social medicine expert services].

PubMed

Seger, W

1996-05-01

In free competition expert services in Social Medicine must supply their expertise with high quality in a short time and at low cost. The demands by customers in respect of motivation of the staff and innovative organisation are as important competitive factors as high quality standards for expertise production. These guiding principles completed by "Kaizen" and "Lean production" are necessary requirements for the further existence of the enterprise in competition. Quality assurance must be promoted in a process looking to the future in active quality management.

An economic analysis of a system wide Lean approach: cost estimations for the implementation of Lean in the Saskatchewan healthcare system for 2012-2014.

PubMed

Sari, Nazmi; Rotter, Thomas; Goodridge, Donna; Harrison, Liz; Kinsman, Leigh

2017-08-03

The costs of investing in health care reform initiatives to improve quality and safety have been underreported and are often underestimated. This paper reports direct and indirect cost estimates for the initial phase of the province-wide implementation of Lean activities in Saskatchewan, Canada. In order to obtain detailed information about each type of Lean event, as well as the total number of corresponding Lean events, we used the Provincial Kaizen Promotion Office (PKPO) Kaizen database. While the indirect cost of Lean implementation has been estimated using the corresponding wage rate for the event participants, the direct cost has been estimated using the fees paid to the consultant and other relevant expenses. The total cost for implementation of Lean over two years (2012-2014), including consultants and new hires, ranged from $44 million CAD to $49.6 million CAD, depending upon the assumptions used. Consultant costs accounted for close to 50% of the total. The estimated cost of Lean events alone ranged from $16 million CAD to $19.5 million CAD, with Rapid Process Improvement Workshops requiring the highest input of resources. Recognizing the substantial financial and human investments required to undertake reforms designed to improve quality and contain cost, policy makers must carefully consider whether and how these efforts result in the desired transformations. Evaluation of the outcomes of these investments must be part of the accountability framework, even prior to implementation.

Investigating variations in implementation fidelity of an organizational-level occupational health intervention.

PubMed

Augustsson, Hanna; von Thiele Schwarz, Ulrica; Stenfors-Hayes, Terese; Hasson, Henna

2015-06-01

The workplace has been suggested as an important arena for health promotion, but little is known about how the organizational setting influences the implementation of interventions. The aims of this study are to evaluate implementation fidelity in an organizational-level occupational health intervention and to investigate possible explanations for variations in fidelity between intervention units. The intervention consisted of an integration of health promotion, occupational health and safety, and a system for continuous improvements (Kaizen) and was conducted in a quasi-experimental design at a Swedish hospital. Implementation fidelity was evaluated with the Conceptual Framework for Implementation Fidelity and implementation factors used to investigate variations in fidelity with the Framework for Evaluating Organizational-level Interventions. A multi-method approach including interviews, Kaizen notes, and questionnaires was applied. Implementation fidelity differed between units even though the intervention was introduced and supported in the same way. Important differences in all elements proposed in the model for evaluating organizational-level interventions, i.e., context, intervention, and mental models, were found to explain the differences in fidelity. Implementation strategies may need to be adapted depending on the local context. Implementation fidelity, as well as pre-intervention implementation elements, is likely to affect the implementation success and needs to be assessed in intervention research. The high variation in fidelity across the units indicates the need for adjustments to the type of designs used to assess the effects of interventions. Thus, rather than using designs that aim to control variation, it may be necessary to use those that aim at exploring and explaining variation, such as adapted study designs.

Using lean principles to improve outpatient adult infusion clinic chemotherapy preparation turnaround times.

PubMed

Lamm, Matthew H; Eckel, Stephen; Daniels, Rowell; Amerine, Lindsey B

2015-07-01

The workflow and chemotherapy preparation turnaround times at an adult infusion clinic were evaluated to identify opportunities to optimize workflow and efficiency. A three-phase study using Lean Six Sigma methodology was conducted. In phase 1, chemotherapy turnaround times in the adult infusion clinic were examined one year after the interim goal of a 45-minute turnaround time was established. Phase 2 implemented various experiments including a five-day Kaizen event, using lean principles in an effort to decrease chemotherapy preparation turnaround times in a controlled setting. Phase 3 included the implementation of process-improvement strategies identified during the Kaizen event, coupled with a final refinement of operational processes. In phase 1, the mean turnaround time for all chemotherapy preparations decreased from 60 to 44 minutes, and a mean of 52 orders for adult outpatient chemotherapy infusions was received each day. After installing new processes, the mean turnaround time had improved to 37 minutes for each chemotherapy preparation in phase 2. In phase 3, the mean turnaround time decreased from 37 to 26 minutes. The overall mean turnaround time was reduced by 26 minutes, representing a 57% decrease in turnaround times in 19 months through the elimination of waste and the implementation of lean principles. This reduction was accomplished through increased efficiencies in the workplace, with no addition of human resources. Implementation of Lean Six Sigma principles improved workflow and efficiency at an adult infusion clinic and reduced the overall chemotherapy turnaround times from 60 to 26 minutes. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies.

PubMed

Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

2014-03-01

The success of quality-improvement projects relies heavily on both project design and the metrics chosen to assess change. In Part II of this three-part American Thoracic Society Seminars series, we begin by describing methods for determining which data to collect, tools for data presentation, and strategies for data dissemination. As Avedis Donabedian detailed a half century ago, defining metrics in healthcare can be challenging; algorithmic determination of the best type of metric (outcome, process, or structure) can help intensive care unit (ICU) managers begin this process. Choosing appropriate graphical data displays (e.g., run charts) can prompt discussions about and promote quality improvement. Similarly, dashboards/scorecards are useful in presenting performance improvement data either publicly or privately in a visually appealing manner. To have compelling data to show, ICU managers must plan quality-improvement projects well. The second portion of this review details four quality-improvement tools-checklists, Six Sigma methodology, lean thinking, and Kaizen. Checklists have become commonplace in many ICUs to improve care quality; thinking about how to maximize their effectiveness is now of prime importance. Six Sigma methodology, lean thinking, and Kaizen are techniques that use multidisciplinary teams to organize thinking about process improvement, formalize change strategies, actualize initiatives, and measure progress. None originated within healthcare, but each has been used in the hospital environment with success. To conclude this part of the series, we demonstrate how to use these tools through an example of improving the timely administration of antibiotics to patients with sepsis.

Mission impossible? The boss wants to double our inventory turns.

PubMed

Gips, J

1998-11-01

Despite the prolific implementation of manufacturing systems, JIT principles, Kaizen events, and cycle time reduction programs over the past few years, high inventories still plague many companies. The assumption that implementing these principles and techniques will automatically result in inventory levels that satisfy management frequently proves to be false. Events like mergers, introduction of new competition, and a dropoff in business often trigger edicts to cut inventories. The cost of inventories also extends beyond the traditional accounting measurements to include hidden operating costs that everyone should want to eliminate. This article looks at the reasons for inventories and explores strategies for reducing them.

Agile rediscovering values: Similarities to continuous improvement strategies

NASA Astrophysics Data System (ADS)

Díaz de Mera, P.; Arenas, J. M.; González, C.

2012-04-01

Research in the late 80's on technological companies that develop products of high value innovation, with sufficient speed and flexibility to adapt quickly to changing market conditions, gave rise to the new set of methodologies known as Agile Management Approach. In the current changing economic scenario, we considered very interesting to study the similarities of these Agile Methodologies with other practices whose effectiveness has been amply demonstrated in both the West and Japan. Strategies such as Kaizen, Lean, World Class Manufacturing, Concurrent Engineering, etc, would be analyzed to check the values they have in common with the Agile Approach.

Development of the Macro Command Editing Executive System for Factory Workers-Oriented Programless Visual Inspection System

NASA Astrophysics Data System (ADS)

Anezaki, Takashi; Wakitani, Kouichi; Nakamura, Masatoshi; Kubo, Hiroyasu

Because visual inspection systems are difficult to tune, they create many problems for the kaizen process. This results in increased development costs and time to assure that the inspection systems function properly. In order to improve inspection system development, we designed an easy-tuning system called a “Program-less” visual inspection system. The ROI macro command which consisted of eight kinds of shape recognition macro commands and decision, operation, control commands was built. Furthermore, the macro command editing executive system was developed by the operation of only the GUI without editing source program. The validity of the ROI macro command was proved by the application of 488 places.

Development of Plant Control Diagnosis Technology and Increasing Its Applications

NASA Astrophysics Data System (ADS)

Kugemoto, Hidekazu; Yoshimura, Satoshi; Hashizume, Satoru; Kageyama, Takashi; Yamamoto, Toru

A plant control diagnosis technology was developed to improve the performance of plant-wide control and maintain high productivity of plants. The control performance diagnosis system containing this technology picks out the poor performance loop, analyzes the cause, and outputs the result on the Web page. Meanwhile, the PID tuning tool is used to tune extracted loops from the control performance diagnosis system. It has an advantage of tuning safely without process changes. These systems are powerful tools to do Kaizen (continuous improvement efforts) step by step, coordinating with the operator. This paper describes a practical technique regarding the diagnosis system and its industrial applications.

Engaging Frontline Leaders and Staff in Real-Time Improvement.

PubMed

Phillips, Jennifer; Hebish, Linda J; Mann, Sharon; Ching, Joan M; Blackmore, C Craig

2016-04-01

The relationship of staff satisfaction and engagement to organizational success, along with the integral influence of frontline managers on this dimension, is well established in health care and other industries. To specifically address staff engagement, Virginia Mason Medical Center, an integrated, single-hospital health system, developed an approach that involved leaders, through the daily use of standard work for leaders, as well as staff, through a Lean-inspired staff idea system. Kaizen Promotion Office (KPO) staff members established three guiding principles: (1) Staff engagement begins with leader engagement; (2) Integrate daily improve- ment (kaizen) as a habitual way of life not as an add-on; and (3) Create an environment in which staff feel psycho- logically safe and valued. Two design elements--Standard Work for Leaders (SWL) and Everyday Lean Ideas (ELIs) were implemented. For the emergency department (ED), an early adopter of the staff engagement work, the challenge was to apply the guiding principles to improve staff engagement while improving quality and patient and staff satisfaction, even as patient volumes were increasing. Daily huddles for the KPO staff members and weekly leader rounds are used to elicit staff ideas and foster ELIs in real time. Overall progress to date has been tracked in terms of staff satisfaction surveys, voluntary staff turnover, adoption of SWL, and testing and implementation of staff ideas. For example, voluntary turnover of ED staff decreased from 14.6% in 2011 to 7.5% in 2012, and 2.0% in 2013. Organizationwide, at least 800 staff ideas are in motion at any given time, with finished ones posted in an idea supermarket website. A leadership and staff engagement approach that focuses on SWL and on capturing staff ideas for daily problem solving and improvement can contribute to organization success and improve the quality of health care delivery.

Four Easy Steps to Drastically Improve Your Phone-Based Customer Service.

PubMed

Peller, Spencer; Beimes, Zachary

2015-01-01

Japan is renowned for impeccable customer service (as anyone who's watched an apple get wrapped up like a crown jewel in a Tokyo grocery store will tell you). The Japanese concept of kaizen (constant improvement) is a fundamental reason for this, and for the enduring success of conglomerates such as Toyota, Honda, and Sony. From afar, you may think this trait is caused by something in the waters from Mt. Fuji, but many in the know credit the work of an American engineer named W. Edwards Deming as the catalyst for this movement. If his ideas could transform a nation, there's no question they can improve the patient satisfaction rates at your practice.

TQM: the essential concepts.

PubMed

Chambers, D W

1998-01-01

This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.

The new health-care quality: value, outcomes, and continuous improvement.

PubMed

O'Connor, S J; Lanning, J A

1991-01-01

No longer convinced that their viewpoint on quality is the only one, different stakeholders in the health-care arena are sharing perspectives to piece together the quality picture. Although still preoccupied with the cost of health care, purchasers are concerned about value--efficiency, appropriateness, and effectiveness--as well as price. Faced with evidence of medically unnecessary procedures and unexamined medical theory, practitioners are searching for appropriateness guidelines, useful outcome measures, and methods to elicit informed patient preferences about elective surgeries. Underlying this search for reliable indicators of quality--now expanded to include patient satisfaction--is a new interest in the Japanese notion of "Kaizen" or continuous quality improvement. The end product of this ferment may determine whether good medicine drives out the bad--or vice versa.

Case study of lean manufacturing application in a die casting manufacturing company

NASA Astrophysics Data System (ADS)

Ching, Ng Tan; Hoe, Clarence Chan Kok; Hong, Tang Sai; Ghobakhloo, Morteza; Pin, Chen Kah

2015-05-01

The case study of lean manufacturing aims to study the application of lean manufacturing in a die casting manufacturing company located in Pulau Penang, Malaysia. This case study describes mainly about the important concepts and applications of lean manufacturing which could gradually help the company in increasing the profit by studying and analyzing their current manufacturing process and company culture. Many approaches of lean manufacturing are studied in this project which includes: 5S housekeeping, Kaizen, and Takt Time. Besides, the lean tools mentioned, quality tool such as the House of Quality is being used as an analysis tool to continuously improve the product quality. In short, the existing lean culture in the company is studied and analyzed, with recommendations written at the end of this paper.

Should Quality School Education Be a Kaizen (Improvement) or an Innovation?

ERIC Educational Resources Information Center

Sun-Keung Pang, Nicholas

1998-01-01

Reviews Hong Kong's School Management Initiative implementation strategies (rational-empirical, power-coercive, and normative-reeducative), compares them with New South Wales, Australia's strategies, and suggests an appropriate strategy for future reforms. In Australia, changes were radical and thorough (using power-coercive strategies), whereas…

Why Health Promotion Needs to Change.

PubMed

Terry, Paul E

2018-01-01

If you ask most health professionals why they do what they do, they invariably speak of being of service. And being of service, for population health workers, becomes ever more meaningful as our work touches ever more lives. To wit, "Kaizen," a Japanese term meaning "change for better," sits shoulder to shoulder with our life's purpose. Health promotion professionals are high performers getting great results but we need to start working on our work. What would it take to increase our impact by 50%? And when we change our processes to accomplish that, what would we change next to get another 50% improvement? Only by stepping back and examining our processes can we see the time and motion required to make what's working now work better and be more accessible to more people next time.

Improvement of Tsukiji free fish market in Tokyo ("Kaizen" of work environment).

PubMed

Kishida, K; Ikegami, T; Maehara, N; Watanabe, A

1996-06-01

"TSUKIJI" is one of the biggest and most famous Free Fish Markets in the world, but there are many problems on the working condition because it was built about 60 years ago. Our investigation was held 1991 to 1993 to give some improvements regarding layout of buildings, working time, heat condition at refrigerator, working posture, and so on. We used a questionnaire on daily life and health care of workers, time study with measurement of heartbeats, and checklist (using Checklist for Improvement of Safety-Health and Working Conditions,' made by ILO). The main occupations in TSUKIJI were seller, buyer, delivery worker, and refrigerator maintenance worker. Their starting time was early in the morning, usually between 2:00 a.m. and 5:00 a.m., but the hardest one was delivery workers starting at 9:00 p.m. They used auto cargo car for carrying to shops from refrigerator or from auction places many times. Sellers had two different types of work. First, the seller set up the auction, numbering the fish (or cases of seafood), arranging them in order, and so on. The rest of the work was transaction of invoices, sometimes using VDU with almost sitting. These works did not look well balanced. Buyer of tuna cut if like lumber by electric saws did not have guard for protection and there were more than 200 machines. Overlooking the market by checklist, some problems were clarified, and suggestions for improvement include restructuring the whole layout of the market or reforming buildings, standardization of the cases, adjustment of health facilities, safety protection on tools and machines, management of working system, working posture, health care, and so on.

From Theory to Practice: "Kaizen" and the Academy of the Pacific Rim

ERIC Educational Resources Information Center

Blasdale, Spencer

2004-01-01

In this article, the author profiles the Academy of the Pacific Rim Charter Public School (Hyde Park, Massachusetts) and describes the school's culture. The school's students, who are in grades 6 through 12, are surrounded by rituals, routines, and relationship-building activities. Pacific Rim's culture stems from and supports the school's…

The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

PubMed

Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

2012-09-01

Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

Lean-driven improvements slash wait times, drive up patient satisfaction scores.

PubMed

2012-07-01

Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

Process Evaluation of Two Participatory Approaches: Implementing Total Worker Health® Interventions in a Correctional Workforce

PubMed Central

Dugan, Alicia G.; Farr, Dana A.; Namazi, Sara; Henning, Robert A.; Wallace, Kelly N.; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L.; Cherniack, Martin G.

2018-01-01

Background Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. Method HITEC-2 compared two different types of participatory program, a CO-only “Design Team” (DT) and “Kaizen Event Teams” (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Results Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. Conclusions PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. PMID:27378470

Process evaluation of two participatory approaches: Implementing total worker health® interventions in a correctional workforce.

PubMed

Dugan, Alicia G; Farr, Dana A; Namazi, Sara; Henning, Robert A; Wallace, Kelly N; El Ghaziri, Mazen; Punnett, Laura; Dussetschleger, Jeffrey L; Cherniack, Martin G

2016-10-01

Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. HITEC-2 compared two different types of participatory program, a CO-only "Design Team" (DT) and "Kaizen Event Teams" (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. Am. J. Ind. Med. 59:897-918, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Participatory action research in corrections: The HITEC 2 program.

PubMed

Cherniack, Martin; Dussetschleger, Jeffrey; Dugan, Alicia; Farr, Dana; Namazi, Sara; El Ghaziri, Mazen; Henning, Robert

2016-03-01

HITEC 2 (Health Improvement through Employee Control 2) is the follow-up to HITEC, a participatory action research (PAR) program that integrates health and work conditions interventions designed by the workforce. HITEC 2 compares intervention programs between two correctional sites, one using a pure workforce level design team and the other using a more structured and time delineated labor-management kaizen effectiveness team. HITEC 2 utilizes a seven step participatory Intervention Design and Analysis Scorecard (IDEAS) for planning interventions. Consistent with PAR, process and intervention efficacy measures are developed and administered through workforce representation. Participation levels, robustness of participatory structures and sophistication of interventions have increased at each measured interval. Health comparisons between 2008 and 2013 showed increased hypertension, static weight maintenance, and increased 'readiness to change'. The PAR approaches are robust and sustained. Their long-term effectiveness in this population is not yet clear. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Issues of organizational cybernetics and viability beyond Beer's viable systems model

NASA Astrophysics Data System (ADS)

Nechansky, Helmut

2013-11-01

The paper starts summarizing the claims of Beer's viable systems model to identify five issues any viable organizations has to deal with in an unequivocal hierarchical structure of five interrelated systems. Then the evidence is introduced for additional issues and related viable structures of organizations, which deviate from Beer's model. These issues are: (1) the establishment and (2) evolution of an organization; (3) systems for independent top-down control (like "Six Sigma"); (4) systems for independent bottom-up correction of performance problems (like "Kaizen"), both working outside a hierarchical structure; (5) pull production systems ("Just in Time") and (6) systems for checks and balances of top-level power (like boards and shareholder meetings). Based on that an evolutionary approach to organizational cybernetics is outlined, addressing the establishment of organizations and possible courses of developments, including recent developments in quality and production engineering, as well as problems of setting and changing goal values determining organizational policies.

Kanban system implementation in cardboard supply process (Case study: PT. Akebono Brake Astra Indonesia - Jakarta)

NASA Astrophysics Data System (ADS)

Laksono, Pringgo Widyo; Kusumawardani, Christina Ayu

2017-11-01

Continuous improvement is needed by every manufacturing company to optimize their production. One way to reach that goal is eliminating waste that occurs in company. In PT. Akebono Brake Astra Indonesia - Jakarta (AAIJ), there are seven "muda" (waste) that always strived to remove, such as muda transportation that occurs in the cardboard supply system made by the non-value movement of PIC in packing area to take cardboard from warehouse. This research use Kaizen theory to get rid of muda transportation by changing the cardboard supply system that were previously done manually by PIC of packing area become taken over by a towing operator and apply Kanban system to improving the cardboard supply system information by creating set up of Kanban system that produce Material and Information Chart (MIFC), Standardized Work Chart (SWC), calculation of Kanban population, and Work Instruction (WI). This research lead to improvement of cardboard supply process, clearer and more cyclic information flow in cardboard supply system, and reduction of cost due to saving of manpower.

Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

Delivering quality of care while managing the interests of all stakeholders.

PubMed

Stopper, Andrea; Raddatz, Agnieszka; Grassmann, Aileen; Stuard, Stefano; Menzer, Marcus; Possnien, Gernot; Scatizzi, Laura; Marcelli, Daniele

2011-01-01

National healthcare systems worldwide face growing challenges to reconcile interests of patients for high-quality medical care and of payers for sustainable and affordable funding. Advances in the provision of renal replacement therapy can only be made by developing and implementing appropriate sophisticated and state-of-the-art business models that include reimbursement schemes for comprehensive care packages. Such business models must succeed in integrating and reconciling the interests of all stakeholders. NephroCare as dialysis provider has adopted and tailored recognized management techniques, i.e. Balanced Scorecard and Kaizen, to achieve these goals. Success of the complete business model package is tangible - strategies initiated to improve treatment quality even at the cost of providers have been translated into win-win scenarios for the complete stakeholder community. Room for improvement exists: the possibility to extend the portfolio of service offerings within the comprehensive care frame, as well as the challenge for achieving a balance between the stability of targets while keeping these up to date concerning new insights. Copyright © 2011 S. Karger AG, Basel.

Information system and website design to support theautomotive manufacture ERP system

NASA Astrophysics Data System (ADS)

Amran, T. G.; Azmi, N.; Surjawati, A. A.

2017-12-01

This research is to create an on-time production system design with Heijunka model so that the product diversity for all models could meet time and capacity requirements, own production flexibility, high quality, meet the customers’ demands, realistic in production as well as creating a web-based local components’ order information system that supports the Enterprise Resource Planning (ERP) system. The Heijunka model for equalization with heuristic and stochastic model has been implemented for productions up to 3000 units by implementing Suzuki International Manufacturing. The inefficiency in the local order information system demanded the need for a new information system design that is integrated in ERP. Kaizen needs to be done is the Supplier Network that all vendors can download and utilize those data to deliver the components to the company and for vendors’ internal uses as well. The model design is presumed effective where the model is able to be utilized as a solution so that the production can run according to the schedule and presumed efficient were the model is able to show the reduction of loss time and stock.

Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

PubMed

Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I

2010-07-01

To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system. Copyright 2010 Elsevier Ltd. All rights reserved.

Ares Launch Vehicles Lean Practices Case Study

NASA Technical Reports Server (NTRS)

Doreswamy, Rajiv; Self, Timothy A.

2007-01-01

The Ares launch vehicles team, managed by the Ares Projects Office (APO) at NASA Marshall Space Flight Center, has completed the Ares I Crew Launch Vehicle System Requirements Review and System Definition Review and early design work for the Ares V Cargo Launch Vehicle. This paper provides examples of how Lean Manufacturing, Kaizen events, and Six Sigma practices are helping APO deliver a new space transportation capability on time and within budget, while still meeting stringent technical requirements. For example, Lean philosophies have been applied to numerous process definition efforts and existing process improvement activities, including the Ares I-X test flight Certificate of Flight Readiness (CoFR) process, risk management process, and review board organization and processes. Ares executives learned Lean practices firsthand, making the team "smart buyers" during proposal reviews and instilling the team with a sense of what is meant by "value-added" activities. Since the goal of the APO is to field launch vehicles at a reasonable cost and on an ambitious schedule, adopting Lean philosophies and practices will be crucial to the Ares Project's long-term SUCCESS.

Applying the Principles of Lean Production to Gastrointestinal Biopsy Handling: From the Factory Floor to the Anatomic Pathology Laboratory.

PubMed

Sugianto, Jessica Z; Stewart, Brian; Ambruzs, Josephine M; Arista, Amanda; Park, Jason Y; Cope-Yokoyama, Sandy; Luu, Hung S

2015-01-01

To implement Lean principles to accommodate expanding volumes of gastrointestinal biopsies and to improve laboratory processes overall. Our continuous improvement (kaizen) project analyzed the current state for gastrointestinal biopsy handling using value-stream mapping for specimens obtained at a 487-bed tertiary care pediatric hospital in Dallas, Texas. We identified non-value-added time within the workflow process, from receipt of the specimen in the histology laboratory to the delivery of slides and paperwork to the pathologist. To eliminate non-value-added steps, we implemented the changes depicted in a revised-state value-stream map. Current-state value-stream mapping identified a total specimen processing time of 507 minutes, of which 358 minutes were non-value-added. This translated to a process cycle efficiency of 29%. Implementation of a revised-state value stream resulted in a total process time reduction to 238 minutes, of which 89 minutes were non-value-added, and an improved process cycle efficiency of 63%. Lean production principles of continuous improvement and waste elimination can be successfully implemented within the clinical laboratory.

What drives continuous improvement project success in healthcare?

PubMed

Stelson, Paul; Hille, Joshua; Eseonu, Chinweike; Doolen, Toni

2017-02-13

Purpose The purpose of this paper is to present findings from a study of factors that affect continuous improvement (CI) project success in hospitals. Design/methodology/approach Quantitative regression analysis was performed on Likert scale survey responses. Qualitative thematic analysis was performed on open-ended survey responses and written reports on CI projects. Findings The paper identifies managerial and employee factors that affect project success. These factors include managerial support, communication, and affective commitment. Affective commitment is the extent to which employees perceive the change as being needed or necessary. Practical implications The results highlight how managerial decisions, approaches to communication - including communication before, during and after CI projects affect project success. The results also show that success depends on the way employees perceive proposed changes. This suggests the need for a more individualized approach to CI, lean, and broader change initiatives. Originality/value This research is the first to fuse project success and sustainability theory to CI projects, beyond Kaizen events, in healthcare environments. The research is particularly important at a time when healthcare organizations are required to make rapid changes with limited resources as they work toward outcome-based assessment and reimbursement rules.

The truth lies somewhere in the middle: Swinging between globalization and regionalization of medical education in Japan.

PubMed

Saiki, Takuya; Imafuku, Rintaro; Suzuki, Yasuyuki; Ban, Nobutaro

2017-10-01

Japan is well known as a super-aging society, with a low birth rate, and has been ranked as one of the countries having the highest quality of healthcare system. Japan's society is currently approaching a major turning point with regard to societal and healthcare reforms, which are influenced by international trends and regional needs. Development of Japanese healthcare human resources, including medical students, is now expected to ride the wave of globalization, while resolving regional problems in the training and delivery of healthcare. Terms and global trends in medical education, such as outcome-based education, community-based education, reflective learning, international accreditation of medical education, and professionalization of educators are well translated into the Japanese language and embraced positively among the Japanese medical educators. However, these trends occasionally sit uncomfortably with cultural variations that are often a common approach in Japan; notably, "hansei" (introspection) and "kaizen" (change for the better). In the world facing a new era where people are unsettled between globalism and regionalism, Japan's future mission is to steer a balanced route that recognizes both global and regional influences and produce global health professionals educators.

Chugakko kyoikukatei kaizen no kihon-hoshin (Basic Policies for the Improvement of the Lower Secondary School Curriculum).

ERIC Educational Resources Information Center

Ministry of Education, Tokyo (Japan).

This document is an English-language abstract (approximately 1,500 words) of a two-part report dealing with curriculum improvement in junior high school. The junior high school should provide education for youth having completed elementary school, at that particular phase of physical and mental development, and prepare them for continuing their…

Assessment of MSFCs Process for the Development and Activation of Space Act Agreements

NASA Technical Reports Server (NTRS)

Daugherty, Rachel A.

2014-01-01

A Space Act Agreement (SAA) is a contractual vehicle that NASA utilizes to form partnerships with non-NASA entities to stimulate cutting-edge innovation within the science and technology communities while concurrently supporting the NASA missions. SAAs are similar to traditional contracts in that they involve the commitment of Agency resources but allow more flexibility and are more cost effective to implement than traditional contracts. Consequently, the use of SAAs to develop partnerships has greatly increased over the past several years. To facilitate this influx of SAAs, Marshall Space Flight Center (MSFC) developed a process during a kaizen event to streamline and improve the quality of SAAs developed at the Center level. This study assessed the current SAA process to determine if improvements could be implemented to increase productivity, decrease time to activation, and improve the quality of deliverables. Using a combination of direct procedural observation, personnel interviews, and statistical analysis, elements of the process in need of remediation were identified and potential solutions developed. The findings focus primarily on the difficulties surrounding tracking and enforcing process adherence and communication issues among stakeholders. Potential solutions include utilizing customer relationship management (CRM) software to facilitate process coordination and co-locating or potentially merging the two separate organizations involved in SAA development and activation at MSFC.

Using the Leitz LMS 2000 for monitoring and improvement of an e-beam

NASA Astrophysics Data System (ADS)

Blaesing-Bangert, Carola; Roeth, Klaus-Dieter; Ogawa, Yoichi

1994-11-01

Kaizen--a continuously improving--is a philosophy lived in Japan which is also becoming more and more important in Western companies. To implement this philosophy in the semiconductor industry, a high performance metrology tool is essential to determine the status of production quality periodically. An important prerequisite for statistical process control is the high stability of the metrology tool over several months or years; the tool-induced shift should be as small as possible. The pattern placement metrology tool Leitz LMS 2000 has been used in a major European mask house for several years now to qualify masks within the tightest specifications and to monitor the MEBES III and its cassettes. The mask shop's internal specification for the long term repeatability of the pattern placement metrology tool is 19 nm instead of 42 nm as specified by the supplier of the tool. Then the process capability of the LMS 2000 over 18 months is represented by an average cpk value of 2.8 for orthogonality, 5.2 for x-scaling, and 3.0 for y-scaling. The process capability of the MEBES III and its cassettes was improved in the past years. For instance, 100% of the masks produced with a process tolerance of +/- 200 nm are now within this limit.

Implementation of 5S Method for Ergonomic Laboratory

NASA Astrophysics Data System (ADS)

Dila Sari, Amarria; Ilma Rahmillah, Fety; Prabowo Aji, Bagus

2017-06-01

This article discusses 5S implementation in Work System Design and Ergonomic Laboratory, Department of Industrial Engineering, Islamic University of Indonesia. There are some problems related to equipment settings for activity involving students such as files which is accumulated over the previous year practicum, as well as the movement of waste in the form of time due to the placement of goods that do not fit. Therefore, this study aims to apply the 5S method in DSK & E laboratory to facilitate the work processes and reduce waste. The project is performed by laboratory management using 5S methods in response to continuous improvement (Kaizen). Moreover, some strategy and suggestions are promoted to impose 5S system within the laboratory. As a result, the tidiness and cleanliness can be achieved that lead to the great performance of laboratory users. Score assessment before implementing 5S DSKE laboratory is at 64 (2.56) while the score after implementation is 32 (1.28) and shows an improvement of 50%. This has implications for better use in the laboratory area, save time when looking for tools and materials due to its location and good visual control, as well as improving the culture and spirit of ‘5S’ on staff regarding better working environment

A study of 6S workplace improvement in Ergonomic Laboratory

NASA Astrophysics Data System (ADS)

Sari, AD; Suryoputro, MR; Rahmillah, FI

2017-12-01

This article discusses 6S implementation in Ergonomic Laboratory, Department of Industrial Engineering, Islamic University of Indonesia. This research is improvement project of 5S implementation in Ergonomic laboratory. Referring to the 5S implementation of the previous year, there have been improvements from environmental conditions or a more organized workplace however there is still a lack of safety aspects. There are several safeties problems such as equipment arrangement, potential hazards of room dividers that cause injury several times, placement of fire extinguisher, no evacuation path and assembly point in case of fire, as well as expired hydrant condition and lack of awareness of stakeholders related to safety. Therefore, this study aims to apply the 6S kaizen method to the Ergonomic laboratory to facilitate the work process, reduce waste, improve work safety and improve staff performance. Based on the score 6S assessment increased audit results by 32 points, before implementation is 75 point while after implementation is 107 point. This has implications for better use for mitigate people in laboratory area, save time when looking for tools and materials, safe workplace, as well as improving the culture and spirit of ‘6S’ on staff due to better and safetier working environment.

The demands and benefits of ergonomics in Sri Lankan apparel industry: A case study at MAS holdings.

PubMed

Abeysekera, John; Illankoon, Prasanna

2016-10-17

Apparel exports bring in sizeable foreign income to Sri Lanka. To protect and promote this industry is a paramount need. This can be carried out by applying Human Factors/Ergonomics (HFE) which has proved to control negative effects at work places. This paper reports a case study which describes the demands and benefits of HFE in MAS Holdings which owns a large share of the apparel industry in Sri Lanka. The study consisted of walk through observation survey, a questionnaire survey and ergonomic work place analysis followed by a training programme to selected employees in three companies. Positive responses to questionnaires revealed good ergonomic practices in the work places surveyed. Ergonomically unfit chairs and potential hazards e.g. exposure to noise and hot environment were detected. It is seen that MAS have introduced strategies originated by Toyota Production System viz. 5S, Kaizen, six sigma etc., which are in fact ergonomic methods. A progressive project MAS boast of viz. 'MAS Operating System' (MOS) empowers training and development to employees. MAS Holdings has adequately realized the benefits of applying HFE as evident by the number of awards received. Relevant companies were advised to take appropriate corrective measures to control the potential hazards.

Ares Project Overview - Quality in Design

NASA Technical Reports Server (NTRS)

Cianciola, Chris; Crane, Kenneth

2008-01-01

This presentation introduces the audience to the overall goals of the Ares Project, which include providing human access to low-Earth orbit, the Moon, and beyond. The presentation also provides an overview of with the vehicles that will execute those goals and progress made on the vehicles to date. The briefing will provide an introduction to Lean, Six Sigma, and Kaizen practices Ares will use to improve the overall effectiveness and quality of its efforts. Finally, the briefing includes a summary of Safety and Mission Assurance practices being implemented within[Ares to ensure safety and quality early in the design process. Integrating Safety and Mission Assurance in Design: This presentation describes how the Ares Projects are learning from the successes and failures of previous launch systems in order to maximize safety and reliability while maintaining fiscal responsibility. The Ares Projects are integrating Safer T and Mission Assurance into design activities and embracing independent assessments by Quality experts in thorough reviews of designs and processes. Incorporating Lean thinking into the design process, Ares is also streamlining existing processes and future manufacturing flows which will yield savings during production. Understanding the value of early involvement of Quality experts, the Ares Projects are leading launch vehicle development into the 21st century.

Driving Student-Centred Calculus: Results of a Comprehensive Case Study for Kaizen Learning in the Sultanate of Oman

ERIC Educational Resources Information Center

Heim, Bernhard; Rupp, Florian; Viet, Nils; Stockhausen, Paul v.; Gallenkämper, Jonas; Kreuzer, Judith

2015-01-01

The art of teaching freshmen students is undergoing a rapid paradigm change. Classical forms of teaching are not applicable any more and an unmanageable offer of new multimedia tools and concepts is glutting the market. Moreover, compared to previous courses, the class size triples. In view of these challenges, we implemented a new teaching…

Development of a work improvement checklist for occupational mental health focused on requests from workers.

PubMed

Tahara, Hiroyuki; Yamada, Tatsuji; Nagafuchi, Keiko; Shirakawa, Chie; Suzuki, Kiyomi; Mafune, Kosuke; Kubota, Shinya; Hiro, Hisanori; Mishima, Norio; Nagata, Shoji

2009-01-01

To develop tools offering definite orientation for managers and employees to support their work improvement through occupational mental health. This research was a part of the Mental Health Improvement & Reinforcement Study (MIR study), conducted from October 2004 to March 2006. We developed a trial version named the Kaizen Check List (KCL) by referring to problem solving methods for quality management. Then we improved it for a formal version named MIR Research of Recognition (MIRROR). A feedback form named MIR Action Guidance (MIRAGe) was also developed. We analyzed data from 1,953 respondents at five manufacturing enterprises in Japan using MIRROR and the Brief Job Stress Questionnaire (BJSQ) to determine whether or not the workers requesting work improvement had more stress than other workers. The KCL had 47 items, which indicated desirable working conditions for mental health at work, and four answer categories. MIRROR has 45 selected items and improved answer categories. MIRAGe displays the results of MIRROR and step-by-step guidance for work improvement. Respondents with request had significantly higher scores in stressor and lower scores in buffer factors compared with respondents without request in many items of MIRROR. A combinational use of MIRROR and stress scales is useful for finding worksites with high risk factors for mental health and for directing focus on work improvement at these worksites according to workers' requests.

PROJECT KAIZEN. Review of the Oversight by Congress of DoD Acquisition Programs with the Aim of Continuous Improvement

DTIC Science & Technology

1994-06-01

legitimate firms from being competitive in a global market and selling to DoD. CONCLUSION While there are some improvements in the way DoD purchases...and a final report . RDT&E BUDGET EXHIBITS DRAFT RDT&E BUDGET EXHIBITS HANDBOOK PREPARATION/REVIEW GUIDELINES Craig A . Farr Dennis L. Ryan, CAPT, USN... A -1 Chapter 5. Financial Management Regulation LIST OF FIGURES Figure 1I- RDT&E Exhibits Timeline

Application of the suggestion system in the improvement of the production process and product quality control

NASA Astrophysics Data System (ADS)

Gołaś, H.; Mazur, A.; Gruszka, J.; Szafer, P.

2016-08-01

The elaboration is a case study and the research was carried out in the company Alco-Mot Ltd., which employs 120 people. The company specializes in the production of lead poles for industrial and traction batteries using gravity casting. The elements embedded in the cast are manufactured on a machining centre, which provides the stability of the process and of the dimensions of the product as well as a very short production time. As a result of observation and analysis the authors have developed a concept for the implementation of a dynamic suggestion system in ALCO-MOT, including, among others, a standard for actions in the implementation of the suggestion system, as well as clear guidelines for the processing and presentation of the activities undertaken in the time between the establishment of the concept (suggestions) and the benefits analysis after the proposed solutions have been implemented. The authors also present how suggestions proposed by ALCO-MOT staff contributed to the improvement of the processes of production and quality control. Employees offered more than 30 suggestions, of which more than a half are being implemented now and further actions are being prepared for implementation. The authors will present the results of improvements in, for example, tool replacement time, scrap reduction. The authors will present how kaizen can improve the production and quality control processes. They will present how the production and quality control processes looked before and after the implementation of employee suggestions.

Implementation of a formulary management process.

PubMed

Karel, Lauren I; Delisle, Dennis R; Anagnostis, Ellena A; Wordell, Cindy J

2017-08-15

The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described. Maintaining a hospital formulary requires clear communication and coordination among multiple members of the pharmacy department. Using principles of lean methodology, pharmacy department personnel within a multihospital health system launched a multifaceted initiative to optimize formulary management systemwide. The ongoing initiative began with creation of a formulary maintenance redesign committee consisting of pharmacy department personnel with expertise in informatics, automation, purchasing, drug information, and clinical pharmacy services. The committee met regularly and used lean methodology to design a standardized process for management of formulary additions and deletions and changes to medications' formulary status. Through value stream analysis, opportunities for process and performance improvement were identified; staff suggestions on process streamlining were gathered during a series of departmental kaizen events. A standardized template for development and dissemination of monographs associated with formulary additions and status changes was created. In addition, a shared Web-based checklist was developed to facilitate information sharing and timely initiation and completion of tasks involved in formulary status changes, and a permanent formulary maintenance committee was established to monitor and refine the formulary management process. A clearly defined, standardized process within the pharmacy department was developed for tracking necessary steps in enacting formulary changes to encourage safe and efficient workflow. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Lean in healthcare: the unfilled promise?

PubMed

Radnor, Zoe J; Holweg, Matthias; Waring, Justin

2012-02-01

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains. Although this suggests that Lean might not currently deliver the efficiency improvements desired in policy, the evolution of Lean in the manufacturing sector also reveals this initial focus on the 'tool level'. In moving to a more system-wide approach, however, we identify significant contextual differences between healthcare and manufacturing that result in two critical breaches of the assumptions behind Lean. First, the customer and commissioner in the private sector are the one and the same, which is essential in determining 'customer value' that drives process improvement activities. Second, healthcare is predominantly designed to be capacity-led, and hence there is limited ability to influence demand or make full use of freed-up resources. What is different about this research is that these breaches can be regarded as not being primarily 'professional' in origin but actually more 'organisational' and 'managerial' and, if not addressed could severely constrain Lean's impact on healthcare productivity at the systems level. Copyright © 2011 Elsevier Ltd. All rights reserved.

How to Reduce Head CT Orders in Children with Hydrocephalus Using the Lean Six Sigma Methodology: Experience at a Major Quaternary Care Academic Children's Center.

PubMed

Tekes, A; Jackson, E M; Ogborn, J; Liang, S; Bledsoe, M; Durand, D J; Jallo, G; Huisman, T A G M

2016-06-01

Lean Six Sigma methodology is increasingly used to drive improvement in patient safety, quality of care, and cost-effectiveness throughout the US health care delivery system. To demonstrate our value as specialists, radiologists can combine lean methodologies along with imaging expertise to optimize imaging elements-of-care pathways. In this article, we describe a Lean Six Sigma project with the goal of reducing the relative use of pediatric head CTs in our population of patients with hydrocephalus by 50% within 6 months. We applied a Lean Six Sigma methodology using a multidisciplinary team at a quaternary care academic children's center. The existing baseline imaging practice for hydrocephalus was outlined in a Kaizen session, and potential interventions were discussed. An improved radiation-free workflow with ultrafast MR imaging was created. Baseline data were collected for 3 months by using the departmental radiology information system. Data collection continued postintervention and during the control phase (each for 3 months). The percentage of neuroimaging per technique (head CT, head ultrasound, ultrafast brain MR imaging, and routine brain MR imaging) was recorded during each phase. The improved workflow resulted in a 75% relative reduction in the percentage of hydrocephalus imaging performed by CT between the pre- and postintervention/control phases (Z-test, P = .0001). Our lean interventions in the pediatric hydrocephalus care pathway resulted in a significant reduction in head CT orders and increased use of ultrafast brain MR imaging. © 2016 by American Journal of Neuroradiology.

Participatory design in lean production: which contribution from employees? For what end?

PubMed

Perez Toralla, M S; Falzon, P; Morais, A

2012-01-01

The proponents of lean production have pointed to the positive effects of the work organization on employees in terms of autonomy, enhanced skills and empowerment mainly by their participation into the continuous improvement of work process. But studies that have examined this issue suggest that the increase in autonomy is not sufficient to compensate for increases work intensity. Participatory design has grown extensively in manufacturing since the 1980's under the impulsion of the Scandinavian socio-technical system approach and it's central in the model of lean production performance. Its main objectives are to improve quality, increase productivity and safety through employee's participation to the reduction of non-value added activities, such as defined by lean production. In the line of the studies on participatory design and continuous improvement the present study examines the functioning of work groups, based on the kaizen model, the aim of which was to improve the proportion of "value-added activities" and working conditions, essentially physical constraints. The main results are consistent with the literature and show that accelerated forms of re-conception activities give employees limited room for maneuver to elaborate solutions based on the analysis of the real activity. This study is part of a broader initiative that goes in the direction of continuous improvement of the design process itself so that it integrates the real constraints of work and propose changes bases on work as it actually takes place, beyond pre-established performance goals bases on the reduction of "non added value activities".

Thoracoscopic part of minimal invasive oesophagectomy in semiprone position: our initial experience.

PubMed

Thakkar, Chirag M; Kumar, Alankar V; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

2014-08-01

Surgical resection with curative intent is till the mainstay of treatment for resectable esophageal cancer. Minimal invasive oesophagectomy has the potential to lower morbidity and mortality. In all likelihood, thoracoscopic oesophagectomy in semiprone position gives all the benefits of prone position and can be converted to thoracotomy without change in patient position if needed. The aim of this study is to analyze the feasibility of thoracoscopic oesophagectomy in semiprone position. This is a retrospective analysis of the data of thoracoscopic oesophgeactomy in semiprone position at Kaizen Hospital, a tertiary care center for gastroenterology during the period of December 2011 to December 2012. All surgeries were performed under general anesthesia with a single-lumen endotracheal tube. Esophageal mobilization was done by thoracoscopic approach in a semiprone position and an end-to-end hand-sewn cervical anastomosis was done. Abdominal part was performed by laparoscopic method in 3 patients and by laparotomy in rest of the patients. Total of 12 patients were included in this study. There was 1 conversion to thoracotomy and 1 surgical mortality. Mean operating time for the thoracoscopic part was 103 minutes, mean estimated blood loss for the thoracoscopic part was 110 mL, mean maximum end-tidal CO2 38.5 mm Hg, mean lymph nodes retrieved 14, and all patients had R0 resection. The median intensive care unit stay was 1 day and hospital stay was 8 days. Thoracoscopic part of thoracolaparoscopic oesophagectomy in semiprone position is a feasible option. It gives all advantages of prone position and thoracotomy is possible without change in patient position. However, further large-scale studies are required.

Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries.

PubMed

Mears, Simon C; Pantle, Hardin A; Bessman, Edward S; Lifchez, Scott D

2015-05-01

Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors' institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. Copyright 2015, SLACK Incorporated.

Improving flow in the OR.

PubMed

Blouin-Delisle, Charles Hubert; Drolet, Renee; Gagnon, Serge; Turcotte, Stephane; Boutet, Sylvie; Coulombe, Martin; Daneau, Eric

2018-03-12

Purpose The purpose of this paper is to increase efficiency in ORs without affecting quality of care by improving the workflow processes. Administrative processes independent of the surgical act can be challenging and may lead to clinical impacts such as increasing delays. The authors hypothesized that a Lean project could improve efficiency of surgical processes by reducing the length of stays in the recovery ward. Design/methodology/approach Two similar Lean projects were performed in the surgery departments of two hospitals of the Centre Hospitalier Universitaire de Québec: Hôtel Dieu de Quebec (HDQ) and Hôpital de l'Enfant Jesus (HEJ). The HDQ project designed around a Define, Measure, Analyse, Improve and Control process revision and a Kaizen workshop focused on patients who were hospitalized in a specific care unit after surgery and the HEJ project targeted patients in a post-operative ambulatory context. The recovery ward output delay was measured retrospectively before and after project. Findings For the HDQ Lean project, wasted time in the recovery ward was reduced by 62 minutes (68 percent reduction) between the two groups. The authors also observed an increase of about 25 percent of all admissions made in the daytime after the project compared to the time period before the project. For the HEJ Lean project, time passed in the recovery ward was reduced by 6 min (29 percent reduction). Originality/value These projects produced an improvement in the flow of the OR without targeting clinical practices in the OR itself. They demonstrated that change in administrative processes can have a great impact on the flow of clinical pathways and highlight the need for comprehensive and precise monitoring of every step of the elective surgery patient trajectory.

A Lean Six Sigma approach to the improvement of the selenium analysis method.

PubMed

Cloete, Bronwyn C; Bester, André

2012-11-02

Reliable results represent the pinnacle assessment of quality of an analytical laboratory, and therefore variability is considered to be a critical quality problem associated with the selenium analysis method executed at Western Cape Provincial Veterinary Laboratory (WCPVL). The elimination and control of variability is undoubtedly of significant importance because of the narrow margin of safety between toxic and deficient doses of the trace element for good animal health. A quality methodology known as Lean Six Sigma was believed to present the most feasible solution for overcoming the adverse effect of variation, through steps towards analytical process improvement. Lean Six Sigma represents a form of scientific method type, which is empirical, inductive and deductive, and systematic, which relies on data, and is fact-based. The Lean Six Sigma methodology comprises five macro-phases, namely Define, Measure, Analyse, Improve and Control (DMAIC). Both qualitative and quantitative laboratory data were collected in terms of these phases. Qualitative data were collected by using quality-tools, namely an Ishikawa diagram, a Pareto chart, Kaizen analysis and a Failure Mode Effect analysis tool. Quantitative laboratory data, based on the analytical chemistry test method, were collected through a controlled experiment. The controlled experiment entailed 13 replicated runs of the selenium test method, whereby 11 samples were repetitively analysed, whilst Certified Reference Material (CRM) was also included in 6 of the runs. Laboratory results obtained from the controlled experiment was analysed by using statistical methods, commonly associated with quality validation of chemistry procedures. Analysis of both sets of data yielded an improved selenium analysis method, believed to provide greater reliability of results, in addition to a greatly reduced cycle time and superior control features. Lean Six Sigma may therefore be regarded as a valuable tool in any laboratory, and

Implementing Lean Manufacturing in Malaysian Small and Medium Startup Pharmaceutical Company

NASA Astrophysics Data System (ADS)

Ibrahim, Wan Mohd Khairi bin Wan; Rahman, Mohamed Abdul; Abu Bakar, Mohd Rushdi bin

2017-03-01

Domestic pharmaceutical industry has been identified by the Malaysian government as an industry to be developed under its 11th economic development plan. Most homegrown pharmaceutical companies fall under the category of small and medium enterprises (SME) and therefore need to be highly efficient in their operations to compete with the multinationals. Though lean manufacturing is a well-known methodology to achieve an efficient operation, only a small percentage of the local SMEs implement it. The study aims to determine the real success factors in lean implementation through systematic review of relevant literature on lean manufacturing implementation in local companies, onsite observation of a selected SME company, Global Factor Sdn. Bhd. (GFSB), that successfully implemented lean manufacturing followed by actual implementation of lean project at IKOP Sdn. Bhd., a small startup pharmaceutical company. Lean tools like Gemba, value stream map (VSM) and spaghetti diagram were used to analyze and improve a process at IKOP Sdn. Bhd. The literature review showed that the implementation of lean manufacturing at Malaysian SMEs involved in pharmaceutical industry is at its infancy. Study at GFSB indicated that successful implementation of lean manufacturing stems from management support, employee’s commitment, government support and knowledge on lean among employees. Application of lean tools in IKOP Sdn. Bhd. to improve the process cycle efficiency of hand sanitizer, i-Hand 4.0, has shown that the GMP guidelines are not jeopardized. The Kaizen improvement project resulted in 46.3% reduction in lead time. It may be concluded that implementing lean manufacturing in any small local startup pharmaceutical company is beneficial in reducing operational costs and increasing the efficiency and effectiveness and does not conflict with the existing GMP guidelines.

NASA Planning for Orion Multi-Purpose Crew Vehicle Ground Operations

NASA Technical Reports Server (NTRS)

Letchworth, Gary; Schlierf, Roland

2011-01-01

tools included Kaizen/Lean events, mockups and human factors analysis. The majority of products developed by this team are applicable as KSC prepares 21st Century Ground Systems for the Orion Multi-Purpose Crew Vehicle and Space Launch System.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

PubMed

Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root

[The total-quality-management-analysis of the continuation and discontinuation of alcohol family treatment: a grassroots approach].

PubMed

Nishikawa, K; Tatsuki, S

2001-06-01

A family support/treatment program was provided to thirty-three cases where a drinking family member (identified patient) had shown alcohol related problems but not yet admitted the problem. After a period of between thirteen and twenty-one months of family treatment, fourteen (42.4%) identified patients started their own treatment. The only statistically significant factor that was related to the patients' treatment program participation was the continuation of family members' involvement in a family treatment program. Among the thirty-three cases, a little less than one half (48.5%) continued the family program. In order to increase the patients' participation, it is crucial to encourage family members to continue their family support/treatment program. In order to identify factors that contribute treatment continuation as well as dropouts, workshops were held with those who dropped out and those who continued the family treatment program. The Total-Quality-Management (TQM) affinity and arrow diagram techniques were employed to classify the participants' statements and to find cause-effect relationships among the identified factors, respectively. Five family treatment discontinuation factors were identified: 1) a lack of information about family support program, 2) resistance against a "family change" orientation in family treatment program, 3) family member burnout, 4) a misfit between family needs for immediate problem solutions and what family program offers, and 5) a temporal improvement of patients' drinking problems. While widely varied factors were found to contribute discontinuation, only a very few factors were identified to facilitate the treatment continuation. It was concluded that treatment discontinuation, rather than continuation, was the norm among the families of problem drinkers. Based on the above findings, three kaizen plans were proposed. First, in order to make sure that family members obtain necessary information about the family support

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

PubMed Central

Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers. PMID:27398803

Evaluating Process Effectiveness to Reduce Risk

NASA Technical Reports Server (NTRS)

Shepherd, Christena C.

2017-01-01

security; loss of confidence in government; failure of publicly funded projects; damage to the environment; ethics violations, and the list goes on; with local, national and even international consequences. The Plan-Do-Check-Act process, also known as the "process approach" can be used at any time to establish and standardize a process, and it can also be used to check periodically for "process creep" (i.e., informal, unauthorized changes that have occurred over time), any necessary updates and improvements. While ISO 9001 compliance is not mandated for all government agencies, if interpreted correctly, it can be useful in establishing a framework and implementing effective management systems and processes.4 Another method that can be used to evaluate effectiveness is the scorecard definitions in Mallory's Process Management Standard5 as a basis for evaluating work on the process level on effective, and continuously improved and improving processes. With processes on the lower end of the scale, agencies are vulnerable to a great many risks, with employees and managers making up many of the rules as they go, leading to the above listed negative results. Without clear guidance for nominal operations, off-nominal situations can, and do, increase the likelihood of chaos. In an increasingly technical environment, with inter-agency communication and collaboration becoming the norm, agencies need to come to grips with the fact that processes can become rapidly outdated, and that the technical community should take on an increased role in the maturation of the agency's processes. Industry has long known that effective processes are also efficient, and process improvement methods such as Kaizen, Lean, Six Sigma, 5S, and mistake proofing lead to increased productivity, improved quality, and decreased cost. Again, government agencies have different concerns, but inefficiencies and mistakes can have dire and wide reaching consequences for the public that they serve. While no one goes