The Seven Focusing Steps of the Theory of Constraints (DRAFT)

2018 ◽  
Author(s):  
Boaz Ronen ◽  
Joseph S Pliskin ◽  
Shimeon Pass
Keyword(s):  
Performance Measures ◽  
Operating Rooms ◽  
Theory Of Constraints ◽  
Full System ◽  
System View ◽  
Global Performance ◽  
System Constraint ◽  
Cost Utilization ◽  
The Cost ◽  
Measures Of Performance

The theory of constraints has the potential to increase throughput significantly, using existing resources. It consists of seven focusing steps that, when applied, can create extra capacity in operating rooms, emergency departments, imaging services, labs, and so on. The seven steps are simple, intuitive, and easy to implement. This chapter discusses the first three steps of the theory of constraints: determining the system’s goal, establishing global performance measures, and identifying the system constraint. Tools are provided for identifying bottlenecks and determining measures of performance for the system. It also introduces the cost-utilization diagram that provides managers with a full-system view.

The Hospital and Clinic Improvement Handbook

2018 ◽  
Author(s):  
Boaz Ronen ◽  
Joseph S. Pliskin ◽  
Shimeon Pass ◽  
Donald M. Berwick
Keyword(s):  
Emergency Department ◽  
Performance Measures ◽  
Waiting Times ◽  
Implementation Process ◽  
Operating Rooms ◽  
Theory Of Constraints ◽  
Limited Time ◽  
Healthcare Organizations ◽  
Clinical Quality

The Hospital and Clinic Improvement Handbook is about doing more using existing resources. For example, achieving more throughput in the operating rooms, reducing waiting times at the emergency department, and improving clinical quality. This is done using the well-established Lean techniques together with the breakthrough philosophies and techniques of the theory of constraints (TOC). These methods and their underlying tools are put together with techniques and methodologies implemented by the authors in dozens of healthcare organizations. The tools include the complete kit concept, the Pareto methodology, the focusing table, and the focusing matrix. The book introduces simple tools that can be implemented quite easily in any hospital or clinic. It also focuses on the implementation process using tools like the 3–1–1 model that directs managers where to focus their limited time resources to best improve the performance of their organizations. Finally, the book introduces effective yet simple performance measures and prescribes the process of ongoing improvement.

Constraint Management in a Bottleneck Environment (DRAFT)

2018 ◽  
Author(s):  
Boaz Ronen ◽  
Joseph S Pliskin ◽  
Shimeon Pass
Keyword(s):  
Waiting Times ◽  
Healthcare Systems ◽  
Operating Rooms ◽  
Theory Of Constraints ◽  
Clinical Quality ◽  
Constraint Management ◽  
System Constraint

This chapter introduces steps 4 through 7 of the theory of constraints—that, respectively, decide how to exploit and utilize the constraint, subordinate the system to the constraint, elevate and break the constraint, and do not let inertia become the system constraint. The chapter shows how to achieve more using the existing resources by focusing on the bottleneck. For example, reducing waste (“garbage time”) of the bottleneck can quite quickly increase the system’s throughput. The subordination of the rest of the system to the bottleneck is then discussed. For this purpose, the scheduling mechanism of drum–buffer–rope can be implemented in some areas of healthcare systems, like operating rooms, leading to increased throughput and reduction of waiting times as well as improved clinical quality.

THE FOREIGN BANK EFFECT ON VALUE CREATION IN COMMERCIAL BANKS INCORPORATED IN THAILAND

2008 ◽  
Vol 53 (02) ◽  
pp. 215-244
Author(s):  
CHANTAL HERBERHOLZ
Keyword(s):  
Performance Measures ◽  
Commercial Banks ◽  
Economic Value ◽  
Value Added ◽  
Foreign Bank ◽  
Level Data ◽  
Beneficial Impact ◽  
Domestic Banks ◽  
The Cost ◽  
Traditional Performance

Using quarterly bank-level data over the period 1997–2005, this paper examines the effect of foreign bank presence on commercial banks incorporated in Thailand, using traditional and value-based performance measures as indicators of the degree of competition and proxies for the efficiency in the provision of banking services. The findings suggest that foreign bank presence is not only beneficial in terms of traditional performance measures, but also in terms of economic profit. The results with respect to economic value added and cash value added, however, cast some doubt over the presumed benefits of opening up, underlining the importance of using a proxy that considers the cost of equity and departs from standard accounting principles. Furthermore, the results indicate that foreign entry through the acquisition of domestic banks appears to have a stronger and more beneficial impact on locally incorporated banks than through the establishment of branches, with majority ownership by a foreign blockholder being of importance.

Cost-utilization of peripheral intravenous cannulation in hospitalized adults: An observational study

2020 ◽  
Vol 21 (5) ◽  
pp. 687-693 ◽  
Author(s):  
Fredericus HJ van Loon ◽  
Tina Leggett ◽  
Arthur RA Bouwman ◽  
Angelique TM Dierick-van Daele
Keyword(s):  
Catheter Insertion ◽  
International Standards ◽  
Personnel Costs ◽  
Peripheral Intravenous Catheter ◽  
Nurses And Physicians ◽  
Supply Costs ◽  
Cost Utilization ◽  
The Cost ◽  
Hospital Protocols ◽  
Mean Time

Aim: In modern healthcare there is increased focus on optimizing efficiency for every treatment or performed procedure, of which reduction of costs is an important part. With this study, authors aimed to calculate the cost of peripheral intravenous cannulation including all components that influence its price. Methods: This observational cost-utilization study was conducted between May and October 2016. Hospitalized adults were included in this study, who received usual care. Peripheral intravenous cannulation was carried out according to current hospital protocols, based on international standards for peripheral intravenous catheter insertion. Device costs were assumed equal to the number of attempts multiplied by the fixed supply costs and applicable costs for additional attempts, whereas personnel costs for both nurses and physicians were based on their hourly salary. Results: A total of 1512 patients were included in this study, with a mean of 1.37 (±0.77) attempts and a mean time of 3.5 (±2.7) min were needed for a successful catheter insertion. Adjusted mean costs for peripheral intravenous cannulation were estimated to be €11.67 for each patient, but costs increase as the number of attempts for successful cannulation increases. The cost for patients with a successful first attempt was lower, at approximately €9.32 but increased markedly to €65.34 when five attempts were needed. Conclusion: Prevention of multiple attempts may lower the costs, and furthermore, additional technologies applied by nurses to individual patients based on predicted difficult intravenous access will make the application of these additional technologies, in turn, more efficient.

scholarly journals Credit Card Fraud Detection Using Machine Learning Techniques

2020 ◽  
pp. 436-442
Author(s):  
Aruna Kumar Joshi ◽  
Vikram Shirol ◽  
Shreekanth Jogar ◽  
Pavankumar Naik ◽  
Annapoorna Yaligar
Keyword(s):  
Credit Card ◽  
Fraud Detection ◽  
Shopping Mall ◽  
Machine Learning Techniques ◽  
Credit Card Fraud ◽  
Public And Private ◽  
Transaction Process ◽  
Illegal Activities ◽  
Cost Utilization ◽  
The Cost

Credit Card Fraud is one of the major moral issues in the public and private bans sector. The effect of this problems leads to the several ethical trouble. The important themes are to notice the distinctive kinds of credit card fraud and to locate different methods that have been used in fraud detection. The sub-point is to suppose about existing and ruin down as of late dispensed discoveries in fraud detection. Probable upon the variety of extortion appeared with the banks or different financial organizations, exceptional measures can be embraced and executed. The work carried out in this paper are usually going to have really beneficial residences as a approaches as expenditure reserve fund and time capability. The cost utilization of the strategies investigated proper right here is in the minimization of credit card fraud. Anyway, there are up to now moral troubles when appropriate credit card customers are unsorted as fraudulent. Credit Card Fraud Detection is an method which will help people for their transaction process in shopping mall and any other transaction process nowadays fraud detection is nothing but an process where the criminals are found and there are many illegal activities are taking place which causes difficulty for people. Here in this paper we are using SMOTE technique to find fraud and this technique will help to sort both the normal transaction and fraud transaction this process can make easy to find fraudulent. And Neural Network KNN are also taken place to find Credit Card Fraud.

Corporate Female Leadership Effects Considering PSI20 and IBEX35 Companies' Performance

2019 ◽  
pp. 280-301
Author(s):  
Mara Madaleno ◽  
Elisabete S. Vieira ◽  
João P. C. Teodósio
Keyword(s):  
Board Of Directors ◽  
Performance Measures ◽  
Positive Influence ◽  
Performance Measure ◽  
Female Leadership ◽  
Accounting Performance ◽  
The Board Of Directors ◽  
Female Presence ◽  
The Relationship ◽  
Measures Of Performance

Using a sample of 47 Portuguese and Spanish firms for the period 2010 to 2017, the authors study the relationship between female presence on board and firm's accounting (ROA and ROE) and market-based (MTB and Tobin's Q) performance. They find that women on the board of directors is positively related to firm's performance, as well as the gender of the CFO and the proportion of women on the listed key professionals, when we consider the market measures of performance, not being so consistent for accounting performance measures. Results were sensitive to the performance measure used. The results reinforce the political options of European Commission gender established quotas, revealing that in the Iberian countries these quotas are not being effectively implemented, even if results suggest that women on board in fact exert positive influence over market performance. This also led us to think that financial markets may also react in a positive way when the CFO of the company is a woman instead of a man, despite the sample limitations both in terms of gender and number of firms.

The Journey From Development to Appraisal

2019 ◽  
pp. 327-342
Author(s):  
Tracy M. Maylett
Keyword(s):  
Performance Management ◽  
Performance Appraisal ◽  
Performance Measures ◽  
Past Performance ◽  
360 Feedback ◽  
Objective Performance ◽  
Objective Performance Measures ◽  
Performance Appraisal Process ◽  
Measures Of Performance

This case study describes an initiative to change a long-standing performance management process at a large manufacturing facility within General Mills that emphasized the attainment of objective performance measures (the “what” of performance) to one that also included the “how” of goal achievement. The organization embarked on a 3-year pilot evaluation of the use of 360 Feedback as a possible solution to replace or supplement their traditional single-source (supervisor) performance appraisal process. The two systems ran in parallel using 140 randomly selected employees. Results showed little correlation between the what measures of performance from the traditional appraisals and the how data collected using the 360 Feedback, supporting the view that job performance should be viewed as requiring both aspects of evaluation, using different methods of assessment. Ultimately, the organization maintained both systems but integrated 360 Feedback into the traditional appraisals as well, creating complementary processes that looked “forward” (development) and “past” (performance).

scholarly journals Understanding the Impact of Trunk and Arm Impairments on Wheelchair Rugby Performance During Competition

2019 ◽  
Vol 14 (5) ◽  
pp. 612-619 ◽  
Author(s):  
Barry S. Mason ◽  
Viola C. Altmann ◽  
Victoria L. Goosey-Tolfrey
Keyword(s):  
Performance Measures ◽  
Tracking System ◽  
Technical Skills ◽  
Wheelchair Rugby ◽  
Technical Performance ◽  
Indoor Tracking ◽  
Arm Function ◽  
The Impact ◽  
Technical Measures ◽  
Measures Of Performance

Purpose: To determine the effect of trunk and arm impairments on physical and technical performance during wheelchair rugby (WR) competition. Methods: Thirty-one highly trained WR players grouped according to their trunk (no trunk [NT]; some trunk [T] function) and arm impairments (poor, moderate, and good arm function) participated in 5 WR matches. Players’ physical (wheelchair mobility) and technical (ball handling) activities were analyzed using an indoor tracking system and video analysis, respectively. Results: Trunk impairment explained some of the variance in physical (10.6–23.5%) and technical (16.2–33.0%) performance. T covered more distance, had more possession, scored more goals, and received and made more passes yet spent less time at low speeds and performed fewer inbounds than NT (≤.05). Arm impairment explained some of the variance in all physical (16.7–47.0%) and the majority of technical (13.1–53.3%) performance measures. Moderate and good arm function covered more distance, reached higher peak speeds, spent more time in higher speed zones, scored more goals, had more possession, and received and made more passes, with a higher percentage of 1-handed and long passes, than poor arm function. Good arm function also received more passes and made a higher percentage of 1-handed passes and defensive blocks than moderate arm function (P ≤ .05). Conclusions: Arm impairment affects a greater number of physical and technical measures of performance specific to WR than trunk impairment during competition. Having active finger function (good arm function) yielded no further improvements in physical performance but positively influenced a small number of technical skills.

Single-Subgroup Performance Measures and Diagnostic Procedures for X-Bar Control Charts

1994 ◽  
Vol 116 (2) ◽  
pp. 216-224
Author(s):  
G. E. Rahn ◽  
S. G. Kapoor ◽  
R. E. DeVor
Keyword(s):  
Performance Measures ◽  
Control Charts ◽  
Simulated Data ◽  
Diagnostic Procedures ◽  
Shewhart Control Charts ◽  
Operational Characteristics ◽  
Shewhart Control ◽  
The Mean ◽  
Measures Of Performance ◽  
Tremendous Impact

Although Shewhart control charts have had a tremendous impact on quality improvement, the inability to precisely measure chart performance has limited their role, and subsequently overall effectiveness in the control of manufacturing processes. Measures of performance in terms of operational characteristics (OC) are defined on two distinct levels: (a) single-subgroup level, which examines the probability of a rule violation at any given subgroup (b) multiple-subgroup level, which considers the probability of one or more rule violations throughout process monitoring. Single-subgroup performance measures for X-bar charts that employ four rules are formulated. These measures are exact expressions of operational characteristics, except for the numerical approximation to the integral of the normal distribution. Applications of these models to simulated data demonstrate their accuracy in predicting chart performance. In addition, a diagnostic methodology is described which utilizes the derived performance measures to predict the mean of a shifted distribution. The proposed diagnostic procedure is illustrated in validation and application examples.

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