INNV-05. MULTIDISCIPLINARY SPINE ONCOLOGY CARE ACROSS THE DISEASE CONTINUUM - UPDATES FOR THE BEDSIDE AND THE BOARDS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi106-vi106
Author(s):  
Erin Dunbar
Keyword(s):  
Initial Symptom ◽  
Multidisciplinary Program ◽  
Current State ◽  
Future State ◽  
Concise Review ◽  
Initial Tumor ◽  
Oncology Care ◽  
Resultant Increase ◽  
Tumor Types ◽  
Primary Spine

Abstract In response to the increased prevalence and complexity of metastatic and primary spine oncology, there has been a resultant increase in stakeholders, treatments and outcomes. A subset of the global multidisciplinary authors will present a timely and concise review of the contents of NOP’s Volume-7, supplement-1, “Multidisciplinary Spine Oncology Care Across the Disease Continuum”. The first portion will review: Epidemiology, Tumor Types, Presentation, Initial Tumor-directed Management, Initial Symptom-directed Management, Subsequent Tumor-directed Management, Subsequent Symptom-directed Management, and Multidisciplinary Program Development and Resources for Stakeholders. The second portion will challenge the current state of care and engage the attendees toward developing initiatives needed for a future state of care. Attendees will receive an update for both the bedside and the boards.

scholarly journals Distributed Interoperable Records: The Key to Better Supply Chain Management

Computers ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 89
Author(s):  
Annegret Henninger ◽  
Atefeh Mashatan
Keyword(s):  
Supply Chain ◽  
Supply Chain Management ◽  
Gap Analysis ◽  
Global Supply Chain ◽  
Full Potential ◽  
Chain Management ◽  
Current State ◽  
Future State ◽  
Distributed Ledger ◽  
Distributed Ledger Technology

The global supply chain is a network of interconnected processes that create, use, and exchange records, but which were not designed to interact with one another. As such, the key to unlocking the full potential of supply chain management (SCM) technologies is achieving interoperability across participating records systems and networks. We review existing research and solutions using distributed ledger technology (DLT) and provide a survey of its current state of practice. We additionally propose a holistic solution: a DLT-based interoperable future state that could enable the interoperable, efficient, reliable, and secure exchange of records with integrity. Finally, we provide a gap analysis between our proposed future state and the current state, which also serves as a gap analysis for many fractional DLT-based SCM solutions and research.

scholarly journals Improving Quality Control Process Through Value Stream Mapping

2018 ◽  
Vol 7 (2.29) ◽  
pp. 219
Author(s):  
Zulfa Fitri Ikatrinasari ◽  
Dan Kosasih
Keyword(s):  
Quality Control ◽  
Lead Time ◽  
Value Added ◽  
Maximum Efficiency ◽  
Value Stream Mapping ◽  
Process Time ◽  
Value Stream ◽  
Current State ◽  
Future State ◽  
Quality Control Process

PT. AEMI is one of the growing electronic component manufacturing company. By this time, Kaizen project has been run and managed to become a culture in PT AEMI. However, the project has not integrated, comprehensive and not yet has a long-term goals. Implementation of value stream mapping (VSM) in PT AEMI is expected to make Kaizen projects more focused and to produce increasing of the maximum efficiency. In addition, VSM Kaizen is believed to make the those programs more integrated, effective and comprehensive. This study aims to: (1) create a current state mapping in the Department of Quality Control PT. AEMI, (2) identify wastes in the Department of Quality Control PT.AEMI, (3) create a future state mapping at the Department of Quality Control PT. AEMI, (4) make a plan of improvement and analyzing the application. Stages of the study were as follows: (1) identification of work processes, (2) collect and analysis of work process time, (3) analysis of the current state mapping, (4) calculate of lead time and process time, (5) analysis of value added and non value-added activities, (6) analysis of wastes, (7) make a plan of future state mapping, (8) improvement design (improvement planning), (9) implementation of improvement, (10) analysis of the implementation of improvements. The results of this study are: 1) current state mapping at QC Department shows that the total lead time of 848 minutes where there is non-value added activity of 778 minutes. 2) identify waste on the handling process where the product movement from assembly to QC for 2 minutes, movement transactions from assembly to QC for 479 minutes and the waiting time at  inspection area for 727 minutes. 3) future state mapping at QC Department shows that the total lead time of 516.5 minutes where there is non-value added activity of 446.5 minutes. 4) the improvement to do is to change the lay out where final inspection is moved from QC to manufacturing so as to result in reduce of non-value added activity by 46%. 

scholarly journals Perbaikan Efisiensi Jalur Layanan Pasien Rumah Sakit dengan Menggunakan Pendekatan Lean Healthcare

2020 ◽  
Vol 3 (4) ◽  
pp. 509-521
Author(s):  
Wresni Anggraini ◽  
Anifah Naswan Ilhamda
Keyword(s):  
Value Added ◽  
Root Cause Analysis ◽  
Value Stream Mapping ◽  
Cause Analysis ◽  
Value Stream ◽  
Root Cause ◽  
Current State ◽  
Future State ◽  
Lean Healthcare ◽  
Cycle Efficiency

Standar pelayanan minimal rumah sakit tentang waktu tunggu untuk rawat jalan yang ditetapkan oleh Kemenkes Nomor. 129/Menkes/SK/II/2008 adalah tidak lebih dari 60 menit.  Masalah yang dihadapi oleh Poli Tulip Rumah Sakit X Pekanbaru adalah waktu menunggu pasien lebih dari 60 menit.  Tujuan dari penelitian ini adalah memberikan usulan perbaikan untuk mengurangi waktu tunggu pasien.. Metode yang digunakan pada penelitian ini adalah  lean healthcare menggunakan analisis Value Stream Mapping (VSM) untuk menentukan nilai Process Cycle Efficiency (PCE). Berdasarkan current state value stream mapping nilai PCE saat ini adalah 16,85%, ini berarti efisiensi lini pada Poli Tulip Rumah Sakit X Pekanbaru masih sangat rendah. Proses usulan perbaikan efisiensi lini dengan cara mengidentifikasi dan mengurangi non value added activity dan waste yang paling sering terjadi pada proses pelayanan pasien. Ditemukan waste yang berpengaruh menyebabkan waste delay adalah waste unnecessary movement dan lost oppurtunity to retain or win customers yaitu sebesar 22,11%. Untuk mencari akar penyebab waste dilakukan root cause analysis. Akar penyebab masalah dari waste yang terjadi di lini pelayanan pasien bersumber dari faktor individual pegawai dan manajerial Rumah Sakit. Simulasi future state value stream mapping dengan menggunakan ARENA dilakukan untuk menguji usulan perbaikan, didapatkan  nilai PCE harapan sebesar 36,18 %, yang berarti dengan usulan perbaikan yang diberikan telah meningkatkan efisiensi jalur layanan pasien di Poli Tulip sebesar 19,33%.

scholarly journals MEMINIMASI PEMBOROSAN DENGAN LEAN MANUFACTURING PADA PROSES PRODUKSI DI PT. IE

2021 ◽  
pp. 1451
Author(s):  
Ahmad Ahmad ◽  
Helena JK ◽  
Andrean Yonathan
Keyword(s):  
Waiting Time ◽  
Cycle Time ◽  
Lean Manufacturing ◽  
Lead Time ◽  
Fault Tree Analysis ◽  
Value Stream Mapping ◽  
Tree Analysis ◽  
Value Stream ◽  
Current State ◽  
Future State

PT. IE is engaged in the business of making Lighting and Lampposts. Based on observations and interviews, there are still some wastes that arise in the flow of the production process, among which there are still many wastes of waiting time, transportation, movement and inventory. These wastes cause the product completion time to be longer and the resulting quality decreases. To eliminate or reduce waste, it is necessary to apply Lean Manufacturing. Lean Manufacturing is a systematic approach to eliminating waste and changing processes by identifying and reducing waste with continuous improvement and striving to create a production flow along the value stream by eliminating all forms of waste and increasing the added value of products to customers. From the Pareto diagram, it is found that transportation waste has the highest percentage of 26.21%, waiting time is 21.38%, motion waste is 19.31% and waste inventories are 15.17%. while the results of the Value Stream Mapping Current State Map mapping obtained a production lead time of 7,680 seconds and a total cycle time of 6,660 seconds and a PCE Current State Map value of 53.09%. Identify the root causes of waste using Fishbone diagrams, 5 Why Analysis, 5W+1H, Fault Tree Analysis and FMEA. After corrective actions have been taken, based on the Value Stream Mapping Future mapping there is a decrease in production lead time to 5,220 seconds and a decrease in total cycle time to 4,860 seconds and an increase in PCE Future State Map to 68.10% so that there is an increase of 15.01% which shows The company's production process has become more Lean.PT. IE bergerak dalam bisnis pembuatan Lighting dan Tiang Lampu. Berdasarkan observasi dan wawancara, masih terdapat beberapa pemborosan (waste) yang timbul di aliran proses produksi di antaranya masih banyak terjadi pemborosan-pemborosan waktu tunggu, transportasi, gerakan dan inventori. Pemborosan-pemborosan tersebut menyebabkan waktu penyelesaian produk menjadi lebih lama dan kualitas yang dihasilkan menurun. Untuk menghilangkan atau mengurangi pemborosan diperlukan adanya penerapan Lean Manufacturing.Lean Manufacturing merupakan pendekatan sistematik untuk mengeliminasi pemborosan dan mengubah proses dengan cara mengidentifikasi dan mengurangi pemborosan dengan perbaikan kontinu dan berupaya untuk menciptakan aliran produksi sepanjang value stream dengan menghilangkan segala bentuk pemborosan serta meningkatkan nilai tambah produk kepada pelanggan. Dari diagram Pareto ditemukan waste transportasi memiliki persentase paling tinggi sebesar 26,21%, waktu tunggu  21,38%, waste motion 19,31% dan waste inventories 15,17%. sedangkan hasil pemetaan Value Stream Mapping Current State Map diperoleh production lead time selama 7.680 detik dan total cycle time selama 6.660 detik serta nilai PCE Current State Map sebesar 53,09%. Identifikasi akar permasalahan pemborosan menggunakan diagram Fishbone, 5 Why Analysis, 5W+1H, Fault Tree Analysis dan FMEA. Setelah dilakukan tindakan–tindakan perbaikan, berdasarkan pemetaan Value Stream Mapping Future ada penurunan production lead time menjadi 5.220 detik dan penurunan total cycle time menjadi 4.860 detik serta ada peningkatan PCE Future State Map menjadi 68,10% sehingga ada peningkatan 15,01% yang menunjukan proses produksi perusahaan telah menjadi lebih Lean.

scholarly journals Increasing Productivity by Reducing Manufacturing Lead Time through Value Stream Mapping

2012 ◽  
pp. 225-229
Author(s):  
Renu Yadav ◽  
Ashish Shastri ◽  
Mithlesh Rathore
Keyword(s):  
Lead Time ◽  
Value Added ◽  
Value Stream Mapping ◽  
Mapping Technique ◽  
Inventory Level ◽  
Lead Times ◽  
Business World ◽  
Value Stream ◽  
Current State ◽  
Future State

To survive in today’s competitive business world, companies require small lead times, low costs and high customer service levels. As such, companies pay more effort to reduce their manufacturing lead times. Value stream mapping (VSM) technique has been used on a broad scale in big companies such as Toyota and Boeing. This paper considers the implementation of value stream mapping technique in manufacturing helical springs by railway spring manufacturing company. It focuses on product family, current state map improvements and the future state map. The aim is to identify waste in the form of non value added activities & processes and then removing them to improve the performance of the company. Current state map is prepared to describe the existing position and various problem areas.. Future state map is prepared to show the proposed improvement action plans. The achievements of value stream implementation are reduction in lead time, cycle time and inventory level. It was found that even a small company can make significant improvements by adopting VSM technology. It was concluded that if we adopt the VSM technique the company could reduce the manufacturing lead time from 36.86 days to 34.06 days.

scholarly journals Kaizen Selection for Continuous Improvement through VSM-Fuzzy-TOPSIS in Small-Scale Enterprises: An Indian Case Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sunil Kumar ◽  
Ashwani Kumar Dhingra ◽  
Bhim Singh
Keyword(s):  
Continuous Improvement ◽  
Cycle Time ◽  
Fuzzy Topsis ◽  
Shop Floor ◽  
Small Scale ◽  
Market Demand ◽  
Current State ◽  
Future State ◽  
Indian Industries

In the era of cut throat competitive market, Indian industries are under tremendous pressure to continuously reduce the cost and improve product quality. The main objective of this research paper is to provide a road map for investigating the opportunities to reduce cost and improve productivity and quality in the existing production system through the application of Lean-Kaizen concept using value stream mapping (VSM) tool at shop floor of an Indian Small-Scale Enterprise (SSE). On the basis of collected data from the selected industry, a current state map was made. After analysis, the current state map was modified to develop a future state map. By comparing current and future state map, the gap areas were identified and takt time (TT) was calculated considering actual market demand. To overcome the gap between current state map and future state map and to synchronize cycle time of each station with talk time, Kaizen event (KE) was proposed. Fuzzy technology for order preference by similarity to ideal solution (TOPSIS) was applied to prioritize and select the appropriate KE for optimized performance level. After analysis of data obtained after application of the Lean-Kaizen concept, the final improvements in terms of improved productivity (57.15%) and reduced lead time (69.47%), reduced cost (65.61%), and station cycle time (75.25%) were recorded. Through the case study drawn from realistic situations of the industry, the authors highlight that implementation of Lean-Kaizen using VSM and fuzzy TOPSIS provides improvement opportunities across the organization. The findings can inspire the SSEs to adopt the Lean-Kaizen concept for optimizing continuous improvement opportunities in their production industry. This study offers the researchers and practitioners a good example for understanding, selecting, and performing KE program. They can even attain more improvement in various areas by establishing or improving these KE programs.

scholarly journals Neurological manifestation of sacral tumors

2003 ◽  
Vol 15 (2) ◽  
pp. 1-6 ◽  
Author(s):  
Michael Payer
Keyword(s):  
Clinical Presentation ◽  
General Pattern ◽  
Clinical Manifestations ◽  
Initial Symptom ◽  
Course Of Disease ◽  
Local Pain ◽  
Extensive Analysis ◽  
Sensorimotor Deficit ◽  
Sacral Tumors ◽  
Tumor Types

An extensive analysis of the existing literature concerning sacral tumors was conducted to characterize their clinical manifestations. Although certain specific manifestations can be attributed to some of the tumor types, a more general pattern of clinical presentation of an expansive sacral lesion can be elaborated. Local pain with or without pseudoradicular or radicular radiation is the most frequent initial symptom and is usually followed by the manifestation of a lumbosacral sensorimotor deficit; bladder/bowel and/or sexual dysfunction appear throughout the natural course of disease.

scholarly journals WASTE ELIMINATION USING VALUE STREAM MAPPING AND VALSAT

2017 ◽  
Vol 3 (2) ◽  
Author(s):  
Dion Avellino Suyanto ◽  
Sunday Noya
Keyword(s):  
Lean Manufacturing ◽  
Lead Time ◽  
Value Stream Mapping ◽  
Value Stream ◽  
Current State ◽  
Future State ◽  
Analysis Tools ◽  
Fierce Competition ◽  
Cycle Efficiency ◽  
Working Efficiency

Fierce competition encourages companies to make continuous improvements to achieve better working efficiency. One method to improve the working efficiency is using the concept of lean manufacturing. The efficiency of the existing work in PT. Rimba Kencana is still not good because there are many processes that are not uniform and because of that, production lead time is increased. By using value stream mapping and value stream analysis tools (VALSAT), the production processes in the company are mapped into the current state mapping and future state mapping. In the current state mapping, the total value of production lead time is 59.49 days and the value of process cycle efficiency (PCE) is 0.013%. After doing improvement on welding department, the total value of production lead time decreased to 48.22 days and the value of process cycle efficiency becomes 0.016%. Keywords: Efficiency, Value Stream Mapping, Value Stream Analysis Tools

scholarly journals Improving Concrete Waste Rate Generation of Structure Projects in Leading Construction Firm in Indonesia

2021 ◽  
Vol 3 (4) ◽  
pp. 12-17
Author(s):  
Daniela Dea Hapsari ◽  
Sumarsono Sudarto ◽  
Gembong Baskoro
Keyword(s):  
Waste Management ◽  
Waste Generation ◽  
Current State ◽  
Future State ◽  
Construction Firm ◽  
Actual Field ◽  
Waste Rate ◽  
Waste Generation Rate ◽  
Management Issues

The Construction and Demolition (C&D) industry is very close to various waste management issues as the generation of waste is inevitable in every construction. In Indonesia, to make an applicable implementation of C&D Waste Management, the improvement must be made by looking into the actual field process. The improvement uses DMAIC as the lean tools and VSM to state the current process of material from its delivery on the site into a waste. Waste that is being monitored is the most used materials in the case study project which are concrete. A notable project was taken for the study as it will help other structure projects to imitate the down-to-earth future state, aiming at the reduction of waste generation rate and also business process improvement. The result shows that the process of concrete from orders to waste took eight steps, and three of them are improved, producing 3% lesser waste from the current state. The best scenario WGR were analyzed to also answer the stakeholder interest within the case study.

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