Leanness evaluation in health-care organizations using fuzzy logic approach

2020 ◽  
Vol 28 (6) ◽  
pp. 1201-1225 ◽  
Author(s):  
M. Suresh ◽  
V. Vaishnavi ◽  
Rajesh D. Pai

Purpose Lean practices are one of the fundamental practices adopted by health-care organizations to improve service quality and to reduce cost. In this context, the measurement of leanness in health-care organizations has become imperative. The purpose of this study is to measure the leanness of a hospital using fuzzy logic. Design/methodology/approach The design of the research includes two major steps. First, the identification of enablers, criteria and attributes of leanness constitutes the measures of assessment. Second, the above measures in the case hospital are assessed by using fuzzy logic approach. Findings This study suggests that leanness assessment is essential to identify the current lean capability of a health-care organization. This would help the health-care organizations to improve their lean performance further. The findings of the study suggest that the leanness of the case hospital is “Lean” (fuzzy range: 5.61, 7.24 and 8.91). Practical implications This study brings in three important implications from managerial point of view. First, it helps the management to assess the current level of leanness of the hospital. Second, it identifies the attributes that prevent the organization from being more lean. Third, it provides suggestive measures to address the weaker attributes and enables the enhancement of lean performance further. Originality/value The leanness assessment framework developed in the hospital operations is found to be original, and it adds value to the leanness assessment in health-care operations.

2017 ◽  
Vol 24 (4) ◽  
pp. 973-993 ◽  
Author(s):  
Rohit Agrawal ◽  
P. Asokan ◽  
S. Vinodh

Purpose The purpose of this paper is to present a study that is focused on application of fuzzy logic and adaptive neuro-fuzzy inference system (ANFIS) approaches for leanness evaluation in an Indian small- and medium-size enterprise (SME). Design/methodology/approach Lean manufacturing concepts are being adopted by SMEs to sustain in the competitive manufacturing landscape. Performance of lean system needs to be assessed using appropriate methods. A model for measuring lean performance is proposed with five enablers, 30 criteria and 90 attributes. Leanness index is computed using fuzzy logic approach and benchmarked with ANFIS approach. Findings Leanness index computed using fuzzy logic approach is found to be (4.47, 5.97, 7.55) and that of ANFIS approach is found to be 5.84 to facilitate benchmarking of leanness evaluation. After finding weaker areas, certain improvement initiatives are being deployed. Research limitations/implications The developed model for leanness evaluation has been test implemented in an SME. In future, the model could be test implemented in several SMEs. Practical implications A case study conducted in an SME involved in heavy engineering fabrication is presented. Therefore, the inferences derived from the study has practical propensity. Originality/value The development of leanness evaluation model for SMEs and deployment in an industrial scenario are the original contributions of the authors.


2019 ◽  
Vol 10 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Abdulaziz Marzouq Almutairi ◽  
Konstantinos Salonitis ◽  
Ahmed Al-Ashaab

Purpose Numerous and diverse organizations have implemented lean principles and practices, which concentrate on improving the efficiency of business processes by reducing cost, waste, consumptions and effort. However, previous assessments have not focused on the leanness of the supply chain in a health-care setting. This paper aims to introduce a method for assessing the successful implementation of lean principles and tools in a supply chain. Furthermore, this paper validates the method in a health-care organization. Design/methodology/approach This paper starts with an extensive literature review on assessing leanness and using multi-grade fuzzy logic. Then, a conceptual model was developed to measure leanness. The conceptual model was validated by discussing the initial version with select academic experts, especially those who deal with leanness in health-care organizations. After responding to the experts’ valuable comments, the health-care organization that is the focus of this case study was chosen based on two criteria. The first criterion was the organization’s ability to participate in the study, and the second was the organization’s commitment to implementing lean principles. These criteria were important to ensure the organization had the necessary foundation for implementing change initiatives such as lean process improvements. Next, a multi-grade (multi-attributes) fuzzy logic was used for leanness measurement. A leanness index was calculated, and the results were validated using experts from the case study organization. Finally, the weaker areas of the organization’s processes were identified to point the way for further improvements. Findings The assessment indicated that the case study organization is not lean. The organization’s weaker attributes were identified, and improvements have been suggested. Research limitations/implications This study focused on a single health-care organization, which was selected from a limited pool of potential organizations, namely, organizations which are accredited by both the Saudi Central Board for Accreditation of Healthcare Institutions and the Joint Commission International. The scope of future research should be extended to multi-case studies to enhance the findings presented in this paper. This paper’s findings can be used to help decision-makers at health-care providers to implement lean thinking in supply chain processes. Practical implications This research may be interest to practicing supply chain managers, as it proposes what enablers, factors and attributes should be emphasized in lean implementation. The proposed model can work as an assessment tool to identify the gap between the present level of leanness and the desired leanness state so the health-care organization can identify what can be improved. This model enables decision-makers in hospital supply chain to take suitable actions for improving lean implementation level. Originality/value This study makes an original contribution to the body of research concerning lean principles; the study developed a conceptual model for leanness assessment that can be applied to the supply chain of health-care organizations. Indeed, the conceptual model is likely to be useful for assessing leanness outside of the health-care field, which suggests avenues for future research.


2018 ◽  
Author(s):  
Arriel Benis ◽  
Nissim Harel ◽  
Refael Barak Barkan ◽  
Einav Srulovici ◽  
Calanit Key

BACKGROUND Data collected by health care organizations consist of medical information and documentation of interactions with patients through different communication channels. This enables the health care organization to measure various features of its performance such as activity, efficiency, adherence to a treatment, and different quality indicators. This information can be linked to sociodemographic, clinical, and communication data with the health care providers and administrative teams. Analyzing all these measurements together may provide insights into the different types of patient behaviors or more accurately to the different types of interactions patients have with the health care organizations. OBJECTIVE The primary aim of this study is to characterize usage profiles of the available communication channels with the health care organization. The main objective is to suggest new ways to encourage the usage of the most appropriate communication channel based on the patient’s profile. The first hypothesis is that the patient’s follow-up and clinical outcomes are influenced by the patient’s preferred communication channels with the health care organization. The second hypothesis is that the adoption of newly introduced communication channels between the patient and the health care organization is influenced by the patient’s sociodemographic or clinical profile. The third hypothesis is that the introduction of a new communication channel influences the usage of existing communication channels. METHODS All relevant data will be extracted from the Clalit Health Services data warehouse, the largest health care management organization in Israel. Data analysis process will use data mining approach as a process of discovering new knowledge and dealing with processing data extracted with statistical methods, machine learning algorithms, and information visualization tools. More specifically, we will mainly use the k-means clustering algorithm for discretization purposes and patients’ profile building, a hierarchical clustering algorithm, and heat maps for generating a visualization of the different communication profiles. In addition, patients’ interviews will be conducted to complement the information drawn from the data analysis phase with the aim of suggesting ways to optimize existing communication flows. RESULTS The project was funded in 2016. Data analysis is currently under way and the results are expected to be submitted for publication in 2019. Identification of patient profiles will allow the health care organization to improve its accessibility to patients and their engagement, which in turn will achieve a better treatment adherence, quality of care, and patient experience. CONCLUSIONS Defining solutions to increase patient accessibility to health care organization by matching the communication channels to the patient’s profile and to change the health care organization’s communication with the patient to a highly proactive one will increase the patient’s engagement according to his or her profile. INTERNATIONAL REGISTERED REPOR RR1-10.2196/10734


Author(s):  
María Carmen Carnero

Sustainability is considered a paradigm for businesses in the 21st Century. Despite this, the existing tools for helping to introduce strategies and manage activities to promote sustainable business are few. These deficiencies become more important in Health Care Organizations owing to its particular conditions of resource consumption and waste production. It is, therefore, essential to have objective tools to assist in monitoring environmental sustainability in this type of organization. This Chapter therefore sets out a multicriteria assessment system constructed by extension to a fuzzy environment of the Technique for Order Preference by Similarity to Ideal Situation (TOPSIS), to assess the environmental responsibility of a Health Care Organization. This model allows joint evaluation of a significant number of decision criteria. The aim is to provide a hospital with a model which is easy to apply, with criteria specific to health care, and which allows its responsibility with regard to the environment to be monitored over time. The model has been used in a Public Hospital.


2020 ◽  
Vol 12 (2) ◽  
pp. 173-186
Author(s):  
Therese Kahm ◽  
Pernilla Ingelsson

Purpose The purpose of this paper is to present the supportive conditions that the first-line health-care managers claim that they need from their own managers and what they experience as their own roles and responsibilities in relation to their coworkers when applying Lean principles and practices. Design/methodology/approach A survey with a Web-based questionnaire was designed and used in a Swedish health-care organization two years after the initiation of Lean to investigate the managers’ views on their role, conditions and ability to create change according to Lean. The result from two of the questions will be presented where one focuses on the relationship to the first-line managers’ own manager and the second on the relationship to their coworkers. Findings The results show that to initiate improvement, work based on Lean first-line managers ask for own managers who are assured about Lean, include them in discussions and ask for follow-ups and results about Lean. Concerning first-line managers’ relation to their coworkers they experience themselves as responsible for leading toward creating a culture where problems and mistakes are viewed as possibilities to improve, for encouraging that new work procedures are tested and for creating commitment and inspiration in relation to their coworkers. Originality/value The questions can be used separately or as part of an entire questionnaire before and along the Lean process to highlight organizational issues such as shared responsibility and supportive relations when developing health care.


2018 ◽  
Vol 31 (2) ◽  
pp. 238-253 ◽  
Author(s):  
Anurag Saxena ◽  
Maura Davies ◽  
Don Philippon

Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys. In addition, five senior leaders were interviewed. Descriptive statistics was used for quantitative data, and qualitative data were analyzed for themes by coding and categorization. Findings There are a large number of shared responsibilities in the hybrid model, as most activities in HCOs bridge administrative and professional spheres. These span the leadership (e.g. global performance and quality improvement) and management (e.g. human resources, budgets and education delivery) domains. The individual responsibilities, except for staff and physician engagement are in the management domain (e.g. operations and patient care). Both partners are responsible for joint decision-making, projecting a united front and joint reporting through a quadrat format. The mutual relationship and joint accountability are key characteristics and are critical to addressing potential conflicts and contradictions and achieving coherence. Practical implications Clarity of role will assist development of standardized job descriptions and required competencies, recruitment and leadership development. Originality/value This is an original empirical study presenting an integrated view of dyad leaders and senior leadership, meaningful expansion of shared responsibilities including academic functions and developing mutual relationship and emphasizing the central role of stability generating management functions.


2017 ◽  
Vol 34 (7) ◽  
pp. 940-954 ◽  
Author(s):  
Abhijeet Ghadge ◽  
Xie Fang ◽  
Samir Dani ◽  
Jiju Antony

Purpose The purpose of this paper is to proactively analyse and mitigate the root causes of the product and security risks. The case study approach examines the effectiveness of the fuzzy logic approach for assessing the product and process-related failure modes within global supply chain context. Design/methodology/approach The case study of a Printed Circuit Board Company in China is used as a platform for conducting the research. Using data triangulation, the data are collected and analyzed through interviews, questionnaires, expert opinions and quantitative modelling for some interesting insights. Findings Fuzzy logic approach for failure mode and effect analysis (FMEA) provides a structured approach for understanding complex behaviour of failure modes and their associated risks for products and processes. Today’s managers should conduct robust risk assessment during the design stage to avoid product safety and security risks such as recalls. Research limitations/implications The research is based on the single case study and multiple cases from different industry sectors may provide some additional insights. Originality/value The study attempts to mitigate the root causes of product and processes using fuzzy approach to FMEA in supply chain network.


2017 ◽  
Vol 28 (2) ◽  
pp. 212-231 ◽  
Author(s):  
Bharat Singh Patel ◽  
Cherian Samuel ◽  
S.K. Sharma

Purpose The purpose of this paper is to report a case study carried out to assess the agility and identify obstacles to agility in a supply chain. A human perception-based framework is used for the calculation of agility. The case study was carried out in a North India-based manufacturing organization. Design/methodology/approach In this study, the concept of a multi-grade fuzzy logic approach is used. Using this concept, the overall agility index has been determined. The fuzzy logic approach has been used to overcome the disadvantages such as impreciseness and vagueness using a scoring method. Findings From the analysis, it is observed that the organization on which the study was performed is “very agile.” After evaluating the agility level, the fuzzy performance importance index is calculated, which helps to identify the barriers of agility in the supply chain. These barriers help decision makers to implement appropriate improvement measures for improving agility level. Overall, 11 barriers were identified in the study. Research limitations/implications Managers of the contemporary manufacturing organization have to measure the agility level of the organization and identify barriers to agility in order to survive in a competitive environment. The obstacles identified in this study are used to improve the performance of the organization. The enterprise should improve on the weak areas in order to achieve the highest agility level. Originality/value The agile supply chain (ASC) enablers proposed by previous researchers are not sufficient for the evaluation of agility of a supply chain. There are a few more ASC enablers such as customer satisfaction, flexibility and adaptability that also play a vital role in making a supply chain agile. Adding these three ASC enablers, a total of seven ASC enablers along with their attributes are being considered for the development of a conceptual model.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Pia Andersson ◽  
Lotta Dellve ◽  
Gunnar Gillberg ◽  
Hans Lindgren

Purpose The present study aims to describe the implementation of a facilitated dialogue model intended to improve communication across professional logics and knowledge boundaries in two units of a large health-care organization in Sweden. Design/methodology/approach This is a mixed-methods study with interviews, field observations and follow- up questionnaires that were conducted during the implementation process. Findings The conclusion drawn in this study is that it is possible to change and improve the dialogue between health-care professionals with the help of a tailored, facilitated dialogue model. The authors found that different professional logics can indeed meet and share perspectives if the right conditions are provided. Moreover, an improved dialogue between different professional groups may contribute to work satisfaction, engagement, social cohesion and communication between professionals. Practical implications This study shows that the right organizational conditions, such as support from managers, must exist if the model’s inherent possibilities are to be used. Inhouse facilitation may be a sustainable model for facilitated workplace dialogue when its implementation is supported by the overall organization. Originality/value The contribution is an empirically based analysis of a new form of model for mediating perspectives within an organization with distinct professional roles. This study shows how, under the right conditions, the model can contribute to a perspective awareness and thus a more mature work organization.


2018 ◽  
Vol 5 (6) ◽  
pp. 687
Author(s):  
Hartarto Junaedi ◽  
Jaya Pranata ◽  
Mochamad Hariadi ◽  
I Ketut Eddy Purnama

<p class="Abstrak">Teknologi komputer saat ini telah banyak digunakan dalam pengembangan animasi atau permainan komputer. Salah satu teknologi itu adalah <em>machinima </em>yaitu suatu sistem yang menggunakan teknologi mesin grafik 3D untuk menghasilkan produk sinematik secara <em>real time</em>. Dalam proses pembuatan produk sinematik itu penempatan posisi kamera sangat memegang peranan penting. Penempatan posisi kamera ini tentu harus sesuai dengan kaidah-kaidah sinematografi. Penelitian ini akan mengusulkan sebuah pendekatan agen cerdas dengan multi perilaku untuk menempatkan kamera <em>virtual</em> dalam lingkungan <em>virtual </em>secara otomatis sesuai dengan gaya seorang sutradara. Setiap kamera <em>virtual </em>itu akan memiliki perilaku yang berbeda berdasarkan kaidah sinematografi sehingga memiliki <em>Point of View</em> (POV) yang berbeda. Untuk memberikan perilaku pada kamera <em>virtual</em> akan digunakan pendekatan berbasis logika fuzzy dengan menggunakan metode <em>mamdani</em>. Jumlah variabel masukan yang digunakan sejumlah tiga dan variabel keluaran sejumlah tiga dengan <em>membership function </em>antara tiga sampai lima. Penelitian ini akan menggunakan simulasi permainan komputer dengan tiga kamera <em>virtual</em> dengan perilaku yang berbeda untuk merekam adegan yang sama dan hasilnya akan divalidasi berdasarkan hasil pengamatan dengan komunitas juru foto.  Pada akhirnya dapat diambil kesimpulan bahwa pendekatan logika fuzzy dapat digunakan untuk memberikan sebuah perilaku atau gaya sutradara pada kamera <em>virtual</em>.</p><p class="Abstrak"><strong>Abstract</strong></p><p class="Abstract">Computer technology is has been used widely in the development of animation or computer games. One of the technologies is machinima, a system that uses reak time 3D graphics engine technology to produce cinematic products. In the process of develop a cinematic product, camera positioning is a very important component. The camera positioning must be comply with cinematography’s rule. This research will propose an intelligent multi agent behavior to positining a virtual camera in a virtual environment automatically according to the director’s style. Each virtual camera will have a different behavior based on cinematographic rules so that it has a different Point of View (POV). To assign a behavior on the virtual camera will be based on  fuzzy logic using the mamdani method. The number of input variables are three and the output variables are three with the number membership functions between three to five. This research will program  a computer game simulation with three multi behavior virtual cameras to capture some scene and the results will be validated based on observations with the photographer community. Finally it can be concluded that the fuzzy logic approach can be used to assign some behavior to a virtual camera.</p>


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