An integrated approach for healthcare services risk assessment and quality enhancement

2019 ◽  
Vol 37 (9/10) ◽  
pp. 1183-1208
Author(s):  
Mahdad Pourmadadkar ◽  
Mohammad Ali Beheshtinia ◽  
Kamran Ghods
Keyword(s):  
Risk Assessment ◽  
Quality Function Deployment ◽  
Failure Modes ◽  
Artery Bypass ◽  
Multiple Criteria Decision Making ◽  
Cost Effective ◽  
Integrated Approach ◽  
Healthcare Services ◽  
Quality Enhancement ◽  
Content Type

Purpose The purpose of this paper is to introduce an integrated approach using failure modes and effects analysis (FMEA), multiple-criteria decision making (MCDM), mathematical modeling and quality function deployment (QFD) techniques, for risk assessment and service quality enhancement in coronary artery bypass grafting (CABG) as a treatment for cardiovascular diseases (CVDs). Design/methodology/approach First, the disruptions in the CABG process are identified and prioritized following FMEA instructions, using two MCDM techniques, called analytic hierarchy process (AHP) and TOPSIS. Consequently, several corrective activities are identified and weighted on the basis of QFD. Finally, a mathematical model is established to determine the most cost-effective activities for implementation. The approach is developed in a fuzzy environment to reflect the uncertainty and ambiguity of human reasoning. Findings Regarding the CABG process disruption, a total of 30 failure modes in four main categories were identified and prioritized. Moreover, eight corrective activities were devised and ranked according to their impact on the failure modes. Finally, considering a limited amount of budget, a sensitivity analysis on the mathematical model’s objective function indicated that using 30 percent of the total budget, required to implement all corrective activities, was enough to cover more than 70 percent of the effects of corrective activities on the failure modes. Originality/value This paper contributes to the quality risk assessment knowledge by introducing an integrated approach to evaluate and improve healthcare services quality. Also, the case study conducted on the CABG process has not been done by other related studies in the literature.

Investigating the causal relationships among failure modes, effects and causes: a system dynamics approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fatemeh Shaker ◽  
Arash Shahin ◽  
Saeed Jahanyan
Keyword(s):  
System Dynamics ◽  
Quality Function Deployment ◽  
Failure Modes ◽  
Integrated Approach ◽  
Production Costs ◽  
Causal Relationships ◽  
System Availability ◽  
Content Type ◽  
Proposed Model ◽  
Potential Failure

PurposeThis paper aims to develop a system dynamics (SD) model to identify causal relationships among the elements of failure modes and effects analysis (FMEA), i.e. failure modes, effects and causes.Design/methodology/approachA causal loop diagram (CLD) has been developed based on the results obtained from interdependencies and correlations analysis among the FMEA elements through applying the integrated approach of FMEA-quality function deployment (QFD) developed by Shaker et al. (2019). The proposed model was examined in a steel manufacturing company to identify and model the causes and effects relationships among failure modes, effects and causes of a roller-transmission system.FindingsFindings indicated interactions among the most significant failure modes, effects and causes. Moreover, corrective actions defined to eliminate or relieve critical failure causes. Consequently, production costs decreased, and the production rate increased due to eliminated/decreased failure modes.Practical implicationsThe application of CLD illustrates causal relationships among FMEA elements in a more effective way and results in a more precise recognition of the root causes of the potential failure modes and their easy elimination/decrease. Therefore, applying the proposed approach leads to a better analysis of the interactions among FMEA elements, decreased system's failure rate and increased system availability.Originality/valueThe literature review indicated a few studies on the application of SD methodology in the maintenance area, and no study was performed on the causal interactions among FMEA elements through an FMEA-QFD based SD approach. Although the interactions of these elements are significant and helpful in risks ranking, researchers fail to investigate them sufficiently.

A novel FMEA model based on fuzzy multiple-criteria decision-making methods for risk assessment

2020 ◽  
Vol 33 (5) ◽  
pp. 881-904 ◽  
Author(s):  
Reza Fattahi ◽  
Reza Tavakkoli-Moghaddam ◽  
Mohammad Khalilzadeh ◽  
Nasser Shahsavari-Pour ◽  
Roya Soltani
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Decision Making ◽  
Failure Mode ◽  
Failure Modes ◽  
Multiple Criteria Decision Making ◽  
Decision Makers ◽  
Content Type ◽  
Proposed Model ◽  
Priority Weights

PurposeRisk assessment is a very important step toward managing risks in various organizations and industries. One of the most extensively applied risk assessment techniques is failure mode and effects analysis (FMEA). In this paper, a novel fuzzy multiple-criteria decision-making (MCDM)-based FMEA model is proposed for assessing the risks of different failure modes more accurately.Design/methodology/approachIn this model, the weight of each failure mode is considered instead of risk priority number (RPN). Additionally, three criteria of time, cost and profit are added to the three previous risk factors of occurrence (O), severity (S) and detection (D). Furthermore, the weights of the mentioned criteria and the priority weights of the decision-makers calculated by modified fuzzy AHP and fuzzy weighted MULTIMOORA methods, respectively, are considered in the proposed model. A new ranking method of fuzzy numbers is also utilized in both proposed fuzzy MCDM methods.FindingsTo show the capability and usefulness of the suggested fuzzy MCDM-based FMEA model, Kerman Steel Industries Factory is considered as a case study. Moreover, a sensitivity analysis is conducted for validating the achieved results. Findings indicate that the proposed model is a beneficial and applicable tool for risk assessment.Originality/valueTo the best of authors’ knowledge, no research has considered the weights of failure modes, the weights of risk factors and the priority weights of decision-makers simultaneously in the FMEA method.

An innovative and integrated approach based on SERVQUAL, QFD and FMEA for service quality improvement

Kybernetes ◽  
2019 ◽  
Vol 49 (10) ◽  
pp. 2419-2453 ◽  
Author(s):  
Serkan Altuntas ◽  
Semih Kansu
Keyword(s):  
Quality Improvement ◽  
Service Quality ◽  
Quality Function Deployment ◽  
Public Hospital ◽  
Failure Modes ◽  
Quality Measurement ◽  
Integrated Approach ◽  
Content Type ◽  
Integrated Methodology

Purpose The purpose of this paper is to propose an innovative and integrated approach based on service quality measurement (SERVQUAL), quality function deployment (QFD) and failure modes and effects analysis (FMEA) for service quality improvement. Design/methodology/approach The SERVQUAL scale is used for service quality measurement, QFD is used for service design and FMEA is used to prevent possible failures during service delivery. Findings A case study in a public hospital in Turkey is performed to show how the proposed approach works in practice. The results of the study show that the proposed approach can be used effectively to assess service quality in practice. Originality/value Service quality has become an important issue for service enterprises facing a fiercely competitive environment to provide sustainability. This is the first study that applies an integrated methodology based on SERVQUAL scale, QFD and FMEA to service quality improvement.

A revised FMEA application to the quality control management

2014 ◽  
Vol 31 (7) ◽  
pp. 788-810 ◽  
Author(s):  
Claudia Paciarotti ◽  
Giovanni Mazzuto ◽  
Davide D’Ettorre
Keyword(s):  
Quality Control ◽  
Failure Modes ◽  
Cost Effective ◽  
Weight Functions ◽  
Time Saving ◽  
Content Type ◽  
Complete Procedure ◽  
Medium Enterprise ◽  
Control Management ◽  
Critical Situations

Purpose – The purpose of this paper is to propose a cost-effective, time-saving and easy-to-use failure modes and effects analysis (FMEA) system applied on the quality control of supplied products. The traditional FMEA has been modified and adapted to fit the quality control features and requirements. The paper introduces a new and revised FMEA approach, where the “failure concept” has been modified with “defect concept.” Design/methodology/approach – The typical FMEA parameters have been modified, and a non-linear scale has been introduced to better evaluate the FMEA parameters. In addition, two weight functions have been introduced in the risk priority number (RPN) calculus in order to consider different critical situations previously ignored and the RPN is assigned to several similar products in order to reduce the problem of complexity. Findings – A complete procedure is provided in order to assist managers in deciding on the critical suppliers, the creation of homogeneous families overcome the complexity of single product code approach, in RPN definition the relative importance of factors is evaluated. Originality/value – This different approach facilitates the quality control managers acting as a structured and “friendly” decision support system: the quality control manager can easily evaluate the critical situations and simulate different scenarios of corrective actions in order to choose the best one. This FMEA technique is a dynamic tool and the performed process is an iterative one. The method has been applied in a small medium enterprise producing hydro massage bathtub, shower, spas and that commercializes bathroom furniture. The firm application has been carried out involving a cross-functional and multidisciplinary team.

Developing physical resilience strategies in passive defense according to identification of endangered areas of urban environments (case study: Ahvaz city)

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mozhdeh Pouryarmohammadi ◽  
Hasan Ahmadi ◽  
AliAkbar Salaripour
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Urban Form ◽  
Urban Areas ◽  
Quality Function Deployment ◽  
Quantitative Methods ◽  
City Centre ◽  
Urban Resilience ◽  
Content Type ◽  
Oil Companies

Purpose This paper aims to focus on reducing the vulnerability of Ahvaz city against urban disasters and lowering the number of casualties and amount of financial losses using modern approaches to develop resilience strategies that can increase urban safety to an acceptable level. The strategic situation of Ahvaz city, because of its abundant resources, the war experience and its location on the boundary regions of Iran, highlights its significance. Ahvaz has a high population and an extended texture, and the existence of extraordinary constructions increases the importance of physical resilience in this city. Design/methodology/approach The present study investigates built environment aspects such as the urban structure, the urban form, land-use proximity pattern, urban road network and crucial and vulnerable centres in Ahvaz, using a combination of qualitative and quantitative methods. Hence, the areas at risk in Ahvaz were identified and illustrated in a comprehensive risk assessment map, and then, by using the strengths, weaknesses, opportunities and threats technique and finally by using the Delphi method, some strategies and plans were presented to reduce the level of vulnerability in Ahvaz. Then, these strategies are prioritized by applying quality function deployment (QFD) technique. Findings The risk assessment result shows that most parts of Ahvaz’s urban areas are highly at risk. The central and northern parts of Ahvaz have the highest vulnerability at a time of crisis. These zones include district 1 (city centre) and districts 2, 3 and 7 at the city’s margins. The result of QFD process showed that the essential urban resilience strategy is to positively consider the passive defence studies with a physical resilience approach. Also, the proper distribution of strategic points in the city, moving the industrial and oil companies from the peripheral area, and facilitating access to vital, crucial centres to support urban regions are considered the most effective strategic plans. Originality/value This paper, with an integrated approach, examines and prioritizes the main physical problems of Ahvaz city based on the spatial analysis and opinions of experts. The physical strategies presented in this paper can significantly reduce the risks and increase the urban resilience of Ahvaz city in the face of crisis.

Benchmarking the risk assessment in green supply chain using fuzzy approach to FMEA

2018 ◽  
Vol 25 (8) ◽  
pp. 2660-2687 ◽  
Author(s):  
Sachin Kumar Mangla ◽  
Sunil Luthra ◽  
Suresh Jakhar
Keyword(s):  
Risk Assessment ◽  
Supply Chain ◽  
Failure Mode ◽  
Failure Modes ◽  
Research Work ◽  
Evaluation Framework ◽  
Green Supply Chain ◽  
Content Type ◽  
Efficient Management ◽  
Fmea Analysis

PurposeThe purpose of this paper is to facilitate green supply chain (GSC) managers and planners to model and access GSC risks and probable failures. This paper proposes to use the fuzzy failure mode and effects analysis (FMEA) approach for assessing the risks associated with GSC for benchmarking the performance in terms of effective GSC management adoption and sustainable production.Design/methodology/approachInitially, different failure modes are defined using FMEA analysis, and in order to decide the risk priority, the risk priority number (RPN) is determined. Such priority numbers are typically acquired from the judgment decisions of experts that could contain the element of vagueness and imperfection due to human biases, and it may lead to inaccuracy in the process of risk assessment in GSC. In this study, fuzzy logic is applied to conventional FMEA to overcome the issues in assigning RPNs. A plastic manufacturer GSC case exemplar of the proposed model is illustrated to present the authenticity of this method of risk assessment.FindingsResults indicate that the failure modes, given as improper green operating procedure, i.e. process, operations, etc. (R6), and green issues while closing the loop of GSC (R14) hold the highest RPN and FRPN scores in classical as well as fuzzy FMEA analysis.Originality/valueThe present research work attempts to propose an evaluation framework for risk assessment in GSC. This paper explores both sustainable developments and risks related to efficient management of GSC initiatives in a plastic industry supply chain context. From a managerial perspective, suggestions are also provided with respect to each failure mode.

scholarly journals Supply chain risk assessment approach for process quality risks

2017 ◽  
Vol 34 (7) ◽  
pp. 940-954 ◽  
Author(s):  
Abhijeet Ghadge ◽  
Xie Fang ◽  
Samir Dani ◽  
Jiju Antony
Keyword(s):  
Risk Assessment ◽  
Fuzzy Logic ◽  
Supply Chain ◽  
Failure Modes ◽  
Design Stage ◽  
Security Risks ◽  
Content Type ◽  
Fuzzy Logic Approach ◽  
Logic Approach

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.

Improving risk evaluation in FMEA with a hybrid multiple criteria decision making method

2015 ◽  
Vol 32 (7) ◽  
pp. 763-782 ◽  
Author(s):  
Hu-Chen Liu ◽  
Jian-Xin You ◽  
Xue-Feng Ding ◽  
Qiang Su
Keyword(s):  
Decision Making ◽  
Failure Modes ◽  
Multiple Criteria Decision Making ◽  
Multiple Criteria ◽  
Analytic Hierarchy ◽  
Effect Analysis ◽  
Maintenance Strategies ◽  
Content Type ◽  
Safety And Reliability ◽  
Hierarchy Process

Purpose – The purpose of this paper is to develop a new failure mode and effect analysis (FMEA) framework for evaluation, prioritization and improvement of failure modes. Design/methodology/approach – A hybrid multiple criteria decision-making method combining VIKOR, decision-making trial and evaluation laboratory (DEMATEL) and analytic hierarchy process (AHP) is used to rank the risk of the failure modes identified in FMEA. The modified VIKOR method is employed to determine the effects of failure modes on together. Then the DEMATEL technique is used to construct the influential relation map among the failure modes and causes of failures. Finally, the AHP approach based on the DEMATEL is utilized to obtain the influential weights and give the prioritization levels for the failure modes. Findings – A case study of diesel engine’s turbocharger system is provided to illustrate the potential application and benefits of the proposed FMEA approach. Results show that the new risk priority model can be effective in helping analysts find the high risky failure modes and create suitable maintenance strategies. Practical implications – The proposed FMEA can overcome the shortcomings and improve the effectiveness of the traditional FMEA. Particularly, the dependence and interactions between different failure modes and effects have been addressed by the new failure analysis method. Originality/value – This paper presents a systemic analytical model for FMEA. It is able to capture the complex interrelationships among various failure modes and effects and provide guidance to analysts by setting the suitable maintenance strategies to improve the safety and reliability of complex systems.

Why telehealth does not always save money for the health system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Centaine L. Snoswell ◽  
Monica L. Taylor ◽  
Liam J. Caffery
Keyword(s):  
Health System ◽  
Data Extraction ◽  
Cost Savings ◽  
Cost Benefit ◽  
Cost Effective ◽  
Healthcare Services ◽  
Content Type ◽  
Frequency Of Contact ◽  
Traditional Service ◽  
Implementation Costs

PurposeThis study aims to determine elements of telehealth that have the potential to increase costs for the health system in the short to medium term.Design/methodology/approachA search of PubMed, EMBASE and Scopus databases was performed in May 2018 using broad terms for telehealth and economics. Articles were included if they identified and explained reasons for an increase in cost for telehealth services. Studies were categorised by economic analysis type for data extraction and descriptive synthesis.FindingsFourteen studies met inclusion criteria and were included in the review. These studies identified that increased health system costs were due to implementation costs (e.g. for equipment, software or staff training), increased use of other healthcare services (e.g. pharmaceutical services) and ongoing service costs (including staff salaries) resulting from telehealth being additive to traditional service (e.g. increased frequency of contact).Originality/valueTelehealth is often assumed to be a cost-effective method of delivering healthcare, even to the point where direct cost savings are expected by decision makers as a result of implementation. However, this investigation suggests it does not routinely reduce costs for the health system and can actually increase costs at both implementation and ongoing service delivery stages. Health services considering implementing telehealth should be motivated by benefits other than cost reduction such as improved accessibility, greater patient centricity and societal cost–benefit.

3PL evaluation and selection using integrated analytical modeling

2017 ◽  
Vol 12 (2) ◽  
pp. 224-242 ◽  
Author(s):  
Abhijeet Haldar ◽  
Umer Qamaruddin ◽  
Rakesh Raut ◽  
Sachin Kamble ◽  
Manoj Govind Kharat ◽  
...  
Keyword(s):  
Multiple Criteria Decision Making ◽  
Real Data ◽  
Integrated Approach ◽  
Third Party ◽  
Vendor Selection ◽  
Data Envelopment ◽  
Third Party Logistics ◽  
Content Type ◽  
Practical Implications ◽  
Selection Of

Purpose The purpose of this paper is to propose a framework for evaluating and selecting the most optimal third-party logistics (3PL) service provider vendor among the available ones. Selection is done based on the performance values of the vendors on certain predefined criteria. Design/methodology/approach An integrated approach involving data envelopment analysis (DEA), technique for order of preference by similarity to ideal solution (TOPSIS) and linear programming (LP) problem has been used to develop a new model for the selection of 3PL vendor. First, DEA is used to evaluate the efficiency of each vendor according to the identified criteria. Second, TOPSIS is applied to rank the maximally efficient vendors. Finally, LP problem is stated and solved to ascertain the quantities to be allocated to each maximally efficient vendor in the context of multiple logistics provider. The proposed DEA–TOPSIS–LP (DETOLP) model is finally tested with real-time industry data for 3PL vendor evaluation and selection. The study, thus, proposes a three-step hierarchical technique for selection of 3PL vendor based on the multiple criteria decision-making approach. Findings The paper focuses on assessing the performance of 26 vendors using a combined approach of DEA, TOPSIS and LP. It is observed that vendor V4 outperforms all the considered vendors, which exactly corroborates with the present scenario within the company. Research limitations/implications Exclusion of qualitative criteria for 3PL vendor selection and the judgment of weights for TOPSIS can be considered as the limitations of the present work. The study has significant practical implications for organizations belonging to any sector or industry. It can help them in evaluating the existing 3PL vendors and selecting the most efficient among them. Originality/value This paper deals with a framework modeled for 3PL vendor selection. It is the first attempt to utilize an integrated approach, i.e. DETOLP model for evaluation and selection of 3PL. For assessment of the model, real data from an Indian company has been taken to analyze the result and compare it with the present scenario within the company.

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