Access to surgical care as an efficiency issue: using lean management in French and Australian operating theatres

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zeyad Mahmoud ◽  
Nathalie Angelé-Halgand ◽  
Kate Churruca ◽  
Louise A Ellis ◽  
Jeffrey Braithwaite
Keyword(s):  
Surgical Care ◽  
Resource Scarcity ◽  
Just In Time ◽  
Structured Interviews ◽  
Content Type ◽  
Global Context ◽  
Inventory Costs ◽  
Operating Theatres ◽  
Theatre Staff ◽  
Improve Access

PurposeMillions around the world still cannot access safe, timely and affordable surgery. Considering access as a function of efficiency, this paper examines how the latter can be improved within the context of operating theatres. Carried out in France and Australia, this study reveals different types of waste in operating theatres and a series of successful tactics used to increase efficiency and eliminate wastefulness.Design/methodology/approachData for this qualitative study were collected through 48 semi-structured interviews with operating theatre staff in France (n = 20) and Australia (n = 28). Transcripts were coded using a theory-driven thematic analysis to characterise sources of waste in operating theatres and the tactics used to address them.FindingsThe study confirmed the prominence of seven types of waste in operating theatres commonly found in industry and originally identified by Ohno, the initiator of lean: (1) underutilised operating rooms; (2) premature or delayed arrival of patients, staff or equipment; (3) need for large onsite storage areas and inventory costs; (4) unnecessary transportation of equipment; (5) needless staff movements; (6) over-processing and (7) quality defects. The tactics used to address each of these types of waste included multiskilling staff, levelling production and implementing just-in-time principles.Originality/valueThe tactics identified in this study have the potential of addressing the chronic and structurally embedded problem of waste plaguing health systems' operating theatres, and thus potentially improve access to surgical care. In a global context of resource scarcity, it is increasingly necessary for hospitals to optimise the ways in which surgery is delivered.

Addressing food loss and waste prevention

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Burcu Kör ◽  
Adriana Krawczyk ◽  
Ingrid Wakkee
Keyword(s):  
The Netherlands ◽  
Food Waste ◽  
Household Consumption ◽  
Resource Scarcity ◽  
Advanced Technology ◽  
Waste Prevention ◽  
Structured Interviews ◽  
Content Type ◽  
Food Loss

PurposeFood waste is one of the most challenging issues humanity is currently facing. Therefore, there has been a growing interest in the prevention of food waste because of world hunger, environmental impacts, resource scarcity and economic costs. The purpose of the study is to investigate the factors that influence food waste and the role of technology in tackling food waste in India and the Netherlands.Design/methodology/approachIn order to explore differences in food loss and waste further this study will examine a number of practices on both the production and the consumer side, in a developing country and a developed country with different culture/economic backgrounds: India and the Netherlands. The factors that influence food waste were examined with a preliminary qualitative study, which consists of semi-structured interviews, and quantitative research that comprises a survey. Semi-structured interviews were conducted in both India and the Netherlands, which consists of five interviews. The survey data was collected from 78 individuals from India and 115 individuals from the Netherlands.FindingsOne of the main findings of the research is food waste is divided into waste within agricultural production (i.e. food loss) and final household consumption (i.e. food waste). Different factors influence food loss in different stages in the supply chain. Some of these factors include wastage during processing, storage, transportation and at the market-place. New technologies can utilize food loss for new purposes, so food loss is reduced to the minimum. Food waste is mainly influenced by food passing expiry date, food that is left too long in the fridge and consumers buying too much food. In final household consumption, technologies such as digital platforms enable individuals or organizations to share and donate their food, thereby creating awareness on food waste prevention and the environmental and ethical benefits.Originality/valueThe authors examine to what extent and in which ways supporting consumers to minimize food waste can be achieved via three stages: (1) understanding and evaluating food loss and waste, (2) identifying the factors that influence food loss and waste, (3) understanding consumer behaviors to encourage food waste reduction and (4) identifying the technological impact that would reduce food waste. As such, this paper contributes to ongoing debates about food waste by looking at the role of context and culture and by exploring differences between developed and developing countries. Also, the authors advance the debate by exploring both the role of advanced technology such as blockchain and drones in both preventing loss and waste as well as non-technological mechanisms.

scholarly journals The use of strategy tools and frameworks by SMEs in the strategy formation process

2019 ◽  
Vol 27 (2) ◽  
pp. 337-367 ◽  
Author(s):  
Lawrence Charles Bellamy ◽  
Nii Amoo ◽  
Kieran Mervyn ◽  
Jacqueline Hiddlestone-Mumford
Keyword(s):  
Formation Process ◽  
Financial Management ◽  
Secondary Data ◽  
Resource Scarcity ◽  
Geographic Region ◽  
Strategic Analysis ◽  
Monitoring And Control ◽  
Structured Interviews ◽  
Strategy Formation ◽  
Content Type

PurposeThe purpose of this study is to examine the use of tools and techniques of strategy and strategic analysis within small- and medium-sized enterprises (SMEs) as a part of the strategy formation process.Design/methodology/approachThis study uses a qualitative, multiple-case-based investigation with semi-structured interviews and secondary data sources to create a context-rich insight to the area examined.FindingsThe findings indicate a strong orientation towards operational tools deployment aligned with financial management and resources and process planning, monitoring and control. Strategic perspectives of the respondents indicate an implicit, rather than explicit deployment of strategy tools and unstructured deployment, but general awareness of the resulting component issues. Clearer strategic approaches and strong implementation appear to positively influence success, when measured by growth.Research limitations/implicationsThis study is limited to nine organisations within a UK geographic region, and therefore, larger-scale investigation would be beneficial to extend and confirm the findings in differing contexts.Practical implicationsWith resource scarcity potentially stymying the opportunity for owner-managers to develop more structured approaches to strategic analysis and development, consideration should be given to how owner-managers can further develop their strategic thinking to support enhanced strategic outcomes for their organisations. Furthermore, strategy educationalists may wish to reflect upon the manner in which they prepare delegates for strategic roles, where the SME context may differ radically from corporate experience.Originality/valueThe methodology for this study differs substantially from previous investigations within the field, which has had relatively few contributions, as it uses in-depth, context-rich qualitative techniques to investigate the micro-processes at play. The conclusions capture new insights and indications and identify areas for further investigation, hence adding to the understanding of a complex and heterogeneous field.

The paradoxes of just-in-time system: an abductive analysis of a public food manufacturing and exporting company in Thailand

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thianthip Bandoophanit ◽  
Siwaporn Pumprasert
Keyword(s):  
Just In Time ◽  
Structured Interviews ◽  
Food Manufacturing ◽  
Content Type ◽  
Purchase Order ◽  
Customer Order ◽  
Direct Observations ◽  
Physical Health Problems ◽  
Freight Forwarder ◽  
Using Data

Purpose study aims to investigate the implementation and impact of a just-in-time (JIT) system in a food manufacturing and exporting company in Thailand. Design/methodology/approach At the company, the authors used an anomaly case study. The authors performed content analysis on the data collected through semi-structured interviews and direct observations to determine operational flows through customer order, production and delivery. The authors constructed a framework that helped in mapping current operations and subsequently assessing JIT’s impacts; the authors reported the best practices to the company’s owner. Based on the follow-up after a year, the authors used an abductive approach to refine the JIT theory using data from case organizations and relevant studies. Findings The company encountered errors and delays in international delivery owing to inadequate inputs resulting from uncertain agricultural production, delayed contact with freight forwarders, improper documentation and insufficient staffing. Besides the highly centralized system, the limitations of the JIT philosophy contributed to the issues, thereby increasing mental and physical health problems and turnover rate. Owing to these paradoxical effects, the authors extended the JIT theory. Of the study’s several recommendations, the company observed only the following: contacting the freight forwarder after the purchase order confirmation, not production completion. The authors observed increased customer satisfaction, despite the additional cost of booking containers early. Originality/value This research presents a balanced JIT that can minimize JIT’s impacts and resource shortage, owing to demand-supply uncertainties and sustain competitiveness.

scholarly journals Lean approach in precast concrete component production

2019 ◽  
Vol 9 (3) ◽  
pp. 457-470 ◽  
Author(s):  
Suryani Ahmad ◽  
Robby Soetanto ◽  
Chris Goodier
Keyword(s):  
Production Process ◽  
Precast Concrete ◽  
Value Added ◽  
Production Performance ◽  
Just In Time ◽  
Structured Interviews ◽  
Work Process ◽  
Content Type ◽  
Process Elements ◽  
Component Production

Purpose This study applied the lean approach to the reinforcement work process in the component production of industrialised building system precast concrete construction (IBSPCC). The purpose of this paper is to identify and eliminate non-value added (NVA) activities to enhance the efficiency of the production process. Design/methodology/approach Data were collected via a case study of six-storey precast concrete building. A mapping of the reinforcement work process was conducted based on observations using time study technique and time-lapsed video, complemented by semi-structured interviews. Findings Through this application, several NVA activities, such as unnecessary inventory, excessive movement and coordination issues, were identified. Production performance could be enhanced by implementing Just-in-Time, Kanban, and layout improvements, which would address NVA activities. Research limitations/implications Due to the complexity of the construction process, only specific process elements were observed. To map the complete process, comprehensive observation must be conducted from beginning to end, which, though worthwhile, would be very time and resource intensive. Originality/value This paper focusses on strategies for improving the efficiency of the IBSPCC production process in Malaysian construction by developing a conceptual framework of the lean approach for the reinforcement work process. Certain aspects in the process such as layout and inventory need to be redesigned and simplified by minimising NVA activities.

Unveiling benefits through franchising in Indian power distribution: addressing the resources scarcity

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mrigakshi Das
Keyword(s):  
Rural Areas ◽  
Power Distribution ◽  
Risk Sharing ◽  
Operational Efficiency ◽  
Resource Scarcity ◽  
Electricity Distribution ◽  
Feedback Systems ◽  
Structured Interviews ◽  
Content Type ◽  
High Loss

PurposeThe Indian power distribution companies are increasingly recognizing franchising for reviving their high loss-making rural pockets. The motivation for franchising has been a reduction of the franchisor's resource scarcity by bringing in operational efficiency and improved service quality to end consumers. However, there is a dearth of evidence on the influence of the franchisee's operations in addressing the resource scarcity of franchisors in predominantly rural areas. This study contributes towards filling the research gap.Design/methodology/approachA qualitative embedded multiple case study was conducted. The cases comprised two rural franchisees operating towards attaining the common goal. The study was built on archival analysis, personal observations and semi-structured interviews with the franchisors and franchisee officials across the organization's hierarchical levels. A conceptual model based on the review of prior literature formed the initial set of coding for the study. The data were presented based on within-case and across-case analysis.FindingsThe analysis revealed that the contract design impacts the requisite operational efficiency achievement. This variation could be elaborated by factors, such as system adaptation across organizational hierarchy, autonomy and independence, review and feedback systems, monitoring, a professional's attitude, bureaucracy, adaption with the local areas, risk sharing, incentives and compensation structure.Research limitations/implicationsThe study findings could be generalized to the extent of similar socio-economic conditions, prevailing governance mechanisms and law and orders. Additionally, since the law does not mandate the regulatory commissions to scrutinize the performance of the franchisees, the study was built on data shared by the franchisees and the discom. Further, this study considered the performance of only two performing franchisees. Matching these actualities with the discoveries of this study remains a continuing project as participation of private players is increasingly being recognized. Therefore, the insights drawn from this study could be used to improve the franchise model and can be scaled up across the nation, regions and sectors.Originality/valueThere is a dearth of literature on franchising in electricity distribution. This study is one of the first studies on studying the franchise system in the electricity distribution sector through the application of a well-accepted management theory.

Expected maintenance waste reduction benefits after implementation of Just in Time (JIT) philosophy in maintenance (a statistical analysis)

2019 ◽  
Vol 25 (1) ◽  
pp. 25-40 ◽  
Author(s):  
Sandeep Phogat ◽  
Anil Kumar Gupta
Keyword(s):  
Data Interpretation ◽  
General Information ◽  
Spare Parts ◽  
Waste Reduction ◽  
Maintenance Cost ◽  
Just In Time ◽  
Content Type ◽  
Great Saving ◽  
Research Findings ◽  
Structured Questionnaire

Purpose The maintenance department of today, like many other departments, is under sustained pressure to slash costs, show outcome and support the assignment of the organization, as it is a commonsensical prospect from the business perspective. The purpose of this paper is to examine expected maintenance waste reduction benefits in the maintenance of organizations after the implementation of just-in-time (JIT) managerial philosophy. For this, a structured questionnaire was designed and sent to the 421 industries in India. Design/methodology/approach The designed questionnaire was divided into two sections A and B to assist data interpretation. The aim of the section A was to build general information of participants, type of organization, number of employees, annual turnover of the organization, etc. Section B was also a structured questionnaire developed based on a five-point Likert scale. The identified critical elements of the JIT were included in the questionnaire to identify the maintenance waste reduction benefits in the maintenance of organizations. Findings On the basis of the 133 responses, hypothesis testing was done with the help of Z-test, and it was found out that in maintenance, we can reduce a large inventory of spare parts and also shorten the excessive maintenance activities due to the implementation of JIT philosophy. All the four wastes: waste of processing; waste of rejects/rework/scrap in case of poor maintenance; waste of the transport of spares, and waste of motion, have approximately equal weightage in their reduction. Waste of waiting for spares got the last rank, which showed that there are little bit chances in the reduction of waiting for spares after the implementation of JIT philosophy in maintenance. Practical implications The implication of the research findings for maintenance of organizations is that if maintenance practitioners implement elements of JIT philosophy in maintenance then there will be a great reduction in the maintenance wastes. Originality/value This paper will be abundantly useful for the maintenance professionals, researchers and others concerned with maintenance to understand the significance of JIT philosophy implementation to get the expected reduction benefits in maintenance wastes of organizations which will be helpful in the great saving of maintenance cost and time side by side great increment in the availability of machines.

scholarly journals User-driven efforts in creating knowledge graph information system

2020 ◽  
Vol 36 (2) ◽  
pp. 97-111
Author(s):  
Stanislava Gardasevic
Keyword(s):  
Information System ◽  
Information Seeking ◽  
Information Needs ◽  
Resource Discovery ◽  
The Body ◽  
Knowledge Graph ◽  
Structured Interviews ◽  
Community Members ◽  
Study Objective ◽  
Content Type

Purpose This paper presents the results of a qualitative study that involved students of an interdisciplinary PhD program. The study objective was to gather requirements to create a knowledge graph information system. The purpose of this study was to determine information-seeking practices and information needs of this community, to inform the functionalities of a proposed system, intended to help students with relevant resource discovery and decision-making. Design/methodology/approach The study design included semi-structured interviews with eight members of the community, followed by a website usability study with the same student participants. Findings Two main information-seeking styles are recognized and reported through user personas of international and domestic (USA) students. The findings show that the useful information resides within the community and not so much on the program website. Students rely on peer communication, although they report lack of opportunities to connect. Students’ information needs and information seeking are dependent on their progress through the program, as well as their motivation and the projected timeline. Practical implications Considering the current information needs and practices, a knowledge graph hosting both information on social networks and the knowledge produced by the activities of the community members would be useful. By recording data on their activities (for example, collaboration with professors and coursework), students would reveal further useful system functionalities and facilitate transfer of tacit knowledge. Originality/value Aside from the practical value of this research that is directly influencing the design of a system, it contributes to the body of knowledge on interdisciplinary PhD programs.

scholarly journals Unpacking the package

2015 ◽  
Vol 12 (4) ◽  
pp. 346-376 ◽  
Author(s):  
Mark Evans ◽  
Basil Phillip Tucker
Keyword(s):  
Organisational Change ◽  
Clean Energy ◽  
Management Control ◽  
Theory And Practice ◽  
Structured Interviews ◽  
Informal Control ◽  
Content Type ◽  
Energy Company ◽  
Management Controls ◽  
Control Package

Purpose – The purpose of this paper is to explore the ways in which both formal and informal control, operating as a package, are implicated in responding to organisational change arising from the introduction of the Australian Federal Government’s Clean Energy Act (2011). Design/methodology/approach – This investigation is based on a review of archival data, and semi-structured interviews conducted with 15 staff at different hierarchical levels within an Australian renewable energy company. Findings – Although formal management control systems and informal control both played important roles in the organisation’s reorientation to organisational change, it was the latter form of control that predominated over the former. The influence of the prevailing organisational culture, however, was pivotal in orchestrating both formal and informal control efforts within this organisation. Originality/value – This study contributes to management control theory and practice in two ways: first, it provides much needed empirical evidence about the ways in which management controls act as a package; second, it offers insights into the relative importance of the components of a management control package in the context of a particular organisational change. In addition, it responds to Laughlin’s (1991) call for empirical “flesh” to be added to the skeletal framework he advocates to make this conceptualisation of organisational change, “more meaningful”.

Experience and expression of social isolation by inner-city high-rise residents

2014 ◽  
Vol 17 (3) ◽  
pp. 151-166 ◽  
Author(s):  
Love M. Chile ◽  
Xavier M. Black ◽  
Carol Neill
Keyword(s):  
Older Adults ◽  
Inner City ◽  
Social Isolation ◽  
Age Groups ◽  
Evidence Base ◽  
Structured Interviews ◽  
Content Type ◽  
High Rise ◽  
Starting Point ◽  
Health And Social Care

Purpose – The purpose of this paper is to examine the significance of social isolation and the factors that create social isolation for residents of inner-city high-rise apartment communities. We critically examine how the physical environment and perceptions of safety in apartment buildings and the inner-city implicate the quality of interactions between residents and with their neighbourhood community. Design/methodology/approach – The authors used mixed-methods consisting of survey questionnaires supplemented by semi-structured interviews and focus group discussions using stratified random sampling to access predetermined key strata of inner-city high-rise resident population. Using coefficient of correlation we examine the significance of the association between social isolation, age and ethnicity amongst Auckland's inner-city high-rise residents. Findings – The authors found the experience and expression of social isolation consistent across all age groups, with highest correlation between functional social isolation and “being student”, and older adults (60+ years), length of tenure in current apartment and length of time residents have lived in the inner-city. Research limitations/implications – As a case study, we did not seek in this research to compare the experience and expressions of social isolation in different inner-city contexts, nor of inner-city high-rise residents in New Zealand and other countries, although these will be useful areas to explore in future studies. Practical implications – This study is a useful starting point to build evidence base for professionals working in health and social care services to develop interventions that will help reduce functional social isolation amongst young adults and older adults in inner-city high-rise apartments. This is particularly important as the inner-city population of older adults grow due to international migration, and sub-national shifts from suburbs to the inner-cities in response to governmental policies of urban consolidation. Originality/value – By identifying two forms of social isolation, namely functional and structural social isolation, we have extended previous analysis of social isolation and found that “living alone” or structural social isolation did not necessarily lead to functional social isolation. It also touched on the links between functional social isolation and self-efficacy of older adults, particularly those from immigrant backgrounds.

Digital forensics and evolving cyber law: case of BIMSTEC countries

2019 ◽  
Vol 22 (4) ◽  
pp. 744-752
Author(s):  
Sisira Dharmasri Jayasekara ◽  
Iroshini Abeysekara
Keyword(s):  
Information Technology ◽  
Design Methodology ◽  
Digital Forensics ◽  
Content Type ◽  
Global Context ◽  
Study Approach ◽  
Legal Frameworks ◽  
Work Done

Purpose The purpose of this paper is to discuss the role of digital forensics in an evolving environment of cyber laws giving attention to Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) countries, comprising Bangladesh, India, Myanmar, Sri Lanka, Thailand, Nepal and Bhutan, in a dynamic global context. Design/methodology/approach This study uses a case study approach to discuss the digital forensics and cyber laws of BIMSTEC countries. The objective of the study was expected to be achieved by referring to decided cases in different jurisdictions. Cyber laws of BIMSTEC countries were studied for the purpose of this study. Findings The analysis revealed that BIMSTEC countries are required to amend legislation to support the growth of information technology. Most of the legislation are 10-15 years old and have not been amended to resolve issues on cyber jurisdictions. Research limitations/implications This study was limited to the members of the BIMSTEC. Originality/value This paper is an original work done by the authors who have discussed the issues of conducting investigations with respect to digital crimes in a rapidly changing environment of information technology and deficient legal frameworks.

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