Implementation of Lean Management in a Multi-Specialist Hospital in Poland and the Analysis of Waste

At the beginning of the 21st century, Lean Management (LM) tools were introduced into the healthcare sector around the world. In Poland, there are still few LM implementations, and they are not of a comprehensive nature. The aim of this article is to present the application of the LM concept in a hospital in Poland as a tool for the identification and analysis of waste and its impact on the process of organizing the provision of medical services on the example of improvements in the process of patient admission. In the period from 1 July 2019 to 31 December 2019, a project of LM implementation was carried out at the Provincial Specialist Hospital in Wroclaw. The project was based on the method of value-stream mapping and 5Why. Standardized interviews (before and after the project) were conducted with people from the hospital management and middle-level managers. The implementation of LM tools resulted in the identification of a number of wastes, which have been divided into groups. The most important waste was paper medical documentation. Its change to an electronic form allowed for a better use of human capital resources; savings included 2.3 nursing positions and 1.09 medical staff positions.

Application of Value Stream Mapping in E-Commerce: A Case Study on an Amazon Retailer

In recent years, the e-commerce market has grown significantly, and the online retail market has become very competitive. Online retailers strive to improve their supply chain operations to reduce costs and to improve customer satisfaction. Value stream mapping (VSM), a tool created by the lean production movement to identify and reduce errors, losses, and lead time and to improve value-added activities, has been proven to be effective in many manufacturing processes. In this study, we investigate the application of value stream mapping (VSM) in the supply chain of an e-commerce retailer on Amazon. By visualizing the entire supply chain with VSM, the waste that is produced during the delivery process from the retailer to the customer was identified. The five whys method was then applied to find the root cause of the waste. Furthermore, a scoring method was developed to evaluate and compare two different supply chain logistic models to identify a strategy for improvement. This study provides a systematic methodology to understand, evaluate, and improve the entire e-commerce supply chain process utilizing VSM. It was demonstrated that the methodology could improve supply chain management efficiency, customer satisfaction, and cost reduction.

Additive Manufacturing in Off-Site Construction: Review and Future Directions

Additive manufacturing (AM) is one of the pillars of Industry 4.0 to attain a circular economy. The process involves a layer-by-layer deposition of material from a computer-aided-design (CAD) model to form complex shapes. Fast prototyping and waste minimization are the main benefits of employing such a technique. AM technology is presently revolutionizing various industries such as electronics, biomedical, defense, and aerospace. Such technology can be complemented with standardized frameworks to attract industrial acceptance, such as in the construction industry. Off-site construction has the potential to improve construction efficiency by adopting AM. In this paper, the types of additive manufacturing processes were reviewed, with emphasis on applications in off-site construction. This information was complemented with a discussion on the types and mechanical properties of materials that can be produced using AM techniques, particularly metallic components. Strategies to assess cost and material considerations such as Production line Breakdown Structure (PBS) and Value Stream Mapping are highlighted. In addition, a comprehensive approach that evaluates the entire life cycle of the component was suggested when comparing AM techniques and conventional manufacturing options.

PFDA-FMEA-VSM Application for Outsourcing Risk Analysis

Manufacturing corporations has the acceptance of the Outsourcing Process (OP) to improve industrial activities as well as to archive the revenue objectives, and with this, Risk Analysis (RA) tools are constantly used to assure expected results. Failure Mode and Effect Analysis (FMEA) is one of preferred RA tools, moreover, it is proven that FMEA adds uncertainty because of the human participation at the RA, afterward it is demonstrated that Pythagorean Fuzzy Dimensional Analysis – FMEA – Value Stream Mapping (PFDA-FMEA-VSM) method removes the uncertainty in RA, likewise it aids to the stakeholders for decision making, giving more advantages improving the use of the resources on the project. This document exhibits a real case scenario in a manufacturing firm applying PFDA-FMEA-VSM method adapted for manufacturing OP. The application of PFDA-FMEA-VSM shows solid RA results, removing the human intervention uncertainty added to the risk ranking, gives advantages to the stakeholders for visualize the main risks in detailed diagram, as well as make easier to take better decisions on where to apply resources and mitigate risks during OP.

A Software Development Life Cycle Case Study Of Lean IT With Value Stream Mapping Analysis

Value Stream Mapping (VSM) is a useful tool for depicting the flow of materials and information in manufacturing and service processes. It is known as one of the most popular lean methods to identify bottlenecks, reduce cycle time, and improve current processes. Although VSM has been extensively used in manufacturing, there are limited studies that applied VSM in non-manufacturing environments. In this study, we present an application of VSM to improve Software Development Life Cycle (SDLC) process in an IT firm. The current process flows (as-is) are mapped to identify non-value-added activities as well as areas for improvement. Based on the analysis of the current state map, we propose recommendations, action plans, and a future state map (to-be-process). We estimate that, with the new process changes, IT project delivery time can be reduced from 210.5 days to 137.5 days – a 34.7% reduction in the software development life cycle process. This provides a powerful base for IT project management and enables the IT department to meet its expected project turnaround time.

VALUE STREAM MAPPING OF OCEAN IMPORT CONTAINERS: A PROCESS CYCLE EFFICIENCY PERSPECTIVE

International cargo transportation is majorly dependent on marine transport, which moves 80% of the international cargo. With the increase in vessel size and the same yard area available for container transportation, it is important to study the processes and understand the efficiency of the container operations process. This research paper aims to review the import container transportation process and understand the process cycle efficiency through lean six sigma concepts. The process is evaluated from the operations process perspective and documentation process at one of the ports of India. The research has been designed by conducting an industry expert review on the process of container transportation from vessel berthing to gate out for import containers, utilising lean six sigma principles such as value stream mapping (VSM) and process cycle efficiency. The results have contributed to the existing knowledge in identifying the waste in the container handling process and demonstrated the inefficiency in the system from the perspective of waiting time of containers due to customs examination, scanning, and inter-terminal handling and movement. The process cycle efficiency of 40% is calculated by analysing the detailed time of handling containers from vessel berthing to gate out. A new future value stream mapping is proposed considering the process cycle efficiency. Future studies will focus on studying this process for export containers and benchmarking the results with the top-performing ocean ports globally.

Cancer Clinic Redesign: Opportunities for Resource Optimization

Ambulatory cancer centers face fluctuating patient demand and deploy specialized personnel who have variable availability. This undermines operational stability through misalignment of re-sources to patient needs, resulting in overscheduled clinics, high rebooking rates, budget deficits, and wait times exceeding provincial targets. We describe how deploying a Learning Health System framework led to operational improvements within the entire ambulatory center. Known methods of value stream mapping, operations research and statistical process control were applied to achieve organizational high performance that is data-informed, agile and adaptive. Caseload management by disease site emerged as an essential construct that incorporates disease site teams into adaptive, reliable care units, clinically and operationally. This supported clus-tering interdisciplinary teams around groups of patients with similar attributes, while allowing for quarterly recalibration. Systematic efforts were made in the negotiation required to im-plement changes that impacted physicians, nurses, clerks, and administrators. Feedback mecha-nisms were created with learnings curated and disseminated by a core team. The change aligned financial expenditures to the regional demand for specialized services and smoothed clinical operations across 5 weekdays and 2 centers. The impact was predictable, optimized expenditures, increased efficiencies across human and physical resource deployment and improved disease site collaboration in patient care.

REDUCING DIRECT LABOR COSTS THROUGH U-SHAPED CELLULAR LAYOUT IN INJECTED AUTOMOTIVE COMPONENTS INDUSTRY

Reducing direct labor costs can be used to create a low operation cost as the way for winning future markets including injected automotive components. This paper aims to provide an overview of direct labor costs reduction in injected automotive components through a U-shaped cellular layout as part of the lean concept. Over a decade, many types of research had already used the lean concept to solve problems in production activity through lean tools. In this paper, several lean tools such as Takt time, value stream mapping, and U-shaped cellular will be used for reducing direct labor costs that have increased yearly in Indonesia since 2015. Those lean tools will be performed in a job-shop of injected automotive components. After performing the U-shaped cellular layout, the direct labor costs were reduced to 25 % by combining the job held by two operators to become one operator.

PROPOSTA DE MELHORIA DO PROCESSO DE CORTE EM ABATEDOURO DE AVES: UM ESTUDO DE CASO EM UMA INDÚSTRIA CAPIXABA

A grande competitividade entre as organizações fez com que as mesmas buscassem meios mais eficientes de aumentar a sua produtividade e reduzir as suas perdas. Assim, é fundamental conhecer as atividades que agregam e não agregam valor ao processo e ao produto. É igualmente importante a implementação de melhoria do processo e aumentos das e receitas, eliminando ou reduzindo as perdas das tarefas. Sendo assim, o estudo tem como seu objetivo uma proposta de melhoria em uma determinada etapa do processo de um abatedouro de aves. Para a pesquisa, foram coletados dados do processo de produção da empresa avaliada. Com a aplicação das ferramentas: Mapeamento de Fluxo de Valor (Value Stream Mapping-VSM) e o Diagrama de Causa e Efeito proporcionaram uma melhor análise do processo obtendo-se assim um diagnóstico da real e atual conjuntura. Portanto, a proposta para melhoria do processo foi elaborada com o objetivo de reduzir as perdas do filé de peito, produto que apresenta um dos valores mais alto de venda, e uma melhor eficiência no processo produtivo.