Lean Implementation and Organizational Transformation: A Literature Review

Manufacturing organizations are constantly striving to develop more effective and flexible means for managing challenges due to globalization and increasing customer expectations. This has led to increased efforts by the business community to research and implement the Toyota Production System, or lean manufacturing, to address these challenges. These efforts have resulted in numerous publications on lean manufacturing, including research reports, scholarly articles, and trade magazine articles. However, the existing body of knowledge on lean manufacturing is disperse and diverse in nature with respect to the application and implementation of lean tools and practices, making it difficult for researchers and practitioners to gain a real grasp of this topic. In this article, we have comprehensively organized the existing work on implementation of lean manufacturing in a more structured way, enabling engineering management practitioners to more easily identify knowledge and best practices and enabling researchers to identify gaps in the extant literature. Lastly, drawing from the organizational science literature, this article also provides important insights on lean manufacturing from the perspective of organizational learning, innovation, and \culture.     

Case Study of Lean in Hospital Admissions to Inspire Culture Change

Abstract

The hospital admissions process is a distinct experience for patients as this is where they start their journey for medical care, usually with a mix of anxiety and anticipation about what is to follow. This process also happens to be long and stressful, with numerous steps, frequent delays, and the occasional glitches along the way. In this study, we used lean thinking and discrete-event simulation to map and model the inpatient admissions process at a multi-specialty hospital in order to improve patient flow and reduce unnecessary waiting and handling by patients and staff. We found that by applying a combination of simple but complementary lean techniques, it was possible to reduce the total patient time in the system by up to 43%, without incurring additional costs or using more resources. The potential for achieving substantial improvements at low cost, combined with the approach of validation-prior-to-implementation adopted in this study, can both help process engineers and engineering managers to build support for any proposed lean initiative. This also makes it possible to sustain continuous improvement in the long term, which is at the heart of the lean approach.     

Artificial Intelligence in Healthcare: Review and Prediction Case Studies

Artificial intelligence (AI) has been developing rapidly in recent years in terms of software algorithms, hardware implementation, and applications in a vast number of areas. In this review, we summarize the latest developments of applications of AI in biomedicine, including disease diagnostics, living assistance, biomedical information processing, and biomedical research. The aim of this review is to keep track of new scientific accomplishments, to understand the availability of technologies, to appreciate the tremendous potential of AI in biomedicine, and to provide researchers in related fields with inspiration. It can be asserted that, just like AI itself, the application of AI in biomedicine is still in its early stage. New progress and breakthroughs will continue to push the frontier and widen the scope of AI application, and fast developments are envisioned in the near future. Two case studies are provided to illustrate the prediction of epileptic seizure occurrences and the filling of a dysfunctional urinary bladder.     

Healthcare framing: Critical realist framing for causal interdependencies and uncertainties within healthcare

Framing of causal interdependencies and uncertainties is important due to factors bringing change to healthcare, such as increasing access to healthcare information via the Internet and increasing self-care. In this paper, it is explained how critical realism can provide a basis for framing causal interdependencies and causal uncertainties within healthcare. The need for critical realist framing of causal interdependencies and uncertainties in healthcare is explained from the perspectives of human to human communication and human to AI communication. An example is provided of critical realist framing for causal interdependencies. Also, an example is provided of critical realist framing for causal uncertainties. Implications are discussed for human to human communication and human to AI communication. Critical realism can provide framing that is easy to grasp and recall. Importantly, critical realist framing can encompass both causal specificity and holistic overview when integrating diverse healthcare options. Moreover, critical realist framing can encompass uncertainties across the “why”, “how”, and “what” of healthcare. These characteristics of critical realist framing are important as end-users become increasingly aware of healthcare diversity and uncertainty.     

Simulation Study: Improvement for Non-Urgent Patient Processes in the Emergency Department

Abstract

This case research was designed to determine if non-urgent patient processes could be improved using a fast-track process in the emergency department of a medical center. The existing fast-track process served 40% of overall walk-in patients at the emergency department. We proposed a series of potential enhancements to patient flow. The proposed smart-track process highlights three features: (1) balancing workload, (2) a flexible re-visit option, and (3) renovation of a portion of the fast-track area into a consulting area. Simulation study results revealed that the enhanced smart-track process has the potential to reduce the average wait time of patients by 73.2% while reducing the burnout of medical staff. This study provides an example of how simulation can be used by engineering managers to make improvements to operations in the healthcare industry.     

Analysis of Clinic Layouts and Patient-Centered Procedural Innovations Using Discrete-Event Simulation

Abstract

Given that healthcare costs in the U.S. continue to climb, engineering managers can help address this situation by identifying designs for cost savings. Using discrete-event simulation, the layout of four different healthcare clinic scenarios considered in a redesign program named Patient Aligned Care Teams were studied. Model 1 is an existing layout in many clinics and Model 2 is staff-centered, while Models 3 and 4 provide additional space including common hallway(s). Our main conclusion is that Model 4 reduces patient travel distances and average queueing waits, while also providing the best privacy in accordance with HIPAA and the most security for the staff.     

Effectiveness evaluation methodology for safety processes to enhance organisational culture in hazardous installations

Safety performance indicators are widely collected and used in hazardous installations. The IAEA, OECD and other international organisations have developed approaches that strongly promote deployment of safety performance indicators. These indicators focus mainly on operational performance, but some of them also address organisational and safety culture aspects. However, operators of hazardous installations, in particular those with limited resources and time constraints, often find it difficult to collect the large number of different safety performance indicators. Moreover, they also have difficulties with giving a meaning to the numbers and trends recorded, especially to those that should reflect a positive safety culture.

In this light, the aim of this article is to address the need to monitor and assess progress on implementation of a programme to enhance safety and organisational culture. It proposes a specific process-view approach to effectiveness evaluation of organisational and safety culture indicators by means of a multi-level system in which safety processes and staff involvement in defining improvement activities are central. In this way safety becomes fully embedded in staff activities. Key members of personnel become directly involved in identifying and supplying leading indicators relating to their own daily activity and become responsible and accountable for keeping the measurement system alive. Besides use of lagging indicators, particular emphasis is placed on the importance of identifying and selecting leading indicators which can be used to drive safety performance for organisational and safety culture aspects as well.     

提高质检机构量值溯源管理质量的思考

通过对测量设备、标准物质量值溯源管理过程进行系统的梳理,抓住管理重点,对易发问题和难点问题进行分析,提出在管理过程中要动态地发现存在的共性的和个性化的问题,采取有效措施,针对原因持续地改进,从源头上有效消除质量偏离,使测量设备、标准物质能一直保持应有的技术性能和测量准确度,为质检机构高质量地完成检验任务提供基础性支持。     

Stakeholder Engagement in Early Stage Product-Service System Development for Healthcare Informatics

Abstract:

This article presents the findings from four case studies on stakeholder engagement in new healthcare information and communication technology (ICT) product-service system (PSS) development. The degree of connectivity between the new healthcare ICT PSS and its intended operating environment has emerged to be an important contextual factor that may impact decisions concerning stakeholder engagement in the early stage development process. The four propositions of stakeholder identification and engagement in the development process, put forward in this article, provide important directions for future work in exploring the implications of PSS characterization in early-stage new healthcare PSS development process.     

Advances and Strategies for Controlling the Quality and Safety of Postharvest Fruit

Fresh fruits are highly valued by consumers worldwide, owing to their delicious flavors, abundant nutrients, and health-promoting characteristics, and as such, fruits make up an important component of a healthy diet. The postharvest quality and safety of fresh fruit involve complex interactions among the fruit, environmental factors, and postharvest pathogens. Efficient regulation of fruit senescence and pathogen resistance, as well as disease-causing abilities of postharvest pathogens, is critical to understanding the fundamental mechanisms that underlie fruit quality and safety. This paper provides a comprehensive review of recent advances and currently available strategies for maintaining fruit quality and controlling major postharvest pathogens, mainly Botrytis cinerea and Penicillium expansum, which may promote sustainable and environmental-friendly development of the fruit industry.     

计量和质量信息管理系统

文章主要介绍了济南钢铁公司计量和质量信息管理系统实施前的状况，从物资计量、能源计量和质量检验等方面阐述了该管理系统的功能。计量和质量系统为配合济钢ERP系统上线提供及时、准确的计量和质量数据。     

Measurement equivalence and mean comparisons of a safety climate measure across construction trades

The use of safety climate measures for needs assessment and interventions has become increasingly popular. However, no research to date has examined whether the meaning and level of safety climate may differ across different groups of interest. This study used multi-group confirmatory factor analyses to investigate the measurement equivalence of a multidimensional safety climate measure across ten construction trade groups (N = 4725). In addition, observed mean differences in safety climate perceptions between trades were examined. Results revealed strong measurement equivalence of the safety climate measure across the construction trade groups. Further, significant mean differences were found between the ten trade groups on all four safety climate scales.     

氧气减压器的检测及其不确定度评定

针对目前氧气减压器无国家检定规程和校准规范,本文介绍了氧气减压器主要技术要求、安全性能要求,并根据要求提出了检测方法和测量不确定度评定,规范福建省对氧气减压器的检测。     

表面测量中抗混叠数字滤波器的设计与实现

在表面测量数据采集系统中,针对抗混叠滤波器设计问题,提出了“模拟滤波器＋数字滤波器”的设计方法．设计了具有线性相位的有限脉冲响应（FIR）型抗混叠数字滤波器,得出了幅频特性和相频特性,满足了表面测量信号处理的要求．与传统的单纯模拟抗混叠滤波器相比,该方法有效降低了对模拟滤波器的设计要求,使其易于实现,滤波效果好．把该方法应用于表面测量系统中,通过对实测数据的应用试验,验证了滤波器的性能．     

Measurement Uncertainty in Airborne Sound Insulation and Single-Number Quantities: Strategy and Implementation in Indian Scenario

This paper presents the factors affecting the uncertainty of measurement in sound transmission loss testing and the single-number quantities (SNQs) used widely in building acoustics. It provides a retrospective view of the recently published work especially in European continent and standard ISO 12999-1 for interpreting and elaborating the concept of calculation of measurement uncertainty in SNQs particularly for the laboratories engaged in sound transmission loss testing in India by presenting case studies for different types of building materials. The study suggests that the poor low frequency sound insulation and low frequency mass-air-mass and flexural resonances inculcate a higher uncertainty in SNQs for building elements. It is imperative to adopt the strategy recommended in ISO 12999-1 in Indian scenario particularly with growing international trade in building materials and technology and for the recognition as well as acceptance of testing results of Indian laboratories across the globe.     

Safety climate: New developments in conceptualization, theory, and research

Although the important role of safety climate in safety outcomes has been established and many studies have been done by scholars in different disciplines and across different cultures, there are still gaps in the literature. The articles in this Special Issue explore the topics of new developments in the conceptualization of safety climate and occupational/industry-focused studies of safety climate, with the goal of identifying different challenges and findings that arise within or across various occupations or industries. We are pleased to have a closing article by Dr. Dov Zohar on “Thirty Years of Safety Climate Research: Reflections and Future Directions.”     

Post-Certification Engineering Taxonomy and Task Value Optimization in the Aerospace Industry

Abstract:

This article proposes a novel taxonomy of post-certification engineering activities as a first step toward true lean product development (PD). Relying on key notions developed in a novel lean engineering performance model, the authors compare the leanness of post-certification versus pre-certification tasks for the design of aerospace parts. Discrete event simulation and integer linear programming models are developed to help ascertain the influence of factors such as multitasking, concurrency, task size, task value, and post-certification budget decision making on lean engineering PD performance. The models developed provide the foundation for enhanced PD performance and the establishment of optimal PD process parameters.     

圆度测量中高斯滤波的逼近实现方法

以B样条函数为基础,将约束条件引入变分原则,并结合小尺度参数高斯滤波器卷积特性,建立高斯滤波器的逼近滤波器。该滤波器与理论滤波器的幅度最大偏差小于1%,并具有零相移特性。在数字滤波算法中,包含两次零相移滤波和加权滤波循环计算,整个算法具有结构形式简单和计算效率较高的特点。根据圆度信号的周期封闭性,采用周期延拓法,消除数字滤波算法存在的边界效应问题。为圆度测量中高斯滤波器的实现提供了一种高精度、高效率的实现方法。