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Sessions for Friday, April 29 Sessions for Friday, April 29 Friday, 08:00 AM - 09:30 AM Friday, 08:00 AM - 09:30 AM, Tuscan 1 Track: HOM, 1 Chair: Roberto Revetria 1 Session: Systems Dynamics in Healthcare 020-0252 Strategy Deployment in UK Healthcare Shulian Zhang, University of Manchester, United Kingdom Claire Moxham, University of Manchester, United Kingdom David Bamford, University of Manchester, United Kingdom Ben Dehe, University of Manchester, United Kingdom April 2009 was an important period for all National Health Service (NHS) Community Health Services (CHS) organisations as they were formally separated from the commissioning service in the Primary Care Trust (PCT). This had many implications, including the need to establish individual board, develop independent strategy, and set-up autonomous governance. The host organisation was keen to investigate the effectiveness of the current strategy deployment (SD) process and subsequently identify areas for improvement. Our investigation looked into adapting strategy deployment systems such as the Closed-Loop Management Systems (Kaplan and Norton 2008) at NHS CHS organisations which can facilitate organisational needs in the area of strategy deployment. As human capital with the suitable skills is required for any successful implementation of a management system, the researchers expanded the scope by including an assessment of the organisation’sreadiness for adapting formal strategy deployment systems in terms of management skills levels. 020-0357 A Systems Dynamics General Model for Supporting Transition to Lean Healthcare Roberto Revetria, University of Genoa, Italy Lean Healthcare, Kaizen and Six Sigma are rapidly transforming healthcare operations from 'new ideas' to a 'way of life.' At the same time, while the concepts of Lean are fairly straightforward, applying the tools to daily work can be counter-intuitive and thus require a credible model to be effectively applied. In a traditional lean approach, consultants take advantages from Value Stream Mapping, the adoption of 5-S and Visual Controls as well as batch reduction and cellular flow. Often these activities have taken a very long time to be adopted mostly due to internal change resistance, and lean implementation projects struggle for achieving their goals. The authors presents an innovative approach based on a reusable high-level model able to capture the relationship among costs, level of services and risks encountered in the transition from classical healthcare to lean health care organization. The paper proposes both methodology and a case study. 020-0702 Improving Patient Safety: How to Use Service Modularity in Healthcare Processes to Manage Systemic Errors Maria Kapsali, Imperial College Business School, United Kingdom John Bessant, University of Exeter Business School, United Kingdom Complexity in healthcare processes stems from the diversity of the components of the service in terms of activities, personnel, resources needed, organizational practices, patient complications and types of services. Current organizational practices have not tackled complexity adequately, allowing for unacceptable levels of errors leading to patient harm. This study suggests firstly at study processes as complex adaptive systems by using the Healthcare Error Proliferation Model, and secondly by using the concept of service modularity in this model in order to redesign the architecture of the processes. For this purpose, 5 healthcare processes from the surgical ward of a UK hospital are analysed through FMEAs, Root Cause Analysis and expert interviews; and their defence layers are used as interfaces where the process components can be reconfigured. The study also uses 5 industrial examples (rail, marine, chemicals, construction, and animal hospital) to show how this is applicable in other settings. 020-0747 Mapping the Brazilian Healthcare Supply Chain: Elements and Their Relationships Andrew Finger, Centro Universitário Metodista, do IPA, Brazil Carlos Lencini, Centro Universitário Metodista, do IPA, Brazil This paper describes aspects of Brazilian healthcare supply chain (HCSC) design and management and provides advances in the existing knowledge about the HCSC, especially for emerging countries. The HCSC in Brazil is a complex supply chain and a very important issue for the country. The research adopts a qualitative approach, with data collected through process mapping, secondary data and interviews with several managers of the key elements of the HCSC. Interviews are used to identify the main SC issues and the different perspectives across the SC. The research identified the elements that form the HSCS, the relationship between these elements and the governance of the SC. The conclusions identify different views and interpretations from the members of the HCSC and develop interesting questions for future research. 020-1026 Managing Emergency Room Crowding: Workplace Constraints vs. Human Capabilities Brad Morrison, Brandeis International Business School, United States Robert Wears, University of Florida, United States Over the past several decades, growth in the demands on the United States emergency care system have outpaced adjustments in the capacity of the system. The result is a widespread phenomenon of crowded emergency rooms, especially in urban hospitals, with associated decreases in receiving timely care and increases in adverse medical outcomes. Motivated by experience and observation of a level 1 trauma center in a busy urban setting, this paper develops a stylized system dynamics model to examine the dynamics of patient flow. Simulation results show that increased ED resilience can come from relaxing bed constraints or from more human capability to cope with increasing workloads. The vulnerability of this system is rooted in the critical interaction between physical constraints imposed by the environment and the human capability of the staff to work at high performance levels under conditions of worsening workload pressure. Friday, 08:00 AM - 09:30 AM, Tuscan 3 Track: SCH, 1 Chair: Zhixin Liu 3 Session: Scheduling with Uncertainty 020-0690 Price Quotation for Uncertain Order Inquiries with Scheduling Cost Zhixin Liu, University of Michigan - Dearborn, United States Liang Lu, The Hong Kong University of Science and Technology, Hong Kong Xiangtong Qi, The Hong Kong University of Science and Technology, Hong Kong We study the coordination between pricing and production scheduling decisions of a manufacturer. Two types of price quotations, simultaneous and sequential, both in coordination with production scheduling, are investigated. A simultaneous quotation quotes all order inquiries simultaneously. When both the price and scheduling cost functions are linear, a unique optimal price quotation can be found efficiently. It is further shown that when all the order inquiries share the same cost weight, volume discount should be provided. However, when the cost weight is proportional to order size, a larger order should be charged a higher price. A sequential quotation quotes order inquiries one at a time. We develop optimal solution approaches for sequential quotation using implicit enumerations and design efficient heuristic algorithms. We study the coordination between pricing and production scheduling decisions of a manufacturer. Two types of price quotations, simultaneous and sequential, both in coordination with production scheduling, are investigated.Friday,A 08:00simultaneous AMquotation - 09:30quotes allAMorder inquiries simultaneously. When both the price and scheduling cost functions are linear, a unique optimal price quotation can be found efficiently. It is further shown that when all the order inquiries share the same cost weight, volume discount should be provided. However, when the cost weight is proportional to order size, a larger order should be charged a higher price. A sequential quotation quotes order inquiries one at a time. We develop optimal solution approaches for sequential quotation using implicit enumerations and design efficient heuristic algorithms. 020-0068 Measuring Agility Index Using System Flexibility and Response Emad Abouel Nasr, Faculty of Engineering, Industrial Eng. Dept., King Saud University, Saudi Arabia Soha Abd Elatty, Mechanical Eng. Dept., Helwan University, Cairo, Egypt, Egypt Mohammed Osman, Mechanical Eng. Dept., Helwan University, Egypt The purpose of this paper is to measure system agility and to propose an agility index which is used to show how agile the system is. The agility index is measured according to the operational perspective and its level which is concerned with two types of dimensions. The first dimension is the flexibility concerning three types: volume flexibility, variety flexibility, and delivery flexibility. The second is the response of the scheduling process applied in the system concerning the schedule stability and the frequency of rescheduling. A simulation model is used to measure agility dimensions and to demonstrate how the level of disruption and initial system conditions affect agility levels. 020-0754 Single Machine Scheduling with Uncertain Processing Times for Completion Time-related Performance Measures Umar Al-Turki, King Fahd University of Petroleum & Minerals, Saudi Arabia Khalid Al-Shareef, King Fahd University of Petroleum & Minerals, Saudi Arabia In this study we consider scheduling n jobs on a single machine such that various completion times related objective functions are minimized in the existence of uncertainty. At the time of scheduling Job Processing
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