Dubai Creek General Hospital Operations Management - Assignment Example

Dubai Creek General Hospital Question 1: Why is it important to get the patient's assessment of healthcare quality? Does a patient have the expertise to judge the healthcare he or she receives? The patient’s assessment of health care quality make take on a varying perspective differing from patient to patient and then too there is nothing wrong or right in how a patient assesses healthcare quality he or she receives. This assessment might differ from the patient himself or herself, his or her family, the community, the provider of the service etc. The patient’s expertise of judging the quality does not come from holding any degree or certification whatsoever. As it is said beauty lies in the eyes of the beholder and that the customer is the king. Therefore, a person under treatment i.e. the patient receiving services has a better idea of what is being offered and this determines whether the person would subsequently visit or not. Question 2: How might a hospital measure quality? There are multiple dimensions for quality assurance of a health care service. The effectiveness of health care, the degree to which desired results are achieved, the technical performance i.e. compliance of standards carried out by health workers and facilities. The efficiency of service delivery, the safe and the secure environment, here it can refer to prevention of injuries, infection and other side effects. Since the hospital and health care is a pure service and all the characteristics of service purely fit into the application when evaluating the quality – the inseparability of the worker with the product requires the best interpersonal relationship building, trust, loyalty, courteousness, responsiveness and agility and effective communication between the patient and the health care service provider – nurse, doctor, surgeon or any other support staff. Since a patient builds up trust in the provider therefore another dimension of quality is the continuity of the service by the same health care provider throughout the course of the treatment. For hospitals and even for walk in clinics the ambiance and the environment, the physical infrastructure, its cleanliness and hygienic condition all help in creating the impression. Question 3: Using the 14 steps in Boeing’s Quality Audit, Table 1, discuss how each might apply to DCGH. 1. Quality to the customer: As earlier mentioned there is no right or wrong in any definition of quality. Internally within the organization conformance to technical performance, certifications and standards, the following of standard operating procedures etc. is a quality aspect. And yes, the quality is obviously compared with that of the competitors. Preferring a hospital over another, a doctor over another is required to find out how the competitor takes over the customers. 2. Quality costs: To an extent the board has identified areas of quality but its focus is more on the internal perception of quality whereas, the external costs are very much ignored by far. And no area for potential cost savings is identified yet. 3. Design review: In the health care services industry, standard operating procedures, checklists for doctors and nurses should be present. Tasks carried out by health workers and facilities do they meet technical expectations of quality. 4. Product qualifications: This has an important application for the health care services company; all drugs, equipments, apparatus coming in has to be tested at each an every level; proper systems designs for the audit and pre qualification of the vendors. 5. Product liability: Since the service is offered, therefore any treatment, medication suggested has to be written down since in case the doctor or the support staff attending is not present at the required time and is replaced by another knows the person’s pre – treatment, treatment history, so that in cases of any emergency or need the problem can be handled well. 6. Process capability: Capability of the process can be judged by the capability and the capacity of the staff – doctors, health care administrators, the support staff. Their interactive nature and confidence building among patients is a reflection of process capability among the patients. 7. Incoming inspection: Any drugs, instruments bought or the material purchased requires proper documentation for control and usage for the administrative purposes – this helps in not resulting in shortages when the situation so deems and no superfluous usage too. 8. Supplier quality: For vendors delivering to the hospital should be aware of their ethical and moral responsibility of supplying the right quality product and not compromising on nay deliverables. Regular supplier audits on their and own premises should be conducted. 9. Process control: Systematic procedure like when a customer is checked in, blood pressure, sugar level, heart beat – basic elements of person’s health are noted and at regular interval to see if the treatment has resulted in normal controls of the patients and to note to prevent any damage that might occur. 10. Inspection and test planning: Even major equipments such as machines, stethoscopes, blood pressure instruments, sugar testing devices, thermometer etc. should be tested and calibrated properly. 11. Quality performance indicators: As discussed in the earlier question, what and how quality performance indicators are important. 12. Employee involvement program: Support staff, doctors, nurses all become an active participant in the provision of service therefore these should be actively involved in the process. So that patients develop their trust and loyalty and can make any complains or share problems with them on a comfortable level. 13. Multifunctional quality improvement team: Quality should not be limited to patients room, but services at the reception, the support staff, cleanliness, hygienic conditions, pure and clean water and food, and even provision of comfort for the patient’s attendance is highly desired. 14. Quality business plan: Since high quality health care is an essential component and saving a human life or valuing a human life is another target. And, issues of performance and quality in the delivery of health services are critical to assessing the effectiveness of different health care providers and to evaluating different health policies. However, policymakers and care providers have not had adequate measures of quality available because of the inherent problems in gathering timely and relevant data, the fact that medical care has so many dimensions, and because so many factors aside from provider quality affect patient outcomes. Question 4: How can the value of a human life be included in the cost of quality control? As a human, it is imperative to value a human life, and it should be considered in the cost of quality for operational management purposes in the hospital; but we know that human life is priceless. So the question arises on how to value it. But, considering the instruments like insurance, where a person buying insurance is betting on his or her human life a certain value is placed on it. Therefore, cost of quality should be made objective by considering factors such as prevention, appraisal, internal and external failure. In economic and financial terms, cost of quality can be measured by adding up expenses incurred on the provision of the treatment, medicine, prices charged for clinical services, the opportunity cost of engaging resources, the support staff and medicines in the treatment of one patient over another etc. becomes a part of the cost of quality. This cost, in addition to costs incurred in achieving or maintaining quality standards also includes costs resulting from not achieving or maintaining quality standards. As earlier mentioned prevention cost is the expense that will be incurred in prevention of defective units of service such as sterilizing instruments earlier to avoid any occurrence of infection etc. Whereas, appraisal cost is the cost incurred in the identification of the defective units of service such as inspecting and quality control checks to run on machines, medicines. The internal failure cost result from preventing a defective service if identified to be passed on the patient example revamping in cases of expired medicine or obsolete equipment. In case the wrong treatment or service is given to the customer external failure costs occur such as administration of wrong medicine to the customer. This results in losing a life and a bad reputation. Question 5: What measures, other than asking patients their opinions, would you take as the hospital administrator to assess the level of service and quality of healthcare provided by your hospital? To assess the level of quality other than patients’ opinion clinical and administrative standards for health care services, communication standards, and design for accreditation, licensing and certifications, meeting international standards and norms set by the ministry of health and other monitoring agencies are the part of the measures that should be considered. Besides, patients other stakeholders including the community is important. RAK Manufacturing Corporation Question 1: As a production manager for RMC, what do you recommend? Why? As a production I am looking for ease in the handling various machine operations, how material is handled, transported and positioned in the machine system and flexibility in the operational sequence of different parts of the product that is manufactured. Moreover, I require flexibility in production of different levels of volume, either lower or expand production incrementally to produce at optimal levels of profitability. Moreover, flexibility in process and program is ultimately required. Thus, to achieve all kinds of flexibility the feasible solution is to have a production system completely under the influence of FMS technology. The adoption of new Flexible Machining System is desire able alternate as it speeds up the process and at a lower cost changes are made to better utilize capacity; labor cost is reduced because of reduction in number of workers, inventory can be reduced because the quick and efficient process planning and programming option in the flexible machining system eases the process. Question 2: Prepare a case by a conservative plant manager for maintaining the status quo until the returns are more obvious. The flexible machining system is a very sophisticated manufacturing system. Its installation is not a standalone decision, it affects all the linked activities of the organization and thus requires substantial pre planning activity and its expensive and costly. Moreover, as a plant manager and closest to the production process there might arise technological problems for exact component positioning and the association of timing that is required to process a component. Question 3: Prepare the case for an optimistic sales manager that you should move ahead with the FMS now. Since Flexible Machining System has limited ability to adapt to changes in the product or product mix therefore, sales manager has to be resistance to any implementation of the system. But, there are two options in these reconfigurable lines – one, there can be dedicated transfer lines, that are suitable for producing huge volumes of certain parts only. And secondly, there are computer numerical control machine tools that have the maximum flexibility available but are slow in furnishing the finished product. To resolve the problem that the sales manager thought was earlier associated with the flexible machining system can be resolved. In situations where peak demands arise, dedicated lines can be used to produce in bulk. Whereas, in periods of fluctuating demand, dedicated line usage may ramp up or ramp down. Flexible machining system is used to catch the shortfalls or overflow in the production process. For sales managers today, systems supporting the flexible machining system include product design for mass customization and mass customization manufacturing system – it helps in achievement of challenges such as reduced lead time and lowering production costs. For sales managers today the competition comes from fulfillment of customer needs better, hence giving popularity to the mass customization manufacturing environment, shortened production life cycles and strategic orientation towards meeting demands of the market. Question 4: As the operations manager for the company, what do you see as the main reasons for moving the operation from a multi-machine operation to an FMS? How would this impact your scheduling, layout design and supply chain management. Since flexible machining system have an option of reconfiguring the whole machine process, and provides more flexibility than a dedicated production line and is faster because of its dual nature. The advantage coming from dedicated transfer line of producing larger quantity of one component is also achieved and flexibility related to general purpose production is achieved. The traditional system, currently used by the RAK Manufacturing Company does not support the flexibility that the flexible machining system serves. The new system if implemented will help in production of diverse range of products in smaller and medium sized batch production. As opposed, the mass customization manufacturing, flexible machining system has flexibility to rapidly respond to deal with complex manufacturing situations. Question 5: The CEO of RMC hires you as an OM consultant to make a recommendation? What would you recommend and why? With flexible machining system, part and tool flow management becomes imperative in the process. Thus, proper scheduling and assignment strategy is to be adopted. For this purpose simulation methods should be adopted. With this implementation, management should be proactive in rapid programming, ability to set up tools and parts off line, ability to place parts and tools on machines accurately with respect to machine’s coordinate system so that parts, tools, machines and alignment of numerical control is in the right direction. This will result ineffective scheduling and sequencing of work, high reliability and uptime. This can be achieved through proper planning of features to be machined in the system, approach direction, identification of rough and fine cuts needed to achieve required tolerances and surface finishes, determining sequence of cuts, cutting time, and required tools and required machines of different strengths, stiffness, range of motion etc. References Schoenbaum, S.C. and Shih, A. (2007) Measuring Hospital Performance: The importance of process measures, Commission on a high performance health system Kingsbury, K. (2008) The value of human life: $129,000, TIME May 20, 2008 McLean, C., Lu, R., Qiao, G. (2003) Flexible manufacturing systems for mass customization manufacturing Ozbayrak, M., Turker, A.K., & Pisman, M. (1997) Part and tool flow management in mulit-cell flexible manufacturing system, Winter Simulation Conference Read More