Day 2
Lecture Arno van Raak
Assignments
Theory
System: Design- Implementation- Design
- System ideally established according to design
- System performance can be lower than expected or can decrease
- Then usually incremental changes are made
- This can work up to a limit
- At some point new design of system is needed
CPI (Continuous process improvement)
It is contingent whether approach for CPI is useful.
- Selection from several CPI approaches can make sense (not at random- contingent/
coherent)
- Determine: what is needed and appropriate.
So consider features of system and environment when choosing
Procedure:
- Unravel features of system and environment
- Look where improvements are needed and which and why
- Determine which CPI and which methods to use
Risk of incrementalism: changes at one location can negatively impact changes elsewhere in system.
So improve locally, thereby considering whole system.
System as defined by Deming
- Network of interdependent components that work together to try to accomplish the aim of
the system.
- A system must have an aim. Without an aim, there is no system.
- Management of a system requires knowledge of the interrelations between all the
components within the system and of the people that work in it.
- A system must be managed. It will not manage itself.
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, - Left to themselves, components become selfish, competitive, independent profit centers,
and thus destroy the system.
- Secret: cooperation between components toward the aim of the organization. We cannot
afford the destructive effect of competition
- Aim: “A system must create something of value, in other words, results. The intended
results, along with consideration of recipients and of costs, mold the aim of the system”.
Improving processes in systems according to Deming
PDSA: Continual Improvement of Process (and product/service)
System of Profound Knowledge (SoPK): do not isolate the process from the system.
- SoPK is the outcome of integration of a number of theories that Deming developed
- Provides a map of theory for people in an organization to continually improve, with the aim
for everybody to win
All about transformation!
Transform the individual
- The individual, once transformed will:
o Be a good listener, but will not compromise
o Continually teach other people
o Help people pull away from their current practice and beliefs and move into the new
philosophy without a feeling of guilt about the past
Transformation of management
1. Create constancy of purpose for improving products and services
2. Adopt the new philosophy
3. Cease dependence on inspection to achieve quality
4. End the practice of awarding business on price alone; instead minimize total cost by working
with a single supplier
5. Improve constantly and forever every process for planning, production and service
6. Institute training on the job
7. Adopt and institute leadership
8. Drive out fear
9. Break down barriers between staff areas
10. Eliminate slogans, exhortations, and targets for the workforce
11. Eliminate numerical quotes for the workforce and numerical goals for management
12. Remove barriers that rob people of pride of workmanship, and eliminate the annual rating
or merit system
13. Institute a vigorous program of education and self-improvement for everyone
14. Put everybody in the company to work accomplishing the transformation
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, Lean
- Value - waste (Muda)
- 5 principles according to Womack & Jones
- 8 types of waste according to Liker
- 14 principles according to Liker
Six sigma
- Data-driven, DMAIC
- Roles
TOC
- Types of constraints
- 5 steps aka POOGI
- DBR
CPI cannot be used for all healthcare aspects patient care. However, can be used for delivery of
medical equipment, catering, administering medication etc.
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