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29/11/2011

Planning and control can be very difficult for a hospital, since hospitals typically provide a mixture of regular, planned activities requiring access to specialized staff and facilities, but they also have to be able to cope withdemand in emergency situations.Discuss the use of SCHEDULING, SEQUENCING and LOADING in hospitals to optimize customer service, minimize resource usage and meet social responsibility goals. (June 2010)

Start with a diagram!

20 marks question

Scheduling Loading

Sequencing Monitoring and control

When to do things?

In what order to do

things?

How much to do?

Are activities going to plan?

The activities of planning and control

Planning and control reconciles supply and demand. Planning concerns what should happen in the future, while controlling copes with the changes. There are four overlapping or connected activities in planning and control such as loading, sequencing, scheduling, and monitoring and control.

As for any organization, planning and control is very important to the hospital too. But, planning and control in a hospital is a difficult operation as the irregular or unexpected changes happens in demand. For example the spread of an epidemic or a natural catastrophe or accidents create emergency situations in a hospital where planning and control becomes vital.

The first consideration should be the loading activity, it is the amount of work that is allocated to a work centre.

There are two types of loading for a hospital to consider, such as finite loading and infinite loading. Finite loading is an approach to planning and control that only allocates work to a work centre up to a limit or up to the useful capacity.

For a hospital usually this is done during the normal conditions, where each department is allocated with exact work. For example an appointment system in the hospital will limit the load per day.

Infinite loading is a situation where work is allocated irrespective of the capacity or other limits. For example a hospital is forced to follow this type of allocation during emergencies.

The next activity to consider in the planning and control is sequencing , it means the activity within planning and control that decides the on the order in which work is to be performed.

In other words this is the decision as on what order the work will be performed. For a hospital this stage is vital, here the decision must be made as what order the patients must be treated.

To enable this decision making there are many rules available in operations management as follows:

Physical constraints – according to the physical nature of the material the work is processed. In case of the hospital, a patient in emergency is treated first.

Customer priority – this allows an important or aggrieved customer, or item, to be processed prior to others, irrespective of the order of arrival of customers or item.

In a hospital a triage system is used, not first in first out. Which means patients in discomfort or serious illness are attended to first.

Due date – here work is sequenced according to when it is due for delivery. This approach usually improves the delivery reliability of an operation and improves average delivery speed.

In a hospital in normal circumstance treatment is based on the appointment system, but as emergencies arise this may change.

Last in first out – where the last in item or material is processed first. But this method cannot be applicable to a hospital.

First in first out – serving customers exactly in the same sequence as they arrive. This is followed in hospital by appointment system.

Longest operation time – here the longest job considered first. But this approach doesn’t according to delivery speed, reliability or

flexibility.

All five performance objectives, or some variant of them could be used to judge the effectiveness of sequencing rules.

The following objectives of dependability, speed and cost are considered to be important.

The next part is scheduling, it is about a timetable showing what time or date jobs should start and when they should end.

In the case of a hospital equipment scheduling such as Scanners, X-RAY can be taken in this context.

But, scheduling is a complex task, where machines/equipments or staff must be scheduled properly. Here the main consideration is that machines will have different capabilities and the staff will have different skills.

There are some rules that we can apply for scheduling as follows:

Forward scheduling – forward work onto work stations as soon as it is practical to do so. For a hospital this is applied in the case of equipments such as X- RAY, Scanners, operating theatres e.t.c.

Backward scheduling – starting the job at a time according to the due date.

The main task of scheduling is to make sure that sufficient numbers of people are working at any point in the time to provide a capacity appropriate for the level of demand at the that point of time.

In a hospital, the duty rostering is used to schedule the staff.

Reference

Page 297 – the text book

298- the text book

299 - the text book

300 - the text book – 308

The new reference book

589

590

595

600

Check the chapter 14 of new reference book clear enough.

You are the operations manager in a hospital that has just appointed a new MD. The MD was the quality manager in the manufacturing company where he previously worked, and introduced Total Quality Management (TQM) to his company. The MD is keen to introduce TQM to the hospital, but you have expressed concern that TQM may be unsuitable for a service organisation like a hospital.

• The MD would like you to write a brief report explaining why you think TQM may be more difficult to implement in a hospital compared with a manufacturing plant. ( June 2009)

This question is tricky in nature, where a professional approach is needed.

First, make sure the answer look like a report, which will ensure 2 marks.

Diagram is drawn .

Operations strategy

Design Improvement

Planning and control

Operations management

Managingimprovement

Total quality management

organizes process improvement Failure prevention

and recovery stop processes

becoming worse

Operations process improvement

makes processes better

TQM and it’s implications in hospitals ( remember to make this as a report)

Introduction

Quality management is important for any organization, which brings customer satisfaction, loyalty and improved financial returns to the organization.

But, same as any approach, we have to analyse the implications of the same in an organization prior to the implementation.

This report, is an attempt to analyze the implications of TQM approach in our hospital.

Situational analysis

TQM approach is regarded as an effective method for improving the quality in an organization. TQM is defined as a philosophy of how to approach the organization of quality improvement.

According to this approach the quality improvement is a collective responsibility of anyone and everyone in the organization.

Elements of TQM

1. Meeting customer needs and expectations of customers

2. Covering all parts of the organization

3. Including every person in the organization

4. Examining all costs which are related to quality

5. Getting things right first time

6. Developing systems and procedures to support quality improvement

7. Developing continuous process of improvement.

Factor analysis The main concern over TQM is the very concept itself; it is derived and operated in manufacturing industry, and not in service industry like hotel, hospital e.t.c

Another concern regarding TQM is the “Buy-in” from staff at all grades. This may lead to the problems as it may even require the senior staff to do the same. For example the senior medical officers.

Again, TQM requires a detailed structure to work on, where hospitals are less structured than manufacturing plants, with more emphasis on 'soft' human issues. Hospitals may be private or state run, and this may have an impact.

In service industry greater emphasis on qualitative rather than quantitative factors compared with manufacturing.

Qualitative factors may be more difficult to evaluate compared with quantitative. As hospital is concerned, the emphasis will be purely on qualitative factors, it is creating feasibility problems.

Creates a culture of high visibility and accountability, which may be resisted by some groups of staff – as TQM propose higher level of accountability the control over the staff will be higher, which can create problems in the employees. How to measure customer service in the hospital? Who are the customers, and how are their needs identified and quantified? – these questions will eventually become hard to be explained. There may be conflicts between different internal stakeholder groups, particularly over introducing the idea of internal customers and suppliers.Possible effects on staff morale due to greater control. – the TQM approach needs the management support where internal customer and supplier idea may be hard to go by.

Still, the term empowerment can pave the way for imbalance between managerial control and employee influence.

Adapt TQM to the circumstances of the organization. Different organizations will have different needs depending on their circumstances. So as an example in the hospital the TQM might become more or less important.

Again, TQM is a kind of ‘quality bureaucracy’, where the hospitals will have to invest large scale management facilities.

Finally TQM can be regarded as ‘management by stress’ – here the management wants all ideas from the staff and finally the staff become replaceable.

Conclusion

So, taking the long term objectives into consideration, I would recommend that the scope of TQM in service industry is limited.

Reference

Chapter 20 the text book

Follow my answer, because this type of questions cannot be answered straight. Again, reading through the critical commentary in chapter 14 will be more helpful.

How would you evaluate if TQM was a success or not if introduced in the hospital? (2009 June)

Total Quality Management is a holistic approach towards the quality management. • In service industry such as hospital to evaluate the success of the same requires

few methods such as results from stakeholder surveys, cost-benefit analysis, lower incidence of complaints etc.

However the basic problem is how to measure the ’success'; qualitative or quantitative approach?

For example: how can it be determined if communication between staff and management has improved?

Both the formal and informal communication channels could be reviewed. Formal channels - Have the systems changed as a result of TQM, how have they changed? Is everybody aware of the system? How effectively is the system being used and monitored? Is the system easy to use and accessible to all? Do the senior management team review the efficiency of internal and external communications, how and when? Is there ownership?

Informal communication - what form do these take? Have they changed since TQM was introduced? Do staff and management feel that informal communication is effective and constructive?

chances for resistance, such as industrial un-rest, views of staff, trade union feedback is important at this stage most importantly the performance must be analyzed to evaluate the success. We can use bench- marking and cost- benefit analysis e.t.c.

Please follow my answer as this is purely from application.

Any question related to the issues of TQM please look at the various options

• Statements representing potential barriers to TQM:• 1 Strategic plans do not include quality goals.• 2 The best practices and/or products of other companies are

benchmarked.• 3 There are excess layers of management.• 4 Quality is treated as a separate initiative.• 5 Quality is not everyone’s responsibility.• 6 Employees are trained in problem identification and problem-

solving techniques.• 7 There is no joint planning with suppliers.• 8 Quality is not effectively measured.• 9 Quality is defined by the customer.

10 Employees are not trained in group-discussion and communication techniques.11 Quality action plans are often vague.12 The strategic plan is customer driven.13 Employees are empowered to implement quality improvement efforts.14 There are adequate resources to effectively employ TQM.15 Cross-functional teams are not employed.16 Employees and/or teams are recognized for achievements in quality improvement.17 Employees are trained in quality improvement skills.18 Top management is visibly and explicitly committed to quality.20 Management’s compensation is linked to achieving quality goals.22 The constraints prohibit effective TQM implementation.23 Employees are resistant to change.Statements representing potential undesirable outcomes from failed TQM:19 Quality improvement efforts rarely meet expectations in terms of desired results.21 There is frequent turnover of employees.24 The high costs of implementing TQM outweigh the benefits.25 There is frequent turnover of management.

A business person wishes to open a new office in a town centre. From your knowledge of facilities design …

• Explain, with examples, how workplace design principles should be applied to this new venture

Please refer to the example outlined in the PBO sample examination marking scheme.

You can find the same in the website under the title of final mock test marking scheme.

Why is quality important? Answers are likely to include a consideration of the impact of quality on costs, revenues and profits, The text book – page 538 b) Selecting the organisation you chose in Question One above, explain how you might use Garvin’s five approaches to quality.

The text book 538

What are the key questions relating to job design that need consideration?

What are the key questions relating to job design that need consideration?

• Consideration of • Tasks to be undertaken, • Responsibilities of the job(s) and how allocated • Work environment • Methods used to complete the jobs, etc. • Need to design to meet the organisations need for work

completion • Provide a motivating, safe & satisfying environment for the

worker • Need to consider the core characteristics of the job, the

psychological state of the worker, and the outcome of the tasks

Explain, with examples, how workplace design principles should be applied to this new venture

• Need to consider layout. Students might include here a brief discussion of process layout & design – relating it to the example. Might also discuss the use of “cell” layout.

• Discussion of how the workplace design should maximise efficiency and effectiveness

• Who will use the workspace? • How will the work be performed? • What technology is needed? • What must the employee be able to see? • What must the employee be able to hear? • What environmental & safety issues need to be addressed • Discussion of ergonomic design

discussion of the above relating it to an office layout. Use of examples to illustrate

Distinguish between statistical process control and acceptance sampling. Which approach is more suitable for your selected organisation, stating reasons for your answer?

Text book 552 & 568.

Quality is one of the five key performance objectives… Explain how quality could be determined and measured in the house design and build project. Give examples and justify your decisions.

( 2011 September)

Draw the diagram shown in the next slide.

I am showing two diagrams for the same question. Please remember that both of them are equally important, however if the time is a constraint draw the first one.

Quality planning and control

Operations strategy

Design Improvement

Planning and control

Operations management

Quality planning and control

The operation supplies …the consistent delivery of products and services at specification or above

The market requires … consistent quality of products

and services

Quality upQuality up

Profits upProfits up

Processing time down

Processing time down

Inventory downInventory down

Capital costs down

Capital costs downComplaint and

warranty costs downComplaint and

warranty costs down

Rework and scrap costs

down

Rework and scrap costs

down

Inspection and test costs downInspection and test costs down

Productivity upProductivity up

Service costs down

Service costs down

Image upImage up

Scale economies up

Scale economies up

Price competition

down

Price competition

down

Sales volume up

Sales volume up

Revenue upRevenue up

High quality puts costs down and revenue up

Operation costs down

Operation costs down

Quality is one of the Five performance objectives of an operation.

There are five performance objectives such as;

Quality ,Speed, Dependability , Flexibility and Speed.

As for any organization, quality is important for house design and build project, because quality is clearly a major influence on customer satisfaction and dissatisfaction.

So, quality can be defined as conformance to specification or doing things right. According to J.M Juran quality is ‘fitness to use’.

In operational point of view, quality is consistent conformance to customers’ specifications. But, customers point of view regarding the quality is different. Individual customer expectations may different. For example for the house design and build project the design that one customer likes may not be the choice for the other. One may perceive the open area in the front yard as waste of space, but the other may consider this as an ideal location for small get-togethers. So, customers’ point of view is as what he/she perceives the product or service to be.

Quality can be regarded an important element of performance objective since;

• Quality increases the revenues • Quality brings the cost down • Enhances the customer satisfaction • Increases the efficiency of the operations

So, to reconcile the customers point of view and operations view we have to understand the Gap Model, which advocates 5 varieties of gaps between customer expectations and what they perceive.

Gap 1 – the gap between customer expectations and management perceptions.

Gap 2 – the gap between management perceptions of what features constitute a target level of quality and the task of translating these perceptions into executable specifications.

Gap 3 – is the gap between quality specifications documented in operating and training manuals and plans and their implementation.

Gap 4 – is the gap between actual manufacturing and service delivery system performance and external communications to the customer.

Gap 5 – is the gap between the customers’ expectations and perceptions.

Taking the design and building project the same analysis can be done. For example some customers would like to have the actual quality of the construction design, but others may prefer to the overall design.

Again, the difference between product and service is evident here. House design and build is a service providing company, where concept is intangible. Again, this service is cannot be stored, to meet the immediate requirement.

In the house design and project industry the quality can be recognized in different ways. For example by way of customer survey, performance awards, quality accreditation such as ISO 9000 e.t.c.

To be able to measure the quality we will have to use different methods. For example Metrology is a such a technique, which is the collection of people, equipment, facilities, methods and procedures used to assure the correctness or adequacy of measurements.

Another approach is internal audits; which is identifying whether documented procedures are being followed and are effective and report issues to the management.

In house design and building project it is essential to measure the quality in the competitive market. Which can be done by performance reviews against targets, where the focus is on finding out how far the targets are achieved. Another method is to conduct internal and external surveys and analyse the result. Finally appraisals will also provide the necessary insights towards the existing quality.

As with any operation the house design and building business also should understand the impact of quality management; where quality is a continuous process which cannot be fulfilled overnight.

Reference

The new reference book – 633, 634, 635, 639, 640, 78, 77.

The text book – 538,539,540, 651 I have tired my best to make this a common

answer so that any question of this kind can be answered in the similar way.

From your knowledge of Business Operations: Discuss the role of the Cinema General Manager (whose job is really Business Operations Manager but with a different title!). Illustrate your answer with relevant examples and operations management models. (2011 March)

DRAW THE DIAGRAM SHOWN IN THE NEXT SLIDE

A general model of operations management

Transformed resources …

Materials Information Customers

Transforming resources …

Facilities Staff

CustomersOutput

products and services

Input resources

Planning and control

ImprovementDesign

Operations strategy

The operation’s strategic

objectives

The operation’s competitive role

and position

Operations management

Operations strategy

Operations management is the activity of managing the resources which are devoted to the production and delivery of products and services. In a cinema theatre the role of a general manager is an operational manager, though it is called as a general manager.

There are three core functions in any operation such as marketing, product/service development, operation function. But there are supporting functions such as accounting and finance, HR e.t.c.

In this scenario we call the operations as all the activities necessary for the fulfillment of customer requests.

All operations produce products and services by changing inputs into outputs. The same is with the cinema theatre, where inputs are the film, the information of changing the same into visual media and customers which the general manager with the help of projection equipments, staff transforms into attractive cinema experince.

All operations are transformation processes …

Transformation processInputs

that transform inputs …

Outputs

into outputs

A general manager in the cinema theatre has the responsibility for all activities in the theatre. The major ones are explained below:

• Understanding the operation’s strategic objectives - the main responsibility is to understand what it is trying to achieve. In other words the general manager is responsible for translating the organization’s goals into performance objectives such as quality, speed, dependability, flexibility and cost.

• Develop the operations strategy for the organization – as a general manger he/she is responsible for setting the principles for decision making.

• Designing operations products/ services – as general manager this activity is to figure the composition of products and services in the cinema theatre. For example restuarents in the theatre, other facilities.

Planning and controlling – it is about deciding as what the operation’s resource might be doing and making sure that they are

doing it.

At this situation, the role of general manger or operational manager becomes vital, because he/she is playing the key role in reducing the cost of operation, increasing the revenue, providing innovation, assuring customer satisfaction e.t.c.

Again, managing the functions and managing the supply chain is another responsibility. Here the general manager will play the key role in identifying, and selecting suppliers and retaining them.

Reference

Chapter 1 the text book