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| 2. |
- Bergman, Bo, 1943, et al.
(författare)
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Five main processes in healthcare: a citizen perspective
- 2011
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Ingår i: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 20:SUPPL. 1, s. I41-I42
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Tidskriftsartikel (refereegranskat)abstract
- A citizen point of view on the healthcare system, its processes and their improvement is emphasised. From this point of view, five main processes are identified: Keeping Healthy, Detecting Health Problems, Diagnosing Diseases, Treating Diseases and Providing for a Good End of Life. The citizen should be looked upon as a cocreator of value and improvement of these processes.
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| 4. |
- Dixon Woods, Mary, et al.
(författare)
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Problems and promises of innovation: why healthcare needs to rethink its love/hate relationship with the new
- 2011
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Innovation is often regarded as uniformly positive. In this paper, we see the role of innovation inquality improvement as more complicated. We identify three known paradoxes of innovation inhealthcare. First, some innovations diffuse rapidly, yet are of unproven value, limited value, or poserisks, while other innovations that could potentially deliver benefits to patients remain slow toachieve uptake. Second, participatory, cooperative approaches may be the best way of achievingsustainable, positive innovation, yet relying solely on such approaches may disrupt positiveinnovation. Third, improvement clearly depends upon change, but change always generates newchallenges. Quality improvement systems may struggle to keep up with the pace of innovation, yetevaluation of innovation is often too narrowly focused to understand the system-wide effects of newpractices or technologies. We propose a new recognition of the problems of innovation, and arguethat new approaches to addressing them are needed.
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| 5. |
- Dixon-Woods, M., et al.
(författare)
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Problems and promises of innovation: why healthcare needs to rethink its love/hate relationship with the new
- 2011
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Ingår i: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 20:SUPPL. 1, s. I47-I51
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Tidskriftsartikel (refereegranskat)abstract
- Innovation is often regarded as uniformly positive. This paper shows that the role of innovation in quality improvement is more complicated. The authors identify three known paradoxes of innovation in healthcare. First, some innovations diffuse rapidly, yet are of unproven value or limited value, or pose risks, while other innovations that could potentially deliver benefits to patients remain slow to achieve uptake. Second, participatory, cooperative approaches may be the best way of achieving sustainable, positive innovation, yet relying solely on such approaches may disrupt positive innovation. Third, improvement clearly depends upon change, but change always generates new challenges. Quality improvement systems may struggle to keep up with the pace of innovation, yet evaluation of innovation is often too narrowly focused for the system-wide effects of new practices or technologies to be understood. A new recognition of the problems of innovation is proposed and it is argued that new approaches to addressing them are needed.
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| 6. |
- Dolah, R., et al.
(författare)
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Outliers effect in measurement data for T-peel adhesion test using Robust parameter design
- 2014
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Ingår i: Jurnal Teknologi (Sciences and Engineering). - : Penerbit UTM Press. - 0127-9696 .- 2180-3722. ; 68:4, s. 77-81
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Tidskriftsartikel (refereegranskat)abstract
- As many researches focused on application of robust design engineering in practical case study, very less concerned on the criticality to data measurement system in parameter design. This paper will emphasize on the importance to be critical to data obtained during experiment. The existence of outliers is often ignored and the impact overlooked, thus endanger the results by producing false alarm and giving completely wrong parameter setting. The optimum condition from the data that contains outliers is compared with the corrected data measurement. The finding presents the indication procedure on how to confirm whether the data is reliable or not for evaluation. The data is unreliable when two main indicators are detected. Firstly, the measurement data plot detects outlier through linear regression analysis as it does not belong on the linear line. Secondly, poor reproducibility presented by estimation and confirmation of signal-to-noise ratio. This failure affects the experimental design and lead to wrong optimum condition. T-peel adhesion test using orthogonal array L9 is done as a case study to elucidate the detection of outlier and outlier effect on optimum condition.
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| 7. |
- Johannesson, Pär, 1969, et al.
(författare)
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A Robustness Approach to Reliability
- 2013
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Ingår i: Quality and Reliability Engineering International. - : Wiley. - 1099-1638 .- 0748-8017. ; 29:1, s. 17-32
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Forskningsöversikt (refereegranskat)abstract
- Reliability of products is here regarded with respect to failure avoidance rather than probability of failure. To avoid failures,we emphasize variation and suggest some powerful tools for handling failures due to variation. Thus, instead of technicalcalculation of probabilities from data that usually are too weak for correct results, we emphasize the statistical thinking thatputs the designers focus on the critical product functions.Making the design insensitive to unavoidable variation is called robust design and is handled by (i) identification andclassification of variation, (ii) design of experiments to find robust solutions, and (iii) statistically based estimations of propersafety margins.Extensions of the classical failure mode and effect analysis (FMEA) are presented. The first extension consists of identifyingfailure modes caused by variation in the traditional bottom–up FMEA analysis. The second variation mode and effect analysis(VMEA) is a top–down analysis, taking the product characteristics as a starting point and analyzing how sensitive thesecharacteristics are to variation.In cases when there is sufficient detailed information of potential failure causes, the VMEA can be applied in its mostadvanced mode, the probabilistic VMEA. Variation is then measured as statistical standard deviations, and sensitivities aremeasured as partial derivatives. This method gives the opportunity to dimension tolerances and safety margins to avoidfailures caused by both unavoidable variation and lack of knowledge regarding failure processes.
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| 8. |
- Korkusuz, Duygu, et al.
(författare)
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Process Capability Analysis for Non-normal Distribution with Lower Specification Limit
- 2011
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Ingår i: IEEE International Conference on Industrial Engineering and Engineering Management. - 2157-3611 .- 2157-362X. - 9781457707391 ; , s. 1466-1470
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Konferensbidrag (refereegranskat)abstract
- Process capability analysis is an important element of any quality improvement initiative. However, estimating process capability is often problematic when it comes to non-normal distributions since the conventional methods sometimes give misleading results. In this paper, a new method for estimating process capability of non-normal distribution with only lower specification limit is proposed. The proposed method only considers the left tail of thedistribution rather than taking all of the data points. Forestimating the process capability, it employs least squarestechnique and normal approximation to the selectedobservations from the left tail. Here, the proposed method is only tested on lognormal distribution. Simulations and real-world data analysis are used for verification and validation purpose, respectively. An easy and practical guideline is also developed.
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| 9. |
- Lifvergren, Svante, 1961, et al.
(författare)
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Lessons from Sweden’s first large-scale implementation of Six Sigma in healthcare
- 2010
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Ingår i: Operations Management Research. - : Springer Science and Business Media LLC. - 1936-9735 .- 1936-9743. ; 3:3-4, s. 117-128
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Tidskriftsartikel (refereegranskat)abstract
- The Skaraborg Hospital Group (SkaS) has implemented a variety of quality management initiatives in the last 20 years in accordance with its strategy of excelling at quality development to fulfill the needs and expectations of its patients. One such initiative is Six Sigma, which has contributed to more than 40 completed improvement projects. Using an action research approach, this article describes the lessons that were learned from the first 22 Six Sigma projects, completed between 2006 and 2008 and having a success rate of 75%. We further describe how these insights have contributed to other ongoing quality improvement activities at SkaS. In particular, the paper presents some key points not earlier described in other Six Sigma healthcare applications.
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| 10. |
- Neuhauser, D., et al.
(författare)
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The meaning of variation to healthcare managers, clinical and health-services researchers, and individual patients
- 2011
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Ingår i: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 20:SUPPL. 1, s. I36-I40
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare managers, clinical researchers and individual patients (and their physicians) manage variation differently to achieve different ends. First, managers are primarily concerned with the performance of care processes over time. Their time horizon is relatively short, and the improvements they are concerned with are pragmatic and 'holistic.' Their goal is to create processes that are stable and effective. The analytical techniques of statistical process control effectively reflect these concerns. Second, clinical and health-services researchers are interested in the effectiveness of care and the generalisability of findings. They seek to control variation by their study design methods. Their primary question is: 'Does A cause B, everything else being equal?' Consequently, randomised controlled trials and regression models are the research methods of choice. The focus of this reductionist approach is on the 'average patient' in the group being observed rather than the individual patient working with the individual care provider. Third, individual patients are primarily concerned with the nature and quality of their own care and clinical outcomes. They and their care providers are not primarily seeking to generalise beyond the unique individual. We propose that the gold standard for helping individual patients with chronic conditions should be longitudinal factorial design of trials with individual patients. Understanding how these three groups deal differently with variation can help appreciate these three approaches.
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