Journal of Health Organisation and Management, Apr 13, 2015
Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving ro... more Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Design/methodology/approach – Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Findings – Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. Research limitations/implications – The study was conducted in one hospital setting. Practical implications – Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. Originality/value – This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.
There is a growing national concern that health care organizations do not have a sound operating ... more There is a growing national concern that health care organizations do not have a sound operating system in place. Reforming the operating system has assumed significance because of increasing operating costs and diminishing reimbursements from the payers. Critics argue that in the last 100 years or so significant strides have been made in product innovation but very little in process innovation. In an effort to improve the internal systems, health care leaders have adopted various process improvement techniques, yet success has remained elusive in most of the cases. The Toyota Production System (TPS), built on basic Industrial Engineering principles, offers powerful tools to revamp health care’s work processes. Its application in the health care sector has been limited despite showing signs of promise. The authors present a successful application of TPS design rules, using a problem solving process adapted from Toyota, in improving the group meal therapy process in a Rehabilitation ...
There is a growing national concern that health care organizations do not have a sound operating ... more There is a growing national concern that health care organizations do not have a sound operating system in place. Reforming the operating system has assumed significance because of increasing operating costs and diminishing reimbursements from the payers. Critics argue that in the last 100 years or so significant strides have been made in product innovation but very little in process innovation. In an effort to improve the internal systems, health care leaders have adopted various process improvement techniques, yet success has remained elusive in most of the cases. The Toyota Production System (TPS), built on basic Industrial Engineering principles, offers powerful tools to revamp health care’s work processes. Its application in the health care sector has been limited despite showing signs of promise. The authors present a successful application of TPS design rules, using a problem solving process adapted from Toyota, in improving the group meal therapy process in a Rehabilitation ...
This paper presents a field research study involving application of the first three design Rules-... more This paper presents a field research study involving application of the first three design Rules-in-Use of Toyota Production System in a health care setting, which like many other health care organizations resembles a broken system. Qualitative research is used to collect the data and a combination of qualitative and quantitative approaches are used to analyze the data. A regression model reveals a significant association between proper application of the rules and outcomes of process improvement efforts. The results confirm that with some refinement, the Rules-inUse are transportable to health care and may provide an answer to health care’s systemic issues.
Journal of Health Organization and Management, 2015
Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving ro... more Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Design/methodology/approach – Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Findings – Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. Research limitations/implications – Th...
Journal of Manufacturing Technology Management, 2012
Purpose – The purpose of this paper is to examine the current state of lean adoption in Indian ma... more Purpose – The purpose of this paper is to examine the current state of lean adoption in Indian manufacturing plants and its impact on operational performance.Design/methodology/approach – A survey questionnaire was developed and adapted based on work done in US industries. The survey questionnaire was sent to 400 firms in four geographic regions in India. In total, 79 usable responses were received for the study.Findings – Since lean manufacturing is a multi‐dimensional construct, the results demonstrate that approximately 80 percent of the respondents have implemented many dimensions of lean – focus on customer needs, pull system, setup time reduction, total productive maintenance, supplier performance, statistical process control, and cross‐departmental problem solving. The operational metrics have improved on all accounts: high productivity, reduced lead time, improved first‐pass correct output, reduced inventory and space requirement. Interestingly, respondents have indicated that first‐pass correct o...
Journal of Health Organisation and Management, Apr 13, 2015
Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving ro... more Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Design/methodology/approach – Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Findings – Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. Research limitations/implications – The study was conducted in one hospital setting. Practical implications – Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. Originality/value – This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.
There is a growing national concern that health care organizations do not have a sound operating ... more There is a growing national concern that health care organizations do not have a sound operating system in place. Reforming the operating system has assumed significance because of increasing operating costs and diminishing reimbursements from the payers. Critics argue that in the last 100 years or so significant strides have been made in product innovation but very little in process innovation. In an effort to improve the internal systems, health care leaders have adopted various process improvement techniques, yet success has remained elusive in most of the cases. The Toyota Production System (TPS), built on basic Industrial Engineering principles, offers powerful tools to revamp health care’s work processes. Its application in the health care sector has been limited despite showing signs of promise. The authors present a successful application of TPS design rules, using a problem solving process adapted from Toyota, in improving the group meal therapy process in a Rehabilitation ...
There is a growing national concern that health care organizations do not have a sound operating ... more There is a growing national concern that health care organizations do not have a sound operating system in place. Reforming the operating system has assumed significance because of increasing operating costs and diminishing reimbursements from the payers. Critics argue that in the last 100 years or so significant strides have been made in product innovation but very little in process innovation. In an effort to improve the internal systems, health care leaders have adopted various process improvement techniques, yet success has remained elusive in most of the cases. The Toyota Production System (TPS), built on basic Industrial Engineering principles, offers powerful tools to revamp health care’s work processes. Its application in the health care sector has been limited despite showing signs of promise. The authors present a successful application of TPS design rules, using a problem solving process adapted from Toyota, in improving the group meal therapy process in a Rehabilitation ...
This paper presents a field research study involving application of the first three design Rules-... more This paper presents a field research study involving application of the first three design Rules-in-Use of Toyota Production System in a health care setting, which like many other health care organizations resembles a broken system. Qualitative research is used to collect the data and a combination of qualitative and quantitative approaches are used to analyze the data. A regression model reveals a significant association between proper application of the rules and outcomes of process improvement efforts. The results confirm that with some refinement, the Rules-inUse are transportable to health care and may provide an answer to health care’s systemic issues.
Journal of Health Organization and Management, 2015
Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving ro... more Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Design/methodology/approach – Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Findings – Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. Research limitations/implications – Th...
Journal of Manufacturing Technology Management, 2012
Purpose – The purpose of this paper is to examine the current state of lean adoption in Indian ma... more Purpose – The purpose of this paper is to examine the current state of lean adoption in Indian manufacturing plants and its impact on operational performance.Design/methodology/approach – A survey questionnaire was developed and adapted based on work done in US industries. The survey questionnaire was sent to 400 firms in four geographic regions in India. In total, 79 usable responses were received for the study.Findings – Since lean manufacturing is a multi‐dimensional construct, the results demonstrate that approximately 80 percent of the respondents have implemented many dimensions of lean – focus on customer needs, pull system, setup time reduction, total productive maintenance, supplier performance, statistical process control, and cross‐departmental problem solving. The operational metrics have improved on all accounts: high productivity, reduced lead time, improved first‐pass correct output, reduced inventory and space requirement. Interestingly, respondents have indicated that first‐pass correct o...
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Papers by Manimay Ghosh