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Lean thinking in healthcare services: learning from case studies

Lean thinking in healthcare services: learning from case studies

182 strategic intent behind, the change process (in a more or less prescriptive way), among others; and another perspective focusing the unsuccessful attempts addressing mostly the cultural and “soft” issues as commitment, individual and organisational constraints and the management versus leadership issues. Studying organisational change for forty years, Beer and Nohria (2000) tried to explain the failure rate o 70 % in change processes through two theories of change. According to these authors, “Theory E”, representing the “hard” side of change, emphasizes the economic value related to restructuring processes. On the other side, the “Theory O”, the “soft” approach of change focuses in corporate culture development and human capability, trust building, emotional commitment by teamwork and communication. The authors posit that the combination of both theories enables successful change along the dimensions: goals, leadership, focus, process, reward system, and use of consultants. Hines’ (2010) iceberg metaphor seems suitable to this distinction, presenting the technology, tools and techniques along with process management, on the hard side, the visible side of Lean, and, below waterline, the soft side with the behaviour and engagement, leadership, strategy and alignment issues. A complete set of prescriptions for successful change in Healthcare organisations, supported in the literature on change, are presented by Steven and Lee (2000). Even the most prescriptive approaches (Kotter, 2007) stress the need of anchoring changes in the organisational culture to achieve a new “way we do things around here”.
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PATTERNS OF SUPPLIER LEARNING: CASE STUDIES IN THE MALAYSIAN AUTOMOTIVE INDUSTRY

PATTERNS OF SUPPLIER LEARNING: CASE STUDIES IN THE MALAYSIAN AUTOMOTIVE INDUSTRY

From the perspective of the buyers, there are costs and benefits to funding supplier development. As noted by Millington et al. (2006), some buyers are only willing to fund for the long term. This certainly is logical, as buyers would need to ensure that the high cost of supplier development is recoverable through future profits made by capable suppliers. Yet there are also other issues that need to be assessed. There are limits to the ability of a buyer to provide supplier development. One issue relates to the lack of buyer knowledge. Buyers would be unlikely to provide funding for technical areas outside of their own field of expertise, thus necessitating the involvement of external parties, which might not be possible in certain circumstances due to issues of company privacy. Another issue could arise when a particular supplier is a subsidiary of a global company. The buyer would then be restricted to involving these particular suppliers in its development programs, as that supplier has already been involved in its own program at its company headquarters. Therefore, the ability of suppliers to provide "know-how" development opportunities for other suppliers might be different from their ability to provide "capacity" (Wagner & Hoegl, 2006). Thus, another possible reason for a lack of buyer-supported training could be due to the two different categories of suppliers. For the purpose of this research, dependent suppliers have been placed in the "capacity" category.
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Multidimensional study of urban squares through perimetral analysis: three Portuguese case studies

Multidimensional study of urban squares through perimetral analysis: three Portuguese case studies

The identified deficiencies can be handled by the use of new computational methods that  allow  for  multidimensional  analysis  and  typological  classifications  based  on  data  mining.  This  interdisciplinary  subfield  of  computer  science  can  be  understood  as  the  practical  application of machine learning, itself a subfield of Artificial Intelligence (AI) dealing with  automatic  learning  from  data  (Witten&Frank,  2005).  Data  mining,  also  known  as  knowledge  discovery  in  databases  (KDD)  (Han&Kamber,  2001)  main  objectives  are  knowledge  extraction,  prediction  and  hypothesis  generation  from  data,  favouring  an  inductive  (bottom‐up)  approach.  This  approach  is  in  opposition  with  confirmatory  techniques  that  require  a  priori  hypotheses  formulation  that  restrict  hidden  information  discovery (Miller&Han, 2001). The automatic learning may be divided in three methods: (i)  unsupervised, when there is no a priori labelled data (e.g. used in segmentation, clustering  and dimensionality reduction); (ii) supervised, when there is a priori labelled data (e.g. used  in  predictive  models  like  regression,  classification  and  rule  induction);  and  semi‐ supervised, when data is partially labelled. Nowadays these techniques are relatively easier  to implement by computational methods and are widely applied to many fields of science,  engineering  and  business.  When  spatial  data  his  involved,  like  in  geographic  information  systems and geoscience, it is designated by spatial data mining (Demsar, 2006).
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Information as the link between purpose, processes, and people: a study of the portuguese institutions

Information as the link between purpose, processes, and people: a study of the portuguese institutions

Abstract: For information management to effectively meet its goal, companies must clearly know the information concept they are pursuing, to whom it belongs, how it is stored, and who is responsible for managing, controlling, and using it. This research aims to evaluate the role of information as an integrating element of purpose, process, and people in Portuguese organizations that focus on collecting, processing, and disseminating information. It is an interdisciplinary study included in the context of Administration and Information Science in the aspect in which information and its flows connect with the various components of the strategic alignment of organizations. This exploratory study adopted a multi-case methodology. Three Portuguese organizations were studied. Data were collected through semi-structured interviews with managers of the organizations under study. The cases were analyzed individually and subsequently subjected to comparative analysis. The findings suggest that, despite the centrality of information in their strategic purpose, the organizations surveyed do not use the information in its internal management and do not present the same effectiveness depicted in the provision of information services to external parties.
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Modelos complexos de predição aplicados na educação

Modelos complexos de predição aplicados na educação

Machine learning is the field providing the majority of the predictive algorithms currently applied in a broad set of areas, from systems biology (Geurts, Irrthum, & Wehenkel, 2009) to ADHD diagnosis (Eloyan et al., 2012; Skogli et al., 2013) and education (Blanch & Alucha, 2013; Cortez & Silva, 2008; Golino & Gomes, 2014; Hardman, Paucar-Caceres, & Fielding, 2013). Among the vast number of algorithms available, the classification and regression trees or CART (Breiman, Friedman, Olshen, & Stone, 1984) are some of the most used due to a triplet pointed by Geurts, Irrthum and Wehenkel (2009): interpretability, flexibility and ease of use. The first item on the triplet regards the understandability of the CART results, since it is a roadmap of if-then rules. James, Witten, Hastie and Tibshirani (2013) point the tree models are easier to explain to people than linear regression, since it mirrors the human decision-making more than other predictive models. The second item on the triplet, flexibility, refers to the applicability of the CART to a wide range of problems, handling different types of va- riables (nominal, ordinal, interval and ratio), with no assumptions regarding normality, linearity, independency, collinearity or homoscedasticity (Geurts, et al., 2009). CART is also more appropriate than the c statistic to study the impact of additional variables to the predictive model (Hastie, Tibshirani, & Friedman, 2009), being especially relevant to the study of incremental validity. Finally, the third item on the triplet, ease of use, refers to the somehow computational facility of implementing the CART algorithm, to the low number of tuning parame- ters and to the widely available software and packages to apply it.
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Achieving Access to Knowledge through E-Learning: A Case Study

Achieving Access to Knowledge through E-Learning: A Case Study

E-learning programs and open access initiatives allow knowledge of these institutions to spread beyond physical boundaries. The Web can hence be used as a way to attract students, scholars and funding from other places, spreading the prestige of these educational institutions all over the world. This has provoked competition between universities to achieve an advantageous visibility on the Web and to improve their position in search engine results.

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Our research falls within the ield of strategic management from the viewpoint of Management, and of information management from the viewpoint of Information Science. Through case studies we have sought to take account of the interdisciplinarity of Management Science and Information Science in the study of strategic alignment, based on information about: the purpose, which can also be viewed as the mission or the raison d’être of the company; processes, which can be understood as the management model; and people, in organizations dedicated to the collection, processing and dissemination of information. We have looked at how the strategy is processed, how it is deployed, and, inally, how the feedback thereof is given to enable the follow-up and monitoring of actions and strategic intentions, aiming to appreciate the role of information in the information environment of the organizations studied.
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APPLYING THE LOGO ENVIRONMENT: LEARNING, DOING AND DISCOVERING THROUGH COMPUTERIZED LEARNING PROJECTS

APPLYING THE LOGO ENVIRONMENT: LEARNING, DOING AND DISCOVERING THROUGH COMPUTERIZED LEARNING PROJECTS

Through the exhibition of three computerized educational projects in different microw orlds w e hope to have show n the possibilities of Logo in providing a learning environment. Program listings in LogoWriter have been provided. Although there are more modern versions of Logo available in the market, it is still felt that the purpose of the paper is w ell served by LogoWriter among other things because there are still many schools using Apple and Pre Window s PC computers, particularly in developing countries. The philosophy of learning by teaching a dumb machine to solve a problem, that is by programming the solution, forces the programmer to master the topic, because the programs w ill not function correctly unless thay are very w ell thought out and are given a touch of generality. In contrast w ith other educational philosophies such as programmed instruction and drill and practice programs in Logo it is the student that programs the machine and not the opposite. Recent versions of Logo have even more facilities than the ones show n here. For example Object Logo [8] is an Object Oriented Language that can do fraction arithmetic, essentially unlimited floating point precision arithmetic, complex number arithmetic, handle an essentially unlimited number of turtles and other objects such as printing and draw ing w indow s, handling of buttons and sliders to control variables, etc. Microworlds [11] is an object oriented package that runs under Windows, manages menus, dialog w indow s and icons w ith the mouse. It has many instructions including some for color animation, and facilities to w ork multimedia, including voice recording, show ing video, editing of graphics w ith a very complete set of colors to design forms and background images. Logo Gráfico [13] developed in Pascal in Argentina is also object oriented, run under Window s has a Pascal like syntax w ith constructions such as w hile and until, very good color graphic animation facilities w ith extra large turtles and turtle forms called actors. It also has special instructions for teaching physics such as object that can be accelerated and follow the law s of mechanics in movements such as simple harmonic motion.
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Sustaining lean thinking in healthcare: case studies

Sustaining lean thinking in healthcare: case studies

formation. Given special regards to the hierarchical structure of healthcare settings, top management should be ready and willing to demonstrate their support for any lean projects whenever issues arise (BEN-TOVIM et al., 2007; CARPENTER, 2011; STEED, 2011). Case studies in the literature findings that physicians and nurses have the most trouble to accepting the cultural changes required for lean when persons of different educational or professional designation make suggestions that change the way their work is carried out (BEN-TOVIM et al., 2007; FILLINGHAM, 2007; CARPENTER, 2011; PAPADOPOULOS et al., 2011). Physicians are considered key contributors to successful change implementation in healthcare and they are not typical employees. Therefore, their attention and involvement is essential. (CARMAN et al., 2010), For instance, one physician of one of the hospitals studied indicated: “We did not want to be involved and we did not believe in anything that was happening. All the physicians thought this was just another fad where the hospital was losing money. However, the board of the hospital was very emphatic and pulled us hard to participate since the beginning of the program. Today I see that our participation (clinical body) was fundamental to obtain several results and to maintain them.” Comparing the hospital units that sustain high level of lean improvements (H1 and H4) with those that had difficulties (H2, H3, H5, H6), the sustaining hospitals units encouraged the agents of change in reflecting about questions such as: Who should be invited to participate in the opening of this project? Who should attend this mapping workshop? Who should participate as member of the kaizen team? Who should participate of the Gemba walk meetings? In the same way, these hospitals encourage the operation to be motivated to participate in all stages of the project. This indicates the relevance of involving people to enhance sustainability. It distinguished the hospital units that sustained lean improvements in a high level (H1 and H4) from the others that did not. We now examine the involvement of people more deeply by comparing the case findings and the literature.
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Evaluation of E-learning Platforms: a Case Study

Evaluation of E-learning Platforms: a Case Study

that will achieve the greatest probability, is more appropriate for this student profile. Case 2: In this situation one platform is evaluated for different student profile (i.e. high school graduates aged 19 using a platform 30 minutes/day and PhD aged 30 using a platform 30 minutes/day). In this case the characteristics of the platform (the time to download a page even if a large number of users are simultaneously connected to the platform, tools for communication with the teacher and/or other users, adapting educational material to each user’s learning style, hierarchy of the educational materials and the complexity of the evaluation feedback) are the same but the student profile is different. Using the regression model I determine the probability that each student uses the platform. If the determined probability is higher for PhD student then the platform is more useful for this student profile.
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Knowledge Organization for Learning.  Conjectures and Methods of Study

Knowledge Organization for Learning. Conjectures and Methods of Study

“The organization of material is very important. In the presentation of ideas by the teacher or writer, organization is needed for clear understanding and mastery on the part of the hearer or reader. In almost all kinds of material there are intrinsic and logical connections which can be used for arranging the material. When the student makes any acquisition he will find it to his ad-vantage to organize it, if it is not already organized; first, so that he can clearly understand it; second, so that he can recall it when he so desires. This logical organization is just the kind of thing that makes the results of learning superior to those of mnemonic systems. The intrinsic relationships among the facts are thus made clearer, which is precisely what it should be. Artificial systems fail to do this; indeed they may even lead one to neglect most significant relationships. The mastery of one who has command of a given field is largely due to the fact that he has organized his material; when he recalls, his facts are in groups, such as might appear in written form under paragraph, section, or chapter heads; when he learns new facts, they find their appropriate place immediately in his scheme of organization.”
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Exploring Students Blended Learning through Social Media

Exploring Students Blended Learning through Social Media

Social media like facebook and/or twitter become one of the most visited and used applications over the internet. They become one of the top internet application recently (Bi et al., 2014). The rapid development of online social networks has tremendously changed the way of people communicating with each other (Rahadi & Abdillah, 2013). They offer borderless environment for various activities. They change how people communicating each other, promoting their products (Baumgartner & Morris, 2010), becoming conventional communications venues for young adults (Abdillah, 2014), campaigning political parties (Abdillah, 2014; Bi et al., 2014; SocialBakers, 2014), disseminating knowledge and information (Abdillah, 2014), etc. This article will discuss the use of social media in managing online learning environment for higher education students in computer science field.
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Analysis of transformation plasticity in steel using a finite element method coupled with a phase field model.

Analysis of transformation plasticity in steel using a finite element method coupled with a phase field model.

The principal factors that possibly affect the transformation plastic deformation in the present calculations can be classified into (a) an externally applied stress, (b) yield stress of each phase, and (c) yield stress ratio of ferrite to austenite. Initially, variations in the transformation plastic deformation with externally applied stresses along horizontal direction of the domain were evaluated. The applied stress was varied as 2, 3, 5 and 8 MPa, and the other calculation conditions, such as the yield stress of austenite and ferrite, and the cooling rate were the same as the calculation in the previous section. For a comparison, the experimental data in the previous study was adopted. The experimentally measured transformation plasticity has been reported in many studies [1,19,27–35]. A few years ago, some of the present authors [18] suggested a model for transformation plasticity in diffusional transformation with the experimental results during the austenite- to-ferrite transformation in plain low carbon steel. These experimental results are compared with the calculated results in the present study. Fig. 8 shows the measured [18] and calculated transformation plastic strains corresponding to externally applied stresses of 2, 3, 5 and 8 MPa. As expected from the internal stress model [1], the transformation plastic deformation was linearly proportional to the applied stress in both the measured and calculated cases. However, the measured amounts of transforma- tion plastic deformation were significantly higher than the calculated ones. Since this disagreement might be caused by uncertainty in the mechanical properties of ferrite and austenite, several case studies were carried out under the conditions of the
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Case studies in Bayesian microbial risk assessments

Case studies in Bayesian microbial risk assessments

We need to know more about the way pathogens and pollutants spread through the environment and how people become exposed to them, particularly as our climate changes. For example, we could see changes in the distribution of diseases such as malaria. New diseases could emerge as a result of changes in agricultural practices and the way we use the land. The overall impact on our health will depend on the nature of exposure and on factors specific to individuals such as their socio-economic status, their level of nutrition, age, genes, gender and behaviour. We need to understand how all these things influence one another.
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VOLUNTEERING FOR CULTURAL HERITAGE CONSERVATION - TWO CASE STUDIES

VOLUNTEERING FOR CULTURAL HERITAGE CONSERVATION - TWO CASE STUDIES

A voluntary action is the key for individual benefits in addition to social ones. The voluntary actions for cultural heritage conservation are meant to provide gains for longs terms and to raise public awareness on the importance of conservation-restoration activities. During the past 5 years different volunteering actions for cultural heritage conservation organized by our faculty alone or in cooperation with the ASTRA Museum from Sibiu were finalized with exhibitions and public events. The case study presented in this paper is referring to the conservation-restoration of two long benches with backrest, dating from the first half of XX th century. The benches restored make parts from a group of artefact that was restored in the restoration camps at ASTRA Museum in 2013 and 2014. The particularity of the benches was de finishing layer that imitates the wood texture known as flander technique. This type of finishing is common to the landler community who was deported from Austria to Transylvania at the end of 17 th century. The approach of conservations – restorations process was different for the artistic painting parts and needs special and appropriate intervention and investigation. While minimum interventions were making in order to preserve the objects for the future, we want to ensure that the value of less known technique can be well understood by younger generations.
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Rev. esc. enferm. USP  vol.47 número4

Rev. esc. enferm. USP vol.47 número4

The assimilaion of knowledge and the development of scieniic concepts in nursing will enable the student to adopt assumpions that will guide his or her acions and pro- fessional aciviies. When we refer to the term professional acivity, we consider the nurse as someone engaged in and helpful to society, someone concerned with the living con- diions of human beings and engaged in solving problems. The process of dialecical interacion, described by Vy- gotsky, signals that the individual, as he or she internalizes cultural forms, transforms them, creaing self-liberaion in the process. To this end, learning and various consituive pro- cesses of human beings are triggered by the relaionship of the subject and the environment to which he or she belongs.
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Learning from simple ebooks, online cases or classroom teaching when acquiring complex knowledge. A randomized controlled trial in respiratory physiology and pulmonology.

Learning from simple ebooks, online cases or classroom teaching when acquiring complex knowledge. A randomized controlled trial in respiratory physiology and pulmonology.

In his review from 2004 Wutoh concluded that there is no significant difference between e-learning and didactic medical teaching [18]. Since then there has been a tremendous develop- ment of both software (e-learning contents and levels) and hardware (mobile devises etc.) suggesting an even better effect today. Both simple and complex knowledge can be taught and even though other skills are not as easy to teach using e-learning (readily available knowledge, manual dexterity, clinical experience and cognitive abilities) future technological developments catering to such complex skill sets may not be far away with the increasing use of computer games, virtual reality simulations and social networks [7].
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: Brapci ::

: Brapci ::

Denis Grogan, Bachelor of Arts e Fellowofthe Library Association do Reino Unido, é Sênior Professor do Department of Information and library Studies do University College of Wales em Aberystwyth (País de Gales). Durante vinte e cinco anos foi chefe do Department of Bibliographical Studies dessa Instituição. É autor de vários livros sobre o serviço de referência: Case studies in reference work (1967), More case studies in reference work (1972), Practical reference work (1979) e o famoso Grogan's case studies in reference work em seis volumes (1987). Em 1991 publicou uma segunda edição revista e ampliada do Practical reference work, agora primorosamente traduzida para o português pelo Prof. Antônio Agenor Briquet de Lemos.
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LASyM: A Learning Analytics System for MOOCs

LASyM: A Learning Analytics System for MOOCs

Abstract—Nowadays, the Web has revolutionized our vision as to how deliver courses in a radically transformed and enhanced way. Boosted by Cloud computing, the use of the Web in education has revealed new challenges and looks forward to new aspirations such as MOOCs (Massive Open Online Courses) as a technology-led revolution ushering in a new generation of learning environments. Expected to deliver effective education strategies, pedagogies and practices, which lead to student success, the massive open online courses, conside red as the “linux of education”, are increasingly developed by elite US institutions such MIT, Harvard and Stanford by supplying open/distance learning for large online community without paying any fees, MOOCs have the potential to enable free university-level education on an enormous scale. Nevertheless, a concern often is raised about MOOCs is that a very small proportion of learners complete the course while thousands enrol for courses. In this paper, we present LASyM, a learning analytics system for massive open online courses. The system is a Hadoop based one whose main objective is to assure Learning Analytics for MOOCs’ communities as a mean to help them investigate massive raw data, generated by MOOC platforms around learning outcomes and assessments, and reveal any useful information to be used in designing learning-optimized MOOCs. To evaluate the effectiveness of the proposed system we developed a method to identify, with low latency, online learners more likely to drop out.
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Cross-border cooperation (CBC) in Southern Europe-An iberian case study. The eurocity Elvas-Badajoz

Cross-border cooperation (CBC) in Southern Europe-An iberian case study. The eurocity Elvas-Badajoz

Abstract: The experiences of cross-border cooperation (CBC), undertaken not only in Europe but throughout the world, have enabled areas to gain greater importance in recent decades at an international level, showing potential for integrative functions and joint development as exemplified by several CBC projects. The present paper assesses the impact of CBC projects by analyzing a protocol established in 2013 between the cities of Elvas and Badajoz, which induced the creation of the Eurocity Elvas-Badajoz. The paper kicks off with a critical review on territorial factors for success in CBC areas, considering the analysis of several case studies throughout Europe. The lessons learned, taken from the analyzed case studies, and the identified territorial success factors were used as assessment points for the investigation of the target study area, the Eurocity Elvas-Badajoz. The investigation explores public participation perceptions towards the identification of what changes with respect to standards of life with the CBC project, providing the current state of affairs and identifying where to place efforts in order to reach sustainable development for the region. While being a transition area, it presents several opportunities for growth. These opportunities have not yet been object of analysis and debate with respect to lasting, sustainable successful growth. The present research enables the identification of several territorial factors for success in the study area, such as the connectivity/movement between cities and strong political commitment. From the identified critical factors, it was possible to highlight the importance of public transportation as a priority for achieving success in this CBC project.
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