Henk de Koning

Lean Six Sigma in Healthcare

&NA; Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up‐to‐date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

Lean Six Sigma in financial services

A power train of an automatic transmission adapted to realize a shift stage comprising five forward speeds and one reverse speed by two simple planetary gear sets and seven friction elements to thereby enable compactness and lightness of the automatic transmission, the power train comprising: a combined planetary gear set provided by fixedly connecting a planetary carrier of a first signal pinion planetary gear set to a ring gear of a second single pinion planetary gear set, and by fixedly connecting a ring gear of a first single pinion planetary gear set to a planetary carrier of a second single pinion planetary gear set; three input units for causing an input to be variably initiated to any of three actuating elements out of various actuating elements at the combined planetary gear set; two output units for causing an output to be variably initiated from any of two actuating elements out of various actuating elements at the first single pinion planetary gear set; and two brakes actuating reaction forces between the respective gear sets and transmission housing.

The CTQ flowdown as a conceptual model of project objectives

The critical quality flowdown (CTQ) is a tool that is the core of the definition phase of most quality improvement projects. It relates high-level strategic focal points to project objectives which in turn are linked to and decompose into CTQs made oper..The purpose of this article is to describe and clarify a tool that is at the core of the definition phase of most quality improvement projects. This tool is called the critical to quality (CTQ) flowdown. It relates high-level strategic focal points to project objectives. In their turn project objectives are linked to and decomposed into CTQs, which are made operational in the form of measurements. In this article the nature of the connections between strategic focal point, project objectives, CTQs, and measurements is elaborated. The CTQ flowdown serves several purposes. It provides clear project definitions, clarifies the business rationale of an improvement project, makes explicit business assumptions behind project definitions, helps to focus on the vital few real business drivers, and facilitates optimally solving trade-off problems. This article provides a theoretical grounding of the CTQ flowdown, and also provides practitioners with a prescriptive template.

The 2-aza-cope N-acyliminium cyclization

Abstract The 2-aza-Cope N-acyliminium ring closure is shown to proceed in a stereoselective fashion via the primary N-acyliminium intermediate 1B . The latter ion can also be generated from the open hydroxymethyllactam 6b .

N-Acyliminium cyclizations via reversible 2-aza-cope rearrangements

Abstract The existence of a reversible 2-aza-Cope rearrangement in cyclizations of N-acyliminium ions derived from 1′- and 2′-vinyl-N-(3′-butenyl)-5-hydroxy-2-pyrrolidinones is established.

Nonrepeatable Gauge R&R Studies Assuming Temporal or Patterned Object Variation

The standard method to assess a measurement systems precision is a gauge repeatability and reproducibility (gauge R&R) study. It exploits replications to estimate variance components that are interpreted as measurement spread. For nonrepeatable measurements, it is not feasible to obtain replications because objects are destroyed when they are measured or because the object changes over time. Possible solutions are to replace replications with measurements of multiple objects or with the measurement of one object at multiple times. Subsequently, these measurements are modeled by a fixed pattern (over time or over positions). We show that the experimental design used in this type of nonrepeatable gauge R&R studies is best constructed in a way that is similar to a Latin square design. These designs have a great flexibility, can be applied in many situations encountered in practice, and have nice mathematical properties as well. We consider several examples in which this approach is applied and worked out. For the examples given, we provide the analysis and the results following the worked-out approach. Analysis of the envisaged experimental set-up is done with linear and nonlinear mixed models in which variance components are estimated by restricted maximum-likelihood estimators.The standard method to assess a measurement system’s precision is a gauge repeatability and reproducibility (gauge R&R) study. It exploits replications to estimate variance components that are interpreted as measurement spread. For nonrepeatable measurements, it is not feasible to obtain replications because objects are destroyed when they are measured or because the object changes over time. Possible solutions are to replace replications with measurements of multiple objects or with the measurement of one object at multiple times. Subsequently, these measurements are modeled by a fixed pattern (over time or over positions). We show that the experimental design used in this type of nonrepeatable gauge R&R studies is best constructed in a way that is similar to a Latin square design. These designs have a great flexibility, can be applied in many situations encountered in practice, and have nice mathematical properties as well. We consider several examples in which this approach is applied and worked out. For the examples given, we provide the analysis and the results following the worked-out approach. Analysis of the envisaged experimental set-up is done with linear and nonlinear mixed models in which variance components are estimated by restricted maximum-likelihood estimators.

Diastereoselectivity in the cyclization of 1-[2-(benzyloxymethyl)-3-butenyl]-5-ethoxy-2-pyrrolidinones

Abstract [2-(Benzyloxymehyl)-3-butenyl]-etoxy-2-pyrrohdinones 12 cyclize upon formic acid treatment indolizinones. The effect of some substituents α to the iminium carbon atom on the diastereoselectivity of the cyclization is discussed.