James O. Meredith

UK health visiting: challenges faced during lean implementation

Purpose – The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK.Design/methodology/approach – Following a series of lean workshops a triangulated approach to data collection was adopted in order to determine the root cause of the challenges that were faced during this lean implementation. The three methods that were selected for qualitative analysis included semi‐structured interviews, document analysis and researcher participant observation.Findings – Six key challenges were identified from the data analysis. These were: high process variability; a lack of understanding of lean; poor communication and leadership; target focused; problems defining waste; and difficulty in determining who is the customer and what do they value?Practical implications – Although this particular lean implantation had limited success, the research has highlighted a number of challenges which would have to be addres...

Lean implementation in primary care health visiting services in National Health Service UK

Background This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Method Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. Results The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Conclusion Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.

Analysis of the compression characteristics of a PEM stack, development of an equivalent spring model and recommendations for compression process improvements

Optimising the compression process during assembly improves the performance of fuel cells. Sufficient and uniform compression across the x, y and z axes ensures uniform current distribution contributing to stack longevity, minimisation of mechanical stresses and optimisation of the well-recognised compromise between mass transport and ohmic losses. In addition, the sealing media experience the necessary forces required to prevent the leakage of reactant gases and thus increase the efficiency of the system. This research paper evaluates the compression characteristics of a test version of a fuel cell compression rig, designed by Horizon Fuel Cell UK, to inform future assembly line design. A MATLAB code was used to assess the compression homogeneity presented on Fuji Prescale Low pressure films. A spring equivalent model is developed to approximate required compressive force for optimal performance. Optimisation of this model is expected to facilitate the development of a compression process which lends itself to the mass production of fuel cells. Recommendations for improving the current process include the use of electronically controlled cyclic compression and an increase in the number of compression pistons. The key finding of this study is a lack of compression symmetry which is associated with the alignment of the jig or component manufacturing and assembly tolerances.

The life cycle impact for platinum group metals and lithium to 2070 via surplus cost potential

PurposeA surplus cost potential (SCP) indicator has been developed as a measure of resource scarcity in the life cycle impact assessment (LCIA) context. To date, quality SCP estimates for other minerals than fossils are either not yet available or suffer methodological and data limitations. This paper overcomes these limitations and demonstrate how SCP estimates for metals can be calculated without the utilisation of ore grade function and by collecting primary economic and geological data.MethodsData were collected in line with the geographical distribution, mine type, deposit type and production volumes and total production costs in order to construct cost-cumulative availability curves for platinum group metals (PGMs) and lithium. These curves capture the total amount of known mineral resources that can be recovered profitably at various prices from different types of mineral deposits under current conditions (this is, current technology, prevailing labour and other input prices). They served as a basis for modelling the marginal cost increase, a necessary parameter for estimating the SCP indicator. Surplus costs were calculated for different scenario projections for future mineral production considering future market dynamics, recyclability rates, demand-side technological developments and economic growth and by applying declining social discount rate.Results and discussionSurplus costs were calculated for three mineral production scenarios, ranging from (US

A knowledge-based approach for the selection of assembly equipment based on fuel cell component characteristics

2014/kg) 6545–8354 for platinum, 3583–4573 for palladium, 8281–10,569 for rhodium, 513–655 for ruthenium, 3201–4086 for iridium and 1.70–5.80 for lithium. Compared with the current production costs, the results indicate that problematic price increases of lithium are unlikely if the latest technological trends in the automotive sector will continue up to 2070. Surplus costs for PGMs are approximately one-third of the current production costs in all scenarios; hence, a threat of their price increases by 2070 will largely depend on the discovery of new deposits and the ability of new technologies to push these costs down over time. This also applies to lithium if the increasing electrification of road transport will continue up to 2070.ConclusionsThis study provides useful insight into the availability of PGMs and lithium up to 2070. It proves that if time and resources permit, reliable surplus cost estimates can be calculated, at least in the short-run, based on the construction of one’s own curves with the level of quality comparable to expert-driven consulting services. Modelling and incorporating unknown deposits and potential future mineral production costs into these curves is the subject of future work.

Full Cost Accounting in the Automotive Industry: A Systematic Review and Methodology Proposal

Unpredictable and dynamic markets are driven by an ever more informed customer base and rapid technological evolution. In order stay competitive, organisations producing physical products need to be agile. To realise a product, an organisation must go through several phases including product design, process planning and manufacturing system design. These phases can exist within and across organisations, spanning the globe and utilizing an enormous range of information and communication standards. So as to understand the requirements of the predominantly sequential phases, resources are exhausted in converting information into a language which upstream and downstream phases can understand. This research paper aims to reduce this effort by capturing knowledge in a core ontology which is formed by product, process and resource domain ontologies. The vision is that phase or domain experts input information into this ontology, which then infers requirements for the adjacent phases based on predefined relationships. The presented approach permits the insertion of additional information as it becomes available because ontologies are extensible and scalable. This supports a concurrent engineering approach and accommodates the needs of modern businesses. This research paper presents a proof of concept based on a Proton Exchange Membrane Fuel Cell (PEMFC). The rationale for the choice of classes and properties in the model are described. The model is successfully proved by describing liaison precedence and the selection of appropriate assembly equipment.

Natural fibre composite energy absorption structures

To date, it is not known how Full Cost Accounting (FCA) can be applied in the automotive context. Therefore the objective of this paper is to review existing methodological approaches in FCA studies and identify the most appropriate for the automotive sector. This systematic literature review of FCA studies extracted ten different methodological approaches in this field. The Sustainability Assessment Model (SAM) is the most developed FCA methodology applicable to automotive organisations. Its strengths are the ability to provide both physical and monetary metrics for sustainability assessment, its flexibility and the ability to combine multiple sustainability dimensions. The SAM takes the full life cycle approach for the sustainability assessment which allows managers to make the best possible choices at the design stage with knowledge about all possible economic, social and environmental costs of the vehicle throughout its lifetime.