Julie Eatock

Quality and continuous improvement in medical device manufacturing

Purpose – The purpose of this paper is to compare a range of quality and continuous improvement strategies and to investigate whether there is a best choice of strategy for use within the medical devices sector.Design/methodology/approach – A brief literature‐based review of a number of continuous improvement strategies. Comparison of these strategies and a subsequent discussion of the rationale that guides the choice of strategy based on the prevailing conditions. An overview of this process in the context of the medical devices sector is provided.Findings – Quality and continuous improvement strategies can be differentiated in terms of their cultural or process focus. Moreover, the favoured leadership style of an organisation may play a part in determining which strategies are likely to be most appropriate. From the medical device and healthcare product perspective, regulatory and purchasing considerations will have a role in determining the strategy adopted.Practical implications – For managers seeking...

Modelling knowledge worker behaviour in business process studies

Purpose – Aims to describe a successful use of simulated knowledge worker behaviour used in the developing online procedures and software for arbitration – the E‐Arbitration‐T projectDesign/methodology/approach – Presents four common factors – deadline, length of task, importance of customer, importance to business – that need to be incorporated within any business process model of knowledge worker behaviour.Findings – A richer model of knowledge worker behaviour is postulated and elements not necessary for the E‐Arbitration‐T model are identified. The knowledge workers day was defined as being made up of Scheduled, On‐demand and At‐will tasks, only some of which may relate to the business process being modelled. A particular question that must be addressed in this extended model is how to model the choices knowledge workers make between competing at‐will tasks.Originality/value – The two pieces of work reported here have generated a rich model of knowledge worker behaviour ready for application and refi...

An exploratory survey of current practice in the medical device industry

Purpose – This study seeks to examine the extent to which mainstream tools and strategies are applied in the medical devices sector, which is highly fragmented and contains a high percentage of small companies, and to determine if company size impacts on manufacturing strategy selection.Design/methodology/approach – A questionnaire was developed and disseminated through a number of channels. Responses were received from 38 companies in the UK and Ireland, describing 68 products taken to market in the past five years.Findings – Because of the limited scope of the survey, the findings are indicative rather than conclusive, and interesting trends have emerged. New to the world products were much more likely to exceed company expectations of market success compared to derivative products. It was found that the majority of these innovative products were developed by small companies. Large companies appear to favour minor upgrades over major upgrades even though these prove – on the data presented – to be less ...

The Implications of Information Technology Infrastructure Capabilities for Business Process Change Success

Although business performance has long been theoretically hypothesised to be dependent on the level of underlying information technology capability, there is a distinct lack of empirical studies to support this claim. In this chapter we discuss preliminary results of ongoing research into the knock-on effects of computer network support to business process performance indicators. Based on a real-life case study of business process change, we develop simulation models that depict operations at three different levels of abstraction (business processes, information system applications, and computer network support). Experiments with different levels of network utilisation generated by increased business workload provide empirical support to the hypothesis that IT capability can be a critical enabler (but equally a critical disabler as well) of business performance improvements.

Meeting the four‐hour deadline in an A&E department

PURPOSE Accident and emergency (A&E) departments experience a secondary peak in patient length of stay (LoS) at around four hours, caused by the coping strategies used to meet the operational standards imposed by government. The aim of this paper is to build a discrete-event simulation model that captures the coping strategies and more accurately reflects the processes that occur within an A&E department. DESIGN/METHODOLOGY/APPROACH A discrete-event simulation (DES) model was used to capture the A&E process at a UK hospital and record the LoS for each patient. Input data on 4,150 arrivals over three one-week periods and staffing levels was obtained from hospital records, while output data were compared with the corresponding records. Expert opinion was used to generate the pathways and model the decision-making processes. FINDINGS The authors were able to replicate accurately the LoS distribution for the hospital. The model was then applied to a second configuration that had been trialled there; again, the results also reflected the experiences of the hospital. PRACTICAL IMPLICATIONS This demonstrates that the coping strategies, such as re-prioritising patients based on current length of time in the department, employed in A&E departments have an impact on LoS of patients and therefore need to be considered when building predictive models if confidence in the results is to be justified. ORIGINALITY/VALUE As far as the authors are aware this is the first time that these coping strategies have been included within a simulation model, and therefore the first time that the peak around the four hours has been analysed so accurately using a model.

Three critical challenges for modeling and simulation in healthcare

By most measures, the adoption of modeling and simulation techniques in healthcare service development falls well short of the uptake of such techniques evident in other sectors, such as business and commerce or aerospace and the military. The question is, why? To answer this, we consider three questions and then turn to the nature of answer which might lead towards greater adoption. The first is the vexed question of how good is good enough? The second concerns how best modeling should link through to decision-making; and the third concerns the culture needed to make the most of modeling and simulation (and whether it is worth the effort to make the transformation). From these, we draw an agenda for further enquiry in terms of stakeholders, their culture, data, and expectations, and the case in terms of value.

A survey of success factors in New Product Development in the medical devices industry

This study of the factors that are correlated with success in new product development (NPD) is based on 68 responses to a survey of medical device companies in the UK and Ireland. It was found that the degree of technological innovation, the involvement of end users in the development process, the dissemination of NPD priorities to staff, and the use of financial analysis throughout the development process were all correlated with success in a statistically significant manner. These findings demonstrate the importance of innovation, integration and the use of financial metrics to sustained product development success. In addition, this survey found that new-to-the world innovations made up only 4.4% of NPD projects in larger companies and 9.3% of NPD projects in small and medium sized enterprises.

Online support for arbitration: designing software for a flexible business process

This paper looks at the challenge of developing a single online system to correctly handle the workflow of any legal arbitration case. In arbitration, the parties are always free to decide the process they will follow but existing online systems lack the flexibility to deal with general arbitration cases. A better system that can guide parties through the chosen process without compromising its legal status is needed. This single system needs to be flexible enough to support a wide range of different arbitration service providers. Conventional requirements engineering attacks uncertainty by getting the client to make choices. Flexible system design requires a different mindset that keeps these choices open until the system is in use. The key is in deciding which design decisions to offer and how they are presented to the user. This problem, and some strategies to deal with it, are illustrated by the analysis developed in the E-Arbitration-T project. The application of human activity simulation to validate the final design is also discussed.

Causal study of low stakeholder engagement in healthcare simulation projects

Stakeholder engagement plays a fundamental role in the success of ‘operational research’ initiatives including simulation projects. However, there is little empirical evidence of real engagement in the context of healthcare simulation. This paper principally examines this issue and aims to provide insights into the possible causes. The paper reports on the results of a literature review and 10 field studies within the UK healthcare settings, supplemented with the authors’ experience in order to arrive at an initial list of the causes, which will then be tested through a survey of expert opinions. Twelve primary and 26 secondary causal factors, which received statistically significant level of agreement from the experts, are presented in a fish-bone diagram. The findings indicate that communication gap between simulation and stakeholder groups is the top primary factor contributing the most to the poor stakeholder engagement in healthcare simulation projects, followed by ‘poor management support’, ‘clinician’s high workload’ and ‘failure in producing tangible and quick results’.

Evaluating telemedicine: A focus on patient pathways

Evaluations of telemedicine have sought to assess various measures of effectiveness (e.g., diagnostic accuracy), efficiency (e.g., cost), and engagement (e.g., patient satisfaction) to determine its success. Few studies, however, have looked at evaluating the organizational impact of telemedicine, which involves technology and process changes that affect the way that it is used and accepted by patients and clinicians alike. This study reviews and discusses the conceptual issues in telemedicine research and proposes a fresh approach for evaluating telemedicine. First, we advance a patient pathway perspective, as most of the existing studies view telemedicine as a support to a singular rather than multiple aspects of a health care process. Second, to conceptualize patient pathways and understand how telemedicine impacts upon them, we propose simulation as a tool to enhance understanding of the traditional and telemedicine patient pathway.