67 research outputs found
An Application of a MCDA Model for Healthcare Site Selection
No full textThe aim of this paper is to report on the development of a Multiple Criteria Decision Analysis (MCDA) Model that was implemented to optimize the location selection for a new healthcare centre. The paper demonstrates how MCDA was used within healthcare to enhance the robustness and transparency of the decision making process.
Literature on MCDA was reviewed to contribute to the model development. It was developed in collaboration with a local Trust as part of a new health centre (£15 million project). A substantial set of data gathered from the public consultation and four specific workshops, allowed to assess the two alternatives using the Evidential Reasoning (ER) approach.
The final model has seven criteria and 28 sub-criteria. This technique was useful to reach a consensus and influenced the Board of Directors to justify the final decision thanks to the robustness and transparency of the process. The paper makes a contribution by implementing a MCDA model in the healthcare sector and by providing a model for future application
Development, test and comparison of two Multiple Criteria Decision Analysis(MCDA) models: A case of healthcare infrastructure location
No full textWhen planning a new development, location decisions have always been a major issue. This paper examines and compares two modelling methods used to inform a healthcare infrastructure location decision. Two Multiple Criteria Decision Analysis (MCDA) models were developed to support the optimisation of this decision-making process, within a National Health Service (NHS) organisation, in the UK. The proposed model structure is based on seven criteria (environment and safety, size, total cost, accessibility, design, risks and population profile) and 28 sub-criteria. First, Evidential Reasoning (ER) was used to solve the model, then, the processes and results were compared with the Analytical Hierarchy Process (AHP). It was established that using ER or AHP led to the same solutions. However, the scores between the alternatives were significantly different; which impacted the stakeholders‟ decision-making. As the processes differ according to the model selected, ER or AHP, it is relevant to establish the practical and managerial implications for selecting one model or the other and providing evidence of which models best fit this specific environment. To achieve an optimum operational decision it is argued, in this study, that the most transparent and robust framework is achieved by merging ER process with the pair-wise comparison, an element of AHP. This paper makes a defined contribution by developing and examining the use of MCDA models, to rationalise new healthcare infrastructure location, with the proposed model to be used for future decision. Moreover, very few studies comparing different MCDA techniques were found, this study results enable practitioners to consider even further the modelling characteristics to ensure the development of a reliable framework, even if this means applying a hybrid approach
Improving clinical access to mental health services in the NHS – the application of Lean thinking
No full textThis paper serves to disseminate findings from implementing Lean in a clinical decision-making service function in a NHS Trust. Operational and performance disparities were identified within the Trust’s service access points, causing inconsistent processes, poor use of staff resources, and service quality variability.
An action research project was designed and research propositions were developed from the literature. We sought to understand the extent that operational performance can be improved following Lean implementation and how it impacts upon clinical decision-making. One of the authors was embedded within the organisation, allowing access to core data and appropriate staff resource. Data collection was achieved through interviews, questionnaires, in-house performance metrics analysis and observations. Lean tools were considered and adapted, then applied with the aim of removing wasteful processes, standardisation and consolidate gate-keeping processes. The effectiveness of Lean implementation was evaluated to determine operational/performance improvements and to capture defined cost/financial benefits and savings
Lean Thinking: Theory, Application and Dissemination
No full textThis book was written and compiled by the University of Huddersfield to share the learnings and experiences of seven years of Knowledge Transfer Partnership (KTP) and Economic and Social
Research Council (ESRC) funded projects with the
National Health Service (NHS). The focus of these
projects was the implementation of Lean thinking and optimising strategic decision making processes. Each of these projects led to major local improvements and this book explains how they were achieved and compiles the lessons learnt. The book is split into three chapters; Lean Thinking Theory, Lean Thinking Applied and Lean Thinking Dissemination
Improving access to health services – Challenges in Lean application
No full textPurpose: Healthcare organisations face significant productivity pressures and are undergoing major
service transformation. This paper serves to disseminate findings from a Lean healthcare project
using a NHS Single Point of Access environment as the case study. It demonstrates the relevance
and extent that Lean can be applied to this type of healthcare service setting.
Design/methodology/approach: Action research was applied and Lean tools used to establish
current state processes, identify wastes and develop service improvement opportunities based upon
defined customer values.
Findings: The quality of referral information was found to be the root cause of a number of process
wastes and causes of failure for the service. Understanding the relationship and the nature of
interaction between the service‟s customer/supplier led to more effective and sustainable service
improvement opportunities and the co-creation of value. It was also recognised that not all the Lean
principles could be applied to this type of healthcare setting.
Practical implications: The study is useful to organisations using Lean to undertake service
improvement activities. The paper outlines how extending the value stream beyond the organisation
to include suppliers can lead to improved co-production and generation of service value.
Originality/value: The study contributes to service productivity research by demonstrating the
relevance and limitations of Lean application in a new healthcare service setting. The case study
demonstrates the practical challenges of implementing Lean in reciprocal service design models and
adds validity to existing contextual models
An empirical investigation in the decision-making processes of new infrastructure development
No full textThe aim of this research is to present and discuss the development and deployment of Lean thinking models and techniques applied to improve the decision-making within the planning and design processes of new infrastructures, within a healthcare organisation.
In the UK, healthcare organisations are responsible for planning, designing, building and managing their own infrastructures, through which their services are delivered to the local population (Kagioglou & Tzortzopoulos, 2010). These processes are long and complex, involving a large range of stakeholders who are implicated within the strategic decision-making. It is understood that the NHS lacks models and frameworks to support the decision-making associated with their new infrastructure development and that ad-hoc methods, used at local level, lead to inefficiencies and weak performances, despite the contractual efforts made throughout the PPP and PFI schemes (Baker & Mahmood, 2012; Barlow & Koberle-Gaiser, 2008). This is illustrated by the long development cycle time – it can take up to 15 years from conception to completion of new infrastructure.
Hence, in collaboration with an NHS organisation, an empirical action research embedded within a mixed-methodology approach, has been designed to analyse the root-cause problems and assess to what extent Lean thinking can be applied to the built environment, to improve the speed and fitness for purpose of new infrastructures. Firstly, this multiphase research establishes the main issues responsible for the weak process performances, via an inductive-deductive cycle, and then demonstrates how Lean thinking inspired techniques: Multiple Criteria Decision Analysis (MCDA) using ER and AHP, Benchmarking and Quality Function Deployment (QFD), have been implemented to optimise the decision-making in order to speed up the planning and design decision-making processes and to enhance the fitness for purpose of new infrastructures.
Academic literatures on Lean thinking, decision theories and built environment have been reviewed, in order to establish a reliable knowledge base of the context and to develop relevant solutions. The bespoke models developed have been tested and implemented in collaboration with a local healthcare organisation in UK, as part of the construction of a £15 million health centre project. A substantial set of qualitative and quantitative data has been collected during the 450 days, which the researcher was granted full access, plus a total of 25 sets of interviews, a survey (N=85) and 25 experimental workshops. This mixed-methodology research is composed of an exploratory sequential design and an embedded-experiment variant, enabling the triangulation of different data, methods and findings to be used to develop an innovative solution, thus improving the new infrastructure development process.
The emerging developed conceptual model represents a non-prescriptive approach to planning and designing new healthcare infrastructures, using Lean thinking principles to optimise the decision-making and reduce the complexity. This Partial & Bespoke Lean Construction Framework (PBLCF) has been implemented as good practice by the healthcare organisation, to speed up the planning phases and to enhance the quality of the design and reduce the development cost, in order to generate a competitive edge. It is estimated that a reduction of 22% of the cycle time and 7% of the cost is achievable. This research makes a contribution by empirically developing and deploying a partial Lean implementation into the healthcare‟s built environment, and by providing non-prescriptive models to optimise the decision-making underpinning the planning and design of complex healthcare infrastructure. This has the potential to be replicated in other healthcare organisations and can also be adapted to other construction projects
An investigation into the issues and perceived performances within healthcare new infrastructure development process
No full textThe aim of this paper is to explore, borrowing a stakeholder theory perspective, the main issues within the development of new healthcare infrastructure. This study investigates, via an online survey (N=85), participants’ perceptions of this process’ problems and performances. The respondents selected were directly involved within the planning and design of a new healthcare infrastructure in an NHS organisation. Healthcare infrastructures are complex developments and involve several groups of stakeholders, with more or less power and involvement, which directly influences the decision making processes and outcomes. It is assumed and recognised from previous studies and direct observations that healthcare infrastructure development processes have substantial room for improvement. However, the lack of understanding and consensus of where problems lie seems a barrier to process improvement. In this paper, using ANOVA, the issues are compared from the four groups of stakeholders’ perspective, and indicate that their perceptions are similar
Servicescape in Sports: levels of fan satisfaction in a UK Rugby League club
No full textA professional Rugby League club, well established in the UK Championship, sought to
place the fans at the centre of the club’s on-going operational and business strategy. The
club directors wanted to increase the home game attendance to sustain the club in the
longer run. They needed to understand the club fan base and to use this evidence to
improve the home game attendance figures. A survey was designed for the fans
(N=511) to express their expectations in order to improve the service quality. This
research has contributed to informing and shaping the future operations strategy of the
club
Paralympics Athletes Survey - Service quality at the London 2012 Games
No full textTo date there has been little evidence captured about athlete’s satisfaction at the
Paralympics Games, specifically about their perceptions of the service quality provided.
Such research has the potential to evidence base and support future decision makers
whilst planning and designing this complex sporting event. This survey captures this
knowledge and highlights, in the athletes opinion, how well designed, organised and
managed the London 2012 Paralympic Games were. Athletes rated 64 of 73 items with
a score in the ‘very satisfied’ category. However, in any system there are areas for
improvement (AFIs), these are highlighted for further investigation
Quality Function Deployment and operational design decisions – A healthcare infrastructure development case study
No full textThe purpose of this paper is to demonstrate how Quality Function Deployment (QFD) can enhance a healthcare organisation’s strategic operational alignment, by synchronising the infrastructure design with the service intention. In this empirical paper, a case study of a £15 million infrastructure development has been used as the unique context to assess and test the experimental findings. QFD was utilised in order to capture and transform the requirements of decision-makers, providers, patients and local communities’ into both service and building design for Project K, a healthcare infrastructure, in the UK. QFD was implemented after the public consultation. The large amount of qualitative data collected from the public consultation was analysed using thematic analysis, which was used as the main QFD inputs. A series of eight facilitated workshops enabled a cross-functional team of 10 high-ranking managers to optimise the future infrastructure features. Two full iterations of the QFD results are presented. Using QFD generated effectiveness and efficiency by creating an information exchange platform and providing the stakeholders with a framework to optimise the decision-making. This paper makes a practical contribution by empirically testing the QFD modelling and providing evidence of its implementation within the complex, dynamic and evolving nature of the healthcare built environment sector. Moreover, from an academic perspective, this study makes a contribution by responding to the call inviting scholars to grow and advance the embryonic and undeveloped research of QFD application in the construction industry (Cudney and Gillis, 2016; Dikmen et al., 2005 and John et al., 2014)
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