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Operations Management In Healthcare Strategy And Practice 1st Edition Corinne M. Karuppan , Nancy E. Dunlap,Michael R. Waldrum - Solutions
4. For each sample of 30 medication orders described in problem 3, the number of medication errors is also recorded (see following table). Develop the appropriate control chart(s). Is the process in control? Why or why not?
3. Samples of 30 medication orders placed in the ED are checked each day against five potential types of errors. The following table shows the number of orders that were found to include errors during the last 15 days. Develop the appropriate control chart(s). Is the process in control? Why or why
2. At BPH, wait times seemed to be in control (Figures 5.7 and 5.8). Does it mean that the situation is satisfactory? Explain why or why not?
1. Based on all the control charts produced by Eric Wong and his staff, anticipate Jennifer Lawson’s reaction and concerns.
9. What is process capability? What is the purpose of Cp? What is the purpose of Cpk?
8. What are zones A, B, and C in a control chart?
7. Distinguish between “sample size” and “number of samples taken.” Use examples to illustrate your answer.
6. When do you use and R charts versus and s-charts?
5. How do you know when to use a p-chart versus a c-chart? A c-chart versus a u-chart?
4. Differentiate between attributes and variables.
3. How do you determine whether a process is in control?
2. What is statistical process control? What is the purpose of control charts?
1. What are the two major causes of variation? Explain each one.
7. Know the basics of probabilistic sampling (see Appendix 5.3)
6. Decide whether a process is capable of meeting predetermined quality requirements
5. Evaluate a process control chart and determine whether the process being monitored is behaving as expected or becoming unstable
4. Develop process control charts to track variables ( and R; and s) over time
3. Develop process control charts to track attributes (p-chart, c-chart, and uchart)over time
2. Determine whether quality indicators are attributes or variables
1. Understand the concept of variation, which affects all processes
6. Look at the quality dashboard (see Table 4.4). Can you identify other quality indicators that would be appropriate?
5. Go to data.medicare.gov/data/hospital-compare and compare providers in your market. Which one would you choose and why? Do you think the data are relevant to all patients? Why or why not?
4. Go to the Institute for Healthcare Improvement website(www.ihi.org/resources/Pages/Tools/FailureModesEffectsAnalysisComparisonFiveMedicationDispensingScenarios.and download the sample FMEA tool comparing five medication dispensing scenarios. Choose one of the scenarios and develop a fishbone
3. Select three scholarly articles discussing the reliability and/or validity of HCAHPS.What are the instrument’s strengths and weaknesses?
2. Translate the VOC into VOP! Download the HCAHPS survey from the CMS website (www.hcahpsonline.org/surveyinstrument.aspx) and develop an indicator for each questionnaire item.
1. In this book, we used the term “third-party” payer. Who are the first and second parties?
12. Regarding question 11, identify actions to improve each step and reduce the occurrence of failure.
11. The table here presents failure modes, causes, and effects for each process step involved in scheduling appointments at BPH’s pediatrics clinic. Estimate the likelihood of occurrence of each failure mode, its likelihood of detection, and its severity. Compute the RPN for each step and for the
10. This is the layout of a nurses’ station. Based on this information regarding traffic, draw a spaghetti diagram and make recommendations for improvement.
9. Develop a checksheet and Pareto diagram for the following complaints regarding patients’ bills:
8. At the hospital cafeteria, typical complaints about the food are: too salty, too mushy, too bland, too greasy, and too starchy. The manager of the cafeteria has compiled the following complaint data during the past month. Develop a Pareto chart and help him decide which problem(s) deserve(s) his
7. Looking at a cause-and-effect diagram, the head of the radiology department identified reasons for long wait times (see table that follows). She wants to prioritize the factors that contribute to the problem. Her staff collected data on the frequency with which these causes contribute to long
6. Identify causes of a steady increase of supply shortages in the exam room. Classify these causes into the categories of people, methods, measurement, environment, equipment, and materials categories, and develop a cause-and-effect diagram.
5. Based on the following relationship matrix, compute the importance weights.
4. Following a survey of the clinical staff, the director of supply chain management is trying to translate customer requirements into process characteristics. Help him accomplish this task based on the following data:
3. Several of the pharmacists are brainstorming to develop process indicators to measure responsiveness. They have solicited your help for this task. Help them develop such indicators.
2. Assume there are two quality indicators: (a) percentage of cases when aspirin was administered after a myocardial infarction, and (b) percentage of patients who received discharge instructions. Which one is a better indicator of quality? Why?
1. One of the surgeons at BPH would like to complement the CAHPS survey with some additional measures pertaining to responsiveness. Generate a few questions that would tap this dimension of patient experience.
15. Select three of Deming’s 14 points and describe them.
14. Describe Deming’s wheel. How is it associated with continuous improvement?
13. What are the three principles of TQM?
12. What are the definition and purpose of each one of the following tools?a. Flowchartb. Checksheetc. FMEAd. Spaghetti diagrame. Cause-and-effect diagramf. Pareto chart g. Control chart h. Run chart
11. What is the difference between a benchmark and benchmarking?
10. Describe Donabedian’s triad.
9. In Box 4.2, you learned about quality function deployment at De Grift. Review their process indicators. Which indicators appear to be the strongest in capturing customers’ requirements? Which ones appear to be the weakest?
8. What is a quality indicator?
7. What is the VOP?
6. What is the VOC?
5. What are the seven steps involved in building the HOQ?
4. What is quality function deployment? What is the house of quality?
3. What is value-based purchasing?
2. Differentiate among the quality expectations of patients, providers, and third-party payers?
1. The U.S. Department of Health and Human Services’ first National Quality Strategy specifies three aims for quality improvement. What are they?
3. Lower costs: reduce the cost of quality health care for individuals, families, employers, and government
2. Healthier people and communities: improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher quality care
1. Better care: improve the overall quality by making healthcare more patient centered, reliable, accessible, and safe
4. If conflicts develop into a situation where mistrust prevails, would you expect documentation of activities to increase or decrease? Why?
3. Identify a failed project that is in the news. Why do you think the project failed?Point to specific factors that may have contributed to the failure.
2. Do you think functional managers would make good project managers?
1. What attributes should a project manager have?
10. The environmental services team in problem 7 wants to complete the process in 65 minutes. Based on the following data, which activities should be crashed, and what is the resulting cost? Find the solution using (a) the marginal cost analysis method, and(b) the LP method. What is the extra cost
9. A team at Bradley Park Hospital is involved in a process improvement project involving six major activities. Because the improvement is viewed as essential to obtain reaccreditation by The Joint Commission, it must be completed before the audit, that is, in 19 weeks. Data on costs and times have
8. Based on the following network and data, use the marginal cost analysis method to show how the project’s duration can be reduced to 35 weeks. What is the extra cost incurred?
7. Bradley Park Hospital’s environmental services team wants to reduce patient room turnover times without sacrificing safety and room cleanliness. Their first task involves identifying all the activities necessary to clean and disinfect a room after patient discharge and their respective
6. A team of trauma surgeons is concerned about the time it takes to receive blood for transfusions. They have identified all the activities involved in the process, their precedence relationships, and their durations.a. Draw the AON network.b. Determine the time estimate for each activity.c. Find
5. The layout redesign of the pediatric ward is expected to take 47 weeks. The standard deviation of the critical path is 2.17 weeks. Find the z-values and determine the probabilities that:a. The project will be completed within 50 weeks.b. The project will take 49 weeks or longer.c. The project
4. For problem 2, assume the following activity times:Based on this,a. Develop a Gantt chart assuming the project starts on Monday, April 28th.b. Determine the earliest start and finish times, the latest start and finish times, and slack for each activity.c. Indicate the critical path and project
3. For problem 1, assume the following activity times:Based on this information,a. Develop a Gantt chart assuming the project starts on Monday, March 3rd.b. Determine the earliest start and finish times, the latest start and finish times, and slack for each activity.c. Indicate the critical path
2. The pathology department at BPH has planned a new project involving 20 activities.The activities and their immediate predecessors are listed in the following table. Draw the appropriate network diagram using (a) the AOA convention, and (b) the AON convention.
1. A group of physicians wants to establish a new protocol. They have identified a list of 13 activities and their precedence relationships to design the protocol, train staff, and implement the new protocol. Draw the appropriate network diagram using (a) the AOA convention, and (b) the AON
9. The Denver VA project was over cost and over budget. What do you think should have been done to keep this project on track?
8. What are the advantages and disadvantages of PERT and CPM?
7. List five reasons that projects fail.
6. What is a Gantt chart? Where is it used?
5. Why is communication so important when managing projects?
4. What are the characteristics of good team members?
3. What is a project charter? What does it include?
2. What is the triple constraint and what does it mean?
1. What is a project? What are the five phases of a project and what happens if you do not complete them all?
11. Understand the major causes of project failure
10. Discuss the advantages and disadvantages of PERT/CPM
9. Crash activity times
8. Schedule projects with probabilistic times
7. Schedule projects with deterministic times
6. Draw network diagrams
5. Develop work breakdown structures
4. Identify the various phases of project management
3. Define the roles and responsibilities of individuals involved in projects
2. Describe a project charter
1. Define the scope of projects
6. Develop more Key Performance Indicators to include in the strategic dashboard presented in Figure 2.6.
5. Watch the following PBS video: “Money and medicine”(http://www.pbs.org/video/2283573727). Describe how Intermountain Healthcare and the UCLA Medical Center tried to improve quality while cutting costs.
4. Go to these two Web sites: (a) video.hbs.edu/videotools/play?clip=rhc_faq073 and (b)video.hbs.edu/videotools/play?clip=rhc_faq071. Do you agree that increasing quality is the best way to decrease cost?
3. Based on its prospectus, Bumrungrad’s strategy is to compete as a differentiated defender. Do you agree? (bh.listedcompany.com/misc/DEBENTURE/20120124-BH-prospectusNo01-2011-EN.pdf)
2. Research three hospitals in your region. What are their respective business strategies?Justify.
1. Select a major hospital in your city/region. Identify the external forces impacting this hospital’s strategy and performance.
13. What are the three types of dashboards?
12. What is a balanced scorecard and why is it important?
11. Discuss the difference between an order winner and an order qualifier. Use an example for illustration.
10. Describe the cumulative model.
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