Things to Discuss, Include, and Additional Information Provide full detailed discussion and comprehensive reasoning behind your responses. Provide supporting information/examples to support your responses. Include and reference graphs, charts, and diagrams where necessary. You will find that the case study for University Health Systems, specifically, will require you to develop charts and diagrams. Each Case Study will focus on information that you will secure from a particular chapter. However, the expectation will be for you look to other chapters within the textbook, as well as outside information, when providing complete answers. Include at least two outside sources. Paper Formatting 1. 2. Title page and bibliography (this is not included in the total page count). 3. 12-point Times New Roman font, double-spaced text, and one-inch margins all around. 4. 5. The beginning and ending of each Case Study should be clear. Adhere to a recognized writing style for formatting citations throughout the paper, and the bibliography. 6. 7. The case studies combined should be at least 7 pages in length. Provide transitions to the next topic/subject matter that are clear. Have clear topics introducing the subject matter being discussed. The reader simply needs to know what you are talking about. CHAPTER 1 - CASE STUDY HEALTH CARE OPERATIONS AND SUPPLY CHAIN STRATEGY Case Scenario: Blue County Memorial Hospital (BCMH) is one of the largest health care organizations in eastern North Carolina. It serves the eastern one-third of North Carolina and maintains a 500-bed facility oering 24/7 acute medical and surgical care. The health care facility has over 30,000 patient admissions a year, and its average length of stay (LOS) is about four days. The health care facility is organized by specialty and staed with qualied MDs, physician assistants (PAs), nurses, and technicians. BCMH contains 12 operating rooms, all with state-of-the-art equipment, numerous wards for postoperative care, and related ancillary services (rehabilitation, testing labs, etc.). The operating room department has a large challenge in that it must manage and allocate equipment and sta so that surgeries can be performed eectively but also in the most ecient manner possible. In all, the assignment of equipment and sta is a dicult job. State regulations require threshold levels for nurse-patient ratios, and not meeting these thresholds may lead to underutilization of available capacity. In turn, the size and mix of sta are critical decisions for the workforce planners. Overstang, understang, or unbalanced stang leads to issues with quality of care and increased patient cost. BCMH meets its stang requirements with a mix of permanent sta and an on-call group of part-time sta available on short notice. There is also temporary stang that occurs for nurses with six-month to one-year contracts. Overall, the hospital's stang needs have been met by 60 percent permanent sta, 35 percent temporary sta, and 5 percent on-call sta. BCMH provides services to patients, and in turn those patients, either through insurance or by direct payments, reimburse BCMH for services provided. Although many services are provided, surgery is one area where BCMH adds value and garners prots. However, surgery demands numerous resources, including equipment and sta (surgeons, nurses, technicians, etc.). BCMH is also responsible for preoperative care and postoperative care. Insucient capacity in any area (surgery, postoperative wards, etc.) can lead to surgical procedures being turned away or to higher costs if accepted when over capacity. Slotting is used for planning and scheduling purposes. Each area within BCMH is broken up in half-day slots, meaning there are 14 slots per week. Slot planning and scheduling is conducted about once a quarter (once every three months). A plan is developed in consultation with surgeons; demand for surgical procedures varies little from year to year, but the demand does have a seasonal component, making some quarters busier than others. In addition, some specialties have peak demands whereas other specialties have very stable demand. The slotting and planning process also encompasses the stang of nurses. The labor cost of nurses for surgery is one of the largest and most controllable operating costs. Nursing stang plans are prepared each month for a month's time frame and two weeks in advance. The nursing schedule is frozen one day in advance and then resource requirements are matched based on the upcoming surgeries. This type of planning is ecient for day-to-day operations but gives limited exibility in terms of the permanent sta, temporary sta, and on-call sta. The nurse scheduler must many times rely on temporary sta or on-call sta when demand changes occur in the short term. Subsequently, BCMH must meet its nursing needs from outside, and in monetary terms the outside sta costs more, as higher rates are paid to the outside sta. In addition, the stang in preoperative and postoperative wards is done in a similar fashion. Question: Is it possible that BCMH could experience the bullwhip effect? What items can be identified that would exacerbate the bullwhip effect at BCMH? How does variability from all areas impact BCMH? Can the use of temporary workers benefit BCMH but also be detrimental at the same time? Please provide detailed discussion for each question. CHAPTER 9 - CASE STUDY DELAYED ROOM CLEANING DILEMMA Case Scenario: University Health Systems' Environmental Services department is tasked with cleaning patient rooms. The hospital facility is three oors and is horizontally laid out (i.e., long hallways to traverse between departments and rooms). The Environmental Services department has been experiencing some issues with the room cleaning process. Specically, the issue is delays in cleaning rooms. While delays cannot be completely eliminated, delays need to be monitored. Leigh, Environmental Services director, has compiled some data over the past three weeks on cleaning delays. She has collected the number of cleaning delays per day and the cause of the delay as written by the room attendant. Leigh's co-workers believe day of the week plays a role in how many cleaning delays occur. Leigh does not agree and wants to show her co-workers that their team should actually be concerned with the reason(s) for the delays. Leigh also believes there has been a trend upward in the number of delays over the past three weeks. Leigh needs assistance in substantiating her claims. Problem: There are ve categories for causes of delays: patient check-out orders delayed, cleaning sta shortage, room occupied, order for patient check-out canceled, or other. Using a scatter plot and a Pareto diagram, help Leigh develop a way to explain her idea to her coworkers. Include dialogue Leigh could use to help clarify her point. The table on the next page contains the pertinent cleaning delay information. TABLE: Cleaning Delay Information Reason Give For Delay ____________________________________________________________________ Day of The Week Total Number Of Cleaning Delays Patient CheckOut Orders Delayed Order For Patient Cleaning CheckStaff Room Out Shortage Occupied Ordered Other ___________________________________________________ M-Week 1 1 1 0 0 0 0 Tu-Week 1 8 3 2 2 1 0 W-Week 1 9 6 0 0 2 1 Th-Week 1 9 5 1 1 1 1 F-Week 1 21 16 5 0 0 0 M-Week 2 8 0 0 5 2 1 Tu-Week 2 19 5 5 5 2 2 W-Week 2 25 10 0 5 5 5 Th-Week 2 25 7 2 2 12 2 F-Week 2 24 5 5 2 7 5 M-Week 3 29 10 10 5 2 2 Tu-Week 3 19 7 5 0 5 2 W-Week 3 21 12 0 5 2 2 Th-Week 3 19 6 3 1 6 3 F-Week 3 24 4 1 7 7 5 CHAPTER 13 - CASE STUDY IMPLEMENTING ELECTRONIC HEALTH RECORDS AT ST. HAMPTON'S HOSPITAL Case Scenario: Assume that you are the project manager at St. Hampton's Hospital, located in a large city in the Midwest area of the United States. Your project team has been tasked with implementing electronic medical records (EMR) at St. Hampton's. The information technology infrastructure is in place and the EMR software has been purchased. Your project focuses on implementation and adoption of EMR across the entire hospital (15 departments). Questions: 1. Explain how you would determine appropriate objectives and trade-os for this project and how you might employ a weighting method to assist with this task. 2. How might use of a SWOT analysis play a role? 3. What role might benchmarking play? 4. Assume that the network for this project is provided in Figure on the second page. Also assume that it is not possible to accomplish tasks A, D, and E any faster than the durations provided in the on the second page. What other data would be needed in order to determine if project crashing can occur? 5. If we now add in the assumption that activity D and activity F require the same person (resource), then we are faced with an example of resource leveling. Either D or F must be delayed. How would we determine which resource leveling option is preferred? FIGURE: Network for Electronic Medical Records Implementation Activity F 6 weeks Activity B 6 weeks Activity C 3 weeks Activity D 4 weeks Activity E 4 weeks