BUSI 760 Week 3 DB Forum 2 Thread Example

Discussion Board Forum 2: Thread

BUSI 760 Quality Management and Productivity, Discussion Board Forum 2 Thread

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The prompt and the imaging network are composites standing in for the course's own; the books and the published research are real; the week, points and readings follow Liberty's public course guide for BUSI 760, which keeps each forum's detailed instructions inside the course.

Our outpatient imaging network operates eleven MRI scanners in six centers. Patients referred for a non-urgent MRI wait an average of nine business days for an appointment, and referring physicians complain constantly. Yet our scanner logs show that scheduled scanner time goes unused 18 percent of the time, through late starts, gaps between patients and no-shows. Long waits and idle machines at the same time mean that our problem is not simply a shortage of scanners. The question this forum poses, which improvement method fits the problem, is therefore a real one for us.

Plenert (2012) argues that each improvement method is designed for a particular kind of problem and that managers should match the tool to the problem rather than adopt a program because it is fashionable. Two broad families are relevant. Lean methods aim at flow, removing waiting, rework, needless handoffs and any step a customer would not pay for. Six Sigma aims at variation and defects: results that differ unpredictably from one case to the next. Our two symptoms point to different families, which is why the choice requires diagnosis.

Lean has a strong evidence base. Shah and Ward (2003), using data from a large census of U.S. manufacturing plants, identified four bundles of lean practices, covering just-in-time flow, quality control routines, preventive care of machines and the people side of the system, including teams and workers trained across several jobs. They found that the bundles contributed substantially to operating performance and that plant size was strongly related to whether lean was implemented, while unionization and plant age mattered less than conventional wisdom held. Their work is a reminder that lean is a system of practices, not a single tool.

Six Sigma is often described as a set of statistical tools, but Schroeder et al. (2008) argue that its tools are similar to those of earlier quality programs. What is new, in their analysis, is an organizational structure: trained improvement specialists, projects selected and led in parallel to the line organization, specific metrics and a disciplined problem-solving method. That structure is suited to problems where the cause of variation is unknown and must be found with data. It is also expensive: belts must be trained, projects take months, and the method's value depends on having reliable data about the process, which our centers collect unevenly.

Mapping our case onto both families clarifies the choice. The gaps between patients and late starts are waste. A walk through our process showed that the scheduling call center books appointments without seeing whether prior authorization is complete, so patients arrive and wait while staff call insurers, and technologists then run behind all day. That is a handoff problem, and lean methods such as value stream mapping and standard work are designed for it. When a walk along the process reveals the waste, no statistical study is needed to locate it. No-shows, by contrast, are variation. Some centers lose 4 percent of appointments to no-shows and others 14 percent, and we do not know why. That is the kind of unexplained variation a Six Sigma project with data analysis is designed to explain.

I would therefore sequence the methods. First, a lean effort to redesign scheduling so authorization is confirmed before booking, with standard start times and a pull system that fills gaps from a short-notice list. Second, once the flow is stable, a Six Sigma project to find the causes of no-show variation across centers, examining reminder timing, travel distance and appointment time of day. We would measure success by days to next available appointment and by scanner utilization. Each center would post both numbers weekly, so the teams doing the work can see the effect of their changes. If waits fall and idle time drops without new scanners, the network will have bought capacity through better management rather than equipment.

References

Plenert, G. (2012). Strategic continuous process improvement: Which quality tools to use, and when to use them. McGraw-Hill.

Schroeder, R. G., Linderman, K., Liedtke, C., & Choo, A. S. (2008). Six Sigma: Definition and underlying theory. Journal of Operations Management, 26(4), 536-554. https://doi.org/10.1016/j.jom.2007.06.007

Shah, R., & Ward, P. T. (2003). Lean manufacturing: Context, practice bundles, and performance. Journal of Operations Management, 21(2), 129-149. https://doi.org/10.1016/S0272-6963(02)00108-0