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1
Cahyaningtyas, Amalia, Hanny Handayani, and Aat Yatnikasari. "Gambaran Pelaksanaan Serah Terima Antar Shift di Rumah Sakit X Jakarta." Holistik Jurnal Kesehatan 14, no. 3 (2020): 383–90. http://dx.doi.org/10.33024/hjk.v14i3.2968.
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A description of handover processes in hospital: A survey from Jakarta, IndonesiaBackground: Handover at the change of nurse shift is one of an important role in patient safety and continuiting quality of care.Purpose: To optimization of implementation of handover processes in hospital: A survey from Jakarta, IndonesiaMethod: An analysis study with approach fishbone diagram, start with filling in questionnaires, observations and interviews and then analyzed using fishbone diagrams. Based on fishbone diagrams, the problem was obtained that the implementation of handover of patient patients was not optimal.Results: To optimize the implementation of handover, implementation was carried out in the form of improving SPO, improving nurses' effective communication with SBAR and making role play video handover.Conclusion: The result is the handover can be optimal with the role and function of management of the head nurse especially a directing role. Recommendations given by follow up and revising the hand over standars, make a pilot project nursing ward and evaluate the implementation of the patient's handover through regular supervision.Keywords: Fishbone Diagram; Handover; Head Nurse; Optimization; DirectingPendahuluan: Serah terima perawat antar shift jaga merupakan salah satu komponen penting dalam mencapai keselamatan pasien dan mempertahankan kualitas asuhan.Tujuan: Meningkatkan optimalisasi fungsi pengarahan kepala ruang dalam pelaksanaan serah tertima antar shift di RS X Jakarta.Metode: Menggunakan study analysis situasi dengan pendekatan diagram tulang ikan, dimulai dengan mengisi kuesioner, observasi dan wawancara dan kemudian dianalisis menggunakan diagram tulang ikan. Berdasarkan diagram tulang ikan, masalah diperoleh bahwa pelaksanaan serah terima pasien pasien belum optimal.Hasil: Untuk mengoptimalkan pelaksanaan serah terima, implementasi dilakukan dalam bentuk meningkatkan SPO, meningkatkan komunikasi efektif perawat dengan SBAR dan membuat role play video serah terima.Simpulan: Hasilnya adalah serah terima dapat dioptimalkan dengan peran dan fungsi manajemen kepala ruang khususnya fungsi pengarahan. Rekomendasi yang diberikan dengan menindaklanjuti dan merevisi SOP serah terima, membuat ruang percontohan dan mengevaluasi pelaksanaan serah terima pasien melalui pengawasan rutin.
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Risykiyana, Desiyarotur, Muhammad Yusril Bahtiar, and Farid Sukmana. "Penilaian Standar Mutu Pada Sistem Perpustakaan Sekolah Di MTs Muhammadiyah 8 Ujungpangkah Menggunakan Standar ISO 20000 Dengan Analisis Fishbone Diagram." JTIM : Jurnal Teknologi Informasi dan Multimedia 3, no. 2 (2021): 130–38. http://dx.doi.org/10.35746/jtim.v3i2.142.
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In the development of a system, quality assurance is needed. A system can be said to be of good quality if it meets the needs of the user. Quality can be measured from various points of view. One point of view to measure software quality is to focus on service management systems. To determine the quality of a system, it is necessary to analyze the quality of the system. The school library system at MTs Muhammadiyah 8 Ujungpangkah has implemented a lot of service management systems to support the process of activities in the library. However, it is not yet known whether the system is in accordance with the assessment standards or not.The author uses the ISO 20000 standard to assess the requirements for obtaining a certificate in the library application by conducting various analyses. This study aims to analyze the application of the library system with ISO 20000. The analytical research methods used include determining clauses, checklists, Likert scale, maturity levels, and fishbone diagrams. The references that I take are based on the results of the analysis of the writing team that I have made including graphs, diagrams, clause scores, checklist scores, Likert scales, maturity levels, and fishbone diagrams. Based on the results of the author's analysis, the school library application system at MTs Muhammadiyah 8 Ujungpangkah does not meet the ISO 20000 standard so that there is still much that needs to be improved in the library system. The Likert scale score is only 11%, while to meet the ISO 20000 standard the Likert scale score must reach at least 60%. The overall problem with this analytical assessment that results in the Library System application not passing the ISO 20000 quality standard is the lack of a Likert scale score and fishbone diagram. With fishbone diagram, the main root cause is found with organitation structure that is not clear to monitor the application working. The hypothesis in this study can be the basis for future research so that the application can meet the feasibility test of the ISO 20000 quality standard.
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Chie, Ho Hwi, Januar Nasution, Ketut Gita Ayu, Nike Septivani, and Yualfin Renaldi. "Porcelain Product Quality Analysis in PT XYZ." ComTech: Computer, Mathematics and Engineering Applications 6, no. 4 (2015): 580. http://dx.doi.org/10.21512/comtech.v6i4.2195.
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PT. XYZ is a company engaged in manufacturing porcelain dinner ware such as plates, cups, teapot, bowl, etc Porcelain product is safe for use and product defect will only affect the aesthetic not the functional side. The company always maintain the quality of the products produced as by maintaining a good product, in terms of visuals, will keep customers interested in the product. Good quality products characterized by quality A / B and C, and the product defect characterized by the quality of D, Lost, and BU. Concepts and methods used to analyze is a statistical process control (SPC) which includes Pareto diagram, fraction nonconformities, flow charts and fishbone diagrams and management tools (fault tree analysis). Statistical Process Control (SPC) is one of the methods, which includes Pareto charts, fraction nonconformities, flow chart, and fishbone diagram and also management tools (fault tree analysis). SPC is useful to find the facts from the problems and factors that affect the quality of the products, while fault tree analysis is useful to analyze each of the production process.
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Setyawan, Ervin, and Farid Sukmana. "Penilaian Standar Mutu Pada Aplikasi Tiket Bioskop dengan ISO 27001 dan Fishbone Analisis." JTIM : Jurnal Teknologi Informasi dan Multimedia 2, no. 4 (2021): 214–22. http://dx.doi.org/10.35746/jtim.v2i4.110.
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Cinema ticket application services make it easy to purchase movie tickets. Various applications, especially in the business sector, certainly require information security that has been guaranteed to be applied and international information security certificates in ISO 27001 quality standards. Therefore, the requirements for obtaining information security certificates in international quality ISO 27001 need to be analyzed first. It requires a lot of preparedness that must be requested in meeting ISO 27001 quality standards. The purpose of this study is to analyze the application of cinema tickets for ISO 27001 eligibility. Analytical research methods used include clauses, checklists, Likert scales, maturity levels, and fishbone diagrams. The authors' references were based on the writer's team's analysis that the authors made, including graphs, charts, clause scores, checklist scores, Likert scales, maturity levels, and fishbone diagrams. Based on the author's analysis results, the cinema ticket application system does not meet ISO 27001 standards, so much needs to be improved in the system. Likert scale scores are still 19%, while to meet ISO 27001 standards, Likert scale scores must reach at least 60%. The overall problem with assessing this analysis, which results in cinema tickets being inappropriate or not passing ISO 27001 quality standards, is the lack of Likert scale scores and fishbone diagrams. This analytical research hypothesis can be the basis for future research that the application can meet the feasibility test of ISO 27001 quality standards.
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Azelya, Iis, and Gesit Thabrani. "Analisis Pengurangan Non-Value Added Activities dengan Metode Lean Six Sigma." Jurnal Kajian Manajemen dan Wirausaha 2, no. 2 (2020): 63. http://dx.doi.org/10.24036/jkmw0284940.
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Purpose - This study was conducted with the intention to find out what is included as non-value added activity that is happened in patient’s flow and how to reduce it using lean six sigma method in outpatient department of regional public hospital of Kerinci M.H A Thalib.Methodology - This research uses lean six sigma method with analysis tools in the form of value stream mapping and fishbone diagrams in order to reduce the activities identified as non value added in the outpatient units of the M. H A Thalib general hospital in Kerinci Regency.Finding - The results of the study showed that the lead time required in the flow of patients in this outpatient unit is 7300.27 seconds with a percentage of Process Cycle Efficiency is only 12.22%, and contributing factors such as databases that are not used effectively, delays in medical personnel, lack of infrastructure, and so on. Keywords: Lean Six Sigma, Value Stream Mapping, Fishbone Diagram, DMAIC, Health Service, Reduce, Non-Value Added Activity
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Waliyuddiin, Muhammad Iqbal, Yudha Arya Prasaja, Farid Sukmana, and Adryan Firdaus. "Penilaian Standar Mutu Pada Aplikasi Parkir Universitas Muhammadiyah Gresik Dengan ISO 9241-11 Dan Fishbone Analisis." JTIM : Jurnal Teknologi Informasi dan Multimedia 3, no. 2 (2021): 121–29. http://dx.doi.org/10.35746/jtim.v3i2.156.
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The parking application service at the University of Muhammadiyah Gresik is an update from the previous system. Of course, this application requires a system that is practical, efficient, and also has good data storage security. One of the references that can be used that these things have been fulfilled in this application is an analysis using ISO 9241-11. The purpose of this study was to analyze the application of UMG parking for the feasibility of ISO 9241-11. Analytical research methods used include determining clauses, checklists, Likert scales, maturity levels, and fishbone diagrams. Clause, checklist use for getting assessment based on the park system, then from that result will be used to get the qualification of this system with liket scale in each clause of this standard, and assessment of all clause with likert scale , the result of level quality assurance of this system will be found. Next the using fishbone diagram can analyze to get the root cause of clause dan quality assurance in ISO 9241-11. Because that , with this study we can know the qualification and the root cause of park system. And the analysis using that tool, this system still not suitable to use ISO 9241-11. The parent of root cause is in efficiency clause in organitation like less costing and planning.
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Zach, Martin. "Applicable quality management tools in a production cycle of a selected company." Global Journal of Business, Economics and Management: Current Issues 8, no. 1 (2018): 10–19. http://dx.doi.org/10.18844/gjbem.v8i1.3295.
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The paper deals with quality control in a Czech manufacturing company, especially at its quality department. The objective is to define the identified production failures, using selected quality management tools, and to determine the causes of technological problems. The following methods and tools were used: cause and effect analysis—Fishbone diagrams (Ishikawa diagrams); Pareto charts, flowcharts and others methods, whose results have been visually displayed. Based on a detail analysis of the production failures, the proposal to eliminate them as well as a draft implementation of the corrective action and its effect on enhancing quality in the production company are presented. The elements such as frequency of controls, adherence to regular inspections and replacement of filters in air conditioning units, cleaning and compliance with the work rules were monitored, as these elements have an impact on product quality and customer satisfaction. The implementation of the corrective actions and the related financial estimate are presented.
 
 Keywords: Quality, production process, quality management tools, quality management, implementation, Pareto diagrams, cause and effect diagrams, safety.
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Wati, Merlin Dyah, Yugowati Praharsi, and Devina Puspita Sari. "Analisis Kinerja, Seleksi dan Pengembangan Vendor Trucking di Perusahaan Logistik." Jurnal METRIS 21, no. 02 (2020): 85–91. http://dx.doi.org/10.25170/metris.v21i02.2492.
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Freight forwarding is a logistics company which provide land delivery services rely heavily on trucking vendors. The available trucking vendors may not fulfill the company's expectations. Therefore the research was conducted to analyze the performance, selection process, management and development of 26 trucking vendors. The research began with the formation of a Critical Success Factor (CSF) and its development, namely a Key Performance Indicator (KPI) in accordance with company objectives. Then the CSF and KPI was weighted through the Analytic Hierarchy Process (AHP) method, determined the optimal performance value of each KPI, measured the performance of each vendor through the scoring method, analyzed the performance of the trucking vendor that was not optimal through Root Cause Analysis (RCA) by looking for the cause based on fishbone diagrams and FMEA tables, as well as providing suggestions regarding the management and development of trucking vendors. The results of the study were 11 CSFs and 28 KPIs that were formed. Based on the selection process conducted on 26 trucking vendors, there are 3 excellent vendors, 4 very good vendors, 11 good vendors, 3 matching vendors, and 5 unsatisfactory vendors. Furthermore, researcher conducted root cause analysis (RCA) of vendor representatives “matching” and “unsatisfactory” categories with fishbone diagrams and FMEA tables. Where the 5 highest RPN values from the FMEA table were given suggestions for improvement. Meanwhile, the excellent, very good, and good vendor categories are developed through strategic plans for the future.
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Al-Bashir, Adnan. "Applying Total Quality Management Tools Using QFD at Higher Education Institutions in Gulf Area (Case Study: ALHOSN University)." International Journal of Production Management and Engineering 4, no. 2 (2016): 87. http://dx.doi.org/10.4995/ijpme.2016.4599.
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<p>Human power’s quality plays the key role in the growth and development of societies where the quality of human powers can be enriched with the high quality education provided by the higher education institutions. The higher education institutions are hereby an important sector of any society since it defines the overall quality of human lives. This research will investigate the application of Total Quality Management (TQM) tools at the higher education institutions; specifically at ALHOSN University. In this study five tools were implemented at ALHOSN University’s engineering college including: Quality Function Deployment, Affinity Diagrams, Tree Diagrams, Pareto Charts, and Fishbone Diagrams. The research will reveal that the implementation of TQM tools has a great benefit for higher education institutions where they have uncovered many area of potential improvement as well as the main causes of some of the problems the Faculty of Engineering is facing. Also, it will show that the implementation of TQM tools on higher education institution systems will enhance the performance of such institutions.</p>
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Hardono, Joko, Hendra Pratama, and Andi Friyatna. "Analisis Cacat Produk Green Tyre dengan Pendekatan Seven Tools." Jurnal INTECH Teknik Industri Universitas Serang Raya 5, no. 1 (2019): 1. http://dx.doi.org/10.30656/intech.v5i1.1462.
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Quality is one aspect that needs to be maintained in increasing consumer confidence and minimizing production costs. A motorcycle tire manufacturing company has a production defect of 5028 during February 2018. This study aims to reduce the number of defective products in the green tire cooking process in the curing area. The methods used in this study are seven tools, especially Pareto diagrams, and fishbone diagrams and analyzed the cause is 5W1H. Of the six types of green tire defects, under cure is the most dominant factor (40%) that causes disability. The improvement in Pneumatic Problems which the problem of under cure is human factors, machinery, and the method of being able to reduce defects by 48% from 891 pieces in February to 463 pieces in May. The decrease in defects in pneumatic problems affects the reduction in the number of defects in green tire products from 5206 pieces in February to 4699 pieces in May.
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Anthony, Muhamad Bob. "Usulan Penurunan Tingkat Kecacatan Produk Pelat Baja dengan Metode Six Sigma." Jurnal INTECH Teknik Industri Universitas Serang Raya 3, no. 2 (2017): 41. http://dx.doi.org/10.30656/intech.v3i2.877.
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This study aims to maximize the decline in the level of product defects to lead to zero defects. Researchers use the six sigma method through 5 stages of completion, namely, define, measure, analyze, improve, and control. Based on the results of the study it can be concluded that the sigma level and the value of DPMO (Defect per Million Opportunities) of the company amounted to 3.47 with possible damage of 24,239 sheets for one million productions. After further analysis using the Pareto diagram, it found that the cutting fault transfer defect was the most common with a percentage of damage of 43%. And based on the results of the analysis of fishbone diagrams, it can be seen that the main factors causing contamination in the production process come from the worker factor (human), followed by machine factors, material, and work methods. The proposed improvements that can be made by the company include updating existing methods and SOPs (standard operating procedures) and monitoring the operator's performance and developing knowledge and planning proper maintenance scheduling.
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Hartono, Hartono, Aldi Pramana Putra, and Tina Hernawati Suryatman. "EVALUASI OVERALL EQUIPMENT EFFECTIVENESS SEBAGAI UPAYA PERBAIKAN PRODUKTIVITAS MESIN PRODUKSI KAIN NON-WOVENS (STUDI KASUS PT. MEGAH SEMBADA INDUSTRIES)." Journal Industrial Manufacturing 5, no. 2 (2020): 11. http://dx.doi.org/10.31000/jim.v5i2.2993.
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The manufacturing industry has a system for applying machinery, labor, equipment and raw materials to be transformed into a product that has a sale value. Production machinery and equipment are the main resources that cannot be separated from the overall resource system owned by the company. At PT. Sumber Wovens Utama production machines are used nonstop and cause a decrease in performance of these machines which include frequent breakdowns, loss of ideal speed, and poor quality. The purpose of this study is to determine the overall value of the effectiveness of the production machinery at this time, to find the root cause of the overall equipment effectiveness value is not as expected, and to provide an improvement to the cause of the low value of the overall equipment effectiveness of the non-wovens fabric production machine. The method used in this research is the Overall Equipment Effectiveness Method to calculate the level of effectiveness and productivity of production machines, Fishbone Diagrams to solve problems in projects and Analysis of 5 why to provide improvements to the level of productivity of these machines. The results showed that the average overall equipment effectiveness value for the period November 2018 - April 2019 was 83.2%, this value was still below the world class standard of 85%. Therefore, it is given an improvement over the overall equipment effectiveness value not being achieved by making regular maintenance schedules for production machines, making standard product changeover procedures, making standard parameters for each type of product and updating it every 1 month, etc. so that it gets good results, namely increases the overall equipment effectiveness value of the production machine to be 88.30%.Keywords: Overall Equipment Effectiveness, Fishbone Diagram, 5 why analys, Mesin Produksi, Kain Non-wovens, Production Machine, Non-wovens Fabric
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Diana Br Keliat, Tio Katana, and Hendrik Johannes Nadapdap. "ANALISIS PENGENDALIAN KUALITAS UNTUK MEMINIMASI PRODUK CACAT PADA BAYAM JEPANG." Agrika 14, no. 2 (2020): 94. http://dx.doi.org/10.31328/ja.v14i2.1357.
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ABSTRAKBayam Jepang adalah komoditas unggulan yang diproduksi oleh PO. Sayur Organik Merbabu dengan tingkat penjualan tertinggi mencapai 1018 kg/bulan. Salah satu faktor yang perlu diperhatikan dalam proses produksi adalah kualitas produk, karena akan berdampak terhadap kepuasan konsumen. Akan tetapi terdapat kendala dalam proses produksi, yaitu sifat tanaman yang sangat rentan rusak dan patah jika tidak diperlakukan secara tepat. Sehingga perlu dilakukan analisis kualitas terhadap Bayam Jepang untuk menekan tingkat kerusakan. Tujuan penelitian ini adalah mengetahui jenis cacat dan faktor-faktor yang mempengaruhi kualitas Bayam Jepang. Penelitian ini dilakukan pada 16 Januari sampai 20 Februari 2020 dengan metode deskripstif kualitatif dan menggunakan alat pengendalian mutu seperti lembar periksa, histogram, peta kendali, pareto dan fishbone. Jumlah informan yang digunakan terdiri dari pemilik usaha, tenaga kerja, petani mitra dan distributor. Setelah dilakukan penelitian ditemukan lima jenis cacat yaitu daun cacat, batang patah, daun kuning, tanaman kerdil dan busuk batang atau daun. Persentase cacat yang paling tinggi adalah daun cacat. Faktor-faktor yang mempengaruhi kualitas Bayam Jepang adalah faktor manusia, metode, dan lingkungan yang didukung dengan pembuatan diagram fishbone.ABSTRACTJapanese spinach is a superior commodity produced by PO. Sayur Organik Merbabu with the highest level of sales reach 1018 kg / month. One factor that needs to be considered in production process is product quality, because it will have an impact on customer satisfaction. However, there are obstacles in the production process, namely the nature of plants that are very susceptible to damage and broken if not treated properly. So it is necessary to conduct a quality analysis of Japanese spinach on an ongoing basis to reduce the level of damage. The purpose of this study is to determine the types of defects and factors that affect the quality of Japanese spinach. This research was conducted on January 16 to February 20, 2020 with qualitative descriptive methods and using quality control tools such as check sheets, histograms, control maps, pareto and fishbone. The number of informants used consisted of business owners, workers, partner farmers and distributors. After doing the research, five types of defects were found, namely defective leaves, broken stems, yellow leaves, dwarf plants and stems or leaf rot, with the highest percentage of defects being defective leaves. While the factors that influence the quality of Japanese spinach are found, namely human factors, methods, and the environment supported by making fishbone diagrams.
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Soleh, Ahmad, and Resista Vikaliana. "Analisis penerapan system application and product in data processing (SAP) pada sistem inventory logistik pada PT. Haier Sales Indonesia, Jakarta Utara." Operations Excellence: Journal of Applied Industrial Engineering 12, no. 1 (2020): 124. http://dx.doi.org/10.22441/oe.2020.v12.i1.011.
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Rapid economic development causes increasingly fierce business competition. Moreover, the development of increasingly sophisticated technology, companies are competing to use technology to increase competitive advantage and efficiency in the company. One of the most popular information technology investments today is the Application of Systems and Products in Data Processing (SAP), systems that do business using a single database that can be accessed by all divisions within the company. The purpose of this research is to study and discuss the application of Systems and Products in Data Processing (SAP) conducted at PT. Haier Sales Indonesia. This study uses qualitative methods through in-depth interviews with IT Managers and Logistics Managers and warehouse administration staff using Pareto diagrams and fishbone diagrams. The results of the evaluation of the application of Application Systems and Products in Data Processing (SAP) in Inventory Logistics that occurred at PT. Haier Sales Indonesia is getting better, all data from every activity has been documented and integrated into the system much faster than the manual process that has been done before and can produce accurate reports. Suggestions are given in order to continue training in SAP Systems and Applications for users in developing SAP Systems and Applications.
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Soleh, Ahmad, and Resista Vikaliana. "Analisis penerapan system application and product in data processing (SAP) pada sistem inventory logistik pada PT. Haier Sales Indonesia, Jakarta Utara." Operations Excellence: Journal of Applied Industrial Engineering 12, no. 1 (2020): 124. http://dx.doi.org/10.22441/oe.v12.1.2020.051.
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Rapid economic development causes increasingly fierce business competition. Moreover, the development of increasingly sophisticated technology, companies are competing to use technology to increase competitive advantage and efficiency in the company. One of the most popular information technology investments today is the Application of Systems and Products in Data Processing (SAP), systems that do business using a single database that can be accessed by all divisions within the company. The purpose of this research is to study and discuss the application of Systems and Products in Data Processing (SAP) conducted at PT. Haier Sales Indonesia. This study uses qualitative methods through in-depth interviews with IT Managers and Logistics Managers and warehouse administration staff using Pareto diagrams and fishbone diagrams. The results of the evaluation of the application of Application Systems and Products in Data Processing (SAP) in Inventory Logistics that occurred at PT. Haier Sales Indonesia is getting better, all data from every activity has been documented and integrated into the system much faster than the manual process that has been done before and can produce accurate reports. Suggestions are given in order to continue training in SAP Systems and Applications for users in developing SAP Systems and Applications.
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Faturochman, Afrizal, Indro Prakoso, Ayu Anggraeni Sibarani, and Katon Muhammad. "Penerapan Metode Six Sigma dalam Analisis Kualitas Produk (Studi Kasus Perusahaan Pemroduksi Baja Tulang Beton)." SPECTA Journal of Technology 4, no. 2 (2020): 45–54. http://dx.doi.org/10.35718/specta.v4i2.189.
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The development of the industrial world from the manufacturing sector must always be carried out by each manufacturing company so that the products marketed are not dead in the market because they are less competitive than their competitors. This is what drives companies to always supervise and make improvements to improve the quality of the products produced. PT.XYZ is one of the manufacturing companies engaged in the national steel industry whose main activity is producing concrete reinforcement steel with the main raw material being hot billets. In carrying out its production, PT.XYZ is not uncommon to find the products that are rejected due to defects. This research was conducted to analyze the number of defective goods produced with the aim that the quality of the products obtained increases and the level of income obtained is more leverage using the Six Sigma method. Cause and effect diagrams (fishbone diagrams) and Pareto diagrams are also used in this study to determine the causes of existing problems and the scale of priority problems that must be solved first. Based on the calculation of the percentage of damage, it can be concluded that there are four cases of the highest defect products, namely: 63.93% non-standard length, 15.51% ear defects, 12.67% digestion, and 7.9% cracking. At the end of this study, the results show that the capability and sigma value of company performance in improving product quality amounted to 7916.2 DPMO with a sigma value of 3.916.
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Lanida, Bella Putri, Tito Yustiawan, and Sylvy Medtasya Dzykryanka. "ROOT CAUSE ANALYSIS ON HOSPITAL STANDARDS AND JOINT COMMISSION INTERNATIONAL STANDARDS: A COMPARATIVE STUDY." Jurnal Administrasi Kesehatan Indonesia 7, no. 1 (2019): 18. http://dx.doi.org/10.20473/jaki.v7i1.2019.18-24.
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Background: Healthcare Associated Infections (HAIs) are infections that patients caught during medical treatment and health care. Prevention and control of infection will lead to patient safety, which ultimately has an impact on efficiency, management of health care facilities, and improvement of service quality. Infection can be controlled by identifying the causes. One method to achieve this goal is the Root Cause Analysis (RCA).Aim: This study aims to analyze the implementation of Root Couse Analysis (RCA) conducted by the Infection Prevention and Control Committee at the Mother and Child Hospital of Kendangsari MERR Surabaya.Method: This is a quantitative observational research that utilizes descriptive data analysis. This study is a cross sectional study and its results are presented narratively.Results: Results show that the Joint Commission International Standard 2015 version of RCA was not fully implemented at the Mother and Child Hospital of Kendangsari MERR Surabaya. Some methods, such as the fishbone and Plan-Do-Study-Action (PDSA), were not implemented. Limited resources became the contributing factor.Conclusion: Infection Prevention and Control Committee at the Mother and Child Hospital of Kendangsari Merr Surabaya has implemented 9 out of 21 RCA steps of the Joint Commission International Standard 2015. The hospital needs to use other methods as an addition to the 5 Why’s in implementing RCA, such as fishbone diagrams and Plan-Do-Study-Action (PDSA), for problem solving planning. Keywords: Root Cause Analysis (RCA), HAIs, Infection prevention and control.
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Utami, Saza Kurnia, and Dony Novaliendry. "PENGEMBANGAN MODUL INTERAKTIF KOMPUTER DAN JARINGAN DASAR BERBASIS ANDROID." Voteteknika (Vocational Teknik Elektronika dan Informatika) 7, no. 4 (2020): 244. http://dx.doi.org/10.24036/voteteknika.v7i4.106720.
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The use of technology in education can simplify the learning process and increase the potential of students in developing interests and potential so that learning objectives can be achieved. Based on observations on the Computer and Basic Networking subjects at SMKN 5 Padang that teachers have not implemented the media in the form of interactive modules in the learning process so that it has an impact on student learning outcomes. The purpose of this research is to develop an interactive module Computer and Basic Networks. Making this module using Android Studio software. The development method begins with system analysis (Fishbone diagram), analysis of the current system, and analysis of the proposed new system in the form of use cases, activity diagrams, and interface design. The conclusion of the development of this module is to produce an interactive module application Computer and Basic Networks that can be accessed via an android smartphone. In addition this module can also be run on a computer / PC. With the media in the form of interactive modules, it can be easier for students to understand the material and is very practical to be used as a learning medium. Keywords:Interactive Modules, Computers and Basic Networks, Android Studio
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Subagya, Fradana, and Endy Suwondo. "INSTABILITAS RENDEMEN CPO PADA INDUSTRI MINYAK SAWIT [CPO Yield Instability on Palm Oil Industry]." Jurnal Teknologi & Industri Hasil Pertanian 23, no. 2 (2018): 82. http://dx.doi.org/10.23960/jtihp.v23i2.82-88.
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The problem faced by the palm oil industry today is the instability of the Crude Palm Oil (CPO) yield. The condition of Fresh Fruit Bunches (FFB) starting from the time of harvesting to transporting to the factory, including during stockpiling at the palm oil mill, is an influential factor affecting the yield of CPO. This study aimed to find the factors causing instability of CPO yield in the palm oil industry. I-MR control maps and fishbone diagrams were used to analyze the factors that cause low CPO yields. From the data analysis for three years, the evidence of CPO yield was not statistically controlled. The causative factor of CPO yield instability included the quality of raw materials, production equipment, character of workers, and environmental conditions, with the dominating factor was the low quality of raw materials.
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Syahrullah, Yudi, and Milenia Rahma Izza. "INTEGRASI FMEA DALAM PENERAPAN QUALITY CONTROL CIRCLE (QCC) UNTUK PERBAIKAN KUALITAS PROSES PRODUKSI PADA MESIN TENUN RAPIER." JURNAL REKAYASA SISTEM INDUSTRI 6, no. 2 (2021): 78. http://dx.doi.org/10.33884/jrsi.v6i2.2503.
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PT. Pajitex is one of the textile industries that produce sarongs and continues to strive to fulfill customer desires through quality sarong products. During the sarong production process, there are still various product defects that can reduce consumer confidence in the resulting sarong products. Therefore, PT. Pajitex strives to reduce the number of defects that occur in the sarong manufacturing process by exploring various causes of defects. The purpose of this study was to analyze the defective edge on the CR3082 plate using the Quality Control Circle (QCC) method. The QCC method is a quality control system through the 8-step method with a continuous improvement system. At the defect search stage, use quality control tools such as Pareto diagrams and fishbone diagrams, and use the Failure Mode Effect Analysis (FMEA) method to obtain the highest RPN value which is a priority in the improvement proposal, and in determining the improvement proposal using the PDCA Methods. Based on the results of the analysis obtained, the cutter cutting and the needling process are not perfect and the tuck-in setting is not precise has the highest RPN value, which is equal to 120, so this activity needs to be monitored and followed up
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Ridwan Harimansyah, Faikar, and Tukhas Shilul Imaroh. "AIRCRAFT SPARE PARTS INVENTORY MANAGEMENT ANALYSIS ON AIRFRAME PRODUCT USING CONTINUOUS REVIEW METHODS." Dinasti International Journal of Management Science 2, no. 1 (2020): 81–90. http://dx.doi.org/10.31933/dijms.v2i1.528.
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The research aims to find the factors that cause high inventory value, increase the value of forecasting precision, service level and cost efficiency with fishbone diagrams and proposed methods. The research sample is 9 spare parts included in classification A in the ABC analysis and maintenance list 2018. Forecasting methods use Moving Average, Single Exponential Smoothing and Syntetos-Boylan Approximation as well as Mean Square Error calculation, deterministic inventory calculation and Continuous Review Method. The results of this study are an increase in logistics costs by $ 808.71 in the inventory management proposal. An increase in service level from 95% to 99% and the error value in the calculation of the proposal becomes smaller using the proposed method. This study also found that the factor causing the high inventory value was due to inaccurate planning methods so that other comparative methods were needed that could increase the precision of demand forecasting.
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Brahmbhatt, Yasmin, Peter Burke, Brianna Shinn, et al. "A Quality Improvement Intervention to Improve the Efficiency of Arteriovenous Access Placement for Pre-Dialysis Inpatients." American Journal of Medical Quality 34, no. 4 (2018): 376–80. http://dx.doi.org/10.1177/1062860618810847.
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The authors aimed to improve the rate of pre-dialysis arteriovenous (AV) access placement for hospitalized patients with advanced chronic kidney disease. The authors developed and implemented a protocol for hospitalized adult patients with an estimated glomerular filtration rate <20 mL/min to streamline the workflow for obtaining AV access. The protocol was piloted on 5 inpatient medical services over 3 months at 1 institution. Specific-Measurable-Achievable-Realistic-Timely (SMART) aims, Fishbone diagrams, Plan-Do-Study-Act cycles, and run charts were used to assess the process and outcomes of the intervention. There were 22 patients in the baseline group and 27 patients in the intervention group. Pre-dialysis AV access increased from 23% to 46%. Length of stay did not differ significantly between the baseline group (8.31 days) and the intervention group (8.4 days). Pathways can improve pre-dialysis AV access without significantly increasing length of stay.
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Suhadak and Tedjo Sukmono. "Improving Product Quality With Production Quality Control." PROZIMA (Productivity, Optimization and Manufacturing System Engineering) 4, no. 2 (2021): 41–50. http://dx.doi.org/10.21070/prozima.v4i2.1306.
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PT. Z is a company engaged in the plastic bag industry. The company produces plastic bags, one of which is a type of ATP 12 x 24 that is often used as plastic wrapping meatballs, sugar and others. A company is certainly required to provide the best quality on its products. To meet the needs and expectations of consumers for the quality of products, the company must improve the quality of existing products. Six sigma is a quality tool that can be used to analyze and process data to maintain or improve the quality of a product based on the process. One of the shorts used in the six sigma method is Define, Measure, Analyze, Improve and Control ( DMAIC). This research focuses on the results of product defects produced for 5 months in 2019. Because of the process analyzed there is data of proportions that are out of control in july and november. So that the data is omitted so that the data can be controlled. The sigma production level of ATP 12 x 24 is currently at the level of 4 sigma so it is necessary to improve to reach the level of 6 sigma. Pareto diagrams and fishbone diagrams can be used as tools to analyze significant factors causing product defects. And it can be known that the causative factor that can be done repair is deflated.
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Wagar, Elizabeth A., Ron Phipps, Robert Del Guidice, et al. "Inpatient Preanalytic Process Improvements." Archives of Pathology & Laboratory Medicine 137, no. 12 (2013): 1753–60. http://dx.doi.org/10.5858/arpa.2012-0458-oa.
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Context.—Phlebotomy services are a common target for preanalytic improvements. Many new, quality engineering tools have recently been applied in clinical laboratories. However, data on relatively few projects have been published. This example describes a complete application of current, quality engineering tools to improve preanalytic phlebotomy services. Objectives.—To decrease the response time in the preanalytic inpatient laboratory by 25%, to reduce the number of incident reports related to preanalytic phlebotomy, and to make systematic process changes that satisfied the stakeholders. Design.—The Department of Laboratory Medicine, General Services Section, at the University of Texas MD Anderson Cancer Center (Houston) is responsible for inpatient phlebotomy in a 24-hour operation, which serves 689 inpatient beds. The study director was project director of the Division of Pathology and Laboratory Medicine's Quality Improvement Section and was assisted by 2 quality technologists and an industrial engineer from MD Anderson Office of Performance Improvement. Results.—After implementing each solution, using well-recognized, quality tools and metrics, the response time for blood collection decreased by 23%, which was close to meeting the original responsiveness goal of 25%. The response time between collection and arrival in the laboratory decreased by 8%. Applicable laboratory-related incident reports were reduced by 43%. Conclusions.—Comprehensive application of quality tools, such as statistical control charts, Pareto diagrams, value-stream maps, process failure modes and effects analyses, fishbone diagrams, solution prioritization matrices, and customer satisfaction surveys can significantly improve preset goals for inpatient phlebotomy.
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Utami, Nurlita, Sena Atmaja, and Yogi Priyo Istiyono. "Analisis Pengendalian Kualitas Bahan Baku Acrylic Resin Pada Produk Spray Paint di PT X." Jurnal Penelitian Teknik industri 1, no. 1 (2021): 31–41. http://dx.doi.org/10.51999/jpti.v1i1.4.
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Thermo Plastic Acrylic resin has an important role in the manufacture of spray paint, namely as a binder or binder. The resin in paint has a function as a film formation, has adhesion to the substrate as well as pigment binders and additives, so that to produce a spray paint with good quality mechanical properties, PT X must be selective in controlling the quality of the raw material for Thermo Plasic Acrylic Resin. The purpose of this study was to determine the problems faced by PT X related to the quality of Thermo Plastic Acrylic Resin raw materials, to identify the most dominant factors affecting the quality of these raw materials and to formulate the most appropriate solutions to be applied in improving the quality of these raw materials. This research uses observation, interview, and literature study methods. Sources of data came from stakeholders and quality control staff of PT X. This study used check sheets, histogram diagrams, u-control maps, and fishbone diagrams to complete the analysis process. From the test results of the Thermoplastic Acrylic Resin raw material, it is known that the factor that causes rejection is due to adhesion, namely 53.57%, gloss 33.33%, and dry touch 13.10%, all three of the total raw materials that are rejected when the raw material is applied in form paint and spray on the film plate. The most dominant cause of reject was poor adhesion, namely 53.57% of the total reject raw materials.
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Kiki, Erina, Darwin Lie, Efendi Efendi, and Sisca Sisca. "ANALISIS PENGENDALIAN KUALITAS (QUALITYCONTROL) UNTUK MENINGKATKAN KUALITAS PRODUK YANG DIHASILKAN PADA CV BINA TEHNIK PEMATANGSIANTAR." SULTANIST: Jurnal Manajemen dan Keuangan 7, no. 1 (2019): 24–33. http://dx.doi.org/10.37403/sultanist.v7i1.134.
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The purpose of this study are: 1. To find out the description of quality control and the products quality produced at CV Bina Tehnik Pematangsiantar. 2. To find out the implementation of quality control to improve the products quality produced at CV Bina Tehnik Pematangsiantar.The results of the study can be summarized as follows: 1. The process of quality control in the production process applied by CV Bina Tehnik Pematangsiantar is not optimal. 2. The aesthetic and conformance dimensions of the product quality produced by CV Bina Tehnik Pematangsiantar are not optimal. 3. From the results of the histogram, irregularities or discrepancies found at the end of the QC or inspection of the final product / finished product are dominated almost 80% by 2 (two) types of non-conformity, namely the state of paint / color and the function of lights and hoses. 4. From the analysis of fishbone diagrams, it is known that the causes of irregularities are derived from raw material, human or worker factors, work methods and the environment. Keyword: Brand Image, Service Quality and Customer Satisfaction
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Plourde, Collin L., William T. Varnado, Barbara J. Gleaton, and Devika G. Das. "Reducing Infusion Clinic Wait Times Using Quality Improvement." JCO Oncology Practice 16, no. 8 (2020): e807-e813. http://dx.doi.org/10.1200/jop.19.00643.
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PURPOSE: Long wait times are a common occurrence for chemotherapy infusion patients and are a source of decreased patient satisfaction. Our facility sought to decrease outpatient infusion clinic wait times by 20% using the Model for Improvement, quality improvement tools, and Plan-Do-Study-Act cycles. METHODS: A multidisciplinary team was formed to address clinic wait times. Patient interviews, time studies, process mapping, brainstorming sessions, affinity diagrams, fishbone diagrams, and surveys were used to define the problem and to develop an intervention. Wait times from check-in until medication administration were analyzed using statistical process control charts. Our Plan-Do-Study-Act cycle led to the addition of a “fast-track” clinic title for patients not waiting for laboratory results on the day of treatment and changes in clinic communication. The fast-track clinic signaled for those patients to have priority for vital sign collection and earlier notification to pharmacy to begin preparing medications. RESULTS: Baseline wait times for patients not requiring laboratories on the day of treatment averaged 1 hour and 33 minutes. After intervention, using statistical process control charts, a shift was observed with a new average wait time of 1 hour and 12 minutes (a 23% decrease). Wait times for patients requiring laboratories on the day of treatment did not change significantly. CONCLUSION: Implementation of a fast-track clinic title and improving communication resulted in a significant reduction in wait times for patients not requiring laboratories on the day of treatment. Future efforts will focus on sustainment and improving wait times for all patients.
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Candrawati, Angela Ayu Dewi, and I. Nyoman Nurcaya. "ANALISIS PENGENDALIAN KUALITAS PRODUK TELUR ASIN PADA UD. SARI LUWIH DI DESA PADANG LUWIH." E-Jurnal Manajemen Universitas Udayana 9, no. 6 (2020): 2332. http://dx.doi.org/10.24843/ejmunud.2020.v09.i06.p14.
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Good quality in the production process, with predetermined standards will minimize damaged products. The study was conducted at UD. Sari Luwih is a manufacturing and trading company that processes and sells salted egg products. This study aims to determine the quality control system of salted egg production processes at UD. Sari Luwih is optimal or not. Research is descriptive with a qualitative approach. The sampling method is by census technique. The data used in this study, is the data on the number of damaged salted egg products in the period from October to November 2019 with a sample of 37,500 eggs saturated. The analysis technique used is statistical quality control (SQC) using Check sheets, P-charts, Fishbone diagrams, and Quality cost. The results of the analysis using the P-chart show the amount of product damage that is beyond the control limits and requires more control, whereas for quality costs in 2019, the company's actual cost of quality is Rp. 21,210,696.89 is greater than the optimum quality cost where the cost is Rp. 17,389,652.10 shows that the cost of quality control has not yet reached the optimal level.
 Keywords: quality cost; quality; statistical quality control; SQC.
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Sabinus, Sabinus, Erlinda Yurisinthae, and Shenny Oktoriana. "IMPLEMENTASI SERTIFIKASI INDONESIAN SUSTAINABLE PALM OIL SYSTEM (ISPO) PADA PETANI KELAPA SAWIT SWADAYA DI KABUPATEN SANGGAU." JSEP (Journal of Social and Agricultural Economics) 14, no. 2 (2021): 166. http://dx.doi.org/10.19184/jsep.v14i2.21161.
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The increase in the number of smallholders (Independent farmers) in Bonti District faces challenges from limited knowledge about cultivation, optimizing the use of production factors, sustainability in production, and the absence of institutions (farmer groups, cooperatives, and farmer groups combined) so that it becomes a problem in the application of the 4 principles and 20 ISPO criteria. The purpose of this study is to analyze the formation of independent farmer groups within the ISPO certification framework. The research method uses the descriptive approach to analyze institutional conditions based on ISPO criteria also uses fishbone diagrams to find out the main problems and to create solutions. The results of this research show the farmers' institutional principles have not been implemented, while 65.96% of the ISPO criteria have not been implemented and only 34.04% of the ISPO criteria have been implemented by farmers. The absence of farmer groups, data collection, and counseling for independent farmer groups in Upe Village. However, farmers show a good response to the initiation of the farmer groups' formation because there is hope that it will facilitate production inputs and the sale of TBS.
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Hayati (Politeknik APP), Dahliyah. "ANALISIS PENERAPAN SISTEM MONITORING PEMASOK." Jurnal Manajemen Industri dan Logistik 4, no. 1 (2020): 27–34. http://dx.doi.org/10.30988/jmil.v4i1.245.
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AbstractThe performance of suppliers both directly and indirectly determines several critical points for the company such as: product prices, product availability in the market, and product quality. It is very important for companies to monitor and improve the quality of raw materials obtained from suppliers, because this will determine the performance of the company, especially on the quality of products produced. The quality monitoring system implemented in the company must be responsive and consider every critical aspect of the non-conformity that occurs, not only using the Supplier Correction Action Request (SCAR) form or the Vendor Corrective Action Request (VCAR) form or the Supplier Corrective and Preventive Action Request (SCPAR) form for all types of non-conformity found. In this study, samples were taken at 3 different companies in order to obtain valid data to analyze and evaluate the existing quality monitoring system to get a new quality monitoring system that more responsive to avoid repeated findings occur. The research method was conducted by classifying non conformity types based on the level of criticism using the Total Quality Management (TQM) approach, fishbone diagrams, Failure Mode and Effect Analysis (FMEA), and Quality Function Deployment (QFD) so that the quality monitoring system produced is more accurate, effective and efficient in handling raw material non-conformities that occur. AbstrakKinerja pemasok baik secara langsung maupun tidak langsung ikut menentukan beberapa point kritikal bagi perusahaan seperti: harga produk, ketersediaan produk di pasar, dan kualitas produk. Sangat penting bagi perusahaan untuk memonitor dan meningkatkan kualitas bahan baku yang diperoleh dari pemasok, karena hal ini akan menentukan performa bagi perusahaan terutama terhadap kualitas produk yang dihasilkan. Sistem monitoring kualitas yang diterapkan di perusahaan harus responsif dan mempertimbangkan setiap aspek kritikal ketidaksesuaian yang terjadi, tidak bisa hanya menggunakan Supplier Correction Action Request (SCAR) form atau Vendor Corrective Action Request (VCAR) form atau Supplier Corrective and Preventive Action Request (SCPAR) form untuk semua tipe non conformity atau ketidaksesuaian yang ditemukan. Dalam penelitian ini, dilakukan pengambilan sampel di 3 perusahaan yang berbeda dengan tujuan agar didapatkan data valid guna menganalisis mengenai sistem monitoring kualitas yang telah ada saat ini dan mengevaluasi untuk mendapatkan sistem monitoring kualitas baru yang lebih responsif sehingga tidak terjadi lagi temuan berulang. Metode penelitian dilakukan dengan mengklasifikasikan tipe non conformity berdasarkan tingkat kritikalnya menggunakan pendekatan Total Quality Management (TQM), penggunaan fishbone diagram, Failure Mode and Effect Analysis (FMEA), dan Quality Function Deployment (QFD) sehingga sistem monitoring kualitas yang dihasilkan lebih akurat, efektif dan efisien dalam penanganan ketidaksesuaian bahan baku yang terjadi.
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Ap, Sapitri, and Firdaus Firdaus. "Waste Konstruksi: Identifikasi Potensi dan Penyebabnya Pada Proyek Perumahan Di Pekanbaru." JURNAL SAINTIS 19, no. 02 (2019): 79. http://dx.doi.org/10.25299/saintis.2019.vol19(02).3904.
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[ID] Waste merupakan salah satu penyebab rendahnya produktivitas. Besarnya potensi waste tentu saja akan merugikan owner ataupun kontraktor. Waste pada industri perumahan dapat mempengaruhi nilai jual rumah itu sendiri. Potensi waste material yang muncul pada proses pembangunan, penting untuk diidentifikasi dan dicari penyebabnya. Tujuan dari penelitian ini adalah mengidentifikasikan waste pada industri konstruksi (proyek perumahan) beserta sumber penyebab waste tersebut. Penelitian bersifat kuantitative dan data primer dikumpulkan dengan bantuan instrument kuesioner. Responden yang terlibat seluruhnya adalah pengawas lapangan/penanggung jawab lapangan proyek perumahan. The Statistical Package for Social Sciences (SPSS) dan fishbone diagram digunakan sebagai alat analisis variable dan indikator penyebab waste. Secara keseluruhan, hasil identifikasi penelitian menunjukkan bahwa material yang berpotensi ditemui pada proyek pembangunan perumahan di Pekanbaru yaitu material kayu dan batu bata (berpotensi sedang), material keramik, genteng, besi beton, cat, tanah, batu, pasir dan plesteran (berpotensi rendah) dan, cardboard packaging, plastic, kaca, metal, aspal dan plafond (berpotensi sangat rendah). Terdapat beberapa variable penyebab waste. Variabel-variabel tersebut terkait dengan sumber daya yang dibutuhkan selama proses pengerjaan proyek. Sumber penyebab waste yang berkonstribusi selama proses produksi secara signifikan dipengaruhi oleh variable: alat/mesin sebesar 0.885, metode kerja sebesar 0.873, material sebesar 0.866, manpower sebesar 0.821, dan lingkungan sebesar 0.808. Satu sumber variable dapat mempengaruhi variable yang lain, sehingga sangat penting untuk memperhatikan penyebab waste agar produktivitas pekerjaan dilapangan tidak terganggu.
 [EN] Waste is one of the causes of low productivity. The potential of waste will certainly harm the owner or contractor. Waste in housing industry can affect the sale price of the house. The potential of material waste in construction process is important to identify and need to find its cause. The purpose of this study is to identify waste in the construction industry (housing project) along with the source of the cause of the waste. Quantitative research is conducted and primary data were collected with questionnaire as the instrument. All respondents involved were supervisor. The Statistical Package for Social Sciences (SPSS) and fishbone diagrams are used as a tool for analyzing variables and indicators of the causes of waste. Overall, the result of research identification shows that the potential material in housing construction projects in Pekanbaru, namely wood and brick material (medium potential), ceramic, roof tile, steel, paint, soil, stone, sand and plastering (low potential) and, cardboard packaging, plastic, glass, metal, asphalt and ceiling (very low potential). There are several variables that cause waste. These variables are related to the resources that needed during the construction process. The sources of waste causes that contribute during the production process are significantly influenced by variables, i.e. tools / machines at 0.885, work methods at 0.873, materials at 0.866, manpower at 0.821, and the environment at 0.808. One source of variables can affect other variables, so it is necessary to pay attention to the waste causes so that work productivity uninterrupted.
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Ap, Sapitri, and Firdaus Firdaus. "Waste Konstruksi: Identifikasi Potensi dan Penyebabnya Pada Proyek Perumahan Di Pekanbaru." JURNAL SAINTIS 19, no. 2 (2019): 79–88. http://dx.doi.org/10.25299/saintis.2019.vol19(2).3904.
Full textAbstract:
[ID] Waste merupakan salah satu penyebab rendahnya produktivitas. Besarnya potensi waste tentu saja akan merugikan owner ataupun kontraktor. Waste pada industri perumahan dapat mempengaruhi nilai jual rumah itu sendiri. Potensi waste material yang muncul pada proses pembangunan, penting untuk diidentifikasi dan dicari penyebabnya. Tujuan dari penelitian ini adalah mengidentifikasikan waste pada industri konstruksi (proyek perumahan) beserta sumber penyebab waste tersebut. Penelitian bersifat kuantitative dan data primer dikumpulkan dengan bantuan instrument kuesioner. Responden yang terlibat seluruhnya adalah pengawas lapangan/penanggung jawab lapangan proyek perumahan. The Statistical Package for Social Sciences (SPSS) dan fishbone diagram digunakan sebagai alat analisis variable dan indikator penyebab waste. Secara keseluruhan, hasil identifikasi penelitian menunjukkan bahwa material yang berpotensi ditemui pada proyek pembangunan perumahan di Pekanbaru yaitu material kayu dan batu bata (berpotensi sedang), material keramik, genteng, besi beton, cat, tanah, batu, pasir dan plesteran (berpotensi rendah) dan, cardboard packaging, plastic, kaca, metal, aspal dan plafond (berpotensi sangat rendah). Terdapat beberapa variable penyebab waste. Variabel-variabel tersebut terkait dengan sumber daya yang dibutuhkan selama proses pengerjaan proyek. Sumber penyebab waste yang berkonstribusi selama proses produksi secara signifikan dipengaruhi oleh variable: alat/mesin sebesar 0.885, metode kerja sebesar 0.873, material sebesar 0.866, manpower sebesar 0.821, dan lingkungan sebesar 0.808. Satu sumber variable dapat mempengaruhi variable yang lain, sehingga sangat penting untuk memperhatikan penyebab waste agar produktivitas pekerjaan dilapangan tidak terganggu.
 [EN] Waste is one of the causes of low productivity. The potential of waste will certainly harm the owner or contractor. Waste in housing industry can affect the sale price of the house. The potential of material waste in construction process is important to identify and need to find its cause. The purpose of this study is to identify waste in the construction industry (housing project) along with the source of the cause of the waste. Quantitative research is conducted and primary data were collected with questionnaire as the instrument. All respondents involved were supervisor. The Statistical Package for Social Sciences (SPSS) and fishbone diagrams are used as a tool for analyzing variables and indicators of the causes of waste. Overall, the result of research identification shows that the potential material in housing construction projects in Pekanbaru, namely wood and brick material (medium potential), ceramic, roof tile, steel, paint, soil, stone, sand and plastering (low potential) and, cardboard packaging, plastic, glass, metal, asphalt and ceiling (very low potential). There are several variables that cause waste. These variables are related to the resources that needed during the construction process. The sources of waste causes that contribute during the production process are significantly influenced by variables, i.e. tools / machines at 0.885, work methods at 0.873, materials at 0.866, manpower at 0.821, and the environment at 0.808. One source of variables can affect other variables, so it is necessary to pay attention to the waste causes so that work productivity uninterrupted.
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KARTIWA, NUR ANNISA RIZKITA, and ENDAH DJUWENDAH. "FAKTOR PENYEBAB KETIDAKMAMPUAN PETANI MEMENUHI PERMINTAAN BABYBUNCIS UNTUKPT. ALAMANDA SEJATI UTAMA SERTASTRATEGI UNTUK MENGATASINYA (Studi Kasus Kelompok Tani Tauhid, Kabupaten Bandung Barat)." Jurnal Social Economic of Agriculture 5, no. 1 (2016): 28. http://dx.doi.org/10.26418/j.sea.v5i1.15057.
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Baby Kenya bean is a bean types that has a good prospects, it has successfully entered the export market. Poktan Tauhid which is a part of the Farmers Group (Gapoktan) Lembang Agri are the farmers group who grows baby kenya bean. The aim of this research are to know the causative factors of farmer that led to an inability to meet the demand for the baby kenya bean for PT. Alamanda Sejati Utama and determine the accurate strategy which can be implemented in Poktan Tauhid to overcome the problems.The research design is qualitative with descriptive analysis technique with fishbone diagrams and analysis of operation strategies with QSPM. The results of the research indicates that a very problematic technical factors among others are the weather conditions, pest and plant disease. While non-technical factors that is very problematic isthe harvest labor. In addition, technical factors that enter into the troubled category are technology, seeds, water availability andthe wind. The alternative strategy that can be implemented in Poktan Tauhid Backward Integration.The implication of this alternative strategy is enabling Poktan Tauhid to better control the process to reschedule planting schedules for every babykenya bean farmer. Moreover, counseling should be given more frequently, related to technologies and the prevention of pests and diseases naturally.Keyword :Causative factors, alternative strategy, baby kenya bean
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M, Hikmat Mulyana, Andira Andira, and Nurhayati Surbakti. "Menurunkan Problem Reject Pinhole di Proses dengan Konsep DMAIC di PT. XYZ, Purwakarta." JIE Scientific Journal on Research and Application of Industrial System 3, no. 2 (2019): 119. http://dx.doi.org/10.33021/jie.v3i2.527.
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PT XYZ is one of the flexible manufacturing industries. In terms of overcoming competition in the printing industry, PT XYZ built the Rotogravure company in 2011. The subsidiary is engaged in manufacturing Cylinder Rotogravure which supplies PT XYZ units. From a few years back since the establishment of this company, the target that should have been reached in amount of 5760 Cylinder / year. This target hasnot been achieved. This occurs because there is a problem in the production process reaching ± 49.4% and continues to appear which results in a disrupted delivery schedule, many customer complaints due to the low quality goods being shipped.The method used for this improvement process is the system or concept of Six Sigma namely DMAIC. From the DMAIC method, the tools used for the analysis process are the Pareto, Fishbone, 5W1H and Data Sheet diagrams. These tools are core tools that are focused on finding problems that often occur at PT XYZ. From the results of this improvement, a design is got to make the cleaning process aids, there were changes in parameters in the production process by reducing the current density and temperature in the Copper machine with a temperature of 30OC and current density of 20 A / dm2. The research and improvements that have been made are 94.45% with a total pinhole wastage of 1 cylinder unit.
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Arya, Amit Kumar, and Suraj Choudhary. "Assessing the application of Kaizen principles in Indian small-scale industry." International Journal of Lean Six Sigma 6, no. 4 (2015): 369–96. http://dx.doi.org/10.1108/ijlss-11-2014-0033.
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Purpose – This study aims to represent Kaizen implementation in a machine vice manufacturing company. Kaizen has shown tremendous impacts on the production techniques and lead times. A large number of small-scale industries have shown their existence in India. It has been difficult for small industries to survive due to tough competition among them. All are facing problems like low production and poor-quality products. Design/methodology/approach – The methodology applied to implement Kaizen in Indian small-scale industry. Fishbone diagrams have been used to represent cause and effects. The result has been shown as savings in terms of money and time. Findings – Inventory access time is reduced up to 87 per cent and total distance travelled and total time taken by product is reduced up to 43.75 and 46.08 per cent, respectively. A habit to maintain a clean workplace has been developed in workers. Research limitations/implications – ISO could be integrated with Kaizen for more improvements. Practical implications – The paper should assist those practitioners and consultants who have the desire to understand a better way of Kaizen implementation in small-scale industries of India. Originality/value – This paper yields lots of values for practitioners to understand the need, impacts and significance of Kaizen implementation in small-scale industries of India. Also, it bridges the gap between theory and practice of Kaizen implementation in real working conditions in Indian industries.
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Hadi, Danang Kumara, Rizka Aidina Putri, Siska Nifroatul Farida, and Imam Santoso. "Application of Cleaner Production in a Fruit Chips Industry." Industria: Jurnal Teknologi dan Manajemen Agroindustri 10, no. 2 (2021): 162–71. http://dx.doi.org/10.21776/ub.industria.2021.010.02.7.
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Cleaner production (CP) is one of the sustainable implementations of a comprehensive preventive environmental strategy involving company processes, products, and services. CP plan implementation still faces obstacles, such as the lack of detailed information, tools, and techniques. This study aimed to determine the variables and to select alternative solutions for cleaner production at a fruit chip industry using the Analytical Hierarchy Process (AHP) method. The research was carried out at PT Agrijaya Indotirta in Malang, East Java. The production process at this company generates waste from the consumption of energy, water, materials, and raw materials. Energy and water consumption are disposed directly without preliminary recycling process. Used oil is sold, and the remaining fruit seeds are sold for seeds. Checklists are used for problem identification, while fishbone diagrams and the 5W1H method are used to solve the problem of getting the best solution from the available alternatives. The weighting results of the alternative solutions using the AHP method show that the application of Good Manufacturing Practice (GMP) (with a weight of 0.287080) on the human resource criteria (with a weight of 0.63699) is a suitable alternative solution for the CP application of fruit chips production at PT Agrijaya Indotirta. Cleaner production can be performed by improving the capacity of human resources as production actors and regulators of proper waste management.
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Somadi, Somadi, and Indani Zulfah. "Analisis Human Error Pada Surat Penyerahan Petikemas (SP2) Dan Warehouse Management System (WMS)." Competitive 16, no. 1 (2021): 42–51. http://dx.doi.org/10.36618/competitive.v16i1.1175.
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PT. XYZ is a logistics service company engaged in the shipping service business of sea / air ships (EMKL / EMKU) and warehousing / warehousing. In the operational field of Full Container Load (FCL) at PT XYZ, there are problems, namely Human Error (Human Error) inputting data into the Container Handover Letter (SP2) and Warehouse Management System (WMS) documents. The purpose of this study was to determine the causative factors and to find out the right recommendations for improvement in the event of data input errors in the WMS system and data input errors in the manufacture of SP2. Data collection techniques, namely by observation and interviews. The analysis technique used fishbone diagrams and 5W + 1H analysis. Factors that cause Human Error are lack of training or trainning, the number of other tasks outside the job description, the absence of work shifts, the atmosphere is too busy by EMKL who takes care of documents, and the absence of an RFID Reader. To minimize the occurrence of Human Errors is to hold training and provide motivation so that employees can take part in training in operating the WMS system, socializing and providing additional benefits or money to employees, recruiting new employees at least divided into 2 team work shifts for the WMS operation section, adding service into two parts, will reduce EMKL queues and speed up document input to WMS, conduct socialization to use RFID.
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Helmig, Sara, Jonathan Burlison, Jennifer Morgan, and Carolyn Russo. "Structured handoff communication between affiliated health care sites." Journal of Clinical Oncology 37, no. 27_suppl (2019): 182. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.182.
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182 Background: The affiliate program at St. Jude Children’s Research Hospital (St. Jude) allows more children access to pediatric oncology care closer to the patient’s home. Currently 8 clinics, located throughout the Southeast and the Midwest, are affiliated with St. Jude and contribute 35% of patients enrolled in St. Jude clinical trials. Handoffs and transitions of care are common weak points in health care provider communication as patients move between sites. Failures in communication led to inefficiencies in care, patient dissatisfaction, and near-miss events. Ensuring that the information exchanged during the patient transition is efficient and complete will benefit patient safety and trust. With no consistent pattern of communication between St. Jude and affiliate clinics, we aimed to develop and implement a standardized communication tool to be used with each patient transition between different health care sites. Methods: Each team of providers (St. Jude and affiliate clinics) created individual flow diagrams to define the current state of communication when patients were transitioning between remote sites. Using fishbone diagrams each team identified the barriers to effective communication. Common barriers were incomplete communication and synthesis by the receiver. Results: We developed a communication bundle. Using IPASS methodology (a communication bundle developed for inpatient handoffs between resident physicians) we designed a standardized mnemonic, SMART (S-summary of plan; M-medications/roadmap; A-action plan; R-return visit date; T-transfer confirmation) for a patient transition between different health care sites. The communication bundle was transmitted by secure email. The time to send or receive the communication bundle was < 10 minutes. We measured % usage of the completed tool prior to transition, staff satisfaction, and number of errors. The SMART bundle was used 80% of the time and improved staff satisfaction. No errors have been identified. Conclusions: Closed loop, high-reliability communication can be accomplished between geographically remote health care sites using a standardized communication tool, which is transmitted electronically.
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Kumar Arya, Amit, and Sanjiv Kumar Jain. "Impacts of Kaizen in a small-scale industry of India: a case study." International Journal of Lean Six Sigma 5, no. 1 (2014): 22–44. http://dx.doi.org/10.1108/ijlss-03-2013-0019.
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Purpose – A large number of small-scale industries have shown their existence in India, tough competition among them made the survival of small industries difficult. All facing problems like reduced production and poor quality. The case study presented in the paper deals with Kaizen implementation in a machine vice manufacturer company. Kaizen has tremendous impacts on the production techniques and lead times. Case study represented is to motivate practitioners for implementing Kaizen in small-scale industries of India. The paper aims to discuss these issues. Design/methodology/approach – The methodology applied to implement the Kaizen in Indian small-scale industry. Fishbone diagrams have been used to represent cause and effects. The result has been shown as savings in terms of money and time. Findings – Processing time has been reduced by 44.4 percent and an amount of Rs. 64,000 has been saved by recovering a total of 80 square feet working area. Improvements in the form of work flow have been achieved. Research limitations/implications – Value stream mapping can be integrated with Kaizen for more reduction in the product lead time. Practical implications – The paper will be worthily for practitioners and consultants for understanding Kaizen implementation in small-scale industry of India. Originality/value – The paper yields lots of values for practitioners to understand the impacts and significance of the Kaizen in small-scale industries of India. Also it bridges the gap between theory and practical of Kaizen implementation in small-scale industry of India.
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Philibert, Ingrid, Carl Patow, and Jim Cichon. "Incorporating Patient- and Family-Centered Care Into Resident Education: Approaches, Benefits, and Challenges." Journal of Graduate Medical Education 3, no. 2 (2011): 272–78. http://dx.doi.org/10.4300/jgme-03-02-34.
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Abstract Purpose A design conference with participants from accredited programs and institutions was used to explore how the principles of patient- and family-centered care (PFCC) can be implemented in settings where residents learn and participate in care, as well as identify barriers to PFCC and simple strategies for overcoming them. Approach In September 2009, the Accreditation Council for Graduate Medical Education (ACGME) held a conference with 74 participants representing a diverse range of educational settings and a group of expert presenters and facilitators. Small group sessions explored the status of PFCC in teaching settings, barriers that need to be overcome in some settings, simple approaches, and the value of a national program and ACGME support. Findings Participants shared information on the state of their PFCC initiatives, as well as barriers to implementing PFCC in the learning environment. These emerged in 6 areas: culture, the physical environment, people, time and other constraints, skills and capabilities, and teaching and assessment, as well as simple strategies to help overcome these barriers. Two Ishikawa (Fishbone) diagrams (one for barriers and one for simple strategies) make it possible to select strategies for overcoming particular barriers. Conclusions A group of participants with a diversity of approaches to incorporating PFCC into the learning environment agreed that respectful communication with patients/families needs to be learned, supported, and continuously demanded of residents. In addition, for PFCC to be sustainable, it has to be a fundamental expectation for resident learning and attainment of competence. Participants concurred that improving the environment for patients concurrently improves the environment for learners.
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Ummi Zakiyah, Iqbal Aidar Idrus. "IMPLEMENTASI KEBIJAKAN MAKASSAR TIDAK RANTASA PEMERINTAH KOTA MAKASSAR (Studi Analisa Teori Isikawa)." Indonesian Journal of Public Administration (IJPA) 3, no. 1 (2017): 70–86. http://dx.doi.org/10.52447/ijpa.v3i1.731.
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Abstract: Cleanliness a reflection for every individual in maintaining the health that is so important in everyday life. As we know that hygiene is a condition free of all impurities, diseases, etc., which can harm all aspects of every activity and behavior of the community environment. Makassar is one of the cities that is currently committed to making the city free of waste or Makassar slogan not slap. This study aims to determine the implementation of policy. To measure the implementation of Makassar policy does not rantasa research menggukana fishborn theory, The basic concept of a fishbone diagram is a fundamental problem placed on the right side of the diagram or on the head of the skeleton of the fishbone. Implementation is still lacking and the community must intervene also help the government in realizing makassar into a clean city where the community must menjada cleanliness of each environment, Activate gotong royong in every urban kelurahan - makassar district to be all involved in peogram work MTR or makassar not rantasa and the main cause for the implementation of the policy can run according to the desired where the matter of hygiene equipment that must be complete at setiak kelurahan located in Each district of Makassar city. Keywords: Cleanliness, Local Government, Policy Implementation Abstrak: Kebersihan sebuah cerminan bagi setiap individu dalam menjaga kesehatan yang begitu penting dalam kehidupan sehari-hari. seperti yang kita ketahui bahwa kebersihan merupakan suatu keadaan yang bebas dari segala kotoran, penyakit, dan lain lain, yang dapat merugikan segala aspek yang menyangkut setiap kegiatan dan perilaku lingkungan masyarakat. Makassar adalah salah satu kota yang saat ini sedang berkomitmen menjadikan kota makassar bebas sampah atau dengan slogan makassar tidak rantasa. penelitian ini bertujuan untuk mengetahui implementasi kebijakan. Untuk mengukur pelaksanaan kebijakan makassar tidak rantasa penelitian menggukana teori fishborn , konsep dasar dari diagram fishbone adalah permasalahan mendasar diletakkan pada bagian kanan dari diagram atau pada bagian kepala dari kerangka tulang ikannya. Implementasinya masih kurang dan masyarakat harus turun tangan juga membantu pemerintah dalam mewujudkan makassar menjadi kota bersih dimana masyarakat harus menjada kebersihan lingkungan masing – masing, aktifkan gotong royong di setiap kelurahan – kelurahan kota makassar tersebut agar semuat turut terlibat dalam peogram kerja MTR atau makassar tidak rantasa dan penyebab utama agar implementasi kebijakan tersebut bisa berjalan sesuai yang di inginkan di mana soal peralatan kebersihan yang harus lengkap di setiak kelurahan yang berada di masing-masing kecamatan kota makassar. Kata kunci: Kebersihan, Pemerintahan Daerah, Implementasi Kebijakan
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Aleem, Sohaib, William C. Torrey, Mathew S. Duncan, Shoshana J. Hort, and John N. Mecchella. "Depression screening optimization in an academic rural setting." International Journal of Health Care Quality Assurance 28, no. 7 (2015): 709–25. http://dx.doi.org/10.1108/ijhcqa-01-2015-0012.
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Purpose – Primary care plays a critical role in screening and management of depression. The purpose of this paper is to focus on leveraging the electronic health record (EHR) as well as work flow redesign to improve the efficiency and reliability of the process of depression screening in two adult primary care clinics of a rural academic institution in USA. Design/methodology/approach – The authors utilized various process improvement tools from lean six sigma methodology including project charter, swim lane process maps, critical to quality tree, process control charts, fishbone diagrams, frequency impact matrix, mistake proofing and monitoring plan in Define-Measure-Analyze-Improve-Control format. Interventions included change in depression screening tool, optimization of data entry in EHR. EHR data entry optimization; follow up of positive screen, staff training and EHR redesign. Findings – Depression screening rate for office-based primary care visits improved from 17.0 percent at baseline to 75.9 percent in the post-intervention control phase (p < 0.001). Follow up of positive depression screen with Patient History Questionnaire-9 data collection remained above 90 percent. Duplication of depression screening increased from 0.6 percent initially to 11.7 percent and then decreased to 4.7 percent after optimization of data entry by patients and flow staff. Research limitations/implications – Impact of interventions on clinical outcomes could not be evaluated. Originality/value – Successful implementation, sustainability and revision of a process improvement initiative to facilitate screening, follow up and management of depression in primary care requires accounting for voice of the process (performance metrics), system limitations and voice of the customer (staff and patients) to overcome various system, customer and human resource constraints.
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Suárez-Barraza, Manuel F., and Francisco G. Rodríguez-González. "Cornerstone root causes through the analysis of the Ishikawa diagram, is it possible to find them?" International Journal of Quality and Service Sciences 11, no. 2 (2019): 302–16. http://dx.doi.org/10.1108/ijqss-12-2017-0113.
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Purpose Some manufacturing and service organizations have made efforts to work on continuous improvement in the form of Kaizen, lean thinking, Six Sigma, etc. The elimination of problems and waste (MUDA for the Japanese) plays a fundamental role in the reduction of operational costs and quality rejections of finished products both internally in the organization and in the supply chain. Some of these efforts use quality control tools to remedy it. Kaoru Ishikawa proposes seven basic quality tools. In this group of quality tools is the cause-and-effect diagram (CED), also known as “The Fishbone” and “Ishikawa diagram”. Exploring this questioning can shed light on the first indications to ratify the arguments of Ishikawa and Deming, that the main problems of companies are found in their processes and perhaps, in a deep way, in some of these cornerstone root causes that have to do with the way organizations are managed. The purpose of this study is to investigate cornerstone root causes through the application of CEDs in 40 Mexican companies that began an effort to improve some of their organizational processes. Design/methodology/approach An exploratory qualitative study was conducted. As a research strategy, the case study method was applied. Using theoretical sampling, the Ishikawa diagrams of 40 companies were analyzed, and 24 semi-structured interviews in depth were conducted. Findings The results of this research confirm the main research question: Are there cornerstone root causes that give way to one or several problems or effects of problems in organizations regardless of their sector? In other words, there were at least seven typical patterns that show the first signs of cornerstones root causes in organizations. Research limitations/implications The method itself is a limitation; 40 case studies are not enough to generalize the results. In addition, the research was conducted only in a single Latin American country; in some cities of Mexico. However, 60 per cent of these companies are multinationals. Practical implications This paper is fundamental to delve into the cornerstones causes that give rise to the problems of organizations of the twenty-first century. The authors understand that these are the first indications, and that they cannot be considered a conclusion of these causes. However, this first theoretical sampling presents a first light on the subject. Originality/value The study contributes to the limited existing literature on total quality management and Kaizen in quality control tools and subsequently disseminates this information to provide impetus, guidance and support toward improving the problems of the organizations of twenty-first century.
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Suriyati, Suriyati. "Desain Perancangan E-Commerce Kain Tenun Lombok Desa Sukarara Lombok Tengah." To Maega | Jurnal Pengabdian Masyarakat 2, no. 2 (2019): 36. http://dx.doi.org/10.35914/tomaega.v2i2.241.
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Lombok is songket woven fabric which has embossed on cotton yarn, threads of silver or gold thread. Songket weaving craft that is learned by the women Sasak is a type of traditional weaving craft. Starting from the yarn manufacturing, dyeing, to the manufacture of woven fabrics, all done the old fashioned way. To make a yarn that will be used for weaving using natural materials, such as fiber pineapple, banana fiber, cotton, and bark. As for the dye, using natural dyes from ingredients that are also naturally anyway. To produce songket cloth of a width of 1.2 m and 2 m in length takes 2-4 weeks. Motif used in the manufacture of songket is a legacy handed down that are not allowed to diseberluaskan. It is said that the traditional songket motifs from village Lombok Sukarara reached more than 100 patterns. Nothing is recorded or drawn details, unless stored in the form of a master to learn generations to come. This study uses qualitative research aimed at understanding more deeply to a problem that is studied. This study investigates the problems in marketing and promoting traditional handicrafts woven Sasak by breaking factor in using fishbone diagrams. Woven Songket generated Lombok society is very unique, because here there is a meeting of western and eastern. Technically, the second meeting of the area led to the integration in other areas in Indonesia that did not exist. Along with the development, songket cloth or woven cloth Lombok has developed the idea, both in terms of the motive and the enrichment of the author, to give birth to works of Neat and very attractive to domestic and foreign tourists. Innovation targeted in this study is an application of e-commerce in helping to market, promote and manage sales songket online.
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Jacobs, Ryan, Marc Steven Hoffmann, Lori Ann Leslie, Lymesia W. Jackson, Alyssa G. Rieber, and Nishin Anil Bhadkamkar. "Reducing the time from diagnosis to treatment of patients with stage II/III rectal cancer at a large county hospital." Journal of Clinical Oncology 32, no. 30_suppl (2014): 141. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.141.
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141 Background: The treatment of stage II/III rectal cancer is complex and requires multidisciplinary collaboration. Delays in definitive treatment may increase morbidity and compromise outcomes. The goal was to reduce the time from pathologic diagnosis to initiation of treatment by 30% for patients with stage II/III rectal cancer at Lyndon B. Johnson General Hospital (LBJGH), which provides care to uninsured and underinsured patients in Harris County, TX. Methods: The charts of 32 patients with rectal cancer diagnosed between July 2012 and December 2013 were reviewed. Baseline data regarding diagnostic and treatment time points were collected. Potential areas for improvement were identified through analysis of the baseline data, affinity sorting, and fishbone diagrams. A multidisciplinary rectal cancer working group with all relevant administrative and subspecialty stakeholders was created to discuss potential interventions and implementation strategies. The project was approved by the MD Anderson Quality Improvement Assessment Board. Results: Twenty-four of the thirty-two patients reviewed had stage II/III rectal cancer and were eligible for multimodality therapy with curative intent. The median time from pathologic diagnosis to treatment initiation was 62 days. The referral process was identified as the greatest source of delays. The median times from diagnosis to medical oncology and radiation oncology referral were 15 and 32 days, respectively. The median time for eligibility verification and clinical review by Case Management was 13 days. Conclusions: Based on these findings, two primary interventions have been instituted: (1) A synchronized referral process that will result in simultaneous consultation of all involved subspecialty services (surgery, medical oncology, and radiation oncology) was created for patients with rectal cancer; (2) Redundancy in the clinical review process was eliminated by coordination between Case Management and the Medical Oncology Chief Fellow. In tandem, these interventions are projected to reduce the time from diagnosis to treatment by approximately 50% (from 62 to 29 days).
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Solis-Hernandez, Maria Pilar, Luka Mihic Góngora, Debora Corina Contreras Toledo, et al. "Optimizing the febrile neutropenia care process in cancer patients in a third level Spanish hospital." Journal of Clinical Oncology 38, no. 15_suppl (2020): e14034-e14034. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e14034.
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e14034 Background: Cancer patients under cytotoxic treatment with fever used to have an average time of antibiotics administration of 11h (median 3h43min) when admitted and identified at the Emergency Room Service in the third level Central University Hospital of Asturias. International guidelines recommend antibiotic administration in the first hour: the so called “Golden Hour”. This delay implies an increase in patient morbidity as well as the cost of managing this complication. Methods: Data was collected from our electronic registry after proper authorization and corresponding anonymization. Pareto and fishbone diagrams were built to point out the possible causes and to stratify them in related subgroups. We measured: Number of visits to ER with fever and Number of inpatients with Febrile Neutropenia diagnosis, Time from the admission to antibiotic administration, Average stay of inpatients with Febrile Neutropenia diagnosis. A protocol associated to electronic tools and validated international scores was designed for patients at Febrile Neutropenia risk and launched on March 2019. Results: 66 patients were included since January 2018. Baseline data showed that the median time to antibiotics indication was 3h50min (average 4h38min) with a median delay of 18min to the administration (average 1h06min), a median of 3h54min (average 10h09min) time to antibiotic administration. When the protocol was activated, median time to antibiotic indication was 30min (average (1h08min) with a median 41min (average 40min) delay in administration, and a median of 1h30min (average 1h42min) time to antibiotic administration. Those with activation of the protocol had average length of stay of 1d13h40min vs. 5d11h18min in those to whom this protocol was not applied. Conclusions: A continuous evaluation effort and the design of appropriate protocols and interventions will increase the efficiency of the oncology patient care process with febrile neutropenia, by reducing unnecessary variability and costs.
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DeSai, Charisma, Keri Janowiak, Beatrice Secheli, et al. "Empowering patients: simplifying discharge instructions." BMJ Open Quality 10, no. 3 (2021): e001419. http://dx.doi.org/10.1136/bmjoq-2021-001419.
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Patients who do not have enough information about their discharge plans have decreased treatment compliance, decreased patient safety, increased emergency department (ED) recidivism, and poor satisfaction. This project aimed to develop and implement a method to assess and improve patient understanding of treatment and discharge plan in the ED. The authors developed a questionnaire to assess patient knowledge using Centers for Medicare and Medicaid Services and Joint Commission recommendations, areas of communication deficits reported in other manuscripts, and ED staff and provider input. Responses from patient interviews were then scored against the medical record. Three trained scorers graded all responses, and inter-rater reliability was calculated using the kappa statistic.Baseline observations found that written discharge instructions were long and tedious, and important information was difficult to find. Based on initial patient scores, stakeholder interviews, and fishbone diagrams, the team developed a one-page simplified information page (SIP) targeted to inform patients their most relevant discharge instructions. Next, the SIP was tested on 118 patients to measure its effect on patient understanding. At the baseline study, no patients had complete understanding of their discharge instructions. The areas of lowest scores were medication instructions and indications to return to the ED. Implementation of the SIP resulted in statistically significant changes in score distribution across all questions assessed with the Wilcoxon signed-rank test. Interrater reliability between scorers was high (kappa=0.84). We incorporated the concept of the SIP to the cover page of our standard discharge instructions.Healthcare providers often spend valuable time educating their patients, and it is important to assess the effectiveness of this teaching to identify areas in which we may improve health literacy and patient understanding. This project has shown that a simple, easy-to-read, concise page developed with patient input significantly improved ED discharge instruction knowledge.
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Sharma, K. Aparna, Anshu Yadav, Chithira Sridhar, Neena Malhotra, Siby Biji, and Kusum Kumari. "Reducing the waiting time to initiation of infertility treatment at a tertiary care centre in India." BMJ Open Quality 9, no. 4 (2020): e000975. http://dx.doi.org/10.1136/bmjoq-2020-000975.
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BackgroundIn a low-resource and high-volume setting, it is often felt that patient care cannot be improved within the limitations of existing infrastructure and resources. However, the use of a systematic problem-solving method can bring about significant improvement even in these settings.AimTo decrease the mean waiting time from first visit to initiation of infertility treatment by 70% within 4 weeks (1–30 June 2019) for patients coming to the gynaecological outpatient department (OPD).MethodsWe constructed a multidisciplinary quality improvement team consisting of an academic consultant, a senior resident physician, a junior resident physician and a nurse to address the problem of long waiting times to initiation of fertility treatment. We collected baseline data from 10 consecutive women presenting to gynaecological OPD with complaints of infertility by calculating the time between their first visit to the facility and the day of performance of hysterosalpingography (HSG). The average waiting time was found to be 6 months and 25 days (mean=6.85 months; 3.5–10 months). The team used process flow diagrams and fishbone analysis to identify various causes of these long waiting times. The main reason for the delay in starting infertility treatment was that the date for HSG was given only after seeing the endometrial aspiration report (ie, after ruling out endometrial tuberculosis as there is a risk of dissemination of tuberculosis during HSG). Also, HSG was done only once a week during a short 2-hour slot in the fluoroscopy room.ResultsAfter the implementation of change ideas, there was significant reduction in the waiting period to starting treatment in patients with infertility. After the first change idea, the average waiting period seen in 10 consecutive patients with infertility reduced to 3.25 months, that is, by 51.8% from baseline within a 2-week interval, and there is shift in the run chart diagram. After the second change idea, the waiting time reduced to 2 months, that is, by 70%, seen in the next 10 consecutive patients with infertility within the next 2 weeks’ time. The results were sustained to the average waiting time of 2 months for 6 months without any additional resources.ConclusionWith a well-organised and conducted quality improvement project and team efforts, the required changes can be brought about in an established conventional healthcare delivery system and improvements can be sustained over a long period of time.
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Coccia, Mario. "Fishbone diagram for technological analysis and foresight." International Journal of Foresight and Innovation Policy 14, no. 2/3/4 (2020): 225. http://dx.doi.org/10.1504/ijfip.2020.10033239.
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Coccia, Mario. "Fishbone diagram for technological analysis and foresight." International Journal of Foresight and Innovation Policy 14, no. 2/3/4 (2020): 225. http://dx.doi.org/10.1504/ijfip.2020.111221.
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