Solution for HW 7 3. See flowchart, below, for the summary of the process.

The most serious problem from the standpoint of customer service is the potential for a 12-hour delay before an order reaches the supervisor for error checking, and another 3-4 hours may be required before entry into the computer. Obviously too much checking and handling of the order occurred, and much of it was many hours after the customer and order information had originally been taken. Suggestions for improvement include: a) processing small batches of orders (perhaps within 1-2 hours, or less); b) building in error checking, perhaps through direct entry of telephone orders into the computer; c) processing information needed for customer verification and setup of new accounts at the time the order is taken; d) having the phone department supervisor simply audit or sample orders for errors; e) developing a computerized method of matching orders and invoices, so that manual verification is not required; generating an exceptions report after step (e), with proofreading required for printing information that cannot be computerized, if order verification and proofreading is a vital step.

8.

The scatter diagram below (see spreadsheet Prob13-08) shows the packing time for a standard size package is lowest for the first group of 20 packers, who average 13.85 minutes, although Packers #20 and 21 are considerably higher than the lower time group members. The packing time for a standard size package is higher for the second group of 20 packers, who average 19.25 minutes, which is considerably longer. This suggests that some workers are able to perform the task much faster than the norm (mean of 16.55). If the output quality is the same for the faster group, as well as the slower one, then the production coordinator should attempt to find the root cause, by observing the methods of both groups, as well as testing to see if there are any significant differences in

abilities between the group members. If the methods used by the first group can be taught to the slower group members, this could increase productivity, reduce cost, and perhaps even improve quality, simultaneously.

Tim by Packer e
25 20
Minutes

15 10 5 0 1 4 7

T es im M ean

10

16

22

28

13

19

25

31

34

37

Packer Num ber

9.

The scatter diagram (see spreadsheet Prob13-09.xls for details) for the AcmeWidget process, shows an interesting, and counter-intuitive result. As the production rate increases, the defect rate decreases. This could be because of the "learning curve" effect in that as operators become more skilled and familiar with the process and production runs are longer, the defect rate can be improved.

40

Production Rate vs. Defects

25 20 Defects 15 Defects 10 5 0 0 5 10 Production Rate 15 20

11.

For the Hensley automobile dealership problem, a comprehensive analysis is required. Chase and Stewart point out that ...poke-yokes are either warnings that signal the existence of a problem or controls that stop production until the problem is resolved. The authors provide an interesting classification of the type of poke-yokes that are relevant in services. These are included here, with an example, rather than trying to provide an exhaustive list of those for Rick Hensleys automobile dealerships service. However see the Figure 13.27, and the Sloan Management Review article for a more detailed listing of process steps and examples. Classification of Errors Task Treatment Tangible Preparation Encounter Resolution Poka Yoke Fix Examples

Color-coded tags on vehicle roof to identify service order / advisor Smile, greeting with, Hello, Ms. Smith. Welcome to Hensley. Clean uniforms; waiting areas clean, with rugs, fresh coffee Appointment reminder calls; customer to bring warranty paperwork Staple correct (legible) copy (not companys copy) of credit card receipt to customers bill Customer satisfaction card given to customer when keys returned

12.

The medication administration process offers numerous possibilities for error at every step. The physician may not write legibly (probably the most frequent source of physician error), or even specify the wrong drug or dosage. The secretary may not transcribe the order correctly. The reviewing nurse may approve an order that is not correct. The pharmacist may not read or interpret the prescription correctly, or may mix up orders.

And the attending nurse may give the wrong medication, or the wrong amount, to the patient. A Medication Error Committee at one hospital identified the highest ranked problems that were deemed to be the most critical in causing severe errors as follows: Having lethal drugs available on floor stocks. Mistakes in math when calculating doses. Doses or flow rates calculated incorrectly. Not checking armbands (patient identity) before drug administration. Excessive drugs in nursing floor stock.

To reduce possible critical errors at the point of medication, these poka-yokes could be applied: Remove lethal and excessive drugs from floor stock. Standardize infusion rates and develop an infusion handbook Educate nurses to double-check rates, protocols, and doses

14.

From the Pareto diagram, below (and spreadsheet Prob13-14.xls), we can conclude that 55% of the problems are with long delays and another 25.2% are due to shipping errors, for a total in the top two categories of 80.2 %. These categories should be improved first. DOT.COM APPAREL HOUSE QUALITY ERRORS & PERCENTAGES Percent Long delays Shipping errors Delivery errors Electronic charge errors Billing errors Total 54.98% 25.18% 7.69% 6.65% 5.50% Cumulative % 54.98% 80.16% 87.85% 94.50% 100.00% Frequency 5372 2460 752 650 537 9771

Percent

Pareto Chart for Dot.Com Apparel House

60.00%

Cumulative %

120.00%

50.00%

100.00%

Percent Within Defect Category

40.00%

80.00% Cumulative Percent

30.00%

60.00%

20.00%

40.00%

10.00%

20.00%

0.00% Long delays Shipping errors Delivery Electronic Billing errors errors charge errors

0.00%

Defect Categories

III. Janson Medical Clinic1 Analysis of the patient complaint data reveals that the three top complaint categories are wait for doctor, ease of appointment, and ease of phoning. All three of these are complicated to handle because of the nature of the business. It does appear that the telephone process is overly complex. The lack of empowerment of receptionists appears to be part of the problem. In addition there seems to be little telephone automation and no easy way of handling routine calls. This might be improved by providing routine phone options, such as ask about appointment date, ask about making an appointment, and billing questions. See Pareto charts, cause-effect diagram, and flowcharts, below. Also see spreadsheet C13JansonCase for more details. 1.
1

The data, for the Pareto Diagram, in order, from highest complaint level to lowest are:

Appreciation is expressed to Lisa Ann Janson, one of Prof. Evans students, who performed the study from which this case is adapted.

Wait for doctor 13 Ease of appointment 12 Ease of phoning 10 Convenient hours 7 Courtesy of receptionist 7 Friendliness of phone receptionist 7 Responsive care via phone 5 Comfortable waiting 4 Physician listens 3 Respectful physician 2 Explanation of condition/treatment 2 Confidence in physicians ability 1 Time to register 1 Respect of nurses 0 Wait for doctor Ease of appointment Ease of phoning Convenient hours Courtesy of receptionist Friendliness of phone receptionist Responsive care via phone Comfortable waiting Physician listens Respectful physician Explanation of condition/treatment Confidence in physicians ability Time to register Respect of nurses 13 12 10 7 7 5 5 4 3 2 2 1 1 0

Number of Responses

10

12

14

Pareto Chart - Dissatisfied Patients

Reasons
to Re re sp gis ec te to r fn ur se s Ti m e

W ait Ea fo rd se oc of to ap r po int Ea m se en t of ph Co on Fr nv Co ing ie en ur nd ien te lin sy th es ou of s of rs re ce ph Re pt on ion sp e ist on re ce siv pt e ion ca ist re vi Co a m ph fo on rta e ble wa Ph itin Ex ys g pla ici Re an na sp lis tio ec te n tfu ns of lp co hy nd si itio cia n/ n tre at m en t

Series1

1.

For the top three sources of patient dissatisfaction, the following C-E diagram shows some possible causes. Note that the answering method is closely related to the difficulty that patients experience in quickly and easily obtaining appointments. TELEPHONE ANSWERING METHOD

TELEPHONE EQUIPMENT

Lack of receptionist empowerment Number of phone lines Number of receptionists Lack of telephone automation Routine call handling same as emergencies Inability to reach busy secretaries Lack of refreshments in waiting area Lengthy checkin process No information on length of wait No TV in waiting area WAITING Excessive waiting times Magazines out of date or unappealing
Patient dissatisfaction

Below are flowcharts that address some of the problems being experienced with the current call answering and check-in process at the clinic.

Proposed Patient Registration Process

Patient signs in

Receptionist offers to validate parking ticket

Receptionist finds proper encounter form with chart

Copy of insurance card made, if required Signature taken, if needed

Information input into computer

Papers embedded in chart form

Chart w/ encounter form placed into inbasket

Receptionist determines if any information is needed from patient based on chart information

Co-payment collected, if needed

Receptionist pages nurse

If nothing more is needed, patient takes a seat

Nurse gets chart and calls patient