Impacts of concurrency, iteration, design review, and problem complexity on design project lead time and error generation

A case study of an aircraft engine manufacturer is used to analyze the effects of management levers on the lead time and design errors generated in an iteration-intensive concurrent engineering process. The levers considered are amount of design-space exploration iteration, degree of process concurrency, and timing of design reviews. Simulation is used to show how the ideal combination of these levers can vary with changes in design problem complexity, which can increase, for instance, when novel technology is incorporated in a design. Results confirm that it is important to consider multiple iteration-influencing factors and their interdependencies to understand concurrent processes, because the factors can interact with confounding effects. The article also demonstrates a new approach to derive a system dynamics model from a process task network. The new approach could be applied to analyze other concurrent engineering scenarios. © The Author(s) 2012.

Physicians in leadership: the association between medical director involvement and staff-to-patient ratios

In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.