A comparative study of hospital management in Great Britain and Brazil : cost information use

In Great Britain and Brazil healthcare is free at the point of delivery and based study only on citizenship. However, the British NHS is fifty-five years old and has undergone extensive reforms. The Brazilian SUS is barely fifteen years old. This research investigated the middle management mediation role within hospitals comparing managerial planning and control using cost information in Great Britain and Brazil. This investigation was conducted in two stages entailing quantitative and qualitative techniques. The first stage was a survey involving managers of 26 NHS Trusts in Great Britain and 22 public hospitals in Brazil. The second stage consisted of interviews, 10 in Great Britain and 22 in Brazil, conducted in four selected hospitals, two in each country. This research builds on the literature by investigating the interaction of contingency theory and modes of governance in a cross-national study in terms of public hospitals. It further builds on the existing literature by measuring managerial dimensions related to cost information usefulness. The project unveils the practice involved in planning and control processes. It highlights important elements such as the use of predictive models and uncertainty reduction when planning. It uncovers the different mechanisms employed on control processes. It also depicts that planning and control within British hospitals are structured procedures and guided by overall goals. In contrast, planning and control processes in Brazilian hospitals are accidental, involving more ad hoc actions and a profusion of goals. The clinicians in British hospitals have been integrated into the management hierarchy. Their use of cost information in planning and control processes reflects this integration. However, in Brazil, clinicians have been shown to operate more independently and make little use of cost information but the potential signalled for cost information use is seen to be even greater than that of their British counterparts.

A multivariate examination of the relationship between strategic planning and organisational performance

Strategic planning and more specifically, the impact of strategic planning on organisational performance has been the subject of significant academic interest since the early 1970's. However, despite the significant amount of previous work examining the relationship between strategic planning and organisational performance, a comprehensive literature review identified a number of areas where contributions to the domain of study could be made. In overview, the main areas for further study identified from the literature review were a) a further examination of both the dimensionality and conceptualisation of strategic planning and organisational performance and b) a further, multivariate, examination of the relationship between strategic planning and performance, to capture the newly identified dimensionality. In addition to the previously identified strategic planning and organisational performance constructs, a comprehensive literature based assessment was undertaken and five main areas were identified for further examination, these were a) organisational b) comprehensive strategic choice, c) the quality of strategic options generated, d) political behavior and e) implementation success. From this, a conceptual model incorporating a set of hypotheses to be tested was formulated. In order to test the conceptual model specified and also the stated hypotheses, data gathering was undertaken. The quantitative phase of the research involved a mail survey of senior managers in medium to large UK based organisations, of which a total of 366 fully useable responses were received. Following rigorous individual construct validity and reliability testing, the complete conceptual model was tested using latent variable path analysis. The results for the individual hypotheses and also the complete conceptual model were most encouraging. The findings, theoretical and managerial implications, limitations and directions for future research are discussed.

Aspects of the design and control of manufacturing systems subject to demand uncertainty

The recent explosive growth in advanced manufacturing technology (AMT) and continued development of sophisticated information technologies (IT) is expected to have a profound effect on the way we design and operate manufacturing businesses. Furthermore, the escalating capital requirements associated with these developments have significantly increased the level of risk associated with initial design, ongoing development and operation. This dissertation has examined the integration of two key sub-elements of the Computer Integrated Manufacturing (CIM) system, namely the manufacturing facility and the production control system. This research has concentrated on the interactions between production control (MRP) and an AMT based production facility. The disappointing performance of such systems has been discussed in the context of a number of potential technological and performance incompatibilities between these two elements. It was argued that the design and selection of operating policies for both is the key to successful integration. Furthermore, policy decisions are shown to play an important role in matching the performance of the total system to the demands of the marketplace. It is demonstrated that a holistic approach to policy design must be adopted if successful integration is to be achieved. It is shown that the complexity of the issues resulting from such an approach required the formulation of a structured design methodology. Such a methodology was subsequently developed and discussed. This combined a first principles approach to the behaviour of system elements with the specification of a detailed holistic model for use in the policy design environment. The methodology aimed to make full use of the `low inertia' characteristics of AMT, whilst adopting a JIT configuration of MRP and re-coupling the total system to the market demands. This dissertation discussed the application of the methodology to an industrial case study and the subsequent design of operational policies. Consequently a novel approach to production control resulted. A central feature of which was a move toward reduced manual intervention in the MRP processing and scheduling logic with increased human involvement and motivation in the management of work-flow on the shopfloor. Experimental results indicated that significant performance advantages would result from the adoption of the recommended policy set.

Computerised control of cellular manufacturing systems

This thesis reviews the existing manufacturing control techniques and identifies their practical drawbacks when applied in a high variety, low and medium volume environment. It advocates that the significant drawbacks inherent in such systems, could impair their applications under such manufacturing environment. The key weaknesses identified in the system were: capacity insensitive nature of Material Requirements Planning (MRP); the centralised approach to planning and control applied in Manufacturing Resources Planning (MRP IT); the fact that Kanban can only be used in repetitive environments; Optimised Productivity Techniques's (OPT) inability to deal with transient bottlenecks, etc. On the other hand, cellular systems offer advantages in simplifying the control problems of manufacturing and the thesis reviews systems designed for cellular manufacturing including Distributed Manufacturing Resources Planning (DMRP) and Flexible Manufacturing System (FMS) controllers. It advocates that a newly developed cellular manufacturing control methodology, which is fully automatic, capacity sensitive and responsive, has the potential to resolve the core manufacturing control problems discussed above. It's development is envisaged within the framework of a DMRP environment, in which each cell is provided with its own MRP II system and decision making capability. It is a cellular based closed loop control system, which revolves on single level Bill-Of-Materials (BOM) structure and hence provides better linkage between shop level scheduling activities and relevant entries in the MPS. This provides a better prospect of undertaking rapid response to changes in the status of manufacturing resources and incoming enquiries. Moreover, it also permits automatic evaluation of capacity and due date constraints and hence facilitates the automation of MPS within such system. A prototype cellular manufacturing control model, was developed to demonstrate the underlying principles and operational logic of the cellular manufacturing control methodology, based on the above concept. This was shown to offer significant advantages from the prospective of operational planning and control. Results of relevant tests proved that the model is capable of producing reasonable due date and undertake automation of MPS. The overall performance of the model proved satisfactory and acceptable.

Planning and implementing safety management systems

This thesis describes a study of the content and applicability of BS8800:1996 Guide to occupational health and safety management systems. The research is presented chronologically, with literature review and content analysis of SMS related guides and standards interwoven with two elements of qualitative empirical work. The first of these was carried out shortly after publication of BS8800 in 1996, a 'before-the-event' investigation of how organisations were intending to approach SMS implementation. The challenges faced by these organisations are reviewed against standard management theory, suggesting that the initial motivation for SMS implementation governs the approach organisations will adopt to guidance such as BS8800. The second phase of empirical work was undertaken in the context of OHSAS 18001, an auditable protocol based on BS8800, which allows organisations to certify their safety management systems. A discussion of the evolution of certifiable safety management system is presented, highlighting the similarities and differences between this, BS8800, SMS and wider management system standards. A case study then reviews the experiences of a catering company that implemented 18001, motivated by the opportunity for certification as a business benefit. The empirical work is used to comment on the guidance provided by BS8800, within its evolved role as guidance organisations may use for implementation of a SMS to be certified according to the specifications of OHSAS 18001. It is suggested that optimal implementation is facilitated by initial status review, continual improvement and the use of annexes, where there are used to make changes to the existing safety management system. This thesis concludes with a discussion of these elements, highlighting pertinent areas within BS8800 where revision or amendment may be appropriate.

Computer integrated manufacturing control

Many manufacturing companies have long endured the problems associated with the presence of `islands of automation'. Due to rapid computerisation, `islands' such as Computer-Aided Design (CAD), Computer-Aided Manufacturing (CAM), Flexible Manufacturing Systems (FMS) and Material Requirement Planning (MRP), have emerged, and with a lack of co-ordination, often lead to inefficient performance of the overall system. The main objective of Computer-Integrated Manufacturing (CIM) technology is to form a cohesive network between these islands. Unfortunately, a commonly used approach - the centralised system approach, has imposed major technical constraints and design complication on development strategies. As a consequence, small companies have experienced difficulties in participating in CIM technology. The research described in this thesis has aimed to examine alternative approaches to CIM system design. Through research and experimentation, the cellular system approach, which has existed in the form of manufacturing layouts, has been found to simplify the complexity of an integrated manufacturing system, leading to better control and far higher system flexibility. Based on the cellular principle, some central management functions have also been distributed to smaller cells within the system. This concept is known, specifically, as distributed planning and control. Through the development of an embryo cellular CIM system, the influence of both the cellular principle and the distribution methodology have been evaluated. Based on the evidence obtained, it has been concluded that distributed planning and control methodology can greatly enhance cellular features within an integrated system. Both the cellular system approach and the distributed control concept will therefore make significant contributions to the design of future CIM systems, particularly systems designed with respect to small company requirements.

Public ownership and control in the private sector

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The planning and management of health for development:a model for Zimbabwe

In this thesis, I view the historical background of Zimbabwe to show the patterns of traditional life that existed prior to settlerism. The form, nature, pace and impact of settlerism and colonialism up to the time of independence are also discussed to show how they affected the health of the population and the pace of development of the country. The political, social and economic underdevelopment of the African people that occurred in Zimbabwe prior to independence was a result of deliberate, politically motivated and controlled policy initiatives. These led to inequatable, inadequate, inappropriate and inaccessible health care provision. It is submitted that since it was the politics that determined the pace of underdevelopment, it must be the politics that must be at the forefront of the development strategy adopted. In the face of the amed conflict that existed in Zimbabwe, existing frameworks of analyses are shown to be inadequate for planning purposes because of their inability to provide indications about the stability of future outcomes. The Metagame technique of analysis of options is proposed as a methology that can be applied in such situations. It rejects deterministic predicative models as misleading and advocates an interactive model based on objective and subjective valuation of human behaviour. In conclusion, the search for stable outcomes rather than optimal and best solutions strategies is advocated in decision making in organisations of all sizes.

Design, implementation and control of a small industrial manufacturing system

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A combination of cyclone and vert techniques for the management of construction projects

Many planning and control tools, especially network analysis, have been developed in the last four decades. The majority of them were created in military organization to solve the problem of planning and controlling research and development projects. The original version of the network model (i.e. C.P.M/PERT) was transplanted to the construction industry without the consideration of the special nature and environment of construction projects. It suited the purpose of setting up targets and defining objectives, but it failed in satisfying the requirement of detailed planning and control at the site level. Several analytical and heuristic rules based methods were designed and combined with the structure of C.P.M. to eliminate its deficiencies. None of them provides a complete solution to the problem of resource, time and cost control. VERT was designed to deal with new ventures. It is suitable for project evaluation at the development stage. CYCLONE, on the other hand, is concerned with the design and micro-analysis of the production process. This work introduces an extensive critical review of the available planning techniques and addresses the problem of planning for site operation and control. Based on the outline of the nature of site control, this research developed a simulation based network model which combines part of the logics of both VERT and CYCLONE. Several new nodes were designed to model the availability and flow of resources, the overhead and operating cost and special nodes for evaluating time and cost. A large software package is written to handle the input, the simulation process and the output of the model. This package is designed to be used on any microcomputer using MS-DOS operating system. Data from real life projects were used to demonstrate the capability of the technique. Finally, a set of conclusions are drawn regarding the features and limitations of the proposed model, and recommendations for future work are outlined at the end of this thesis.

The planning and market scope for a hydroponic turnkey operation

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