Facets of operational performance in an emergency room (ER)

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's operational performance in general and the trade-offs in flow times, inventory levels (that is the number of patients waiting in the system), and resource utilization; (3) the impacts of potential process and staffing changes to improve the ER's performance. Specifically, the paper discusses four proposals for streamlining the patient flow: establishing designated tracks (fast track, diagnostic track), creating a holding area for certain type of patients, introducing a protocol that would reduce the load on physicians by allowing a registered nurse to order testing and treatment for some patients, and potentially and in the longer term, moving from non-ER specialist physicians to ER specialists. The paper's findings are based on analyzing the paths and flow times of close to two thousand patients in the emergency room of the Medical Center of Leeuwarden (MCL), The Netherlands. Using exploratory data analysis the paper presents generalizable findings about the impacts of various factors on ER's lead-time performance and shows how the proposals fit with well-documented process improvement theories. © 2010 Elsevier B.V. All rights reserved.

Ellátási lánc kapcsolatok modellezése = Modeling of supply chain relationships

A dolgozatban az ellátási láncokban meglévő diadikus kapcsolatok minőségét állítjuk a vizsgálatok középpontjába. Az irodalomban számtalan megközelítés ismert az ellátási lánc kapcsolatok fejlődésének leírására. Ezen fejlődési elméletek inkább elméleti szinten írják le a diadikus kapcsolatok változását, annak empirikus tesztelhetőségét nem vizsgálják. Dolgozatunkban kísérletet teszünk az ellátási lánc kapcsolatok fejlődésének empirikus vizsgálatára. Arra próbálunk választ találni, hogy az életciklus hipotézis az üzleti kapcsolatok időbeli fejlődésére alkalmazható-e. = Our paper combines two approaches using data of an internet based questionnaire and applying quantitative analysis it tests the hypothesis business relationship development in time can be described with the concept of life cycle. The concept of life cycle is widely used in business research. Among others the diffusion of innovation is described using this concept, or the concept of product life cycle just to name a few. All of these researches analyze the life cycle along a specific variable (for example the volume of sales or revenue in case of the product life cycle) which (except the last stage of the cycle, the decline) has a cumulative character resulting in the widely known specific shape of a life cycle. Consequently testing a life cycle hypothesis inevitably means the acceptance of some type cumulativity in the development.

Optimizing Supply Chain Performance in China with Country-Specific Supply Chain Coordination

The implementation of country-specific supply chain coordination techniques ensures an optimal global supply chain performance. This paper looks at success factors going with a supply chain coordination strategy within the global supply chain of a successful, medium-sized, privately-owned company, one having locations in North America (USA), Europe (Hungary) and Asia (China). Through the shown GSL’s Chinese plant, we will endeavor to argue that increased collaboration in the supply network with appropriate supply chain coordination brings down not only the inventory level but can also improve conformance quality and reduce quoted lead times.

Cross-country and inter-temporal analysis of Supply Chain Integration (SCI): China, Hungary and the Netherlands - changes in SCI from 1996 to 2008

Using plant level data from a global survey with multiple time frames, one begun in the late 1990s, this paper introduces measures of supply chain integration and discusses the dynamic relationship between the level of integration and a set of internal and external performance measurements. Specifically, data from Hungary, The Netherlands and The People’s Republic of China are used in the analyses. The time frames considered range from the late 1990s till 2009, encompassing major changes and transitions. Our results seem to indicate that SCI has an underlying structure of four sets of indicators, namely: (1) delivery frequency from the supplier or to the customer; (2) sharing internal processes with suppliers; (3) sharing internal processes with buyers and (4) joint facility location with partners. The differences between groups in terms of several performance measures proved to be small, being mostly statistically insignificant - but looking at the ANOVA table we can conclude that in this sample of companies those having joint location with their partners seem to outperform others.