Care delivery value chains for ophthalmic clinics in Switzerland

Perceived patient value is often not aligned with the emerging expenses for health care services. In other words, the costs are often supposed as rising faster than the actual value for the patients. This fact is causing major concerns to governments, health plans, and individuals. Attempts to solve the problem have habitually been on the operational effectiveness side: increasing patient volume, minimizing costs, rationing, or closing hospitals, usually resulting in a zero-sum game. Only few approaches come from the strategic positioning side and "competition" among hospitals is still perceived rather as a danger than as a chance to create a positive-sum game and stimulate patient value. In their 2006 book, "Redefining Health Care", the renowned Harvard strategy professor Michael E. Porter and hospital management expert Professor Elizabeth Olmsted Teisberg approach the challenge from the positive-sum perspective: they propose to form Integrated Practice Units (IPUs) and manage hospitals in a modern, patient value oriented way. They argue that creating value-based competition on results should have the same effect on the health care sector like transparency and competition turned other industries with out-dated management models (like recently the inert telecommunication industry) into highly competitive and customer value creating businesses. The objective of this paper is to elaborate Care Delivery Value Chains for Integrated Practice Units in ophthalmic clinics and gather a first feedback from Swiss hospital managers, ophthalmologists, and patients, if such an approach could be a realistic way to improve health care management. First, Porter's definition of competitiveness (distinction between operational effectiveness and strategic positioning) is explained. Then, the Care Delivery Value Chain is introduced as a key element for understanding value-based management, followed by three practice examples for ophthalmic clinics. Finally, recommendations are given how the Care Delivery Value Chain can be managed efficiently and how the obstacles of becoming a patient-oriented organization can be overcome. The conclusion is that increased transparency and value-based competition on results has the potential to change the mindset of hospital managers-which will align patient value with the emerging health care expenses. Early adapters of this management approach will gain a competitive advantage. [Author, p. 6]

Purchasing and supply management capabilities in Finnish medium-sized enterprises

Purchasing and supply management (PSM) has become increasingly important for companies to survive in current highly competitive market. Increased outsourcing has extended the role of PSM, making external resource management and supplier relationships critical success factors in business. However, the recent research has mainly concentrated on large enterprises. Therefore the PSM issues related to medium-sized enterprises represent a significant research area. The thesis aims to explore the status and role of PSM in Finnish medium-sized firms, understand how strategic companies consider PSM to be, clarify what are the competence requirements for PSM professionals, and increase the understanding of PSM capabilities needed from the points view of individual competence and organisational capabilities. The study uses data that was collected in 2007 from purchasing executives at the director/CEO level representing a sample of 94 Finnish firms. 54 % of the respondent enterprises had a supply strategy. The total supply cost was on average 60 % of firms' turnover. Centralisation of PSM and outsourcing of logistics will increase in Finnish medium-sized enterprises. The findings point out that Finnish medium-sized enterprises had strategical features of PSM. However, Finnish firms have not concentrated on making strategies that relate to PSM. The elements that explain the existence of a supply strategy could be found in this study. It can be concluded from this study that there is an advantageous base for the development of strategic PSM, because nearly all the enterprises were of the opinion that PSM capabilities have an effect on business success. When reviewing the organisational capabilities, the five most important development elements were supplier relationships, both operational and strategic processes, time management, and personnel's competence. Training in internationalisation, strategic management, and communication could help to improve competences of PSM personnel.

IEA Bioenergy Task 40 “Sustainable International Bioenergy Trade: Securing supply and demand” Country report of Finland 2008

This study considered the current situation of biofuels markets in Finland. The fact that industry consumes more than half of the total primary energy, widely applied combined heat and power production and a high share of solid biomass fuels in the total energy consumption are specific to the Finnish energy system. Wood is the most important source of bioenergy in Finland, representing 21% of the total energy consumption in 2006. Almost 80% of the wood-based energy is recovered from industrial by-products and residues. Finland has commitment itself to maintaining its greenhouse gas emissions at the 1990 level, at the highest, during the period 2008–2012. The energy and climate policy carried out in recent years has been based on the National Energy and Climate introduced in 2005. The Finnish energy policy aims to achieve the target, and a variety of measures are taken to promote the use of renewable energy sources and especially wood fuels. In 2007, the government started to prepare a new long-term (up to the year 2050) climate and energy strategy that will meet EU’s new targets for the reduction of green house gas emissions and the promotion of renewable energy sources. The new strategy will be introduced during 2008. The international biofuels trade has a substantial importance for the utilisation of bioenergy in Finland. In 2006, the total international trading of solid and liquid biofuels was approximately 64 PJ of which import was 61 PJ. Most of the import is indirect and takes place within the forest industry’s raw wood imports. In 2006, as much as 24% of wood energy was based on foreignorigin wood. Wood pellets and tall oil form the majority of export streams of biofuels. The indirect import of wood fuels increased almost 10% in 2004–2006, while the direct trade of solid and liquid biofuels has been almost constant.

Improving the effectiveness of supply chain development work – an expert role perspective

This study focuses to the intersection of three sets of activities in a company: expert work, development work and supply chain management, SCM. Experts and expert work represent a set of individuals whose efficiency and impact this study is intended to improve, while development work defines the set of organizational activities to focus on. SCM as an expertise area acts as the platform on which this study is built. The study has two aims. Firstly, it aims to derive a model helping an SCM expert to increase the effectiveness of expert work in development tasks by understanding the encountered organizational situations and processes better, reflecting his/her past and future actions to organizational processes and selecting and adjusting the processes and contents of his/her work accordingly. Secondly, it aims to develop applicable approaches and methods to understand, evaluate and manage the organizational processes and situations in development work. The integrative model on approaches and methods to improve the effectiveness of development processes is split to two aggregate dimensions: technical performance of the developed solution and consumption of resources of the development process. Six potential approaches and methods aiming at helping in the management of organizational dimensions are presented in enclosed publications. The approaches focus on three subtasks of development work: decision making, implementation and change, and knowledge accumulation. The approaches and methods have been tested in case studies representing typical development processes in the area of supply chain management. As a result, four suggestions are presented. Firstly, SCM experts are advised to consider the SCM development work to be consisting of development processes. Secondly, inside these processes they should identify and evaluate the risk of difficult decision-making related to organizational factors. Thirdly, they are prompted for an active role in implementation and change, supporting the implementation through whole process. Finally, the development should be seen in a holistic view, taking into account the stage of knowledge and organizational issues related to it, and adopt a knowledge development strategy.

Contract manufacturing networks structure and supply chain management

The usual objectives that companies have for subcontracting are studied in this thesis. The case company’s objectives for contract manufacturing now and in the future are identified. The main objective of the thesis is to create a focused model for the structure and supply chain management in the contract manufacturing network. This model is made for case company’s certain profit center. The different possibilities and their advantages and disadvantages for the structure and supply chain management are examined trough a theoretical review of literature. The possibilities found are then examined from the case company’s point of view. The case company point of view is established based on the opinions of the case company’s representatives. The outcome of the thesis is that the star shaped structure with supply chain management centralized to case company would be the best choice for the case company to manage the contract manufacture network.

The influence of substratum type and nutrient supply on biofilm organic matter utilization in streams

We investigated the effect of benthic substratum type (sand and rocks) and nutrient supply (N and P) on biofilm structure and heterotrophic metabolism in a field experiment in a forested Mediterranean stream (Fuirosos). Rock and sand colonization and biofilm formation was intensively studied for 44 d at two stream reaches: control and experimental (continuous addition of phosphate, ammonia, and nitrate). Structural (C, N, and polysaccharide content and bacterial and chlorophyll density) and metabolic biofilm parameters (b-glucosidase, peptidase, and phosphatase enzyme activities) were analyzed throughout the colonization process. The epilithic biofilm (grown on rocks) had a higher peptidase activity at the impacted reach, together with a higher algal and bacterial biomass. The positive relationship between the peptidase activity per cell and the N content of the epilithic biofilm suggested that heterotrophic utilization of proteinaceous compounds from within the biofilm was occurring. In contrast, nutrient addition caused the epipsammic biofilm (grown on sand) to exhibit lower b-glucosidase and phosphatase activities, without a significant increase in bacterial and algal biomass. The differential response to nutrient addition was related to different structural characteristics within each biofilm. The epipsammic biofilm had a constant and high C:N ratio (22.7) throughout the colonization. The epilithic biofilm had a higher C:N ratio at the beginning of the colonization (43.2) and evolved toward a more complex structure (high polysaccharide content and low C:N ratio) during later stages. The epipsammic biofilm was a site for the accumulation and degradation of organic matter: polysaccharides and organic phosphorus compounds had higher degradation activities

Converter Supply Transformer For LVDC Distribution System

This master’s thesis is focused on optimizing the parameters of a distribution transformer with respect to low voltage direct current (LVDC) distribution system. One of the main parts of low voltage direct current (LVDC) distribution system is transformer. It is studied from several viewpoints like filtering capabilities of harmonics caused by rectifier, losses and short circuit current limiting Determining available short circuit currents is one of the most important aspects of designing power distribution systems. Short circuits and their effects must be considered in selecting electrical equipment, circuit protection and other devices.

Supply chain costs of a small board lot: sheet cutting and logistics

Succeeding in small board lot (0-20 tons) deliveries, is not always prosperous and failures as well as extra costs compared to standard costs arise. Failure deliveries from converting plants to customer locations tie a lot of unwanted and unexpected costs. Extra costs are handled as quality costs and more precise, internal failure costs. These costs revolve from unsuccessful truck payloads, redundant warehousing or unfavorable routing as examples. Quality costs are becoming more and more important factor in company’s financial decision making. Actual, realized truck payload correlates with the extra costs occurring, so filling the truck payload all get-out well is a key to lower the extra costs. Case company in this study is Corporation A, business segment Boards. Boards have outsourced half of their converting in order to gain better customer service via flexibility, lead time reductions and logistics efficiency improvements. Examination period of the study is first two quarters of year 2008 and deliveries examined are from converters to the customer locations. In Corporation A’s case, the total loss in failure deliveries is hundreds of thousands of Euros during the examination period. So, the logistics goal of getting the right product to the right place and right time for the least cost, does not completely realize.

Unitizing in Supply Chain – Case SECU Container

The aim of this thesis is to analyze how increasing the level of unitizing affects to the costs in the transport system of a Finnish paper and board company. The parts of the supply chain where costs are analyzed are limited to domestic inland transport and port operations. Supply Chain management is important aspect of modern day companies’ strategies. Intermodal transport and different transport systems are the key items which are studied in the theory part of this thesis. In the case study the payload simulations for SECU container (Stora Enso Cargo Unit) stuffed in mills sites are base of the cost analyze of this thesis. Thesis also makes a glance for the restrictions and development trends in Finnish railroads. In analyze SECU containers are moved up to the mill site for stuffing. This increases the level of unitizing in supply chain. Analyze is made for three variation of current traffic lines. Analyze shows that when idea of intermodalism is well used there is considerable cost savings to gather in pre-transportation and port operations. But also effects to mill sites and destination ports needs to be take under considering. In analyze the effects of increased axle weight for SECU container transportation in Finnish railroads is studied. When transport unit is stuffed in earliest possible point supply chain and unloaded the last possible point the savings made in chain can be considerable. In case study of this thesis almost 40% savings in total costs could be reached in pre transportation and port operations when unitizing level is increased in supply chain.

Energy Supply of Detached Houses in Russia and Finland

The problem of choosing the heating system is always relevant when building new houses. Type of energy source (solid fuel, liquid fuel, gas, electricity, alternative sources) is the main issue in choosing the heating system. The work gives a comprehensive overview of heating methods, determines their advantages and disadvantages taking into account economical and ecological situations in Finland and Russia. Quantitative contribution of single Finnish and Russian detached houses in the overall level of carbon dioxide emissions is estimated when using each method. Comparison of Russian and Finnish energy markets and their impact on electricity pricing is made in the work. The influence of air pollution on environmental offsets according to Russian and Finnish legislative and normative acts is determined.

Frequency converter protection against supply network phenomena

This master’s thesis is focused on power supply network disturbances and their effects on the frequency converter – one of the components of modern process crane electrical system. The most critical disturbance types, their causes and the effect they bring to crane electrical system was determined in this work. Variety of protective devices used for mitigation of disturbances is investigated. Device protection solutions for the frequency converter used in crane applications are presented. Analyses of the power supply requirements for frequency converter and various components of crane electrical system were carried out and as a result the crane power supply requirements list that guarantees normal crane operation was built. This list is to be included in crane projects for troubleshooting purposes in order to determine potentially dangerous network.

Supply chain cost saving potential analysis

Target of this study was to examine the current supply chain with focus on external part and identify the cost potential areas which lie there. The goal was to evaluate the cost save potential and give estimate what would be required in order to realise it. Base data related to study was searched and examined with using company’s enterprise resource planning system. In case feasible two types of scenarios were built in order to describe the scale of save potential. First scenario was theoretical and achieving it would require further investments and second scenario was realistic approach where more limitations were taken into account. The results clearly show that there is high save potential in supply chain costs linked to balance between internal and external operations. Realising of it would require at least minor investments as current internal capacity is not on a level to fully absorb the additional volumes which are needed in order to realise the potential. This study can be used as a basis when starting new projects related to investment needs.

The role of power relations in strategic supply management – A value net approach

Supplier relationships are key elements of supply management and thus have attracted substantial research interest among academics and practitioners. The collaborative nature of relationships has been the focus of the mainstream research, and limited interest has been channelled towards power in buyer–supplier relationships. However, power is one of the key factors determining the outcomes in many business relations. Hence, one of the main objectives of this dissertation is to clarify how power may influence the nature of buyer–supplier relationships and, moreover, the depth of collaboration. Another main objective is to clarify the role of power relations in strategic supply management. Given the different nature of relationships, the firm needs divergent strategies in its supply management in order to handle them efficiently. Power has been identified as one of the factors that affect the nature of buyer–supplier relationships, and firms should thus develop strategies for handling power relations. Three research questions are addressed in pursuit of these objectives, the aim being to clarify the sources of power, the influence of power on collaboration, and the role of buyer–supplier relationships in the firm’s supply strategy. This dissertation has two parts. The first part provides a synthesis of the overall dissertation, and the second part comprises five complementary research papers. The qualitative research method is applied in an empirical case study from the Finnish food industry. The main contribution of this dissertation is that it clarifies the role of power relations in strategic supply management in value nets, and discloses the nature of power as an influencing factor in supplier relationships. It extends the discussion on power in buyer– supplier relationships in highlighting the context of networks and raising the question of network effects on power relations. It also illustrates how power positions and power relations in value nets can be determined based on the sources of power of the network actors, and shows their influence on collaboration.

Supply management capability

The objective of this thesis is to define supply management capability. The thesis study what factors consist of supply management capability, and which of those factors are critical to achieving competitive advantage. One objective is also to study how firms can measure their supply management capability. This study is a qualitative research. The thesis examines the literature regarding to supply management and the context of capability and there are used Delphi panel to examine the current and future insights of supply management professionals concerning of supply management skills and capability. The empirical data of the thesis was collected by interviews. The Delphi panel was used in data collection and analysis and for prioritization of the factors of supply management capability. The thesis includes lists of factors of supply management capability. Main findings of the study were that there is no one clear, generally suitable set of supply management skills which bring competitive advantage for all firms and the most important factors of supply management capability, according to the experts, are total cost analysis, customer focus, general business view, market knowledge and supplier relationships. In this study the supply management capability is defined as organization’s overall capacity and ability to achieve a holistic understanding of purchasing needs, manage its suppliers and collaborative partners, and conduct its internal tasks, routines and responsibilities in a way that achieves desired results. The results of this thesis show also that Finnish firms need more right kind of supply management knowledge.