Les hôpitaux sont confrontés à des contraintes économiques fortes et à des exigences de plus en plus élevées en termes de qualité et de sécurité des soins. La prise en charge médicamenteuse est également soumise à ces contraintes d'autant qu'elle relève d'un processus complexe pluriprofessionnel et présentant également des enjeux économiques et sociétaux importants. Afin de répondre à ces difficultés, une solution pourrait être la réorganisation des processus et la relocalisation des ressources grâce aux démarches d'amélioration de processus issues du génie industriel. Le Lean, une approche d'amélioration des processus métiers mise au point dans les années 90 par les chercheurs du Massachussetts Institute of Technology, consiste à optimiser la valeur pour le patient tout en minimisant les gaspillages et en recherchant l'excellence opérationnelle à travers l'amélioration continue. Des résultats encourageants consécutifs à l'utilisation de cette approche en milieu hospitalier ont déjà été rapportés. Cependant, une analyse approfondie de la littérature a montré qu'aucune des démarches Lean décrites dans la littérature n'était construite de manière à fournir un support méthodologique robuste permettant d'entreprendre une démarche Lean pour l'amélioration des processus métiers à l'hôpital. Face à ce constat, nous proposons une méthode Lean pour l'amélioration des processus métier, structurée et adaptée au milieu hospitalier, basée sur une triangulation entre données de la littérature, entretiens semi-dirigés et un cas d'étude. Cette méthode a été validée sur le site de l'hôpital Antoine Béclère lors d'un projet d'amélioration du processus de prise en charge médicamenteuse. Son application a entre autre permis d'améliorer la qualité, la sécurité et l'efficience de la prise en charge médicamenteuse en Médecine Adulte Polyvalente. / Hospitals are facing strong economic constraints and increasing requirements in terms of quality and safety of care. Medication management, a complex and multi-professional process with major economic and social issues, is also subject to these constraints. To address these difficulties, a solution could be to reorganize processes and relocate resources through the use of industrial engineering Business Process Improvement approaches. Lean is a Business Process Improvement approach developed in the 90s by researchers of the Massachusetts Institute of Technology. It aims at maximizing the value for the patient while minimizing waste and seeking operational excellence through continuous improvement. Many encouraging results related to the use of this approach in hospitals have been reported. However, a thorough analysis of the literature showed that none of the Lean approaches described in the literature was structured to provide sufficient methodological to perform a Lean journey aiming at improving business process in hospitals. This is why we propose a Lean method to improve business processes in hospitals based on a triangulation between literature data, semi-structured interviews and a case study. This method was tested and validated in the Antoine Béclère hospital where quality, safety and efficiency of the medication management process in a medicine unit were improved.

Abstract The relationships between software producing companies, their customers and other parties involved have growing importance in the turbulent and fast developing business environment of today. The software industry itself is characterized by the Commercial-Off-The-Shelf (COTS), tailored, and Modified-Off-The-Shelf (MOTS) businesses modes. In this versatile context of cooperation, financing and acquisitions demand exact details of the ownership of the products, i.e. the Intellectual Property Rights of these products and services. Legal forms and contracting procedures are emerging as the critical issues for the development of the information technology industry. This study addresses the problem of how software contracting has been approached and what concepts and models have been presented to understand it. Further, the question of the role of inter-organisational relationships (business-to-business) and intra-organisational process evolution in software contracting is discussed. The domains of interest and of relevance in this research are software development process, business process, legal process, and the contracting process itself, and the evolving interaction between these processes. The focus of this study is especially on contracting and on analysing the process of contracting, i.e. the dynamics, dependencies and elements of process related issues. The empirical part of the study was completed by analysing twelve software producing companies - eight were Finnish firms established in Silicon Valley (USA) and the rest were local Finnish firms with international operations. Based on the empirical findings, a software-contracting model was elaborated to describe how the contracting processes form and evolve in the context of software business. The model gives more understanding of the evolving contract processes and relationships. Further, the research produced concepts of how to manage contracting processes in the software business. Contributions of this study are, first, the well-defined model for contracting process in a software developing company. The elaborated model gives new insight into the elements, interrelationships and governance structures included in the contracting process and the relationship development between cooperating companies. Software companies can compare their contractual situation with the model. This enables them to develop their own processes further to respond to the present-day requirements. Secondly, the study specifies and introduces three different generic contracting networks for COTS, tailored, and MOTS business modes of software developing companies. It was established that these three business modes have similarities as well as differences in the application of software contracting processes. The COTS business relied firmly on multiform licensing practices, whereas the tailored business saw the framework contract as the main contractual tool and interestingly the MOTS business employed combinations of these two previous forms, i.e. both licensing and framework contracts. This study evoked some interesting future research prospects. In order to create a more accurate overall view of the whole contracting process the research should be continued and take the interplay of both customer and supplier under closer scrutiny. Another important issue would be to examine the contracts used in these different business modes from a strict legal viewpoint and the possible transformation of the predominant legal practices.

Galbraith (1995:2) states that “organizations continuously search for more effective approaches in order to survive, to remain competitive, to maintain their operations and to grow in an ever-changing and competitive environment. To achieve sustainable business results, organizations must actively manage cost, quality, product and service features by means of their efficient and effective application of managerial and operational systems within a well-designed organizational framework.” Porter and Tanner (2004:3) argue that “in their endeavour to remain competitive organizations have over the last few decades in search of the ultimate system or methodology tried and tested all the various performance improvement approaches or performance enablers (ISO 9000, Business Process Reengineering (BPR), Business Excellence, Continuous Improvement, Total Quality Management (TQM), Just-in-Time, Project Management, Six Sigma, Lean Sigma, etcetera). Although thousands of organizations implemented these performance enablers, few organizations achieved their envisaged state of excellence.” Kerzner (1997:2) argues that “there are only two ways in which work gets done in organizations: through business processes or through projects. Business processes are permanent work structures that transform inputs continuously into outputs as ongoing operations. Projects on the other hand are temporary work structures that shut down once the output has been achieved.” Robbins, (1998:629) states that “since the organizations’ success or failure is essential due to the things that its employees do or fail to do (processes), any planned change must also be concerned with changing the behaviour of individuals and groups within the organization.” It is therefore critical that management does have scientific control over the function or Critical Core Capability that touches “the way things get done”. The researcher are therefore of the opinion that business process being the core descriptor of the “how”, “what”, “when”, and “why” of every individuals daily interaction with his work, his colleagues, his organization and his clients is maybe by far the biggest factor of satisfaction, dissatisfaction, harmony or conflict in the organization and determines to a large extent what the behaviour of the individual, the groups and the organization at large will be on a daily basis. Business Process was identified as core to all the performance enablers and was elevated to a Critical Core Capability status in many organizations. Derived from the above Business Process Management as a Critical Core Capability should encompass the four management functions, and should be supported by a proper organizational framework that includes strategy, structure, policies, procedures, and people. The literature search also confirmed that “synergy”, i.e. “The whole is more than its parts”, is paramount to success when it comes to the management of a Critical Core Capability. With the above as reference the researcher set out to establish which criteria should be included in a measurement instrument to measure Business Process Management as a Critical Core Capability in an organization. The following primary research question was formulated and used as vantage point to develop, as the primary objective, said instrument: What must be implemented, in terms of strategies, governance, enterprise architecture, and process optimization, to ensure that organization culture, people’s behaviour and the work environment will be conducive to successfully establish and maintain Business Process Management as a Critical Core Capability of an organization? Based on a proper research process and methodology the researcher utilized the following methods to develop the Test Instrument: <ul> <li> A comprehensive literature study;</li> <li> Discussions with and inputs from experts;</li> <li> Questionnaires; and</li> <li> Statistical analysis.</li> </ul> An Assessment Tool for Measuring Business Process Management as a Core Capability in an organization comprising ninety items clustered in six criteria in a five factor scale was developed and tested in two organizations as well as in three different business units in the one organization. The final Descriptive Statistics showed that the overall reliability of the items per criterion was highly acceptable with Cronbach Alpha Coefficients of 0.7315, 0.9216, 0.8224, 0.7650, 0.8248, and 0.7722 respectively, (higher than the acceptable level of 0.70). The final analysis therefore concluded that the assessment tool, the Business Process Management Competency Assessment Model (BPMCAM), is a reliable tool that can distinguish in terms of Business Process Management as a Critical Core Capability the level of an organization’s readiness to implement and/or to sustain the Business Process Management functionality as a Critical Core Capability. / Thesis (PhD)--University of Pretoria, 2008. / Human Resource Management / unrestricted

Drawing on multiple theoretical lenses, this research studies continuous transformation, or ‘morphing’, of a business process resource network (BPRN). The aim is to further our understanding of continuous organisational change at the lowest levels of analysis within an organisation: that is, at the resource level, and that resource’s relationships to other resources as they exist within a BPRN. Data was gathered from a single, in depth case study. Analysis was achieved by means of mapping BPRN evolution using ‘temporal bracketing’, ‘visual’ and ‘narrative’ approaches (Langley, 1999). The analysis revealed two mechanisms that appear to govern microstate morphing: bond strength and stakeholder expectation. In addition, four factors emerged as important: environmental turbulence, timing and timeliness of changes, concurrency of changes, and enduring business logic. An emergent model of microstate morphing which acknowledges the importance of socio-materiality in actor network morphogenesis (ANM) is presented. This study shows how effective relationships and configuration of resources within the BPRN can be achieved to facilitate timely, purposeful morphing. Five propositions are offered from the emergent ANM model. Specifically, these relate to the conditional operating parameters and the identified generative mechanisms for continuous organisational transformation within the BPRN. Implications for practice are significant. A heuristic discussion guide containing a series of questions framed around the ANM model to highlight the challenges of microstate morphing for practitioners is proposed. Two routes for future research are suggested: replication studies, and quantifying BPRN change in relation to an organisation’s environment using a ii survey instrument and inferential statistical analysis based on the ANM model features and propositions.

While several approaches exist for modeling goals and business processes in organizations, the relationships between these two views are often not well defined. This inhibits the effective reuse of available knowledge in models. This thesis aims to address this issue through the introduction of a Goal-oriented Pattern Family (GoPF) framework that helps constructing business process models from organization goals while expanding these goals, establishing traceability relationships between the goal and process views, and improving reusability. Methods for extracting domain knowledge as patterns, which are composed of goal model building blocks, process model building blocks, and their relationships, and for maintaining the patterns over time are also presented. The GoPF framework provides the infrastructure for defining pattern families, i.e., collections of related patterns for particular domains. The foundation of GoPF is formalized as a profile of the User Requirements Notation, a standard modeling language that supports goals, scenarios, and links between them. A method for the use of GoPF is defined and then illustrated through a case study that targets the improvement of patient safety in healthcare organizations. The framework and the extraction/maintenance methods are also validated against another case study involving aviation security in a regulatory environment. The GoPF framework is expected to have a positive impact on the scientific community through the formalization, evolution, and reuse of patterns in domain-specific business domains. From an industrial viewpoint, this framework will also help intermediary organizations (such as consulting firms) who are required to repeatedly create and document goal and process models for other organizations in their business domain.

[Context] Interdisciplinary healthcare teams (IHTs) include practitioners from different disciplines who collaborate for providing care to patients. IHTs often follow clinical workflows composed of tasks that must be executed by practitioners with specific capabilities. The membership in an IHT can however evolve over time for a given patient. [Problem] Existing Business Process Management (BPM) suites and their workflow execution engines are designed for supporting and monitoring general workflows, but they are insufficient in supporting the allocation of tasks to the most suitable practitioners during the execution of healthcare workflows in a dynamic context. [Methodology] Using Design Science Research, this thesis builds on top of an existing semantic layer, which includes an ontology defining IHT team concepts and relationships that are used to reason automatically about team dynamics, in order to add dynamic team management to BPM suites. It does so by proposing and designing middleware (including a generic interface) that enables the semantic layer to command the BPM suite to allocate suitable practitioners to tasks during the execution of clinical workflows. The design and implementation of this middleware are discussed, and the latter is tested on a commercial BPM suite for two realistic clinical processes. [Results] The proof-of-concept implementation demonstrates the feasibility of using middleware with a generic interface to add support for IHT executing BPM suite when managing a patient. In addition, the thesis also demonstrates that the ontology used in the semantic layer is minimal, that is, all of its concepts and relationships are necessary for the required team functionalities (usually absent from BPM tools) to work properly.

Long wait times are a global issue in the healthcare sector, particularly in Canada. Despite numerous research findings on wait time management, the issue persists. This is partly because for a given hospital, the data required to conduct wait times analysis is currently scattered across various information systems. Moreover, such data is usually not accurate (because of possible human errors), imprecise and late. The whole situation contributes to the current state of wait times. This thesis proposes a location-aware business process management system for real-time care process monitoring. More precisely, the system enables an improved visibility of process execution by gathering, as processes execute, accurate and granular process information including wait time measurements. The major contributions of this thesis include an architecture for the system, a prototype taking advantages of commercial real-time location system combined with a business process management system to accurately measure wait times, as well as a case study based on a real cardiology process from an Ontario hospital.

Managing the process of a product's development prior to its release is the dominant theme of this graduation thesis. In today's modern turbulent world, businesses compete to be a strong force in the market arena. From start to finish it is necessary to keep the consumer's demands and wants as the driving force when managing the operation. Factors that are critical in the implementation of the operation are working with a manageable portfolio, forecasting unforeseen expenses, profit gains and losses. Purchasing the most recent and efficient software program or electronics to assist in the operation could be more effective but more expensive upfront. On the other hand, purchasing a complex program or electronics will be ineffective if the user is unable to comprehend its complete functions or abilities. Proper and thorough analysis is necessary in foreseeing all possible obstacles to a smooth operation. Presently, it is not uncommon for companies to implement new technology without previous analysis. The result is a rapidly growing demand for a product reliant on this technology to help produce or support it. As a result, they find themselves in a tight spot very soon. Resolving the issue consists of additional and extended analyses of changes and in the reimplementation of the technology, a process that can be slow and tap into an already tight budget. In conclusion, this dissertation surmises that documentation of and organized implementation of processes in a real manufacturing corporation is necessary to improve not only the quality of processes in support of reaching economic targets but also in assuring quality labour performances of all employees.

The diploma thesis deals with the theme of Modeling business processes with orientation to the metric process interface. The aim of the thesis is to design the architecture of metric, which enabled to construct type metrics of the process interface. Firstly, the reader is informed about the basic terms related to process modeling, process management and connection of strategy with metrics. The next part describes the architecture of metrics created, which is oriented to supporting the process management of the organization. The set of type metrics was chosen with consideration to the possibility of their placement on process interface. The set created in this manner should help to connect strategy with processes when implementing into organization. The last part of the thesis describes the practical application of knowledge obtained in the PARMA project. This project deals with the proposal and implementation of the process management into the Bureau of the Municipality of Prague 10. The thesis deals with two processes and the conclusions obtained in the theoretic part of the thesis are applied herein.

Today, business process modelling is important part of analysis and design of the information systems. There is number of standards, which is concerned with process modelling, whereas each of them represents a little different approach. The project Opensoul created general metamodel, which defines basic elements and their mutual associations, which all standards should meet. In other words, it defines basic rules for process modelling. The goal of this thesis is to compare chosen standards of process modelling with Business process metamodel of Opensoul initiative. The results of this comparison would have provide basis to answer the question, which standard supports in the best way the rules of process modelling defined by metamodel through the system of elements and their associations. This goal requires specifying the method, on which basis the comparison will be made. This method comprises the extension of metamodel with new elements and their relations to other elements, and the extension of some elements with some workflow patterns defined by Workflow Patterns initiative. That is the main benefit of this thesis.