Approved for public release, distribution unlimited / Approved for public release; distribution unlimited. / Healthcare costs throughout the United States are on the rise, drawing increased scrutiny from government officials and Congress. The cost of pharmacy operations and pharmaceuticals is growing at a rate that is alarmingly higher than that of the total cost of military healthcare itself. Recent congressional legislation has essentially given the Department of Defense the ultimatum to cut costs for beneficiaries wherever possible, or risk having benefits arbitrarily cut by Congress. In the face of this possibility, cutting costs through better business practices must be explored, particularly within the area of pharmacy operations. This project explores the potential cost savings that can be realized by implementing Lean Six Sigma (LSS) methodology in the pharmacy operations of the DoD Medical Treatment Facilities (MTF). This research proves that implementing Lean Six Sigma methodology will improve military pharmacy operations, often at little cost, while realizing significant savings and increased customer satisfaction.

The aim of this work is a detailed introduction to the theory of Lean six sigma management tool and verify its efficacy in practice on the individual case. Process to be improved in this work is recovery of overdue debts on english market of certain international company. Of the possible tools Lean six sigma methodologies were chosen the most suitable for a particular process and main causes of large amounts of overdue recievables were identified. As the best steps to improve the process were indentified sending statements of account to customers, improve communication quality and appealing for compliance maturity according to the rules of English banking system. With the methodology we achieved improvement on Sigma parametr on the researched process.

There is no evidence in the literature of biomechanical stability characteristics comparing conventional rectangular screw placement with that of an angled mono-cortical screw plating system where standard 2mm diameter screws are applied at angles more acute than conventional 90° screws, through plate holes machined (cut) for a definite specific screw angle placement P. Angled screws will have an obvious clinical advantage of direct line of vision insertion, through an intra-oral route without the disadvantage of trans-buccal (cutaneous) approach required for conventional 90° rectangular screw application. Angled screw application will result in the prevention of possible, less post-operative swelling, nerve fall out (motor and/or sensory), haematoma, false aneurysm and scarring as unwanted clinical complications associated with trans-buccal extra-oral surgical technique. Intra-oral angled screw application will result in definitive cost saving due to less operating time required. Post-treatment removal of angled screws is uncomplicated, requiring only intra-oral surgical approach, without trochar use or skin incisions for screwdriver application. By determining angle displacement values at certain clinical relevant force values for both compression/tension and torsion, preference can be established for ideal angle(s) of screw application in a plating system. An own unique, designed and manufactured, jig and inclined screw insertion (ISI) plates were implemented during the biomechanical evaluation of stability at different screw angle applications in a Zwick machine. For the purpose of this biomechanical comparative investigation an inclined screw insertion (ISI) plate was manufactured with 90°, 75°, 60° and 45° angled plate holes orientated in line with the long-axis (quadrant 3) of the distal section of the plates and diagonal across (quadrant 1) in the proximal section of the plates. Screws with an ISI angle of 30° in any quadrant application resulted in lifting the plate from the bone surface and caused cortical bone destruction during pilot drilling. The results for mono-cortical 7mm screw placement proved superior in biomechanical stability during tension/compression - forces for screw insertion angles of 60° and 45°, when compared to conventional 90° rectangular screw placement. Screws inserted at an angle of 75° demonstrated no improvement in compression/tension stability when compared with 90°.Torsion force stability for all of the 75°, 60° and 45° inclined screw insertion (ISI) systems proved more stable compared to conventional 90° screw angle plates. It is concluded that angled monocortical screw placement between angles 60° and 45° has clinical significance as far as stability, intra-oral surgical technique and time-cost factor is concerned. The results of this biomechanical behaviour investigation of ISI, evolved new terminology such as screw-tip shifting, screw-tip travel, lag potential and clinical significance for the range of screw angle placement. Angled orientation to the plate design and plate geometry is also defined in terms of tension line distribution in the anatomical region for application in the mandible. An unique quadrant description for ISI is described for future communication. An international patent, based on the ISI principle, has been registered for monocortical six-hole plates of firstly different geometric designs to conform to specific anatomical topographic sites in the mandible and secondly specific screw plate-holes angled at 60° in different orientation to the plate (Patent:PCT/EP 2006/006365), (Addendum 6). A specific L-shaped, mandibular angle plate with screw holes at a 60° angle where orientation shifts from in-line with the long-axis of the plate in the distal three plate holes to diagonal orientation in the proximal section of the plate, is designed and manufactured by Stryker/Leibinger as an example of such a patent plate. It is recommended that a smart-lock plate with plate holes at 55° angles be manufactured to allow screw angle placements of 65° - 45° in different angle orientations. Pilot hole drilling and ISI can be performed without the use of a drill-guide. / Thesis (PhD)--University of Pretoria, 2009. / Maxillo-Facial and Oral Surgery / unrestricted

Globalisation has opened up international markets for South African companies, but has also introduced competition in the domestic market. As a result, South African organisations are forced to attain global efficiency levels if they are to compete on the world market as well as maintain their domestic market share. Organisations have to come with creative methods that can enhance their competitiveness, one of them being the Six Sigma. Six Sigma is a measurement-based strategy that focuses on process improvement and variation reduction as a means towards performance improvement. The methodology has a reputation of success, however a number of organisations believe that the methodology is not relevant to their specific competitive needs. Six Sigma is seen as another continuous improvement tool applicable to first world country organisations which will fade away with time. The study was undertaken to find out challenges and successes of implementing a Six Sigma methodology at Continental Tyre SA. The findings of the study revealed that the experience of implementing Six Sigma methodology at Continental Tyre SA is similar to those experienced by first world organisations. It is concluded that Six Sigma methodology can improve organisation processes and yield financial benefits irrespective of organisation location or background. However, organisations must follow a systematic guideline when implementing the methodology. The study provides recommendations on how Continental Tyre SA can align their strategy in order to achieve organisational objectives. The following recommendations were made: Roll out Six Sigma to support departments; Align the strategy to address critical success factors; Improve project turnover time and measure the success on financial savings and number of projects completed.

The master´s thesis deals with the company engaged in providing services in IT. The main aim of the thesis is to map selected logistics chain of company and to use selected techniques of Lean Six Sigma for optimizing it. The first part of the thesis deals with the current situation on the market reverse logistics associated with electronics and legislative requirements for the supplying of warranty claims. The theoretical part introduces concepts of lean manufacturing and tools for the process mapping. The practical part has a goal with tools DMAIC to shorten the lead time of repair, to find waste and downtime it the service process, which have affect on the customers satisfaction.

The aim of this work is to determine a methodology to measure the leanness level of the organizations that have an internship in the framework of the minor specialization of Quality Management and Lean Six Sigma at University of Economics. The theoretical part of the Thesis presents issues of Lean Six Sigma methodology, describes basic characteristics and main Lean Six Sigma tools. The Thesis also describes process of a research, on which was applied the proposed measurement methodology of an internship impact on organizations. The research methodology describes leanness measurement approach, process of data collection and its subsequent analysis and evaluation. The last chapter includes conclusion of results, suggestions and recommendations to improve Quality Management and Lean Six Sigma Practical.

Diploma thesis of "Management of Six Sigma projects" is dealing with possibilities of using this technique in specific continuous improvement projects. Main goal is to analyse tools of this method on real situation and proof that Six Sigma is usable to manage this kind of projects. This work will include necessary theoretical basics from project management scope based on generally approved PMBOK methodology. Part of this analysis will be concerned on comparison of PMBOK principles and Six Sigma method. Explanation of Six Sigma basics won't be omitted as well through the fact this method has achieved a significant value in recent times. Practical part of this paper will be composed as case study example of a logistics project in DHL Exel Supply Chain company where I have been employed in United Kingdom.

The thesis describes the main assumptions of professional real estate agents. First at the theoretical level and then it compares these findings with real data. The result of this thesis is a picture of the characteristics of real estate agents and a creation of basic recommendations for improving their business practices.

The aim is to use Lean Administration metodology to improve custom clearance process steps that do not add value, but it is necessary to carry out them due to legislative reasons. The company has excellent results of applying the Lean principles in manufacturing and this thesis will bring to the company specific application of Lean Enterprise metodolgy outside manufacturing. The thesis is proof of the implementation of the company philosophy of continuous improvement, perfection does not exist, there is always the possibility of improvement.

The aim of the thesis is to suggest recommendation to optimize and increase efficiency in a process of catering ordering in a company Express Deli by using methods of lean six sigma. The work is built as real project od lean six sigma using some methods of the methodology lean six sigma. In the theoretical part of the thesis, methods of lean six sigma used in the practical part, are described. These methods are mainly methods of process mapping. Each chapter is a step of DMAIC methodology. Core part of the thesis is process mapping at a customer side, so in the other part there are all recommendations directly focused on customers requirements. The results of the work are suggested proposals for process improvement. Some of them were implemented during the project.