Productivity advances generated from ‘lean manufacturing’ are self–evident. Plants that adopt ‘lean’ are more capable of achieving shorter lead times, less waste in the system and higher quality levels. The goal of this study was to ascertain which ‘lean’ tools and techniques are available for use. A matrix was constructed with a summation of the authors who agree that specific ‘lean’ tools will reduce cycle time. It was found that reduced set–up time and waste elimination are most affected by the implementation of ‘lean’ tools and techniques. An empirical study was conducted to confirm the results of the literature study. The respondents’ knowledge on the ‘lean’ tools was also tested. It was found that respondents have a sound understanding of set–up time; they agree that it must be reduced in the plant. Pre–scientific evidence and the response from the empirical study confirm that there is a substantial amount of waste in the factory. A current state value–stream map was drawn from a single welded part Product X. The value–stream was analysed to reduce the cycle time in the process, with the focus on set–up time reduction and waste elimination. The future state value–stream map was drawn, displaying astonishing results. A continuous improvement (kaizen) programme will help reduce the cycle time even further by making use of the other ‘lean’ tools discussed in this study. This programme forms part of the procedure to optimise cycle time. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2012.

Productivity advances generated from ‘lean manufacturing’ are self–evident. Plants that adopt ‘lean’ are more capable of achieving shorter lead times, less waste in the system and higher quality levels. The goal of this study was to ascertain which ‘lean’ tools and techniques are available for use. A matrix was constructed with a summation of the authors who agree that specific ‘lean’ tools will reduce cycle time. It was found that reduced set–up time and waste elimination are most affected by the implementation of ‘lean’ tools and techniques. An empirical study was conducted to confirm the results of the literature study. The respondents’ knowledge on the ‘lean’ tools was also tested. It was found that respondents have a sound understanding of set–up time; they agree that it must be reduced in the plant. Pre–scientific evidence and the response from the empirical study confirm that there is a substantial amount of waste in the factory. A current state value–stream map was drawn from a single welded part Product X. The value–stream was analysed to reduce the cycle time in the process, with the focus on set–up time reduction and waste elimination. The future state value–stream map was drawn, displaying astonishing results. A continuous improvement (kaizen) programme will help reduce the cycle time even further by making use of the other ‘lean’ tools discussed in this study. This programme forms part of the procedure to optimise cycle time. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2012.

Submitted by Bruna Rodrigues (bruna92rodrigues@yahoo.com.br) on 2016-09-28T12:28:44Z No. of bitstreams: 1 DissMPFte.pdf: 1012457 bytes, checksum: 6124d4a74a53050982226492d8d53133 (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T19:03:27Z (GMT) No. of bitstreams: 1 DissMPFte.pdf: 1012457 bytes, checksum: 6124d4a74a53050982226492d8d53133 (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T19:03:35Z (GMT) No. of bitstreams: 1 DissMPFte.pdf: 1012457 bytes, checksum: 6124d4a74a53050982226492d8d53133 (MD5) / Made available in DSpace on 2016-10-10T19:03:44Z (GMT). No. of bitstreams: 1 DissMPFte.pdf: 1012457 bytes, checksum: 6124d4a74a53050982226492d8d53133 (MD5) Previous issue date: 2016-04-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Consider a sequence of independent coin flips where we denote the result of any landing for H, if coming up head, or T, otherwise. Create patterns with H's and T's, for example, HHHHH or HTHTH. How many times do we have to land the same coin until one such two patterns happens? For example, let the sequences being THTHHHHH and TTHTTHTHTH. The number of times that we landed the coin until HHHHH and HTHTH happens it was eight and ten times respectively. We can generalize this idea for a finite number of patterns in any nite set. Then, the rst of all interest of this dissertation is to nd the distribution of the waiting time until a member of a nite colection of patterns is observed in a sequence of Markov chains of letters in from finite set. More speci cally the letters in a nite set are generated by Markov chain until one of the patterns in any fi nite set happens. Besides that, we will find the probability of a pattern happen before of all patterns in the same nite set. Finally we will find the generator function of probability of waiting time. / Consideremos uma sequência de lan camentos de moedas em que denotamos o resultado de cada lan çamento por H, se der cara, ou por T, se der coroa. Formemos uma palavra apenas com H's e T's, por exemplo, HHHHH ou HTHTH. Quantas vezes arremessaremos uma mesma moeda at e que uma das duas palavras acima ocorrer á? Por exemplo, dadas as sequências THTHHHHH e TTHTTHTHTH. O n úmero de vezes que arremessamos a moeda at é que HHHHH e HTHTH ocorreram pela primeira vez e oito e dez, respectivamente. Podemos generalizar a ideia acima para um n úmero fi nito de palavras em um alfabeto finito qualquer. Assim, o nosso principal objetivo dessa disserta ção e encontrarmos a distribui ção do tempo de espera at é que um membro de uma cole ção fi nita de palavras seja observado em uma sequência de ensaios de Markov de letras de um alfabeto fi nito. Mais especifi camente, as letras de um alfabeto finito são geradas por uma cadeia de Markov at é que uma das palavras de uma cole ção finita ocorra. Al ém disso encontraremos a probabilidade de que determinada palavra ocorra antes das demais palavras pertencentes a um mesmo conjunto fi nito. Por último encontraremos a fun ção geradora de probabilidade do tempo de espera.

Le nombre de véhicules électriques (VEs) augmente de plus en plus depuis des dernières années. De ce fait, des problèmes d’attente dans les stations de recharge apparaissent, vu leur nombre limité dû aux coûts élevés d’installation. En outre, il y a des problèmes liés d'une part à l’autonomie due à la capacité limitée des batteries et des problèmes liés d'autre part à la crainte d’avoir une portée insuffisante pour atteindre une destination du véhicule ou de tomber en rupture d’énergie entre un point de départ et un point de destination. Faire de la planification de recharge et diriger les conducteurs vers des stations de recharge disponibles pendant leur trajet pourraient contribuer à résoudre ces deux problèmes. Pour ce faire, une communication bidirectionnelle entre les VEs et la grille serait utile. C’est dans ce cadre, que ce projet est proposé. D’une part, dans ce projet, on propose une architecture sécurisée où les VEs et la grille intelligente peuvent échanger les données pour effectuer une réservation des créneaux horaires dans les stations de recharge et planifier les itinéraires. Une étape d’authentification et d’autorisation du véhicule ou de l’usager est primordiale pour garantir la sécurisation des échanges et la confidentialité des données des VEs. Cela implique une demande de fournir des informations en mode crypté à travers les protocoles de sécurisation. Cette étape d’authentification et d’autorisation est établie après une étape de notification du VE. D’autre part, on met en place un nouveau schéma pour planifier les itinéraires des VEs. Ce schéma prend en compte l’état de charge du véhicule, son origine, sa destination et les stations de recharge disponibles sur la route. Le schéma établit la réservation dans les stations selon des mécanismes d’optimisation de temps d’attente du VE dans les stations de recharge et de sa consommation d’énergie globale durant son voyage depuis le point d’origine jusqu’à la destination voulue. / Abstract : The number of electric vehicles (EVs) has increased significantly in recent years. Owing to the limited number of charging stations (CSs), the waiting time in charging stations has swelled. In addition, the limited capacity of EV batteries can evoke the drivers’ range-anxiety, defined as the fear of having insufficient range to reach a destination. Make a charging planning and directing the drivers to the available charging stations during their journey could help to solve these problems. To do this, a bidirectional communication between the EVs and the smart grid would be useful. It is within this framework that this project is proposed. In this project, we propose a secure architecture where EVs and the smart grid can exchange data information for making slots reservation at the charging stations and route planning. Authentication and authorization of EVs or users is essential to guarantee EVs confidentiality and the exchange of information. This implies a request to provide the sensitive information in encrypted mode through security protocols. These procedures are executed after the EV notification process. Besides, we propose a new scheme for planning EVs itineraries. This scheme considers the state of charge of EVs, their starting positions, their destinations and the charging stations available on the road. The system establishes the reservation of the charging slots via optimizing the waiting time at charging stations as well as the energy consumption during EVs journey, from their starting positions to their designated destinations.

Omhändertagandet av personer som är i behov av vård skall vara lika för alla med ett respektfullt bemötande. Patienter bör få individanpassad vård tillsammans med ett omhändertagande som innebär personligt bemötande på individens villkor. Behandling och kommunikation är nyckelfaktorer för att möta vården med att förebygga ohälsa och lidande hos patienter. Inom akutmottagningar omhändertas människor som är i akut behov av vård vilket kan innebära att de patienter som söker akuthjälp och får låg prioritet i triage-systemet kan vänta länge på vård. Ett bemötande inom sjukvården bör vara anpassat med hänsyn till lika villkor för alla människor. Hög arbetsbelastning ses på akutmottagningar i hela världen. Orsaker till detta kan bero på att det faktiska antalet personer som besöker vården ökar eller att patienter söker akutvård istället för primärvård. En annan orsak som kan bidra till höga belastningen på akutmottagning kan vara att patienter ofta inte känner till, eller litar på, andra vårdgivare. Patienter som uppsöker akutvård bör få information om hur de kan vända sig till andra vårdgivare där de kan få hjälp. Syftet var att beskriva faktorer som påverkar upplevelsen av vistelsen för patienter på en akutmottagning. Metoden var en litteraturbaserad studie i form av en litteraturöversikt baserad på 16 vetenskapligt granskade artiklar med kvantitativ och kvalitativ ansats. Resultatet var att kommunikation, information, väntetiden, bemötande och tillfredsställdes var faktorer som påverkar patienters upplevelse av vistelse på akutmottagning. Klar och tydlig kommunikation, ett gott bemötande och att ge information angående t.ex. eventuell väntetid kan bidra till en ökad tillfredsställelse hos patienten under vistelsen på akutmottagningen.

Dagens industrier utvecklas snabbare och ständigt uppstår nya teknikutvecklingar som skapar nya krav och kräver förändringar inom tillverkningsindustrin. Eliminering av flaskhalsar är viktigt inom läkemedelsindustrin för att möta den ökade efterfrågan. Med tanke på att läkemedelsindustrin växer har polymerase chain reaction-tekniken (PCR) blivit en av de mest värdefulla teknikerna inom biovetenskap, diagnostik och rättsmedicin. Utvecklingen av PCR-teknik drivs av flera marknadsaktörer och skapar hård konkurrens. På grund av den höga konkurrensen är det avgörande att främja teknisk utveckling och skapa en optimal produktion inom läkemedelsindustrin för att möta marknadens efterfrågan. Det kan vara kostsamt att producera pålitlig utrustning inom läkemedelsindustrin. För att skapa affärsmål och analysera förbättringsmöjligheter inom produktionsprocessen kan optimeringssystem skapas med hjälp av simulering. Genom att skapa en virtuell modell kan data samlas för att identifiera problem inom tillverkningsindustrin. Genom flödessimulering kan en flaskhalsanalys skapas med fokus på väntetider, cykeltider och genomströmning. Denna studie svarar på forskningsfrågorna: (1) Vilka problem identifierar flödessimuleringar vid analys av prestanda och flaskhalsar för förpackningslinjer inom läkemedelsindustrin? (2) Vilka effekter får lösningsförslaget på prestandan för flaskhalsflödet i produktionsprocessen? Genom att simulera olika scenarier och identifiera problem relaterade till resursanvändning och prioriteringar vid sammanfogningspunkter kan lösningar på flaskhalsar identifieras. Genom att jämna ut prioriteringarna och använda buffertlager kan företag skapa ett jämnare flöde och förbättra motståndskraften i sina tillverkningssystem. Studien visar att design- och layoutval har en betydande effekt på den totala genomströmningen, vilket betonar vikten av noggrann layoutplanering och optimering inom läkemedelsindustrin. Genom att förbättra nyckeltal som medeltid mellan fel och medeltid mellan reparation kan företag öka genomströmning, produktivitet och effektivitet samtidigt som de uppnår ekonomisk, ekologisk och social hållbarhet. Rekommendationer för framtida studier inkluderar att undersöka operatörsplacering och maskinhastighetens inverkan på väntetiden. / Today's industries are developing at a faster pace and new technological developments are constantly being developed that create new demands and require changes within the manufacturing industry. Eliminating bottlenecks is important in the pharmaceutical industry in order to meet the increased demand. Given that the pharmaceutical industry is a growing industry, polymerase chain reaction (PCR) technology has become one of the most valuable technologies used in life sciences, diagnostics and forensics. The development of PCR technology is carried out by several market players and causes strong competition. Due to the high level of competition, it is essential to promote technological development and create optimal production in the pharmaceutical industry in order to meet market demand. It can be expensive to produce reliable equipment in the pharmaceutical industry. To create business goals and analyze improvement opportunities within the production process, optimization systems can be created using simulation. By creating a virtual model, data can be collected to identify problems within the manufacturing industry. With the help of flow simulation, a bottleneck analysis can be created with a focus on waiting times, cycle times and throughput. This study answers the research questions (1) What problems do flow simulations identify when analyzing the performance and bottlenecks of packaging lines in the pharmaceutical industry? (2) What effects does the proposed solution have on the performance of the bottleneck flow in the production process? By simulating different scenarios and identifying problems related to resource usage and priorities at join points, solutions to bottlenecks can be identified. By smoothing priorities and using buffer stocks, companies can create a smoother flow and improve the resilience of their manufacturing systems. The study demonstrates that design and layout choices have a significant effect on total throughput, which emphasizes the importance of careful layout planning and optimization within the pharmaceutical industry. By improving key metrics such as mean time between failure and mean time to repair, companies can increase throughput, productivity and efficiency while achieving financial, ecological, and social sustainability. Recommendation for future studies includes studying the effect of operator location and machine speed on waiting time.

Hospitals around the country are struggling to provide timely access to inpatient beds. We use discrete event simulation to study the inpatient admission and discharge processes in US hospitals. Demand for inpatient beds comes from two sources: the Emergency Department (ED) and elective surgeries (NonED). Bed request and discharge rates vary from hour to hour; furthermore, weekday demand is different from weekend demand. We use empirically collected data from national and local (Massachusetts) sources on different-sized community and referral hospitals, demand rates for ED and NonED patients, patient length of stay (LOS), and bed turnover times to calibrate our discrete event simulation model. In our computational experiments, we find that expanding hours of discharge, increasing the number of days elective patients are admitted in a week, and decreasing length of stay all showed statistically significant results in decreasing the average waiting time for patients. We discuss the implications of these results in practice, and list the key limitations of the model.

Service reliability is one of the main factors influencing public transport level of service and, thus, passengers’ satisfaction. Public transport services are subject to various sources of uncertainty related to traffic conditions, public transport operations and passenger demand. Passengers are able to form their perception of trip attributes and service reliability through accumulating experiences of repetitive travel choices. Perceived service reliability can be improved either by increasing the ground-truth service reliability (e.g. introduce exclusive bus lanes, control strategies etc.) or by providing real time information (RTI) to passengers. However, RTI prediction schemes might not be perfectly accurate and thus, passengers might be able to account for the reliability of the provided information as well. The learning mechanism of individuals becomes, as a result, an important component in Dynamic Transit Assignment Models (DTAM) which enables accounting for how perceived reliability of service and the provided information evolves, through iterative network loading. This thesis provided the modeling framework for passengers’ perception of reliability and its effects on decision making with respect to path choice. Within-day effect is represented through the incorporation of scheduling constraints, while passengers’ learning mechanism accounts for updates in their expectations and the perceived level of information credibility in the day-to-day context. The proposed model was applied to Stockholm’s rapid transit network which was simulated in BusMezzo, an agent-based public transport assignment model. The application used the real-world timetables, vehicle schedules and RTI prediction scheme. Passengers’ learning function was analysed under various specifications which corresponded to different levels of adaptation. The results highlight the importance of capturing service uncertainty and the credibility associated with alternative information sources, while they stress the need for empirical estimation and validation of the proposed model. This study also provides the framework for future evaluation of measures which aim to improve service reliability.

Bakgrund: År 2022 gjordes cirka 1,8 miljoner besök på akutmottagningar runt om i Sverige. Akutsjukvårdens premisser skiljer sig från annan vård genom avsaknad av tidsbokning och öppettider dygnet runt. Omvårdnaden på akutmottagningen påverkas av organisatoriska faktorer som resurser i form av personal och arbetsbelastning, i samspel med individuella faktorer hos sjuksköterskan som erfarenhet, kommunikationsförmåga och förmåga att involvera patienten. Det teoretiska ramverket Fundamentals of care är ett modernt internationellt teoretiskt ramverk utvecklat för att knyta an teori till praktik inom omvårdnad i den moderna hälso- och sjukvården. Syfte: Att beskriva patienters upplevelser av att söka vård på en akutmottagning. Metod: En allmän litteraturöversikt baserad på 15 vetenskapliga artiklar av kvalitativ och kvantitativ ansats. Fundamentals of care användes som teoretisk utgångspunkt. Datainsamlingen genomfördes via sökningar i databaserna CINAHL och PubMed. Artiklarna kvalitetsgranskades med ett bedömningsformulär och analyserades genom en integrerad analys. Resultat: Fem huvudkategorier framstod: Information, Delaktighet, Förväntningar, Väntan och Miljö. Patienterna upplevde sårbarhet och avsaknad av kommunikation på akutmottagningen. Att vara delaktig upplevdes som essentiellt. Det existerade outtalade förväntningar hos patienterna och långa väntetider ansågs negativt men kunde påverkas i en positiv riktning genom god omvårdnad. Både den Slutsats: Patienterna i denna studie upplevde en sårbarhet på akutmottagningen och önskade att bli bemötta med professionalitet och empati. De ville etablera en relation till sjuksköterskan och vårdpersonal och förväntade sig att bli uppmärksammade på sina behov ur ett holistiskt perspektiv. Ramverket Fundamentals of cares tre dimensioner kan användas som en teoretisk utgångspunkt för att identifiera viktiga hållpunkter genom patientens besök på akutmottagningen. Detta för att förbättra patientsäkerheten, ge en individualiserad vård, ökad delaktighet och minska negativa upplevelser från besöket på akutmottagningen. / Background: In 2022, approximately 1.8 million visits were made to emergency departments around Sweden. The premises of emergency care differ from other care due to the lack of appointment bookings and 24-hour opening hours. The nursing care in the emergency department is influenced by organizational factors such as resources in the form of personnel and workload, in interaction with individual factors of the nurse such as experience, communication skills and the ability to involve the patient. The theoretical framework Fundamentals of care is a modern international theoretical framework developed to link theory to practice in nursing care in modern healthcare. Aim: To describe patients' experiences of seeking care in an emergency department. Method: A general literature review based on 15 scientific articles of qualitative and quantitative approach. Fundamentals of care was used as the theoretical starting point. The data collection was made from searches in the databases CINAHL and PubMed. The articles' quality was reviewed using an assessment form and they were analyzed using an integrated analysis method. Results: Five main categories emerged: Information, Participation, Expectations, Waiting and Environment. Patients experienced vulnerability and a lack of communication in the emergency department. Being involved was felt to be essential. There were unspoken expectations among the patients and long waiting times were considered negative but could be influenced in a positive direction through good nursing care. Both the physical and psychosocial environment at the emergency department were perceived as stressful. Conclusion: The patients in this study experienced vulnerability in the emergency department and desired to be treated with professionalism and empathy. They wanted to establish a relationship with the nurse and nursing staff and expected to have their needs addressed from a holistic perspective. The three dimensions of the Fundamentals of care framework can be used as a theoretical starting point to identify important points of reference through the patient's visit to the emergency department. This is to improve patient safety, provide individualized care, increased participation and reduce negative experiences from the visit to the emergency department.

Aim: The aim was to examine waiting times for cataract extraction in Sweden from an intersectional gender perspective; quantitative with regard to waiting times for different patient groups, and qualitative in order to identify factors that might contribute to gender differences in waiting time. Furthermore, the aim was to examine implications of critical realism and situated knowledges for studies of gender differences among patients regarding access to cataract extraction and more generally as grounds for studies of (in)equity in care.   Methods: Studies I and II were register studies, and linear regression was performed in Study I and logistic regression in Study II. Mean waiting times for female and male patients were calculated in both studies. In Study III, focus group interviews were conducted at two eye clinics with differences in gender-related waiting times. The analysis method used was constructivist grounded theory, and text analyses were performed in Study IV.   Main findings: Longer waiting times were associated with patients who were female, retired, of higher age, born outside the Nordic countries, having lower income, lacking education at university level and not being categorized by means of NIKE. Female patients had longer waiting time in all categories. The following factors might contribute to why female patients have longer waiting times: Traditional male occupations were constructed as being more demanding for visual acuity, while the need for good visual acuity in women’s work life was questioned; Assertive behaviour among men was explained in legitimizing ways; Behaviour among men with poor vision was constructed as safety risks in relation to driving and hunting. Concerning meta-theoretical aspects, both critical realism and situated knowledges can be fruitful for studies of (in)equity in care but are to some degree incompatible with each other.   Conclusions: Differences in waiting times at eye clinics can be related to gender constructions. The prevailing pattern of female cataract patients systematically having longer waiting time than male patients that emerges in this thesis is noteworthy in relation to the principle of equity in care. Furthermore, it is noteworthy that waiting times were related to age, retirement, and native country as well as income and education levels.