The 2001 Institute of Medicine's (I.O.M.) landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century observes that, "[though] medical science and technology have advanced at a rapid pace,...the health care delivery system has floundered in its ability to provide consistently high-quality care" (I.O.M. 2001). The report recommended six quality aims for a twenty-first century health care system; one of them being patient-centered care. It explains patient-centered care as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions" (I.O.M. 2001). This research is aimed at directly addressing this I.O.M. recommendation and seeks to understand quality care in the context of the I.O.M. guideline which clearly states that to achieve quality "the patient is the source of control of interactions" with the provider system. The objectives of this project are: (i) to gain a deeper and clearer understanding of the ways patients as customers of an outpatient clinic evaluate health care providers, and (ii) to determine if varying definitions of service quality exist with in a clinic containing a complex constituency. The project site chosen was the set of outpatient clinics at USF Health that makes for a complex site (e.g. eighty different specialties, outpatient surgical units, practicing and academic environment, multi-disciplinary teams at work involving multiple levels of health care professionals and complex inter-personal relationships) to carry out this research. The formal hypothesis can be stated as follows: H1: There exist identifiable differing classes of patients with varying perceptions of Service Quality in an outpatient setting. The subsequent research questions that the research aims to address are that, given that differing patient classes can be identified, do they have an impact on the overall patient-perceived quality and how significant is the impact? The project will contribute to a change in the approach at the clinic from a profession-centered to a patient-centered effort. It will raise the awareness among clinicians about how patients view quality care which can then be integrated into the system, institutionalized over time and thus help them improve their ability to provide quality care as preferred by patients. It will also serve to educate and empower the patients by increasing their participation and strengthening their role as partners with clinicians in a health care system. According to a review of the consumer health literature (Hibbard 2003), patients who collaborate with their health care providers and play an active role in their health care have improved health outcomes. It also enables future work in metric identification to promote continuous improvement in care provision. Though the research was conducted at a specific outpatient setting, it will have wider applicability as it can be a model worth emulating more broadly. The study also contributes to the academic literature that clearly indicates that there is a recognized need for more research on the delivery of outpatient care (Hammons 2003). Additionally, the study can be applicable and useful in other environments with complex constituencies (e.g. university classrooms, public transportation and travel industry).

Scientific evidence of human impact on the natural environment, such as global warming, continues to mount. Green manufacturing systems that focus on minimizing environmental impact of manufacturing processes and products are ever more important to our sustainable future. Green manufacturing systems are slow to gain acceptance as manufacturers are focused on implementing Lean manufacturing systems, generally considered the most competitive manufacturing systems in the world. In recent years, researchers and the US Environmental Protection Agency (EPA) have sought to "build a bridge" between Lean and Green manufacturing systems, in hopes that the rapid expanse of Lean can serve as a catalyst to the implementation of Green manufacturing systems.This study contributes to this growing body of knowledge by determining if leading Lean manufacturers are transcending beyond the traditional limits of Lean and implementing Green manufacturing systems as part of their overallwaste reduction strategy. In this work Lean manufacturing plants that have been evaluated by a panel of experts from the Shingo Prize for Excellence in Manufacturing are surveyed on the diffusion of Green manufacturing system practices throughout their operation. A full system correlation analysis is performed utilizing forty-eight measures of Lean and Green manufacturing systems under the categories of management system, waste reducing techniques, and results. Data analysis indicates that known Lean manufacturers are significantly Greener than the general population of manufacturers in twenty-five of twenty-six measures of Green manufacturing. Lean manufacturers who implement Green manufacturing systems have the strongest results in both Lean and Green result areas, particularly cost reduction, indicating synergy between Lean and Green manufacturing systems. Manufacturing plants that choose to vertically integrate versus horizontally integrate their Lean systems transcend to Green manufacturing. Mexican plants in the study practice significantly higher levels of material resource efficiency and are more inclined to develop industrial partnerships to resolve environmental issues. The study also identifies a critical need for integrating Lean and Green management systems to drive synergistic waste reducing techniques throughout the operation. An integrated Lean and Green manufacturing system model, dubbed "Zero Waste Manufacturing", is proposed as a solution for economically and environmentally sustainable manufacturing.

In the construction industry, onsite labour is one of the most variable and costly factors which affect project profits. Due to the variable nature of construction labour and its correlation with profits, construction managers require a comprehensive understanding of the activities of workers onsite. For project success, it is important that workers are spending the majority of their time installing materials which advance the project. This material installation time is known in the construction industry as “direct-work” or “tool time”. Site management should continuously seek to improve the direct-work rate through the life of the project. A review of the literature indicates that no workface assessment method exists in the literature which provides: (1) a detailed description of worker activities, and (2) a continuous productivity improvement process to help management identify productivity inhibitors affecting site labour, to develop a plan to reduce or eliminate these issues, and to measure improvements as a result of these changes. In response to this need, this research has focused on the development of a workface assessment method called activity analysis. Activity analysis is a continuous productivity improvement process which efficiently measures the time expenditure of workers onsite and identifies productivity inhibitors that management must reduce or eliminate to provide workers with more time for direct-work activities. Six case studies were conducted to verify the feasibility of the activity analysis process. Further, cyclical data from two major construction firms was collected and statistically analyzed to validate the hypothesis that activity analysis can improve direct-work rates. It has been concluded that activity analysis, as a continuous productivity improvement process, is both feasible and when continually applied to a construction site, can significantly improve direct-work rates through the life of a project.

Continuous Improvement processes are commonly used by many organizations facing competitive pressure. By implementing continuous incremental changes, it allows optimizing resources while maintaining flexibility. However, it requires significant resources and involvement from all levels of management, as well as field workers. Continuous Improvement is based on the study of processes and the identification of recurrent problems; therefore it is particularly adapted to manufacturing activities and other repetitive processes. R&D (Research and Development) activities are less repetitive and tend to be iterative, which make them more difficult to study. Yet these activities represent a strong competitive asset and an early mistake or misunderstanding might have a significant cost. The objective of this project was to study the deployment of Continuous Improvement for R&D processes through a literature review and a case study in the pharmaceutical industry. Action research has been the research method that has been employed; the particularity of this method is that the researcher participates actively to the studied change. It resulted in the identification of some characteristics that have to be taken into account in the deployment of improvement activities. First the culture is based on problem-solving, which increase the efficiency of data study and analytical method whilst formalization tools are less efficient, as well as performance indicators related to improvement activities. Besides, the need of customers (both internal and external) is difficult to define and is subject to evolution; this issue tends to be aggravated by a lack of communication. Moreover, development projects being unique and highly iterative, it is recommended to study processes at a more conceptual level, although no specific mapping tool seems particularly adapted. Finally, beside the study of general processes, the study of each individual project (project reviews) allows individual and collective learning. This project also propose a tool allowing the study of information flows between activities and teams in order to reduce mismatch between need and reality (and thus communication issues). This tool relies on the use of local SIPOC diagrams to represent activities and the mapping of flows between each of them.

The purpose of this study was to investigate the total quality management of the academic administration services’ post–graduate department within the Potchefstroom Campus of the North–West University, in terms of the following: – The implementation of TQM at the University – The organisational profiles of the University – How the organisation’s goals and missions are structured around the needs of its customers – Total Quality Management is a concept generally used throughout organisations providing tertiary education in South Africa. There are, however, some universities that do not use TQM. This study investigates the use of TQM within a tertiary education institution at the post–graduate administration department. The results of the problems experienced through the implementation of TQM are reported in this study. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2012.

There can be little doubt that Six Sigma is far more than just another novelty concept; in fact, it can be considered as a proven quality philosophy and if applied correctly, ensures a competitive advantage. A rapidly increasing number of firms, from all industries and of all sizes, are now reporting significant savings or returns on their program and training investments, because of the implementation of Six Sigma. This paper investigates the origin, definition, financial benefits and challenges of Six Sigma and its implementation. Certain critical success factors determine the successful implementation of Six Sigma in any firm. Many firms have reported significant benefits as a result of Six Sigma project implementation, though not all are yet success stories. This paper reviews the literature related to the critical success factors for the effective implementation of Six Sigma. This research will provide the useful information for firms, which are willing to implement Six Sigma and help firms avoid the risks during the process of Six Sigma implementation. The primary objective of this exploratory research is to identify the critical success factors required for the successful implementation of Six Sigma. Then, based on the critical success factors identified in literature and the survey, the purpose is to develop and propose an applicable framework for firms to successfully implement Six Sigma. The research is explorative of nature and a survey research design was used with a questionnaire as data-gathering instrument. Descriptive statistics (e.g. means and standard deviations) were used to analyse the data. The results confirmed that the most critical success factors for successful Six Sigma implementation include management commitment, change management, effective communication and alignment. The proposed framework presents six interlinking components of Six Sigma which is dependent on these four critical success factors. Limitations in the research are identified and recommendations for future research are made. / Thesis (M.B.A.)--North-West University, Vaal Triangle Campus, 2009.

There can be little doubt that Six Sigma is far more than just another novelty concept; in fact, it can be considered as a proven quality philosophy and if applied correctly, ensures a competitive advantage. A rapidly increasing number of firms, from all industries and of all sizes, are now reporting significant savings or returns on their program and training investments, because of the implementation of Six Sigma. This paper investigates the origin, definition, financial benefits and challenges of Six Sigma and its implementation. Certain critical success factors determine the successful implementation of Six Sigma in any firm. Many firms have reported significant benefits as a result of Six Sigma project implementation, though not all are yet success stories. This paper reviews the literature related to the critical success factors for the effective implementation of Six Sigma. This research will provide the useful information for firms, which are willing to implement Six Sigma and help firms avoid the risks during the process of Six Sigma implementation. The primary objective of this exploratory research is to identify the critical success factors required for the successful implementation of Six Sigma. Then, based on the critical success factors identified in literature and the survey, the purpose is to develop and propose an applicable framework for firms to successfully implement Six Sigma. The research is explorative of nature and a survey research design was used with a questionnaire as data-gathering instrument. Descriptive statistics (e.g. means and standard deviations) were used to analyse the data. The results confirmed that the most critical success factors for successful Six Sigma implementation include management commitment, change management, effective communication and alignment. The proposed framework presents six interlinking components of Six Sigma which is dependent on these four critical success factors. Limitations in the research are identified and recommendations for future research are made. / Thesis (M.B.A.)--North-West University, Vaal Triangle Campus, 2009.

The purpose of this study was to investigate the total quality management of the academic administration services’ post–graduate department within the Potchefstroom Campus of the North–West University, in terms of the following: – The implementation of TQM at the University – The organisational profiles of the University – How the organisation’s goals and missions are structured around the needs of its customers – Total Quality Management is a concept generally used throughout organisations providing tertiary education in South Africa. There are, however, some universities that do not use TQM. This study investigates the use of TQM within a tertiary education institution at the post–graduate administration department. The results of the problems experienced through the implementation of TQM are reported in this study. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2012.

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