This report is an evaluation on the use of Lean Construction by the contracting company Kruse Smith AS (KS). The study addresses how well the implementation of KS new Lean policy is carried out, what improvements can be made and how the policy itself can be improved. Lean is a planning methodology used by companies to increase workflow and reduce waste in a project. Lean Construction is a development of Lean to adapt to the construction industry. Kruse Smith AS is a construction company engaged in building-, construction- and real estate business. This study focuses on building projects. The survey was done by including three ongoing construction projects: Project 1 - Blocks of flats in Kristiansand Project 2 - High School in Lyngdal Project 3 - Blocks of flats in Sandnes By the results we see that the various projects interpret the policy in different ways and therefore end up with different ways of organizing and structuring the workplace. Yet we see that the basic objectives of the policy can be achieved without necessarily having to do the same. To strengthen the implementation of the policy from the corporate side, they can place the focus on monitoring the various projects, usually where most managers are not accustomed to the use of Lean. In addition, to inform everyone and to create a better knowledge of Lean they can post something about this in the Health and Safety Plan(HMS-plan) as this will be read by all. An improvement of the implementation can also be strengthened if the company puts the most experienced Lean workers with other inexperienced in the various projects. The policy itself can be strengthened by placing greater emphasis on evaluation and continuous improvement, such as entering regular meetings for this. The policy can also focus more on the removal of waste to get rid of as much as possible of unnecessary transportation, searching and waiting. The policy can be further improved by developing the company's deviation system, to include suggestions and improvments. / Dette rapporten er en undersøkelse om bruken av Lean Construction i entreprenørselskapet Kruse Smith AS. Undersøkelsen tar opp hvor godt implementeringen av Kruse Smiths nye Lean policy utføres, hvilke forbedringer som kan gjøres og hvordan selve policyen kan forbedres. Lean er en planleggings metodikk som brukes av bedriften for å øke produksjons flyten og minke sløsing i et prosjekt. Lean Construction er en videreutvikling av Lean for å tilpasse byggebransjen. Kruse Smith AS er et entreprenørselskap som driver med bygg-, anlegg- og eiendomsvirksomhet. Denne undersøkelsen tar for seg prosjekter innen bygg. Undersøkelsen ble gjort ved å inkludere tre pågående byggeprosjekt: Prosjekt 1 – Boligblokker i Kristiansand Prosjekt 2 – Ungdomsskole i Lyngdal Prosjekt 3 – Boligblokker i Sandnes Av resultatene ser man at de ulike prosjektene tolker policyen på forskjellige måter og ender derfor opp med forskjellig organisering og strukturering av arbeidsplassen. Allikevel ser man at de elementære målene i policyen kan bli nådd uten å nødvendigvis måtte gjøre det samme. For å styrke implementeringen av policyen kan det fra bedriftens side legges fokus på oppfølging av de ulike prosjektene, gjerne mest der hvor ansvarlige ikke er vant med bruken av Lean. I tillegg kan det for å informere alle og skape en bedre kjennskap til Lean legges inn noe om dette i helse, miljø og sikkerhets planen (HMS-planen) da denne skal leses av alle. Man kan også bevist plassere de mest Lean erfarne med andre uerfarne i de ulike prosjekt. Policyen kan styrkes ved å legge større fokus på evaluering og kontinuerlig forbedring ved eksempelvis å legge inn faste møter for dette, det kan også fokuseres på fjerning av sløsing slik at man kvitter seg mest mulig med unødvendig transport, leting og venting. Policyen kan i tillegg forbedres ved en videreutvikling av avviksystemet som i dag kun har fokus på uønskede hendelser og kvaliteter, til å også inkludere forbedrings forslag.

Despite a Presidential Order in 2004 that launched national incentives for the use of health information technology, specifically the Electronic Health Record (EHR), adoption of the EHR has been slow. This study attempts to quantify factors associated with adoption of the EHR and Computerized Provider Order Entry (CPOE) by combining multiple organizational theories and empirical studies. The study is conducted in two phases. The primary phase of this study identifies and evaluates the effects of external environmental and internal organizational factors on healthcare organizations to adopt the EHR. From secondary data, twelve IVs (df=19) are chosen based on existing models and literature. Logistic regression is used to determine the association between the environmental factors and EHR adoption. The secondary phase of this study examines the adoption of five variations of CPOE using the same IVs from phase one. This EHR component of CPOE is chosen due to its promotion as a solution to help cross the quality chasm (IOM, 2001). Secondary data are analyzed and logistic regression is used to quantify the association between the factors of EHR adoption and CPOE adoption. Eleven of the twelve IVs are significant between the two phases (p<.1). This study uses data from 2009 because the HITECH Act was passed that year and significant government incentives were offered for those health care organizations (HCOs) that meet the qualifications of meaningful use. This study serves as a baseline for future studies, extends the work of other empirical studies, and fills a gap in the literature concerning factors associated with the adoption of the EHR and specific dimensions of CPOE. The Kruse Theory developed is strongly based in literature and reflects complexity commensurate with the health care industry.

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