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22

18-19 2015, ,

TOCPA
, , 2015 .




, Nottingham Business School, NTU, UK
(Roy.stratton@ntu.ac.uk)

: QFI Consulting, UK
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TOC

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Creative Output
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Lean

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TOC Lean-sigma
Kanban


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Lean - Sigma TOC

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Lean Sigma ,


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Lean Sigma ,

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TOC: :
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!!!!
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26%
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:
TOC lean-sigma

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(4 )
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():
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and spearman, 1995)
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1995)
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CCPM

5(D)
5(D)

2(B)

2(B)

4(C)
1(A) 3(B)

1(A)

4(C)

3(B)

: A,B,C,D

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TQM/Six Sigma

Lean

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(, 2008)



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4 3 : ,
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/ 4

; ;
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54
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A&E
SitRep

4 - 12 hours

Over 12 hours

90
80
70

/Jonah

60
50
40
30
20
10
0

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A&E UK (4 )

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Stratton, R., and Knight A., 2010 Managing Patient Flow using Time Buffers. 56
Journal of Manufacturing Technology Management, 21 (4) pp. 484-498.
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//

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https://www.youtube.com/watch?v=ADXWuEYmVCE

59

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. .

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1
MDT


,

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MDT

PDD 1

PDD 2

MDT
2

PDD 3

MDT
3

PDD 4

MDT
4

MDT
5

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Stratton, R., and Knight A., 2010. Managing Patient Flow using Time Buffers. 63
Journal of Manufacturing Technology Management, 21 (4) pp. 484-498.
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:
: 8

64

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Frimley Park NHS 2009-2012

65

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5
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2 ()

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(T)
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69

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(T)

(I)

(I)
(OE)

70

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13

,
11 12

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4-


23% 3,5

()
( - )
1200

1000
462 / 1.91%
800

940 / 3.88%
1433 / 5.92%
2851 / 11.78%

600

4170 / 17.23%
4499 / 18.59%

400

4187 / 17.30%
4302 / 17.77%
200

1363 / 5.63%

0
0.00.20.40.60.81.01.21.41.61.82.02.22.42.62.83.03.23.43.63.84.04.24.44.64.85.05.25.45.65.86.0
()

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25% 110
; 10%
140

()
( - ( ))
500
450

400
350
300
Patient Count
250

Mean

200

Median
75th Percentile

150

90th Percentile

100
50

0
6
12
18
24
30
36
42
48
54
60
66
72
78
84
90
96
102
108
114
120
126
132
138
144
150
156
162
168
174
180
186
192
198
204
210
216
222
228

()

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Lean-Sigma

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Lean

(Radnor et al., 2012)
,

(Branao de Souza,
2009; Radnor, 2010; Spears, 2005; Young and McClean, 2008; Radnor
and Broaden, 2008).
Lean ,
,
(RIE Rapid Improvement
Events),
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.
, ,

.

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TQM/Six Sigma

Lean

TOC

()

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"Kanban"

()

77

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,

,


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"Kanban" , , ,
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78

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Hopp W.J., and Spearman, M.L., 1995. Factory Physics. Singapore:
McGraw Hill.
Hopp W. (2008), Supply Chain Science
Ohno, T. (1988), The Toyota Production System; Beyond Large-Scale
Production. Portland, OR: Productivity Press.
Radnor, Z.J., Holweg, M. and Waring, J. (2012), Lean in healthcare: The
unfulfilled promise?. Social Science & Medicine, Vol.74, pp. 364-371.
Stratton, R. and Knight, A. (2010), "Managing patient flow using time
buffers"", Journal of Manufacturing Technology Management, Vol. 21,
No 4, pp. 484 - 498
Stratton, R. (2012), Buffer Management in Context. TOCICO annual
international conference, Chicago.

www.tocpractice.com

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