A methodology for the modular structure planning of product-service systems

Product-service system (PSS) is an important way of the transformation and upgrading of modern manufacturing industry, it is also one of core development trends of intelligent manufacturing. A PSS can be configured quickly and cheaply to meet the customer's personalized product and service requirements via a PPS design platform, and a modular master structure is the core of PSS design platform. When a PSS instance is configured, it needs to determine the module types and make decisions on the types of PSS firstly, so as to build a master structure for PSS. Therefore, the decision-making on module types and customization degree is a key step to establish the PSS modular master structure. This article proposes a five-step planning method for the modular structure planning of PSS. Firstly, the PSS module types are classified based on the Kano model. Then, bi-level decision-making on modules and its properties are finished by using conjoint analysis method, includes the customer's decision-making on modules and their properties, and the manufacturer's modules and their properties, which provides support for PSS modular optimization configuration design. Finally, the proposed methodology is validated through the case of power transformer. The proposed module planning method for the PSS modular structure helps to determine the module types for PSS services solution layer and generic part layer.

[Structure of Relationships Formed by Occupational Health Nurses for Co-operating with Managers to Support Workers with Mental Health Concerns]

OBJECTIVE

Occupational health staff and managers play important roles in supporting workers with mental health concerns and mutual co-operation among them is a necessary element. However, when co-operating with other professionals, several problems arise that often make such co-operation a challenge. Effective mutual actions are needed to promote such co-operation, and relationships must be formed for this purpose. Therefore, in this study, we aimed to clarify how occupational health nurses form relationships for facilitating co-operation with managers to provide support to workers with mental health concerns.

METHODS

Data were collected using semi-structured interviews with 11 occupational health nurses who provide individualized mental health support and who have at least 5 years of experience as occupational health nurses. Analysis of the recorded interviews was performed using a qualitative statistical method (KJ method).

RESULTS

Six elements that constitute the formation of relationships were identified. When occupational health nurses form relationships for facilitating co-operation with a manager to provide support to workers, they "form relationships through strategic communication" with them and when co-operation is required, they form a relationship by "acting in a manner that suits the manager," such as his/her character and the situation. To support this relationship, occupational health nurses "provide mental support to the manager" by listening to his/her anxiety or real intention about supporting the subordinate with mental health concerns and provide relief while understanding their burdens during the co-operation. Occupational health nurses even "provide support to the manager in their activities," which assessed the situation at the workplace as the specialist and advised the manager to understand how to concern to the subordinate specifically. In addition, they "indirectly support the manager" which included coordinating with the concerned persons so as to not excessively burden the manager. Such support promoted the "creation of systems for clear roles" of managers in supporting the subordinate with mental health concerns.

DISCUSSIONS

Relationships that occupational health nurses form with their managers were the structure which formed emotional human relationships from the front or back necessity of co-operation causes and developing confidence in relationships with the foundation of emotional human relationships.

How to survive climate change and still run a thriving business

Climate change presents clear and pressing threats to business--materials and product shortages, price volatility, legal bans or consumer backlash, and damaged transportation infrastructure, to name just a few. But there are opportunities as well. Lowitt, a consultant in the sustainability field, has developed a series of detailed checklists that will help smart managers reduce operational, regulatory, and reputational risk while finding new ways to cut costs, improve performance, enhance customer relationships, and otherwise increase competitiveness. The checklist recommendations, tested and refined through Lowitt's research into and work with firms including Coca-Cola, GE, and Owens Corning, cover four broad areas in the product life cycle: sourcing, manufacturing, distribution, and consumption. Actions range from educating and incentivizing employees to use climate change-conscious behavior to measuring and reporting key metrics to determining when alternative materials, methods, sites, or contract partners may be called for. Like any such tool, the checklists don't provide a one-size-fits-all plan. Rather, they equip executives to customize their strategies according to factors such as their goods and services, risk tolerance, customer needs, and reliance on third parties throughout the value chain.

Understanding how orthopaedic surgery practices generate value for healthcare systems

BACKGROUND

Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems.

QUESTIONS/PURPOSES

We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits.

METHODS

We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals.

RESULTS

A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management.

CONCLUSIONS

There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and demonstrate the value they create in healthcare organizations.

Taking a good look at the competition

Among the steps to take in conducting a focused analysis of your competitors: Assess your market clout and understand who your competition is. Determine how important your core service area is to your competitors. Tap intelligence networks within your own organization.

Design thinking

In the past, design has most often occurred fairly far downstream in the development process and has focused on making new products aesthetically attractive or enhancing brand perception through smart, evocative advertising. Today, as innovation's terrain expands to encompass human-centered processes and services as well as products, companies are asking designers to create ideas rather than to simply dress them up. Brown, the CEO and president of the innovation and design firm IDEO, is a leading proponent of design thinking--a method of meeting people's needs and desires in a technologically feasible and strategically viable way. In this article he offers several intriguing examples of the discipline at work. One involves a collaboration between frontline employees from health care provider Kaiser Permanente and Brown's firm to reengineer nursing-staff shift changes at four Kaiser hospitals. Close observation of actual shift changes, combined with brainstorming and rapid prototyping, produced new procedures and software that radically streamlined information exchange between shifts. The result was more time for nursing, better-informed patient care, and a happier nursing staff. Another involves the Japanese bicycle components manufacturer Shimano, which worked with IDEO to learn why 90% of American adults don't ride bikes. The interdisciplinary project team discovered that intimidating retail experiences, the complexity and cost of sophisticated bikes, and the danger of cycling on heavily trafficked roads had overshadowed people's happy memories of childhood biking. So the team created a brand concept--"Coasting"--to describe a whole new category of biking and developed new in-store retailing strategies, a public relations campaign to identify safe places to cycle, and a reference design to inspire designers at the companies that went on to manufacture Coasting bikes.

If brands are built over years, why are they managed over quarters?

Brands are on the wane. Many consumer-goods companies blame the big-box discount retailers, but the Wharton School's Leonard Lodish and the Fuqua School's Carl Mela have a different explanation. Their research suggests that companies have damaged their brands by investing too much in short-term price promotions and too little in long-term brand building. To rescue their brands and increase profitability, corporate managers must arm themselves with long-term measures of brand performance and use them to make smarter marketing decisions. Several factors explain the short-sightedness of brand management: the increased availability of weekly, or even hourly, scanner data, which show a clear link between discounts and immediate boosts in sales; the relative difficulty of measuring the effects of advertising, new-product development, and distribution--all of which can contribute to a brand's long-term health; the short tenure of most brand managers; and the near-term orientation of Wall Street analysts. Although discounts do increase sales in the short-term, they ultimately lower profit margins. If a product is often discounted, consumers learn to buy it only when it's on sale. Moreover, when one firm increases its discounts, others usually follow suit, lowering everyone's margins. Executives can monitor a brand's long-term performance by watching a dashboard of measures. Only after examining such measures, for example, did managers at Clorox discover that the company's heavy discounting and decreased advertising had caused a steady decline in overall bleach sales and profit margins. In response, Clorox reduced discounting and increased television advertising, moves that ultimately strengthened the brand and reversed the firm's downward trends.

The re-emergence of clinical service line management

As healthcare leaders are positioning their organizations for a more competitive environment characterized by expanding consumer choice models, they are renewing their attention on organizing along clinical service lines. Bringing together clinical services in ways meaningful to patients can improve quality b better integrating care, while at the same time strengthening an organization's market position and creating new opportunities for increased physician collaboration--from collaborative planning to management to economic participation.

A buyer's guide to the innovation bazaar

Companies seeking new ideas or product concepts from outside sources may find the "innovation bazaar," with its wide array of choices and methods of acquiring them, a confusing, chaotic place. Nambisan and Sawhney have crafted a conceptual guide for managers who understand the importance of going outside their firms for innovation but are uncertain about how to do it. The authors' "external sourcing continuum" shows at a glance how shopping for, say, raw ideas compares with shopping for market-ready products in terms of cost, risk, multiplicity of options, and speed of commercialization. Raw ideas, whether acquired directly from the inventor or through a patent broker, licensing agent, or some other intermediary, tend to be low cost but high risk and take a long time to bring to market. Market-ready products, often acquired as stand-alone businesses through a venture capitalist or business incubator, are more expensive and narrow one's choices, but they can be launched quickly and with less risk. Between these two approaches lies a third, facilitated by the "innovation capitalist." This new kind of intermediary provides client companies with access to a broad range of innovative product or technology ideas that are nearly market ready, thereby mitigating early-stage risks and lowering the time to market without significantly increasing acquisition costs. The authors compare the advantages and disadvantages of using intermediaries associated with the three approaches and provide a checklist of factors to consider when placing your company on the external sourcing continuum. If you've been oriented toward one end of the continuum or the other, you can increase your options and your flexibility by expanding into the middle.

The innovation value chain

The challenges of coming up with fresh ideas and realizing profits from them are different for every company. One firm may excel at finding good ideas but may have weak systems for bringing them to market. Another organization may have a terrific process for funding and rolling out new products and services but a shortage of concepts to develop. In this article, Hansen and Birkinshaw caution executives against using the latest and greatest innovation approaches and tools without understanding the unique deficiencies in their companies' innovation systems. They offer a framework for evaluating innovation performance: the innovation value chain. It comprises the three main phases of innovation (idea generation, conversion, and diffusion) as well as the critical activities performed during those phases (looking for ideas inside your unit; looking for them in other units; looking for them externally; selecting ideas; funding them; and promoting and spreading ideas companywide). Using this framework, managers get an end-to-end view of their innovation efforts. They can pinpoint their weakest links and tailor innovation best practices appropriately to strengthen those links. Companies typically succumb to one of three broad "weakest-link" scenarios. They are idea poor, conversion poor, or diffusion poor. The article looks at the ways smart companies - including Intuit, P&G, Sara Lee, Shell, and Siemens- modify the best innovation practices and apply them to address those organizations' individual needs and flaws. The authors warn that adopting the chain-based view of innovation requires new measures of what can be delivered by each link in the chain. The approach also entails new roles for employees "external scouts" and "internal evangelists," for example. Indeed, in their search for new hires, companies should seek out those candidates who can help address particular weaknesses in the innovation value chain.

Companies and the customers who hate them

Why do companies bind customers with contracts, bleed them with fees, and baffle them with fine print? Because bewildered customers, who often make bad purchasing decisions, can be highly profitable. Most firms that profit from customers' confusion are on a slippery slope. Over time, their customer-centric strategies for delivering value have evolved into company-centric strategies for extracting it. Not surprisingly, when a rival comes along with a friendlier alternative, customers defect. Adversarial value-extracting strategies are common in such industries as cell phone service, retail banking, and health clubs. Overly complex product and pricing options, for example, may have been designed to serve various segments. But in fact they take advantage of how difficult it is for customers to predict their needs (such as how many cell phone minutes they'll use each month) and make it hard for them to choose the right product. Similarly, penalties and fees, which may have been instituted to offset the costs of undesirable customer behavior, like bouncing checks, turn out to be very profitable. As a result, companies have no incentive to help customers avoid them. Tactics like these generate bad publicity and fuel customer defections, creating opportunities for competitors. Virgin Mobile USA, for example, has lured millions of angry cell phone customers away from the incumbents by offering a straightforward plan with no hidden fees, no time-of-day restrictions, and no contracts. ING Direct, now the fourth-largest thrift bank in the United States, offers accounts with no fees, no tiered interest rates, and no minimums. In industries where squeezing value from customers is commonplace, companies that dismantle these harmful practices and design a transparent, value-creating offer can head off customer retaliation and spur rapid growth.

The value captor's process: getting the most out of your new business ventures

The high failure rate among new business ventures is usually chalked up to the fundamental uncertainty of the process. In actuality, say McGrath and Keil, flawed ways of assessing and managing ventures may account for the disappointing amount of value they generate. Instead of taking the go/no-go approach, whereby a project either advances toward launch or is killed, decision makers should consider a range of alternatives: recycling the venture by aiming it at a new target market; spinning it off to other owners or a joint venture; spinning it in to an established business unit; or salvaging useful elements such as technologies, capabilities, knowledge, and patents. Firms that excel in value extraction--the "value captors" whose practices and mind-set this article explores--have created formal processes to systematically mine successes, failures, and everything in between. They know that a venture should be treated like a scientific experiment, in which learning plays a critical role. They are ready to seize new opportunities if a venture falters on its original course. They foster networks to promote cooperation and collaboration between established business leaders and venture teams and involve people from throughout the company in the venture review process. They don't allow financial criteria to dominate the reviews, and they recognize that the best people to launch a business may not be the ones who developed the idea. If your innovation pipeline is dry, your promising projects are being strangled for lack of a speedy payback, or someone else has made a fabulous business out of a slightly altered idea that you abandoned, consider the value captor's path.

Creating and promoting a sports performance service offering

Many private hospitals and physician groups are exploring the possibility of expanding their facilities to include advanced ancillary services. Services such as a sports performance center provide additional opportunities for quality patient care and at the same time augment the bottom line. By offering additional ancillary services, healthcare organizations such as an orthopaedics practice can become a full-service center enabling clinicians to more fully provide care to their patients. Marketing and promotion play a crucial role in this type of service. These activities must be designed and carried out in a way that encourages productive results and collaboration as the organization strives to position itself as a full-service center and as a sports specialist in its community.

U.S. Trends In CABG Hospital Volume: The Effect Of Adding Cardiac Surgery Programs

Hospital coronary artery bypass graft (CABG) volume is inversely related to mortality--with low-volume hospitals having the highest mortality. Medicare data (1992-2003) show that the number of CABG procedures increased from 158,000 in 1992 to a peak of 190,000 in 1996 and then fell to 152,000 in 2003, while the number of hospitals performing CABG increased steadily. Predictably, the proportion of CABG procedures performed at low-volume hospitals increased, and the proportion in high-volume hospitals declined. An unintended consequence of starting new cardiac surgery programs is declining CABG hospital volume--a side effect that might increase mortality.

A marketing clinical doctorate programs

Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.

Production flow analysis: a tool for designing a lean hospital

Production flow analysis (PFA) was used in the planning process for a new acute care hospital. The PFA demonstrated that functional organisation--for example, with centralised medical imaging-- generates a lot of back and forth patient transfers between functional units. This to-and-fro patient flow increases lead times of care processes and also exposes the patients to unnecessary complications. PFA produced an ideal patient flow model and layout model for the acute care hospital. Thus, PFA revealed information for use in proximity ranking of different units of the hospital; the planning team then decided which units should be placed next to each other. Medical imaging should be essentially ubiquitous, to achieve simple, high-velocity patient flow. Thus, a modern decentralized layout model for medical imaging was planned. Furthermore, PFA enables optimizing transfer routes for patients and also, e.g., lift capacity in the hospital.

An academic-community cardiovascular service line affiliation: design, implementation, and performance

Both affiliation with an academic medical center and implementation of service line management may be effective management strategies for community health care organizations. The authors describe the design, implementation, and performance of a unique combination of these two distinct strategies for cardiovascular program development in the affiliation of the University of Florida Health Science Center with Health First, a regional community-based integrated delivery system.

Complementary and alternative medicine--a consumer CAM-paign

Complementary and alternative medicine (CAM) isn't just for the "New Age" set anymore-increasingly, patients are voting with their feet, choosing those institutions that offer CAM therapies.

Branding. Presbyterian Hospital of Dallas, TX

To help position Presbyterian Hospital of Dallas as a referral center rather than a large community hospital, the facility launched an aggressive multiphase campaign, with Phase I already underway as of April. By using real-life patient testimonials to highlight procedures, technologies, and services not offered by competitors, the effort hopes to increase brand recognition in the Dallas area.

What a difference good design makes

Ways to build product differentiation into the development process are outlined here in one company's case study.

An analysis of international health care logistics

PURPOSE

The primary purpose of this study is to undertake a diagnostic investigation of the international health care logistical environment and determine whether regulatory policies or industry procedures have hindered the implementation of just-in-time (JIT) systems and then to recommend operational improvements to be achieved by implementing JIT Systems.

DESIGN/METHODOLOGY/APPROACH

The analysis was conducted in a systematic manner and compared the anticipated benefits with benefits validated in other industries from the implementation of JIT. An extensive literature review was conducted.

FINDINGS

In this particular study the cost and benefit outcomes achieved from a health care JIT implementation were compared with those achieved by the manufacturing, service, and retail industries. Chiefly, it was found that the health service market must be restructured to encourage greater price competition among priorities. A new standardization process should eliminate duplication of products and realize substantial savings.

ORIGINALITY/VALUE

The analysis was conducted in a systematic manner and compared the anticipated benefits with benefits validated in other industries from the implementation of JIT.