Direct and Indirect Impacts on Health in New Zealand

Direct and Indirect Impacts on Health in New Zealand Nina Grace A. Martinez ASSESSMENT 2 This report is about the different direct and indirect impacts on health in New Zealand and in which these determinants will affect the inequalities in health. Determinant Factors In order to improve the health status of the population and reduce health inequalities in New Zealand, it is important to identify and understand the main factors that protect and promote good health. These factors are known as the determinants of health. Some of these factors are income and poverty, employment and occupation, education, housing, and culture and ethnicity. Social networking is also a factor and of increasing interest. There is now good evidence that social, cultural and economic factors are the most important determinants of good health. Demographic distribution There are 4,579,228 people in total here in New Zealand. It is estimated that there is an increase of one person every 5 minutes. Statistically, there is 1 birth in every 8 minutes and 49 seconds, 1 death in every 19 minutes and 2 seconds and a net migration in every 8 minutes and 25 seconds. For life expectancy, statistically more females live longer than males, approximately 83% females and 79% males. This is due to the higher number of males who are introduced early to smoking, alcohol and drugs. It happens even within the family, inside their own houses wherein, as narrated by you (Ms. Alma Villanueva), that a seven (7) year old child, if I’m not mistaken, was already been using drugs. Income Income is the most important determinant of health and is strongly related to health and well-being. On average, household income in New Zealand declined between 1981 and 1993, with single parent, Maori and Pacific households experiencing the greatest income reductions. The link between poverty and ill health is clear; with exemptions like the most financially incapable families experience the highest rates of illness and premature death. Greater income inequality within society may also be associated with increased overall mortality. Both poverty and income inequalities increased in New Zealand over the past decade. Having less income will lessen an individual or families access to health care. All other problems correlate with low income household. A person will be hesitant to seek for any medical treatment fearing what the cost might be. He or she is more concern on what to put on the table. Employment Employment also plays a particular part in health. Income and employment goes hand in hand as a determinant for health. When a person is unemployed, obviously he or she has a low income or none at all. This will be a factor for him or her to even sustain for him or herself more so with the access to health if he or she is ill. Employment not only affects a person’s physical health but also his or her mental health because being unemployed may bring depression and other psychological ailments due to lack of food and any means to sustain his or her health and well-being and limited or no access to health care services. Even though it is important to have jobs for good health, there are also some occupation related risks that can jeopardize an individual’s health and well-being like causing him or her injuries while at work. Education Low level of education is associated with poor health. Education goes alongside with income and employment as it determines one’s status in society and economy. Having good or higher educational level will make one more productive in terms of having a job and making more income thus more literate and are able to comprehend with any medical treatments needed for one’s well-being and health. Educated people can make healthier decisions in life about health-related habits such as diet and exercise. Statistically speaking, around 20% of New Zealand adults have poor literacy skills. Housing Houses here in New Zealand are very expensive. The high cost of houses is making it difficult for families with low income to budget their expenses for food, education, transport and health services. Because of the high cost of houses, families tend to overcrowd in one house thus making them more susceptible to diseases like respiratory infection or meningococcal disease. Culture and Ethnicity/Traditions/Religious beliefs Cultural factors have its positive and negative influence on health. Like for example, Maoris have a higher number of mortality rate than in New Zealanders because Maoris are more passive in their attitude towards health and most of them lack education and some have no jobs at all thus they have no access to health care services. Maori people experience more health problems thus their mortality and morbidity rates are higher compared to non-Maoris. These are all due to poor socioeconomic status. Some cultures also have their different ways of treating or dealing with any physical ailments. Like for example in my home country, the Philippines, we have different traditions or cultural practices in dealing with illnesses. One of which is consulting a â€Å"quack doctor† or faith healer wherein this particular faith healer is said to be an expert in curing any unexplainable illness. We Filipinos are believers of the supernatural beings in this world. Especially those who are on a below-average familial status, they are those that strongly believe in faith healers or the supernatural beings. For them, any illness is associated with â€Å"na engkanto† or witchcraft. That being said, any traditions or cultural practices has its impacts on health. Consulting faith healers or others with no medical background or knowledge will delay treatment or even cause further damage or worst, death, to patients because of malpractice. Another thing besides culture and tradition is religion. Religion plays a role in health as well. Some religious groups practice differently towards health. For example, Jehovah’s Witness people, they are not allowed to receive any blood transfusion, even if this will prolong the life of the person, still it is not allowed because it will be against their religious practice. Social Networking/Social Cohesion People with strong family, community and cultural ties have better health than people who are socially isolated. Socially isolated people are more prone to having mental or psychological problems. These people include single parent families, people with mental illness, people who are unemployed and those who are living alone and who are old. Being isolated from society or the community is depressing, making one vulnerable to any harm possible. Political Values Making policy that influence health is important. The New Zealand government is responsible for it. A policy about health and well-being of the community is very critical. These policies differ from country to country. One of the policies here in New Zealand is the National Drug Policy wherein its aim is to reduce or limit the supply and use of harmful drug related substances like alcohol, tobacco and illegal drugs. With this policy, the people of New Zealand are now more aware of its effects and consequences if they use or consume such harmful drugs or alcohol. This policy is pro health and enhancement of the people’s well-being. Public Attitudes on health Attitude is a person’s way of thinking or what he or she feels towards something or maybe even someone. An individual’s value is the backbone of his or her attitude. However he or she perceives health is completely because of how she or he views it. Behavior on the other hand is how that person acts or reacts to a particular situation. It is also influenced by the attitude that person has. It is known that New Zealand is a multicultural country. There is a mix of every race and ethnicity in New Zealand thus, each and every ethnicity, race or culture has its own beliefs and practices on health, and each has its own perception or attitude towards health. For example, the Maori people, majority of them are not educated; therefore most of them are illiterate thus making them unaware of what are the benefits of having access to health care services. Another example is the Pacific Islanders, wherein they believe that smoking cessation must come from within, meaning that there should not be any assistance from any programmes of the Ministry of Health to help someone, from the Pacific Islander group, to quit smoking. Others, however, are more aware of what illness and health is. Like the non-Maoris or other New Zealanders and even the migrants, because they are more educated and knowledgeable as to what illness can do to them and how important health is to all. Awareness is the key to good health and well-being of a person. However, for some who are aware, still there are hesitations to access health services because of the cost. Cost of the medical consultation and the medication. Another factor is the lack of availability or time to seek treatment. These are all due to the different determinant factors affecting health and well-being. The Maoris and Pacific Islanders or other ethnic groups that lack awareness should be taught of the importance of health. Make them aware of its effects and consequences if they do not access health care service when they are sick. Like for example the importance of immunization that provides protection from communicable diseases. Also the importance of screening programmes for Cancer for example. Screening is highly important to detect potential problems at an early stage especially with asymptomatic people. It can also provide or offer effective interventions. Awareness and prevention is key to a healthy well-being of a person. To access health, the people must first know that health services do exist. Health is strongly influence by a wide range of cultural, social, economic and environmental factors here in New Zealand. A person’s income, education, ethnicity, culture and social status can be very influential with his or her health and well-being. Without income and employment there will be issues concerning his or her basic needs, access to health, transportation and other needs. One must be educated to ensure jobs. Poverty and unemployment is rampant in New Zealand despite the booming outlook of its country. The government plays a vital role in formulating laws or policies derived from national and international laws that will then benefit or help the poor and unemployed people of New Zealand by subsidizing health services, providing free houses and free education for children of poor families. Prioritizing health on the agenda of the public policy will make the public more aware of the significance of health on the government and policy maker’s decisions. The participation of the public to the policy is a very strong factor to determine the success of the policy. Bibliography Health and Pacific Peoples in New Zealand. (n.d.). Retrieved from Statistics New Zealand: http://www.stats.govt.nz/browse_for_stats/people_and_communities/pacific_peoples/pacific-progress-health/influences-on-health-well-being.aspx The National Advisory Committee on Health and Disability. (1998). The social, cultural and economic determinants of health in New Zealand: Action to Improve Health.

Pom Study Guide

Service Processes – Session 1 The Lean Enterprise Clear focus in operating decisions leads to superior performance But, limits to flexibility, risk of (market or technical) obsolescence, or the routine Operations Strategy is about deciding what solution to offer (product or service), to who, and how to deliver it. [pic] [pic] [pic] [pic] [pic] Manufacturing Process – Session 2 Distinct business processes are appropriate to create distinct value propositions Jumbled flow (job shop) for low volume and highly customized solutions †¢ Disconnected line flow (batch) for multiple products in moderate volumes †¢ Connected line flow (Assembly line) for high volume of major products †¢ Continuous flow for commodity products Important sources of cost differentials †¢ Operations strategy †¢ Operational efficiency The dynamics of the product-process matrix †¢ Positioning in the P-P matrix is not only driven by operations strategy but also by the product lifeline †¢ Moving in the P-P matrix requires changing the entire mindset/culture of the organization [pic] [pic] [pic] [pic] pic] Part II – Business Process Analysis and Improvement Customer Response Performance in Services – Session 3 From parameters to performance If s = 1 server [pic]or use lookup table if s > 1 Parameters sNumber of Servers ?Frequency of arrivals -> x/day / x/hr / x/minute ?Average service time -> days / hrs / minutes ?=1/ ? Service rate ?Utilization; ? = /s CVCoefficient of variation; CV = ? /? (stddev/mean) CVSVariation of service time = / , = 1 if Exponential, 0 if constant. CVAVariation of arrival rate = / , = 1 if Poisson. Average performance measures WqWaiting time WTotal throughput timeLqNumber of customers in the queue LNumber of customers in the system Wq + ? Customer response time Single Server What are the parameters? ?,? , CVA, CVS 1. Find ? = 2. Find Wq from the formula above 3. Lq = ? Wq W = Wq + ? L = ? W Multiple Server 1 . What are the parameters? ?,? , s 2. Find ? = /s 3. Find Lq from table using s and ? ; Assumes CVA = 1 and CVS = 1. 4. Wq = Lq/? W = Wq + ? L = ? W Assembly lineJob Shop CVS0> 1 CVA^v Utilization (target)~90%~60% If multiple production machines, equalize Lq across the production lines Waiting is â€Å"inevitable†, even with less than 100% utilization Scale effects, ? †¢ Utilization effects, ? /(1- ? ) †¢ Variability effects, (CVA2 + CVS2)/2 Little’s Law: Inventory = rate x wait (on average) In general, for stable systems (? < 1), the average inventory in system = average arrival rate x average time in system. Can also be used to calculate the average time in system. L = ? W Managing waits/customer response time †¢ Remove non-value added steps to reduce processing time (? v, ? v) †¢ Reduce variability in demand (CVAv) and process (CVSv) †¢ Pool resources to more effectively use existing capacity (s^) Lessons for Life: Keep slackWhat is the Goa l of the Enterprise? – Session 4 Definitions ThroughputThe rate at which the system generates revenues Production is not revenue Capacity utilization is not the goal, only a possible means to achieve it InventoryThe level of capital invested in the system â€Å"It takes money to make money† †¦ just don’t take too much Money costs money; Opportunity cost of equity, interest charged on debt. Managing with bottlenecks 1. Find the bottleneck 2. Maximize throughput by exploiting the bottleneck o Avoid starving the bottleneck (create buffer for some inventory in front of it). Lost capacity at bottleneck is lost forever o Schedule to keep it busy. Reduce number of setups at the bottleneck (big batches) 3. Elevate: Increase capacity at bottleneck o Reduce length of setup time at the bottleneck o Quality check: Don’t let bad parts be processed on the bottleneck o Offload work to any other resource that can handle it (e. g. cross training, task offloading; res ources in-house or contracted out) o More capacity at bottleneck means more throughput 4. As one bottleneck is resolved, a new bottleneck appears elsewhere. Repeat! 5.Minimize inventory at non-bottlenecks o ‘Drum’ and ‘rope’ scheduling to let the bottleneck set the pace for input materials, to ‘balance flow’. o Reduce batch sizes at non bottle-neck o Efficiency & capacity improvements at non-bottleneck may reduce inventory, but won’t improve throughput 6. Bottleneck early in process simplifies flow management 7. The bottleneck may also be o Accounting systems or focus on operational targets (are not goals, should enable achievement of goals) o Mindsets o Suppliers o Market The â€Å"Goal† approach to management 1. Identify your goal . Identify your bottleneck 3. Exploit your bottleneck a. Don’t starve the bottleneck b. Lost capacity at the bottleneck is lost forever 4. Subordinate all other decisions to step 3 a. The bottle neck is the â€Å"drum† for loading the system 5. Elevate your bottleneck a. Find ways to increase the capacity at the bottleneck 6. Identify your next bottleneck a. Don’t let inertia set in Process of Continuous Improvement †¢ WHAT is it that I should seek to achieve? What is the fundamental challenge? †¢ WHERE is the bottleneck? What prohibits me/us from doing better? †¢ HOW to change?How can I alleviate or even remove this bottleneck? It is the task of the manager to create a process for continuous improvement, not just ad hoc solutions. Key Lessons from Industrial Excellence Award (IEA) Changing Strategies3 months Changing Product Design6 months – 2 years Changing Plant Process2 – 4 years Excellence of Plant Managers †¢ Forecast needed changes in company’s manufacturing strategy †¦ before anyone tells them †¢ Prepare plant’s processes for future changes in product mix †¦ before anyone tells them Busines s Process Economics – Session 5 Process Model Effective capacity of process as a whole is determined by the bottleneck step (step with the smallest effective capacity, expressed in units of final output) †¢ Expressed in units of final output, the effective capacity of a process step depends on downstream losses †¢ Effective capacity of a step also depends on the net availability of that step (including working hours, equipment breakdowns, preventive maintenance, †¦) †¢ In a continuous process, no inventory between steps is allowed. If one step becomes unavailable all upstream steps are immediately blocked and all downstream steps are immediately starved.Levers for Process Improvement †¢ Yield improvements/quality control o Before bottleneck ? Reduce input cost per unit output (lower variable costs! ) ? Capacity doesn’t change (bottleneck still limiting factor) o After bottleneck ? More output per unit input (lower variable costs! ) ? Capacity i ncreases (effect on fixed cost allocation per unit) ? Might change the bottleneck †¢ Bottleneck speed improvement (infrastructure/availability similar) o Increases capacity – more productive hours o Unit variable costs don’t change (same output per unit input) o Bottleneck might shift Ask to see throughput model †¢ Volatility: Can be in demand and price more than in production process Key Lessons †¢ Process flow analysis is needed to understand economics of production and value of improvement, which is essential for good business decisions †¢ The impact of levers for improvement depend on where (in the system) they are used: o Improvement at bottleneck ? Improves the whole system ? May shift the bottleneck o Yield (and quality) improvement before bottleneck ? Use less input per unit output o Yield (and quality) improvement after bottleneck ? Produce more outputs per unit inputYou can always improve by implementing continuous improvement/learning eff orts. Part III – Inventory: Operations and Tactics Customer Response Performance in Manufacturing Operations – Session 6 The Toyota Production System is the benchmark. Definitions BlockingCaused when downstream is slower than upstream StarvationCaused when downstream is faster than upstream BTFBuild-To-Forecast BTOBuild-To-Order Response Times – CRT ? TPT = OQT + PCT CRTCustomer Response Time TPTThroughput Time OQTOrder Queue Time PCTProcess Cycle Times The role of inventory Blocking goes down with inventory, use idle time to produce buffers.If we have a buffer, then starvation will also go down. Push 1. No WIP control 2. If buffer before has units, you produce at next machine Pull 1. WIP control 2. If inventory buffer after needs units, you produce at previous machine If no variability, PUSH = PULL! As variability increases for each machine, what happens to system capacity and why? †¢ As CV2 increases, we are already losing capacity and further increase ha s less effect. †¢ Asymptotic behaviour – capacity approaches 0. As serial length of facility increases, what happens to system capacity and why? As length increases, we are already losing capacity to variability and further increase has less effect. †¢ Asymptotic behaviour – capacity approaches 0. †¢ Once again, kanban length increases capacity. WIP Strategy | |Push |Pull | |BTO | |Target | |BTF |Compaq Now |>^ | Producing to Forecast – Session 7 Supply Chain Management – How Much To order |Demand |5 |6 |7 | |Probability |1/3 |1/3 |1/3 | Cost: $5 |Price |$5. 05 |$10 |$100 | Order Quantity |5 |6 |7 | Reasoning: Margin vs Cost. If margin < Cost, = Cost or > Cost, order quantity will vary accordingly. |Qty |5 |6 |7 | |E[Sales] |5 |5*1/3 + 6*2/3 |5*1/3 + 6*1/3 + 7 * 1/3| |E[Lost Sales] |1 |1/3 |0 | |E[Salvage] |0 |1/3 |1 | E[Demand] = 6 E[Sales] = E[Demand] – E[Lost Sales] E[Salvages] = i – E[Sales] i = ordered quantity -C + VProb (D ? i) = 0 VProb(D ? i) = C Prob(D ? i) = C/V i = ? + z?E[Profits] = Revenue – Cost = Price * E[Sales] + Salvage*E[Salvage] – i * C E[Sales] = E[Demand] – E[Lost Sales] E[Lost Sales] = E[D – i] = NormalLoss(z)* ? Supply Decisions – Alternative Manufacturing / Processing 1. Calculate â€Å"Profit† function for alternative 1 (piV1 – C1) 2. Calculate â€Å"Profit† function for alternative 2 (piV2 – C2) 3. Solve for pi by setting piV1 – C1 = piV2 – C2 4. pi defines the breakpoint. a. Alternative 1 is better when P(D? i) ? pi b. Alternative 2 is better when P(D? i) > pi 5. Use the z-lookup table to find z for pi a. Use this to calculate the order quantity for Alternative 1 (i1) 6.Calculate the full chance tree for option 2 to find total order quantity (i*) 7. Calculate i2 = i* – i1 Note: If multiple options, repeat process successively. Business Process Competition: M&S and Zara – Session 8 |[pic] |[pic] | Inventory Management depends upon the clock speed of the process †¢ Long lead times -> Forecast -> FGI Process (in contrast to product) innovation is an enormous weapon that can disupt the basis of competition †¢ Drive to mass customization, postponement, †¦ †¢ Shifts the diagonal of the product-process matrix downContinuous improvement is a key competitive weapon too, but can lead to rigidity †¢ Market segments, product needs, and technologies shift o Can you adapt your process and market approach fast enough? †¢ Business process reengineering is a difficult alternative to execute †¢ Business process portfolio management may be a good alternative Part IV – Total Quality Management Quality Management in Services – Session 9 Deming †¢ Prevention rather than cure o Process Improvement o Plan, Do, Check, Act †¢ Variations in Manufacturing and Service performance comes from o Process Design – 99% Process Operati ons – 1% †¢ How to divide process variations across design and operations? †¢ Process variation occurs due to many factors o Normal Distribution! ? Central tendency = mean (? ) ? Variability = standard deviation (? ) Historical Performance †¢ Process is in control – process works well according to historical performance †¢ Process is out of control – process has changed 1. Historical mean [pic] 2. Two points consecutively close to UCL or LCL 3. Five consecutive points above/below mean 4. Increasing or decreasing trends (mean is shifting) Tracking Mechanics Discrete variables (Yes/No or OK/defect measure) †¢ P-chart (or s-chart) track proportion defectives (or cumulative number of defectives) †¢ Identify when process goes outside of lower control limit (LCL) or upper control limit (UCL) †¢ Continuous variables (width, time, temp, †¦) †¢ X-bar identifies changes in central position (process mean) through tracking sample mean †¢ R-bar identifies changes in variability (process variation) through tracking sample range (hi-low) Capability analysis †¢ What is the currently â€Å"inherent† capability of my process when it is â€Å"in control†? Conformance analysis SPC charts identify when control has likely been lost and assignable cause variation has occurred Investigate for assignable cause †¢ Find â€Å"Root Cause(s)† of Potential Loss of Statistical Control Eliminate or replicate assignable cause †¢ Need Corrective Action To Move Forward Process Capability & Total Quality Management – Session 10 Definitions CpProcess Capability ratio CpkProcess Reliability Index LCLLower Control Limit LSLLower Specification Limit LTLLower Tolerance Limit (See LSL) UCLUpper Control Limit USLUpper Specification Limit UTLUpper Tolerance Limit (See USL) Potential [pic] gt; 1implies that potential is good, i. e. that the specification limits are greater than the potential performance of the system < 1implies that the potential is bad Performance [pic] > 1implies that performance is good, i. e. that the upper and lower specification limits are more than 3 standard deviations away from the mean performance of the system Why Quality? †¢ Revenue Impact – Customer Satisfaction o Value o Fitness of Use †¢ Cost Impact – Cost of poor quality o Prevention costs o Appraisal costs o Internal failure costs o External failure costs Costs of Quality : Juran model Prevention Costs |Appraisal Costs |Internal Failure|External Failure | | | |Costs |Costs | |Very good machines |Inspection costs |Cost of rework |Costs of warranty | |Very well-trained |Review costs |Scrap costs |Customers go to | |workers | | |competitors | |Excellent, |Workers stopping |Lost time on |Legal costs | |well-defined process |the line |machines | | |Standard operating |Process improvement| |Brand image | |procedures defined |costs | |affected | |clearly | | | | At each stage, costs multiply by a factor of 10!!! The Process Improvement Cycle – PDCA †¢ PLAN a quality improvement o Select theme, grasp situation, preliminary analysis, training programmes, introduce tracking measures and controls, etc†¦ †¢ DO the investigations for improvements Investigate the deviations from â€Å"normal† behaviour – these are opportunities for improvement – and find improvement actions †¢ CHECK the effectiveness of improvement actions o Confirm the effect of countermeasures †¢ ACT by implementing the improvement measures throughout the company [pic] PART V – Course in Review Inventory Between Buyers and Suppliers – Session 11 JIT – Just in Time †¢ Produce what the customer wants, when it is wanted, in the amount it is wanted, where it is wanted †¢ High Volume †¢ Low Inventory (raw materials, WIP, FGI) †¢ Demand pull (produce when needed) †¢ Little JIT: scheduling, inve ntory †¢ Bit JIT (â€Å"lean†): eliminate waste in all activities (scheduling, inventory, human resources, vendors, technology) Seven Forms of Waste (â€Å"MUDA†) |Seven Methods to Eliminate Waste | |Overproduction |Focused factory networks | |Waiting time |Group technology | |Transportation waste |Quality at the source | |Inventory waste |JIT production | |Processing waste |Uniform plant loading | |Waste of motion |Kanban production | |Product defects |Minimize setup times | JIT vs JIT II |JIT |JIT I |Ideal view: piece for piece; lot for lot | | | |Eliminate excess (RMI, WIP and FGI) inventory | | | |Pull supply chain view | | | |Supplier timely and efficient source (RMI) | |JIT II |Administration and management | | | |Eliminate administrative waste | | | |Supplier pulls production from his own plant | | | |Supplier is an effective source of ideas too | Potential gains †¢ Reduced lead times of delivery †¢ Reduced costs of procurement †¢ Avoid exces s inventory stock †¢ Better monitoring of incoming quality †¢ Greater role in new product development for supplier Potential hazards †¢ Supplier gains inside information on cost, process & design †¢ Loss of bargaining power with supplier †¢ Cannot change suppliers easily Requirements for JIT II to create opportunities for win-win †¢ Fair prices †¢ Commitment Communication †¢ Transparency Increasing competition leads to greater focus on core competencies and process efficiencies †¢ JIT is about having lean manufacturing processes to reduce waste †¢ JIT II is about reducing waste with suppliers and distributors Benefits of JIT II include †¢ Improve communication across firm boundaries †¢ Reducing rework †¢ Reducing duplication †¢ Offload work to any other resource that can handle it (e. g. cross training, task Real Just-In-Time delivery (less inventory in the supply chain) †¢ Increased involvement in the buyer- supplier relationship results in better products/services for the customer Conditions for JIT II to work Sufficient volume and transactions to generate cost savings †¢ Supplier has good engineering capabilities to improve overall product/service †¢ Supplier does not provide core technologies for the buyer †¢ TRUST†¦. How to build trust? o Common goal, open communication, and commitment ———————– Prob(D< i) -c C = c – s ith unit demanded Prob(D ? i) Salvage Value ith unit not demanded Revenue Value = revenue – salvage Work in Progress PUSH PULL No Inventory Control Inventory Control Finished Goods Inventory Build-To-Forecast Build-To-Order FGI >> 0 FGI ~0 Capability Analysis Conformance Analysis Eliminate Assignable Cause Investigate for Assignable Cause Pom Study Guide Service Processes – Session 1 The Lean Enterprise Clear focus in operating decisions leads to superior performance But, limits to flexibility, risk of (market or technical) obsolescence, or the routine Operations Strategy is about deciding what solution to offer (product or service), to who, and how to deliver it. [pic] [pic] [pic] [pic] [pic] Manufacturing Process – Session 2 Distinct business processes are appropriate to create distinct value propositions Jumbled flow (job shop) for low volume and highly customized solutions †¢ Disconnected line flow (batch) for multiple products in moderate volumes †¢ Connected line flow (Assembly line) for high volume of major products †¢ Continuous flow for commodity products Important sources of cost differentials †¢ Operations strategy †¢ Operational efficiency The dynamics of the product-process matrix †¢ Positioning in the P-P matrix is not only driven by operations strategy but also by the product lifeline †¢ Moving in the P-P matrix requires changing the entire mindset/culture of the organization [pic] [pic] [pic] [pic] pic] Part II – Business Process Analysis and Improvement Customer Response Performance in Services – Session 3 From parameters to performance If s = 1 server [pic]or use lookup table if s > 1 Parameters sNumber of Servers ?Frequency of arrivals -> x/day / x/hr / x/minute ?Average service time -> days / hrs / minutes ?=1/ ? Service rate ?Utilization; ? = /s CVCoefficient of variation; CV = ? /? (stddev/mean) CVSVariation of service time = / , = 1 if Exponential, 0 if constant. CVAVariation of arrival rate = / , = 1 if Poisson. Average performance measures WqWaiting time WTotal throughput timeLqNumber of customers in the queue LNumber of customers in the system Wq + ? Customer response time Single Server What are the parameters? ?,? , CVA, CVS 1. Find ? = 2. Find Wq from the formula above 3. Lq = ? Wq W = Wq + ? L = ? W Multiple Server 1 . What are the parameters? ?,? , s 2. Find ? = /s 3. Find Lq from table using s and ? ; Assumes CVA = 1 and CVS = 1. 4. Wq = Lq/? W = Wq + ? L = ? W Assembly lineJob Shop CVS0> 1 CVA^v Utilization (target)~90%~60% If multiple production machines, equalize Lq across the production lines Waiting is â€Å"inevitable†, even with less than 100% utilization Scale effects, ? †¢ Utilization effects, ? /(1- ? ) †¢ Variability effects, (CVA2 + CVS2)/2 Little’s Law: Inventory = rate x wait (on average) In general, for stable systems (? < 1), the average inventory in system = average arrival rate x average time in system. Can also be used to calculate the average time in system. L = ? W Managing waits/customer response time †¢ Remove non-value added steps to reduce processing time (? v, ? v) †¢ Reduce variability in demand (CVAv) and process (CVSv) †¢ Pool resources to more effectively use existing capacity (s^) Lessons for Life: Keep slackWhat is the Goa l of the Enterprise? – Session 4 Definitions ThroughputThe rate at which the system generates revenues Production is not revenue Capacity utilization is not the goal, only a possible means to achieve it InventoryThe level of capital invested in the system â€Å"It takes money to make money† †¦ just don’t take too much Money costs money; Opportunity cost of equity, interest charged on debt. Managing with bottlenecks 1. Find the bottleneck 2. Maximize throughput by exploiting the bottleneck o Avoid starving the bottleneck (create buffer for some inventory in front of it). Lost capacity at bottleneck is lost forever o Schedule to keep it busy. Reduce number of setups at the bottleneck (big batches) 3. Elevate: Increase capacity at bottleneck o Reduce length of setup time at the bottleneck o Quality check: Don’t let bad parts be processed on the bottleneck o Offload work to any other resource that can handle it (e. g. cross training, task offloading; res ources in-house or contracted out) o More capacity at bottleneck means more throughput 4. As one bottleneck is resolved, a new bottleneck appears elsewhere. Repeat! 5.Minimize inventory at non-bottlenecks o ‘Drum’ and ‘rope’ scheduling to let the bottleneck set the pace for input materials, to ‘balance flow’. o Reduce batch sizes at non bottle-neck o Efficiency & capacity improvements at non-bottleneck may reduce inventory, but won’t improve throughput 6. Bottleneck early in process simplifies flow management 7. The bottleneck may also be o Accounting systems or focus on operational targets (are not goals, should enable achievement of goals) o Mindsets o Suppliers o Market The â€Å"Goal† approach to management 1. Identify your goal . Identify your bottleneck 3. Exploit your bottleneck a. Don’t starve the bottleneck b. Lost capacity at the bottleneck is lost forever 4. Subordinate all other decisions to step 3 a. The bottle neck is the â€Å"drum† for loading the system 5. Elevate your bottleneck a. Find ways to increase the capacity at the bottleneck 6. Identify your next bottleneck a. Don’t let inertia set in Process of Continuous Improvement †¢ WHAT is it that I should seek to achieve? What is the fundamental challenge? †¢ WHERE is the bottleneck? What prohibits me/us from doing better? †¢ HOW to change?How can I alleviate or even remove this bottleneck? It is the task of the manager to create a process for continuous improvement, not just ad hoc solutions. Key Lessons from Industrial Excellence Award (IEA) Changing Strategies3 months Changing Product Design6 months – 2 years Changing Plant Process2 – 4 years Excellence of Plant Managers †¢ Forecast needed changes in company’s manufacturing strategy †¦ before anyone tells them †¢ Prepare plant’s processes for future changes in product mix †¦ before anyone tells them Busines s Process Economics – Session 5 Process Model Effective capacity of process as a whole is determined by the bottleneck step (step with the smallest effective capacity, expressed in units of final output) †¢ Expressed in units of final output, the effective capacity of a process step depends on downstream losses †¢ Effective capacity of a step also depends on the net availability of that step (including working hours, equipment breakdowns, preventive maintenance, †¦) †¢ In a continuous process, no inventory between steps is allowed. If one step becomes unavailable all upstream steps are immediately blocked and all downstream steps are immediately starved.Levers for Process Improvement †¢ Yield improvements/quality control o Before bottleneck ? Reduce input cost per unit output (lower variable costs! ) ? Capacity doesn’t change (bottleneck still limiting factor) o After bottleneck ? More output per unit input (lower variable costs! ) ? Capacity i ncreases (effect on fixed cost allocation per unit) ? Might change the bottleneck †¢ Bottleneck speed improvement (infrastructure/availability similar) o Increases capacity – more productive hours o Unit variable costs don’t change (same output per unit input) o Bottleneck might shift Ask to see throughput model †¢ Volatility: Can be in demand and price more than in production process Key Lessons †¢ Process flow analysis is needed to understand economics of production and value of improvement, which is essential for good business decisions †¢ The impact of levers for improvement depend on where (in the system) they are used: o Improvement at bottleneck ? Improves the whole system ? May shift the bottleneck o Yield (and quality) improvement before bottleneck ? Use less input per unit output o Yield (and quality) improvement after bottleneck ? Produce more outputs per unit inputYou can always improve by implementing continuous improvement/learning eff orts. Part III – Inventory: Operations and Tactics Customer Response Performance in Manufacturing Operations – Session 6 The Toyota Production System is the benchmark. Definitions BlockingCaused when downstream is slower than upstream StarvationCaused when downstream is faster than upstream BTFBuild-To-Forecast BTOBuild-To-Order Response Times – CRT ? TPT = OQT + PCT CRTCustomer Response Time TPTThroughput Time OQTOrder Queue Time PCTProcess Cycle Times The role of inventory Blocking goes down with inventory, use idle time to produce buffers.If we have a buffer, then starvation will also go down. Push 1. No WIP control 2. If buffer before has units, you produce at next machine Pull 1. WIP control 2. If inventory buffer after needs units, you produce at previous machine If no variability, PUSH = PULL! As variability increases for each machine, what happens to system capacity and why? †¢ As CV2 increases, we are already losing capacity and further increase ha s less effect. †¢ Asymptotic behaviour – capacity approaches 0. As serial length of facility increases, what happens to system capacity and why? As length increases, we are already losing capacity to variability and further increase has less effect. †¢ Asymptotic behaviour – capacity approaches 0. †¢ Once again, kanban length increases capacity. WIP Strategy | |Push |Pull | |BTO | |Target | |BTF |Compaq Now |>^ | Producing to Forecast – Session 7 Supply Chain Management – How Much To order |Demand |5 |6 |7 | |Probability |1/3 |1/3 |1/3 | Cost: $5 |Price |$5. 05 |$10 |$100 | Order Quantity |5 |6 |7 | Reasoning: Margin vs Cost. If margin < Cost, = Cost or > Cost, order quantity will vary accordingly. |Qty |5 |6 |7 | |E[Sales] |5 |5*1/3 + 6*2/3 |5*1/3 + 6*1/3 + 7 * 1/3| |E[Lost Sales] |1 |1/3 |0 | |E[Salvage] |0 |1/3 |1 | E[Demand] = 6 E[Sales] = E[Demand] – E[Lost Sales] E[Salvages] = i – E[Sales] i = ordered quantity -C + VProb (D ? i) = 0 VProb(D ? i) = C Prob(D ? i) = C/V i = ? + z?E[Profits] = Revenue – Cost = Price * E[Sales] + Salvage*E[Salvage] – i * C E[Sales] = E[Demand] – E[Lost Sales] E[Lost Sales] = E[D – i] = NormalLoss(z)* ? Supply Decisions – Alternative Manufacturing / Processing 1. Calculate â€Å"Profit† function for alternative 1 (piV1 – C1) 2. Calculate â€Å"Profit† function for alternative 2 (piV2 – C2) 3. Solve for pi by setting piV1 – C1 = piV2 – C2 4. pi defines the breakpoint. a. Alternative 1 is better when P(D? i) ? pi b. Alternative 2 is better when P(D? i) > pi 5. Use the z-lookup table to find z for pi a. Use this to calculate the order quantity for Alternative 1 (i1) 6.Calculate the full chance tree for option 2 to find total order quantity (i*) 7. Calculate i2 = i* – i1 Note: If multiple options, repeat process successively. Business Process Competition: M&S and Zara – Session 8 |[pic] |[pic] | Inventory Management depends upon the clock speed of the process †¢ Long lead times -> Forecast -> FGI Process (in contrast to product) innovation is an enormous weapon that can disupt the basis of competition †¢ Drive to mass customization, postponement, †¦ †¢ Shifts the diagonal of the product-process matrix downContinuous improvement is a key competitive weapon too, but can lead to rigidity †¢ Market segments, product needs, and technologies shift o Can you adapt your process and market approach fast enough? †¢ Business process reengineering is a difficult alternative to execute †¢ Business process portfolio management may be a good alternative Part IV – Total Quality Management Quality Management in Services – Session 9 Deming †¢ Prevention rather than cure o Process Improvement o Plan, Do, Check, Act †¢ Variations in Manufacturing and Service performance comes from o Process Design – 99% Process Operati ons – 1% †¢ How to divide process variations across design and operations? †¢ Process variation occurs due to many factors o Normal Distribution! ? Central tendency = mean (? ) ? Variability = standard deviation (? ) Historical Performance †¢ Process is in control – process works well according to historical performance †¢ Process is out of control – process has changed 1. Historical mean [pic] 2. Two points consecutively close to UCL or LCL 3. Five consecutive points above/below mean 4. Increasing or decreasing trends (mean is shifting) Tracking Mechanics Discrete variables (Yes/No or OK/defect measure) †¢ P-chart (or s-chart) track proportion defectives (or cumulative number of defectives) †¢ Identify when process goes outside of lower control limit (LCL) or upper control limit (UCL) †¢ Continuous variables (width, time, temp, †¦) †¢ X-bar identifies changes in central position (process mean) through tracking sample mean †¢ R-bar identifies changes in variability (process variation) through tracking sample range (hi-low) Capability analysis †¢ What is the currently â€Å"inherent† capability of my process when it is â€Å"in control†? Conformance analysis SPC charts identify when control has likely been lost and assignable cause variation has occurred Investigate for assignable cause †¢ Find â€Å"Root Cause(s)† of Potential Loss of Statistical Control Eliminate or replicate assignable cause †¢ Need Corrective Action To Move Forward Process Capability & Total Quality Management – Session 10 Definitions CpProcess Capability ratio CpkProcess Reliability Index LCLLower Control Limit LSLLower Specification Limit LTLLower Tolerance Limit (See LSL) UCLUpper Control Limit USLUpper Specification Limit UTLUpper Tolerance Limit (See USL) Potential [pic] gt; 1implies that potential is good, i. e. that the specification limits are greater than the potential performance of the system < 1implies that the potential is bad Performance [pic] > 1implies that performance is good, i. e. that the upper and lower specification limits are more than 3 standard deviations away from the mean performance of the system Why Quality? †¢ Revenue Impact – Customer Satisfaction o Value o Fitness of Use †¢ Cost Impact – Cost of poor quality o Prevention costs o Appraisal costs o Internal failure costs o External failure costs Costs of Quality : Juran model Prevention Costs |Appraisal Costs |Internal Failure|External Failure | | | |Costs |Costs | |Very good machines |Inspection costs |Cost of rework |Costs of warranty | |Very well-trained |Review costs |Scrap costs |Customers go to | |workers | | |competitors | |Excellent, |Workers stopping |Lost time on |Legal costs | |well-defined process |the line |machines | | |Standard operating |Process improvement| |Brand image | |procedures defined |costs | |affected | |clearly | | | | At each stage, costs multiply by a factor of 10!!! The Process Improvement Cycle – PDCA †¢ PLAN a quality improvement o Select theme, grasp situation, preliminary analysis, training programmes, introduce tracking measures and controls, etc†¦ †¢ DO the investigations for improvements Investigate the deviations from â€Å"normal† behaviour – these are opportunities for improvement – and find improvement actions †¢ CHECK the effectiveness of improvement actions o Confirm the effect of countermeasures †¢ ACT by implementing the improvement measures throughout the company [pic] PART V – Course in Review Inventory Between Buyers and Suppliers – Session 11 JIT – Just in Time †¢ Produce what the customer wants, when it is wanted, in the amount it is wanted, where it is wanted †¢ High Volume †¢ Low Inventory (raw materials, WIP, FGI) †¢ Demand pull (produce when needed) †¢ Little JIT: scheduling, inve ntory †¢ Bit JIT (â€Å"lean†): eliminate waste in all activities (scheduling, inventory, human resources, vendors, technology) Seven Forms of Waste (â€Å"MUDA†) |Seven Methods to Eliminate Waste | |Overproduction |Focused factory networks | |Waiting time |Group technology | |Transportation waste |Quality at the source | |Inventory waste |JIT production | |Processing waste |Uniform plant loading | |Waste of motion |Kanban production | |Product defects |Minimize setup times | JIT vs JIT II |JIT |JIT I |Ideal view: piece for piece; lot for lot | | | |Eliminate excess (RMI, WIP and FGI) inventory | | | |Pull supply chain view | | | |Supplier timely and efficient source (RMI) | |JIT II |Administration and management | | | |Eliminate administrative waste | | | |Supplier pulls production from his own plant | | | |Supplier is an effective source of ideas too | Potential gains †¢ Reduced lead times of delivery †¢ Reduced costs of procurement †¢ Avoid exces s inventory stock †¢ Better monitoring of incoming quality †¢ Greater role in new product development for supplier Potential hazards †¢ Supplier gains inside information on cost, process & design †¢ Loss of bargaining power with supplier †¢ Cannot change suppliers easily Requirements for JIT II to create opportunities for win-win †¢ Fair prices †¢ Commitment Communication †¢ Transparency Increasing competition leads to greater focus on core competencies and process efficiencies †¢ JIT is about having lean manufacturing processes to reduce waste †¢ JIT II is about reducing waste with suppliers and distributors Benefits of JIT II include †¢ Improve communication across firm boundaries †¢ Reducing rework †¢ Reducing duplication †¢ Offload work to any other resource that can handle it (e. g. cross training, task Real Just-In-Time delivery (less inventory in the supply chain) †¢ Increased involvement in the buyer- supplier relationship results in better products/services for the customer Conditions for JIT II to work Sufficient volume and transactions to generate cost savings †¢ Supplier has good engineering capabilities to improve overall product/service †¢ Supplier does not provide core technologies for the buyer †¢ TRUST†¦. How to build trust? o Common goal, open communication, and commitment ———————– Prob(D< i) -c C = c – s ith unit demanded Prob(D ? i) Salvage Value ith unit not demanded Revenue Value = revenue – salvage Work in Progress PUSH PULL No Inventory Control Inventory Control Finished Goods Inventory Build-To-Forecast Build-To-Order FGI >> 0 FGI ~0 Capability Analysis Conformance Analysis Eliminate Assignable Cause Investigate for Assignable Cause

Analyse How Moliere Uses Comedy as a Dramatic Technique in Le Tartuffe

Set in the 17th century, Moliere’s Drama, Le Tartuffe is a satirical representation of religious hypocrisy. Its comedy drives the play in a direction where the audience can not only be entertained but understand the morals which are portrayed. It is important to realise the historical context that influenced Moliere’s work of Le Tartuffe in order to understand the construction of the characters and comedy portrayed. Commedia dell’arte were a group of traveling players in Italy who specialised in improvised theatre, creating stock characters for every performance for the audience to identify with and understand their representation in a comic way. Some of these features have been known to have inspired Moliere’s construction of the plot and characters such as Clever talking Dorine shedding light on the truth. In that way, Dorine almost acts as a comedic dramatic tool to highlight the truths and themes of the play. This is particularly evident in her dialogue towards Madame Pernelle, ‘Il passe pour un saint dans votre fantaisie:/Tout son fait, croyez-moi, n’est rein qu’hypocrisie’(Moliere: 1. 1. 69) In supporting this idea, Peter Hampshire Nurse writes that Dorine has ‘brilliant wit with which she ridicules hypocrisy’ (1991:85). Although the majority of modern audience’s would find the witty servant humorous, Paula Alekson noted that ‘Moliere became a master of â€Å"Le ridicule†, so much so that in the process of making the audiences laugh, he made a multitude of serious enemies’(2007:ll 15-16). Away from the controversy that the themes created, Moliere generates much more of the comedy in terms of language, structure and pace of the play. For example in the exposition, when Madame Pernelle talks to the rest of the characters, we are able to see the desire of power towards the daughters as they try to speak by saying, ‘Mais†¦. Je crois†¦mais ma mere’ (Moliere:1. 1)but are cut off every time. Furthermore, repetition is used when Orgon says, ‘Et Tartuffe? / Le pauvre home! (Moliere:1. 4) This conveys Orgons constant obsessive nature over Tartuffe which provokes laughter. Of course when being performed the proxemics and movement of the character along with the dialogue would emphasise the comedy and complete farce that Moliere had stylized the play with. Overall, we are able to conclude that Moliere uses a variety of different techniques, and themes to make the comedy work for the play. We realise that it is not just a form of entertainment but to aid the audience in following the events in the play; to understand the central themes. Andrew Calder noted that Moliere does this in both his plays, Le Tartuffe (1664) and Don Jaun (1665). Calder states that they go ‘beyond the comic stage, and both reflect a lively interest in some of the most topical, moral and theological issues of the time. ’ (1973:153). [Wordcount:457] Bibliography Moliere, 2006. Le Tartuffe. Paris: Larousse. Alekson, Paula. 2007. Dramatic and Theatrical Style a la Moliere: Le ridicule, le naturel, and â€Å"The comic war†. [online] Available at: http://www. mccarter. org/Education/tartuffe/html/4. html Calder, Andrew. 1973. Moliere: The Theory and Practice of Comedy. London:Athlone Nurse, Peter Hampshire,1991. Moliere and The Comic Spirit. Geneve:Libraire Droz

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