The art and science of winning physician support for Six Sigma change

Active physician participation and acceptance of Six Sigma is critical to successful implementation. Take a look at strategies and techniques that can help secure physician support for Six Sigma.     

Leveraging risk assessment for foodborne outbreak investigations: The Quantitative Risk Assessment-Epidemic Curve Prediction Model

Root cause analysis can be used in foodborne illness outbreak investigations to determine the underlying causes of an outbreak and to help identify actions that could be taken to prevent future outbreaks. We developed a new tool, the Quantitative Risk Assessment-Epidemic Curve Prediction Model (QRA-EC), to assist with these goals and applied it to a case study to investigate and illustrate the utility of leveraging quantitative risk assessment to provide unique insights for foodborne illness outbreak root cause analysis. We used a 2019 Salmonella outbreak linked to melons as a case study to demonstrate the utility of this model (Centers for Disease Control and Prevention [CDC], 2019). The model was used to evaluate the impact of various root cause hypotheses (representing different contamination sources and food safety system failures in the melon supply chain) on the predicted number and timeline of illnesses. The predicted number of illnesses varied by contamination source and was strongly impacted by the prevalence and level of Salmonella contamination on the surface/inside of whole melons and inside contamination niches on equipment surfaces. The timeline of illnesses was most strongly impacted by equipment sanitation efficacy for contamination niches. Evaluations of a wide range of scenarios representing various potential root causes enabled us to identify which hypotheses, were likely to result in an outbreak of similar size and illness timeline to the 2019 Salmonella melon outbreak. The QRA-EC framework can be adapted to accommodate any food–pathogen pairs to provide insights for foodborne outbreak investigations.     

Simplicial Pivoting Algorithms for a Tractable Class of Integer Programs

We present a tractable class of integer feasibility problems. This class of max-closed IP problems was studied in somewhat restricted form by Glover, Pnueli, Hochbaum and Chandrasekaran and has a logic counterpart known as the class of Horn formulas. First we modify the existing algorithms in order to avoid the related recognition problem. Then we show that in order to solve these max-closed IP problems, simplicial path following methods can be used. This is important because these methods are flexible with respect to starting conditions, which make them more suitable than the top-down truncation algorithms that have been suggested.     

Vocational Psychology and Career Guidance Practice: An International Partnership

Vast changes in the world of work spurred by rapid technological growth and globalization have called for a more inclusive, progressive, and forward thinking conceptualization of vocational theory, practice, training, and policy. Discussions across 8 discussion groups at the 2007 joint symposium of the International Association for Educational and Vocational Guidance, Society for Vocational Psychology, and National Career Development Association addressed various topics in the field of vocational psychology and career guidance. Several themes emerged that have captured the attention of career scholars and practitioners across the globe: culture and context in theory and practice, research as a process within a contextual system, partnership and collaboration, and social responsibility and public policy.     

Development of a Quantitative Microbial Risk Assessment for Human Salmonellosis Through Household Consumption of Fresh Minced Pork Meat in Belgium

A quantitative microbial risk assessment (QMRA) according to the Codex Alimentarius Principles is conducted to evaluate the risk of human salmonellosis through household consumption of fresh minced pork meat in Belgium. The quantitative exposure assessment is carried out by building a modular risk model, called the METZOON-model, which covers the pork production from farm to fork. In the METZOON-model, the food production pathway is split up in six consecutive modules: (1) primary production, (2) transport and lairage, (3) slaughterhouse, (4) postprocessing, (5) distribution and storage, and (6) preparation and consumption. All the modules are developed to resemble as closely as possible the Belgian situation, making use of the available national data. Several statistical refinements and improved modeling techniques are proposed. The model produces highly realistic results. The baseline predicted number of annual salmonellosis cases is 20,513 ( SD 9061.45). The risk is estimated higher for the susceptible population (estimate  4.713 × 10⁻⁵; SD 1.466 × 10⁻⁵  ) compared to the normal population  (estimate 7.704 × 10⁻⁶; SD 5.414 × 10⁻⁶)  and is mainly due to undercooking and to a smaller extent to cross-contamination in the kitchen via cook's hands.     

Comparing Expressed and Revealed Preferences for Risk Reduction: Different Hazards and Question Frames

Studies often note the wide differences that exist in costs per death avoided across U.S. federal programs and regulatory contexts. This paper explores two new, related explanations for these differences. First, it argues that the patterns of revealed preferences (public allocations) may be related to public values, which are measured here through subjects' expressed preference responses to a contingent valuation survey regarding risk reduction. Subjects' expressed values are compared to actual (and proposed) costs of safety regulations for a similar set of hazards. We discover strong congruence in the ranking of expressed values and actual values. Second, the paper presents the results of a subsequent survey that investigates why the patterns observed in the first survey might occur. It suggests that one reason for the observed similarities between revealed and expressed preferences may be in how choices are framed. The paper hypothesizes that both subjects and decision makers may frame valuation decisions in the same way: as percentage changes from the reference point provided by the base rate of deaths for that hazard.     

How Close Is Close Enough: Public Perceptions of the Risks of Industrial Facilities

Public opinion poll data have consistently shown that the proportion of respondents who are willing to have a nuclear power plant in their own community is smaller than the proportion who agree that more nuclear plants should be built in this country. Respondents' judgments of the minimum safe distance from each of eight hazardous facilities confirmed that this finding results from perceived risk gradients that differ by facility (e.g., nuclear vs. natural gas power plants) and social group (e.g., chemical engineers vs. environmentalists) but are relatively stable over time. Ratings of the facilities on thirteen perceived risk dimensions were used to determine whether any of the dimensions could explain the distance data. Because the rank order of the facilities with respect to acceptable distance was very similar to the rank order on a number of the perceived risk dimensions, it is difficult to determine which of the latter is the critical determinant of acceptable distance if, indeed, there is only one. There were, however, a number of reversals of rank order that indicate that the respondents had a differentiated view of technological risk. Finally, data from this and other studies were interpreted as suggesting that perceived lack of any other form of personal control over risk exposure may be an important factor in stimulating public opposition to the siting of hazardous facilities.     

An environmental life cycle optimization model for the European pulp and paper industry

Will paper recycling reduce the environmental impact of the European pulp and paper sector? If so, is maximal paper recycling the best policy to optimize the life cycle of the pulp and paper sector? We explore these questions using an approach that combines materials accounting methods and optimization techniques. Environmental impact data are inputs for a linear programming network flow model to find optimal configurations for the sector. These configurations consist of a mix of different pulping technologies, a geographical distribution of pulp and paper production, and a level of recycling consistent with the lowest environmental impacts. We use the model to analyse scenarios with different recycling strategies. Recycling offers a reduction in environmental impact in regions with a high population and a large production of paper and board products. Regions with a large production of graphic products should focus on cleaner virgin pulp production with energy recovery. We conclude that relocation of paper production also offers a reduction in environmental impact. However, the severe effects on the economy make this policy less attractive than a combination of recycling, cleaner pulp production and energy recovery.     

European management: An emerging competitive advantage of European nations

This article extends the debate begun in the June 1992 issue of EMJ when the authors first criticized Michael Porter's explanatory framework in his Competitive Advantage of Nations (1990), over the role of national culture on the competitive advantage of nations. In this paper, Frans van den Bosch and Arno van Prooijen stress that Europe is a locus of competitive advantage if one is prepared to pay attention to the possibility of ‘European Management’ as a potential asset of European firms. In this connection, the transnationalization of European firms is of importance.     

Policy analysis in a socioeconomic model of basic needs applied to four countries

This article summarizes the results of a socioeconomic model of basic needs that was applied to four countries—Brazil, Colombia, India, and Kenya. A modeling approach was thought necessary in order to make more precise the concept of basic needs. Although the work has not been entirely successful in doing that, from the policy experiment attempted, and given the limitations of the models used, we believe that an approach centered on the provision of basic needs will help the poorest satisfy their needs more quickly than is possible under alternative approaches.