Six Sigma to reduce claims processing errors in a healthcare payer firm

Abstract

As a continuous improvement practice, Six Sigma has been accepted globally across the service industry. In the past decade, the application and success of Six Sigma in healthcare services has been remarkable. Despite the fact that several papers on Six Sigma have appeared in the erstwhile literature related to healthcare operations, there is a dearth of field studies highlighting the application of Six Sigma in healthcare outsourced firms, in specific to healthcare payers that engage in a non-clinical setup. The aim of this paper is to explore the role of Six Sigma within the healthcare payer outsourced firms, where error-free delivery becomes critical. The article contributes to the literature of Six Sigma in healthcare outsourcing highlighting how ‘Six Sigma as a methodology’ could help reduce claims adjudication errors in a healthcare payer firm. The Six Sigma DMAIC project case study presented as part of the paper delivered a saving of USD 0.53 million and is a classic example of how Six Sigma can bring bottom-line impact to healthcare outsourced organizations. Managerial implications and lessons learned are discussed alongside the concluding notes.     

A tradeoff model for green supply chain planning:A leanness-versus-greenness analysis

This article presents a tactical supply chain planning model that can be used to investigate tradeoffs between cost and environmental degradation including carbon emissions, energy consumption and waste generation. The proposed model also incorporates other aspects of real world supply chains such as multiple transport lot sizing and flexible holding capacity of warehouses. A solution methodology, the Nested Integrated Cross-Entropy (NICE) method, is developed to solve the proposed mixed-integer nonlinear mathematical model. The application of the model and solution method is investigated in an actual case problem. Analysis of the numerical results focuses on investigating the relationship between lean practices and green outcomes. We find that (1) not all lean interventions at the tactical supply chain planning level result in green benefits, and (2) a flexible supply chain is the greenest and most efficient alternative when compared to strictly lean and centralized situations.     

Measuring impact of Lean implementation on construction safety performance: a structural equation model

Abstract

The construction industry is a risky endeavour. Therefore, it is essential to develop significant safety measures for lowering risks and ensuring safety during projects. However, current safety applications are yet to be developed given the increasing number of workplace accidents. Among these, Lean applications have the potential to improve safety standards and enhance safety performance. Within this context, this study develops components for Lean implementation and construction safety performance, and it presents a conceptual framework to study the relationship between them. A questionnaire was designed and given to Lean practitioners to quantify the impact of the components. Structural Equation Modelling was used to analyse the framework and validate the relationship between Lean implementation and safety performance. The results of the study indicate that there is a significant relationship between Lean implementation and safety performance. The findings also imply that firms that perform well in implementing Lean practices achieve better safety performance. The primary contribution of this research is to prove that Lean practices are closely related to safety performance, with the aim of encouraging construction practitioners to work in a safer environment by using well-established Lean practices. Moreover, the study aims to expand the use of Lean practices to achieve better safety performance by revealing the strong ties between safety and Lean. Finally, this study can guide construction practitioners to adopt Lean techniques and apply them in their projects to enhance safety performance.     

浅议“六书”“三书”

汉字的"六书"理论是指汉字的六种构造条例,是后人根据汉字的形成所作的归纳和概括,而非造字法。"六书说"依据小篆分析汉字结构,反映了汉字构造的法则,许慎用它分析汉字具有划时代的意义,但也有局限性。唐兰、陈梦家、裘锡圭分别提出"三书说"理论,对传统"六书"有所突破,又有新的问题出现。本文以时间为纲,对相关理论家主要观点做出阐释,并分析他们之间的继承和发展、价值与不足。     

从“六普”数据看加快上海社会保障建设的紧迫性

从“六普”数据看,上海人口状况与全国有较大不同,全国人口增速减缓,上海人口增长加快;全国人口老龄化加速,上海常住人1：2的老龄化下降,户籍老龄化上升;上海“少子化”比全国更突出;上海比全国获得更多的人口红利;全国人口向经济发达地区流动,上海人口向城郊结合部和郊区流动;上海劳动人1：7高峰年龄段提前全国5—10年,一方面给上海带来就业压力,另一方面使上海比全国更早进入退休高峰期,社会保障面临更大压力。大量外来劳动力进入上海,给上海养老保险制度改革带来契机。扩大城镇养老保险覆盖面,拓宽社会保障资金筹措渠道,加快户籍制度改革,加强对外来人口的服务与管理。加快老龄事业建设,积极应对人口老龄化。     

北魏六镇研究现状与未来发展——首届北魏六镇学术研讨会综述

2014年8月,＂首届北魏六镇学术研讨会＂在内蒙古包头市固阳县举行。来自国内五十余位专家学者就北魏六镇的考古及保护、北魏长城的确证与保护、北魏民族的交锋与融合、固阳文化风俗的传承与发展进行了深入探讨,为今后一个时期北魏六镇学术研究指明了方向。     

Lean Six Sigma implementation: modelling the interaction among the enablers

Abstract

Lean Six Sigma (LSS) methodology has been acquiring a prominent position in organisations. The aim of this study is to demonstrate an approach to LSS implementation in organisations using the development of a hypothetical model based on interpretive structural modelling (ISM) and fuzzy Matriced Impacts Croisés Multiplication Appliquée á un Classement (fuzzy MICMAC) analysis phenomenon. Seventy Lean Six Sigma enablers (LSSEs) have been identified through extensive literature review and out of which 40 most important LSSEs were finalised through opinions of experts both from industry and academia. Furthermore, the valuable expert opinions have been applied to determine contextual relationships between these significant LSSEs and a hierarchical model has been created based on an ISM. The fuzzy MICMAC analysis has also been utilised to classify the enablers based on the dependence and driving power, and validate the created ISM-based model. The developed hierarchical model will assist to understand interrelationships and interdependencies among the identified LSSEs. Having high driving and low dependence power, the LSSEs have strategic significance because of their driving character. On the other hand, having high dependence and low driving power, LSSEs are more performance orientated. The mutual influence, driving and dependence power of LSSEs render valuable information to top management to distinguish between independent and dependent LSSEs. An organisation desiring of adopting LSS may get benefited by the understanding of LSSEs and their interactions.     

Case study in Six Sigma methodology: manufacturing quality improvement and guidance for managers

This article discusses the successful implementation of Six Sigma methodology in a high precision and critical process in the manufacture of automotive products. The Six Sigma define–measure–analyse–improve–control approach resulted in a reduction of tolerance-related problems and improved the first pass yield from 85% to 99.4%. Data were collected on all possible causes and regression analysis, hypothesis testing, Taguchi methods, classification and regression tree, etc. were used to analyse the data and draw conclusions. Implementation of Six Sigma methodology had a significant financial impact on the profitability of the company. An approximate saving of US$70,000 per annum was reported, which is in addition to the customer-facing benefits of improved quality on returns and sales. The project also had the benefit of allowing the company to learn useful messages that will guide future Six Sigma activities.     

中国现代歌谣研究的分类问题探讨

歌谣分类一直是现代歌谣研究中悬而未决的问题。早在现代歌谣学诞生之初,学术界就引发了关于歌谣分类问题的讨论。以周作人、顾颉刚、邵纯熙为主的“六分法”、“歌者分类法”和“七情”分类法代表了当时的三种分类理念。他们的分类方法为当时歌谣研究带来便利,但同时也引起颇多争议。这些争议促使人们从更客观的角度认识歌谣分类问题,也为后世歌谣分类体系的建构提供参考依据。     

探讨性与天道——《郭店儒简》的作者归属 及其思想辨析

《郭店楚墓竹简》出土并整理发表以后,为学术界补写或改写先秦思想史提供了极为珍贵的思想资料。但学界对其中的儒家竹简（简称《郭店儒简》）分歧尤大。《郭店儒简》应定编为十一篇,可认定为子思学派之作,应命名为《郭店楚墓竹简·子思子》。其思想主旨是阐述了先秦儒家关于性与天道、王道与德治的思想主张,上承孔子的“德治”主义,下启孟子的“性善”论与“仁政”说,在中国思想史上起了从孔子过渡到孟子的桥梁作用。