Intelligent systems in manufacturing: current developments and future prospects

Global competition and rapidly changing customer requirements are demanding increasing changes in manufacturing environments. Enterprises are required to constantly redesign their products and continuously reconfigure their manufacturing systems. Traditional approaches to manufacturing systems do not fully satisfy this new situation. Many authors have proposed that artificial intelligence will bring the flexibility and efficiency needed by manufacturing systems. This paper is a review of artificial intelligence techniques used in manufacturing systems. The paper first defines the components of a simplified intelligent manufacturing systems (IMS), the different Artificial Intelligence (AI) techniques to be considered and then shows how these AI techniques are used for the components of IMS

Towards fully-facilitated DES modelling:a successful project

The literature suggests that increasing stakeholder engagement in modelling has a positive impact on healthcare improvement projects using discrete-event simulation (DES). This suggests analysts should strive for the ‘fully-facilitated’ mode of simulation, meaning conducting the whole simulation project together with stakeholders. This paper investigates whether this might be possible in practice. This work arose from a research project with an Italian hospital. The paper describes a simulation project that succeeds in being fully-facilitated through all stages as far as the implementation stage, through combining Business Process Model and Notation (BPMN) and DES. We believe it is the first time that a fully-facilitated DES project in healthcare has been described

Toyota Kata:A missing link in quality improvement in healthcare?

There is great attention in the literature to how to achieve the culture change necessary for adopting and sustaining quality improvement, particularly ‘lean’, in anything more than a superficial way. This is a particularly prominent issue in the English NHS. Toyota Kata is a set of organisational routines designed to embed the foundational behaviours underlying Toyota’s management system. They are currently being tried for the first time in the NHS. We find evidence that, even in this very challenging environment, kata can develop lean management behaviours. Though it is necessarily slow and demanding, these behavioural habits can be embedded

Quality of medication use in primary care - mapping the problem, working to a solution: a systematic review of the literature

Background: The UK, USA and the World Health Organization have identified improved patient safety in healthcare as a priority. Medication error has been identified as one of the most frequent forms of medical error and is associated with significant medical harm. Errors are the result of the systems that produce them. In industrial settings, a range of systematic techniques have been designed to reduce error and waste. The first stage of these processes is to map out the whole system and its reliability at each stage. However, to date, studies of medication error and solutions have concentrated on individual parts of the whole system. In this paper we wished to conduct a systematic review of the literature, in order to map out the medication system with its associated errors and failures in quality, to assess the strength of the evidence and to use approaches from quality management to identify ways in which the system could be made safer. Methods: We mapped out the medicines management system in primary care in the UK. We conducted a systematic literature review in order to refine our map of the system and to establish the quality of the research and reliability of the system. Results: The map demonstrated that the proportion of errors in the management system for medicines in primary care is very high. Several stages of the process had error rates of 50% or more: repeat prescribing reviews, interface prescribing and communication and patient adherence. When including the efficacy of the medicine in the system, the available evidence suggested that only between 4% and 21% of patients achieved the optimum benefit from their medication. Whilst there were some limitations in the evidence base, including the error rate measurement and the sampling strategies employed, there was sufficient information to indicate the ways in which the system could be improved, using management approaches. The first step to improving the overall quality would be routine monitoring of adherence, clinical effectiveness and hospital admissions. Conclusion: By adopting the whole system approach from a management perspective we have found where failures in quality occur in medication use in primary care in the UK, and where weaknesses occur in the associated evidence base. Quality management approaches have allowed us to develop a coherent change and research agenda in order to tackle these, so far, fairly intractable problems