Work Study and Methods Engineering
Institute of Quality & Technology Management
University of the Punjab, Lahore.
Prepared by: ASIM AMJAD
Email: [Link]@[Link]
IE-313: WS & ME
LAB 01 – CAUSE AND EFFECT DIAGRAM
Draw cause and effect diagram for the following case of DHQ hospital. What are the root causes
so that they can be targeted for improvement?
Case Study of DHQ Hospital
This case study on DHQ Hospital reveals a quite interesting picture. It is about the supply chain
management and directed toward achieving highest possible efficiency in that. The case study
reveals that the hospital is facing immense problem to ensure sound supply chain management.
There is no coordination among every action and there is haphazardness everywhere. Too many
people are giving orders, sometimes they are experiencing overstocking and sometimes there is no
stock to fulfil the demand of the patients, the number of suppliers is too many and too many people
are interfering in the supply chain management system. There are other problem areas as well like
staffs are not linked in the system, people are unwilling to share information and people are
directionless. As a result, the hospital is increasingly failing to maintain its well established and
long lasted reputation.
The DHQ Hospital reveals that the major issue of the hospital is its supply chain management
system. Supply chain management is comprehensively defined as the summation and integration
of all the sub-systems that require providing goods or services to the customers. Here, this hospital
is a service organization and its supply chain consists of inventory management, ordering, stock-
keeping, delivery, patient admission, tracking of order, information system and all other processes
required for running the hospital smoothly. In addition, all of this takes place in the environmental
set-up of the hospital and is carried out by the management. The first fishbone analysis reveals that
the major issue of the hospital is to ensure smooth system of supply chain. If that has been fulfilled
then there is no reason why the organization can’t achieve its historical success. But why it is not
happening? Where the problem exists? Whether people are inefficient, or the entire process is
faulty? The second fishbone analysis will give the answer.
Acquiring most suitable equipment and utilizing those properly is always the key for every
operation maintenance as well as supply chain management. But an inside look at the case study
reveals that one of the main causes of the inefficient supply chain management of the hospital is
Institute of Quality & Technology Management Page 2
University of the Punjab
IE-313: WS & ME
because of the inability of the authority to maintain and acquire proper equipment. Some
equipment is not utilized up to the fullest capacity while some other is organized in a haphazard
way. The people of the hospital do not have adequate IT facility to look after the equipment in a
better way and they also lack technical supports. High costs of new equipment are another
profound reason. Due to that factor the hospital has not been able to capture updated equipment
and lagging behind the competition.
Efficient business process requires efficient supply chain and operation process. A sound process
ensures synergy and contributes towards greater business success in product and service industry.
The practices of the DHQ Hospital reveal that they are currently undertaking a very inefficient and
faulty process. The reasons of that are poor inventory management and that are causing stock out
and overstocking at times. The poor execution of the process is also rooted to the causes like high
costs, lack of specifications, and faulty ordering system. Too many suppliers and high lead times
are also worsening the case.
People are the lifeblood of every organization. If they are not well-motivated and well-directed, it
is very difficult for that organization to gain success. The people of the hospital are found to be
involved in power war and they are never ready to trust each other. There is no coordination among
them and very few are sure about their job specifications. As a result they are failing to contribute
towards the organization’s goal and as a result the supply chain management system is suffering a
lot and the hospital is losing is reputation.
Materials management is the key for ensuring smooth and high-performed supply chain
management. The hospital of this case study is found to be managing the materials in an inept way.
There is no professionalism and duplicity of the order is more frequent than ever before. The
reasons of poor materials management are also rooted into few serious causes like high costs of
supplies, lack of proper storage capacity, unavailability of required materials at required times. It
is very much essential to eliminate these problems for ensuring proper management of the
materials and smooth supply chain management.
Environment needs to be conducive for high level of business success. But for the DHQ Hospital
environment is found to be inconvenient and as a result it is worsening the supply chain
management and business process ultimately. The reasons behind it are protectionism, resistance
Institute of Quality & Technology Management Page 3
University of the Punjab
IE-313: WS & ME
to change, unsound set up, rivalry among employees etc.
Management outlines the strategies and action plans for every set of actions in products or service
operation. They are virtually responsible for carrying out the business process as well as supply
chain. If they are inefficient the organization has to suffer a lot. The picture of the hospital of this
case study reveals the same picture. Here, the supply chain is inefficient because management is
inefficient. The inside story of management’s inefficiency reveals that they are suffering from
hidden costs, short budget, lack of innovation, lack of employee orientation, absence of material
manager, lack of relationship with suppliers etc. As a result they have not been able to keep the
supply chain management system on the right track.
(Adapted from Application of Fishbone Analysis for Evaluating Supply Chain and Business
Process-A Case Study on the St James Hospital by Bose, Tarun Kanti)
LAB 02 – OUTLINE PROCESS CHART (OPC)
Develop an outline process chart by watching video of car engine manufacturing and assembly.
Car Engine Assembly Video
LAB 03 – FLOW DIAGRAM
Read the following passage and make a flow diagram.
All the parts requiring enameling (painting) have to be phosphated first. Baskets containing BMX
Cycle parts are dipped into a series of nine tubs containing a degreasing solution, phosphoric acid,
a ‘passivating’ solution, and a series of hot and cold water baths. This phosphating treatment
enables the steel surface to retain the enameled paint for a longer period of time and provides a
more durable finish. Once phosphating is complete, the parts are placed on jigs and the jigs are
hung on a conveyor. The conveyer passes through the drying oven at a speed allowing each part
to spend approximately 50 minutes in the oven, and baked at 150°C. This is done in order to
Institute of Quality & Technology Management Page 4
University of the Punjab
IE-313: WS & ME
remove all water and thus protect the internal side of the tubing against corrosion. After drying the
parts go through the enameling workstation where two operators spray them with one of the six
colors (black, white, yellow, grey, red and purple). The parts are then passed through the oven
again.
LAB 04 – LAYOUT PLANNING (WORKPLACE)
Draw the workplace layout shown below. Assume the size of table to be 5 x 2 feet. The size of bin
for nuts, bolt and clamps is 20 x 15 cm. and for the assemble unit is 15 x 6 cm. Assume missing
dimensions.
Institute of Quality & Technology Management Page 5
University of the Punjab
IE-313: WS & ME
LAB 05 – PLANT LAYOUT
Draw the plant layout as shown below.
Institute of Quality & Technology Management Page 6
University of the Punjab
IE-313: WS & ME
LAB 06 – SWIMLANE DIAGRAM
Draw the swimlane diagram (cross-functional flowchart) for the following case.
CASE
Physicians and patients have been complaining about delays in the ambulatory surgery department
at a local hospital. A two-week study conducted by a breakthrough improvement team determined
that the major reason for delays was that the operating rooms (ORs) did not always contain all the
supplies needed to perform the surgical procedures that had been scheduled.
The team is now meeting to construct a high-level flow diagram of the process to identify places
for additional data gathering as the team enters the diagnostic journey. The team also feels that the
flow diagram will be useful in explaining needed changes and for setting up a better monitoring
system to hold the gains when the breakthrough improvement project is completed.
Below is an excerpt of the discussion that takes place in the meeting.
Kamran (the team leader): “What are the boundaries of the process we want to diagram today?”
Ali: “Why don’t we look at what happens between the time that I, as the surgeon, call to schedule
the surgery and the time, 30 minutes prior to the scheduled surgery, when I arrive to check on the
condition of the patient and the OR.”
Kamran: “Does everyone agree?” (Nodding of heads around the table.) “So, what happens when
the surgeon calls?”
Bilal: “At that point, the surgeon is talking to me in the Ambulatory Surgery Scheduling Office.
We schedule an OR time slot by making an entry in the Master Schedule database. Of course, we
work out a convenient time with the surgeon and the patient.”
Ali: “We do this over the phone, in my office, with the patient right there, so everyone knows the
schedule. Anyway, I believe that that is outside the process we are flow diagramming, because our
data showed that we don’t have a problem with patients or physicians not showing up. Remember,
the problem is that the OR is not ready on schedule.”
Institute of Quality & Technology Management Page 7
University of the Punjab
IE-313: WS & ME
Ahmad: “So what happens next, Bilal?”
Bilal: “The patient shows up in the department an hour before surgery, we process the patient’s
paperwork, we call the surgeon to remind him or her of the schedule and advise that the patient
has arrived, and the surgeon then checks in 30 minutes prior to the scheduled time. It’s really very
simple.”
Aliza: “You’ve left out a number of steps, Bilal. I and the other nurses in the Ambulatory OR
check the Master Schedule database to see what procedures are coming up and what supplies we
need to order. We try to check this two days before the surgery; in other words, if it’s Monday, we
are checking Wednesday’s schedule to allow plenty of time to get supplies. We order the supplies
we need from Ahmad’s people in the supply room.”
Bilal: “How do you know what supplies to order?”
Aliza: “I don’t think we need to go into the details of that for this high - level flow diagram. But
basically, we just look at the procedure listed in the database and order a ‘kit’ for that procedure.”
Ahmad: “In keeping with the hospital’s cost-containment efforts, Bilal, the nurses don’t keep
many supplies on hand. We went through a process six months ago to define standard ‘kits’ for all
the procedures we perform in the Ambulatory OR. The nurses call us and tell us how many kits
they need for which procedures, and we deliver the supplies as soon as we can. But I didn’t realize
that you were working on a two-day lead time, Aliza. That might not be enough time in all cases
for routine processing.”
Aliza: “If we get very busy, we may not even give you that much notice.”
Kamran: “Okay, so you deliver the ‘kits.’ Then what happens?”
Aliza: “I don’t think we need to get into all the detail just now, but we basically set up the OR with
the supplies in the kits. All of this is supposed to happen before the patient shows up for his or her
surgery. In other words, the OR should be completely set up an hour before the scheduled surgery.”
Ahmad: “Now we are at the point where Bilal was earlier—processing the paperwork and so on.”
Institute of Quality & Technology Management Page 8
University of the Punjab
IE-313: WS & ME
LAB 07 – VALUE STREAM MAPPING
Draw the following value stream map.
Institute of Quality & Technology Management Page 9
University of the Punjab
