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NSYSU

1. J. Tseng, Charles. Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan.

Degree: Master, EMBA, 2004, NSYSU

Abstract English Abstract From small hospitals to large medical centers, the Taiwan healthcare organizations today are unable to significantly increase investments or generate more revenue due to the strict regulations of current National Health Insurance and Global Budget policies. This predicament is further complicated by the healthcare systemâs inability to change from its traditional mass production architecture and mentality. Mass customization (MC) and focused factories (FF) are being applied across many industries with great success â achieving quality at low cost. These are new concepts that can bring significant customer value, allowing organizationsâ quality and profitability to improve from increasingly commoditized businesses. This consumer-centric transformation can be one way for Taiwanâs healthcare organizations to get closer to patientsâ needs and step out of the traditional confines of the NHI and healthcare delivery. These novel ideas are so akin to the healthcare ideal, yet the traditional healthcare design and Taiwanâs anti-market healthcare policies effectively impedes changes and progress in this direction. This paper intends to assert that MC and FF can be one effective solution to the problems in Taiwanâs healthcare organizations â specifically for the specialty community hospitals. In this way, these small hospitals can capture the value premiums of this new consumerism trend and transform itself into a competitive business, creating higher values for life and health for its customers. This paper will begin with an in-depth background and SWOT analysis of the Taiwan healthcare system and its participants. After an understanding of this industry, a pertinent literature review of the MC and FF concepts and mechanics will be done. A case comparison study of three specialty healthcare organizations will be done to evaluate their differences in competitive strategy, marketing orientation, operational effectiveness, human resources advantage, and organizational performance. The three organizations include a traditional specialty hospital (Gee-Tien Ear Nose & Throat Hospital), a single procedure-based focus factory (Shouldice Hospital), and a disease management focus factory (MedCath Corporation). Finally, a full discussion will ensue to assess the applicability of FF and MC concepts for specialty community hospitals in the Taiwan healthcare market. Keywords: Specialty Hospitals, Mass Customization, Focused Factory, Taiwan Healthcare Advisors/Committee Members: Jen-Her Wu (chair), Jason H. Huang (committee member), Chang-yung Liu (chair).

Subjects/Keywords: Mass Customization; Specialty Hospitals; Taiwan Healthcare; Focused Factory

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

J. Tseng, C. (2004). Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan. (Thesis). NSYSU. Retrieved from http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0721104-142049

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

J. Tseng, Charles. “Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan.” 2004. Thesis, NSYSU. Accessed September 22, 2019. http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0721104-142049.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

J. Tseng, Charles. “Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan.” 2004. Web. 22 Sep 2019.

Vancouver:

J. Tseng C. Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan. [Internet] [Thesis]. NSYSU; 2004. [cited 2019 Sep 22]. Available from: http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0721104-142049.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

J. Tseng C. Focused Factory â A Novel Business Strategy for Specialty Hospitals in Taiwan. [Thesis]. NSYSU; 2004. Available from: http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0721104-142049

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. Claudio Rogerio Negri da Silva. Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura.

Degree: 2005, Universidade Federal de São Carlos

A gestão de sistemas de manufatura tem se tornado mais complexa na medida em que novos produtos estão surgindo, a demanda de produtos é incerta, os ciclos de vida são mais curtos e uma grande variedade de produtos competem pelos mesmos recursos. Esta tese trata o projeto e planejamento de sistemas discretos de manufatura, baseados em modelos de redes de filas abertas, para auxiliar no processo de tomada de decisões. Porque sistemas de manufatura podem ser representados por redes de filas genéricas, e não existem métodos exatos de solução, aqui é empregado o método aproximado de decomposição para avaliar o desempenho dos sistemas em diferentes configurações. Mostra-se nesta tese que estas aproximações são adequadas e efetivas para estimar os estoques em processo (WIP) e o leadtime de produção de uma rede de manufatura real de uma indústria metal-mecânica. Mostra-se ainda que os modelos de alocação de capacidade discreta, baseados nestas aproximações, também são efetivos para avaliar e otimizar o desempenho da rede do estudo de caso em diferentes configurações. Curvas de trade-off entre investimento em capacidade e WIP são geradas e são úteis não somente para auxiliar um gerente a estimar quanto alocar de capacidade, mas também para decidir onde alocá-la na rede de filas. As curvas também auxiliam a tomada de decisões em termos de capacidade, se a variabilidade das chegadas externas, o mix de produtos e/ou a taxa de produção da rede mudam. Além de adicionar capacidade, a partição da instalação é outra alternativa para reduzir a complexidade do sistema. Esta tese também aborda o problema de projeto de fábrica focalizada, envolvendo a partição da instalação em subplantas e a alocação de capacidade em cada estação das subplantas. Novamente, as aproximações por decomposição foram utilizadas para avaliar e otimizar o desempenho do sistema. Apesar de sua importância, este problema tem sido muito pouco reportado em literatura. Nesta tese, o objetivo é reduzir a complexidade do sistema do ponto de vista da gestão do produto, ou do ponto de vista da gestão da estação. Do ponto de vista da gestão do produto, é apresentado um modelo cuja restrição de complexidade é um limitante superior para a variância do leadtime dos produtos na rede. Do ponto de vista da gestão da estação, a restrição de complexidade do modelo fixa o tempo médio de espera de um produto na estação, quando há espera. Mostra-se, por meio destes modelos para alguns casos que, a partição da instalação em subplantas reduz a complexidade do sistema, sem necessidade de investimentos adicionais em capacidade. Além disso, algumas vezes, é possível manter (ou até melhorar) o desempenho da rede, particionando-a em subplantas que necessitam de menos capacidade do que a configuração original com uma planta única.

The management of manufacturing systems have become more complex, once that new products are arising, product demands are uncertain, life cycles get shorter, and a wide variety of products compete for common resources. This thesis deals with the design and…

Advisors/Committee Members: Reinaldo Morabito Neto.

Subjects/Keywords: ENGENHARIA DE PRODUCAO; Pesquisa operacional; Fábrica focalizada; Rede de filas aberta; Modelos de otimização; Projeto de sistema de manufatura; Focused Factory; Manufacturing System Design; Performance Evaluation Models; Open Queueing Network; Optimization Models; Trade-off Curves

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Silva, C. R. N. d. (2005). Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura. (Thesis). Universidade Federal de São Carlos. Retrieved from http://www.bdtd.ufscar.br/htdocs/tedeSimplificado//tde_busca/arquivo.php?codArquivo=713

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Silva, Claudio Rogerio Negri da. “Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura.” 2005. Thesis, Universidade Federal de São Carlos. Accessed September 22, 2019. http://www.bdtd.ufscar.br/htdocs/tedeSimplificado//tde_busca/arquivo.php?codArquivo=713.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Silva, Claudio Rogerio Negri da. “Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura.” 2005. Web. 22 Sep 2019.

Vancouver:

Silva CRNd. Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura. [Internet] [Thesis]. Universidade Federal de São Carlos; 2005. [cited 2019 Sep 22]. Available from: http://www.bdtd.ufscar.br/htdocs/tedeSimplificado//tde_busca/arquivo.php?codArquivo=713.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Silva CRNd. Aplicação de modelos de redes de filas abertas no projeto e planejamento de sistemas discretos de manufatura. [Thesis]. Universidade Federal de São Carlos; 2005. Available from: http://www.bdtd.ufscar.br/htdocs/tedeSimplificado//tde_busca/arquivo.php?codArquivo=713

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation


Virginia Commonwealth University

3. Lucas, D. Pulane. Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital.

Degree: PhD, Public Policy & Administration, 2013, Virginia Commonwealth University

Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into… Advisors/Committee Members: Carl F. Ameringer, Roice D. Luke, Wally R. Smith, I-Shian Suen.

Subjects/Keywords: Disruptive; Disruptive Innovation Theory; Disruptive Transformations; Disruptive Innovation; Innovation; Technology; Technological Innovation; Medical Innovation; Medical Technology; Medical Advancement; Laparoscopy; Laparoscopic Surgery; open surgery; appendectomy; cholecystectomy; bariatric surgery; weight loss surgery; appendectomies; cholecystectomies; inpatient; outpatient; ambulatory; ambulatory surgery; ambulatory surgery center; acute care general hospital; hospital; acute care hospital; general hospital; health care; healthcare; hospital industry; health care industry; Clayton Christensen; Clayton M Christensen; Michael Porter; Harvard Business School; Virginia Commonwealth University; Center for Medicare & Medicaid Services; CMS; Health policy; public policy; public administration; organizational theory; organization theory; Population Ecology Theory; Competitive Strategy; policy analysis; John Kimberly; Organization Size; Structural Inertia; liability of smallness; health spending; health care cost; specialty medical facility; open system; niche width dynamic; outpatient department; technology shift; surgical setting; surgical setting shift; medical facility shift; substitution threat; health system; system level analysis; Ecological Approach; hospital trends; ambulatory surgery trends; reimbursement rate; Medicare; CMS coverage decision; P J DiMaggio; DiMaggio and Powell; w w Powell; Hannan and Freeman; M T Hannan; Organizational change; minimally invasive surgery; less invasive surgery; Prospective Payment System; Outpatient Prospective Payment System; entreprenuerial physician; health care organization; health care management; Roice Luke; Carl Ameringer; new technology; surgical utilization; elective surgery; Medicare Payment Advisory Commission; MedPAC; coverage decision; trends in surgery; abdominal surgery; surgical variation; physician-owned; physician ownership; physician autonomy; outpatient clinic; utilization trends; unnecessary surgery; Pfeffer Salancik; technology diffusion; redefining health care; interdisciplinary research; health care delivery; panel design; diffusion of hospital technology; state variation; regional variation; local health care market; government intervention; medical facility; health care capacity; focused factory; advances in health care; physician organization relationship; hospital competition; medical specialization; hospital expansion; medical arms race; integrated care; integrated health system; J E Wennberg; health care transformation; reimbursement scheme; surgical volume; Florida; Wisconsin; policy making; health policy analysis; competitive dynamics; center of excellence; intervening factor; service line competition; service-line competition; surgical reimbursement; innovative business model; innovative technology; environmental influence; established firm; new market entrant; patient safety; sophisticated technology; Harvard Divinity School; Wilder School of Government and Public Affairs; Public Affairs, Public Policy and Public Administration; Social and Behavioral Sciences

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Lucas, D. P. (2013). Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital. (Doctoral Dissertation). Virginia Commonwealth University. Retrieved from https://scholarscompass.vcu.edu/etd/2996

Chicago Manual of Style (16th Edition):

Lucas, D Pulane. “Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital.” 2013. Doctoral Dissertation, Virginia Commonwealth University. Accessed September 22, 2019. https://scholarscompass.vcu.edu/etd/2996.

MLA Handbook (7th Edition):

Lucas, D Pulane. “Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital.” 2013. Web. 22 Sep 2019.

Vancouver:

Lucas DP. Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital. [Internet] [Doctoral dissertation]. Virginia Commonwealth University; 2013. [cited 2019 Sep 22]. Available from: https://scholarscompass.vcu.edu/etd/2996.

Council of Science Editors:

Lucas DP. Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital. [Doctoral Dissertation]. Virginia Commonwealth University; 2013. Available from: https://scholarscompass.vcu.edu/etd/2996

.