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The purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand.

The action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology.

The number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved.

This study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations.

This is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.

Liquid encapsulation techniques have been used extensively in advanced semiconductor packaging, including applications of underfilling, cavity‐filling, and glob top encapsulation. Because of the advanced encapsulation materials and the automatic liquid dispensing equipment involved, it is very important to understand the encapsulation material characteristics, equipment characteristics, encapsulation process development techniques in order to achieve the encapsulation quality and reliability. In this paper, the authors will examine the various considerations in liquid encapsulation applications and address the concerns on material characterization, automatic liquid dispensing equipment/process characterization and the encapsulation quality and reliability. The discussions will be helpful for future material and process development of semiconductor packages.

The aims of this paper are to illustrate the use of Lean tools to reduce inpatient waiting time and to evaluate critical success factors of Lean implementation in an inpatient pharmacy in a Thai public hospital.

This study was carried out through action research methodology by following four key phases: identification of problems; planning action; taking action; and evaluation. In the “taking action” phase, Lean tools, including value stream mapping and 5S were implemented to improve dispensing process in an inpatient pharmacy. In the “evaluation phase”, the critical success factors of Lean implementation in an inpatient pharmacy were evaluated by the participants.

Lean methodology was successfully implemented to reduce the waiting time associated with a three days dose distribution system. As a result of Lean application, the average process time reduced from 8.81 to 7.2 min and the standard deviation reduced from 5.49 to 4.45 min. Moreover, the support of middle management and the leadership were the key success factors of Lean implementation in an inpatient pharmacy.

Hospitals can improve the dispensing process by using Lean tools which are easy to apply and use. This study is appropriate for hospital managers looking for changes in pharmacy services or other departments.

This is the first study that has applied Lean tools to improve the dispensing process in an inpatient pharmacy in Thai hospitals. This study offers important insights into the critical success factors of Lean employment in the inpatient pharmacy.

The purpose of this paper is to present a new tile dispensing decision-making to improve a row formation of a product flow-based tiling automation that has been being developed to support tile placement for custom mosaic design.

A new tile dispensing decision-making combines maximum tile loading and simple cycle strategies to minimize time for forming rows of tiles. The maximum tile loading strategy is for minimizing the number of loading rounds, while the simple cycle strategy is for minimizing the movement during the row formation.

This proposed decision-making has been developed; implemented in LabVIEW software; linked with other LabVIEW-based programs to control the system; and tested. The results showed the tile dispensing with the proposed decision-making performed better than the previous one.

The tiling automation is being developed and is currently on a prototyping stage.

Tile dispensing is critical for this row by row automated assembly, but the existing shortest distance strategy does not guarantee the best performance for a row formation. Therefore, the combination of the maximum tile loading and simple cycle strategies has been developed to improve the performance of the product flow-based tiling automation to better support assembly of custom mosaic design that requires individual tesserae to be assembled to particular positions to illustrate an image properly.

In the electronic assembly industry, low-temperature soldering holds great potential to be used in surface mounting technology. Tin–bismuth (Sn–Bi) eutectic alloys are lead-free solders applied in consumer electronics because of their low melting point, high strength and low cost. This paper aims to investigate how to address the problem of hot tear crack formation during Sn–Bi low-temperature solder (LTS) in the mass production of consumer electronics.

This paper explored the development of hot tear cracks during Sn–Bi soldering in the fabrication of flip chip ball grid arrays. Experiments were designed to simulate various conditions encountered in Sn–Bi soldering. Quantitative analysis was conducted on the number of hot tear cracks observed in different alloy compositions and solder volumes to explore the primary cause of hot tear cracks and possible methods to suppress crack formation.

Hot tear cracks existed in Sn–Bi solders with different bismuth (Bi) contents, but increasing the solder volume reduced the number of hot tear cracks. Experiments were designed to test the degree of chip transient thermal warpage with temperature change, and, according to the results, glue was dispensed in specific areas to reduce chip warpage deformation. Finally, the results of combined process experiments pointed to an effective method of low-temperature soldering to suppress hot tear cracks.

The study focuses on Sn–Bi solders only without other solder pastes such as SAC305 or Sn–Zn series.

With the growing popularity of smart electronics, especially in intelligent terminals, new energy vehicles electronics, solar photovoltaic and other field, there will be more and more demand for low- temperature, energy-saving, lead-free solders. Therefore, this study will help the industry to roll out LTS (Sn–Bi) solutions rapidly.

In the long term, lean and green manufacturing is expected to be essential for maintaining an advanced manufacturing industry across the world. Developing new LTSs and soldering processes is the most effective, direct solution for energy conservation and emission mitigation. With the growing popularity of smart electronics, especially in intelligent terminals, new energy vehicles and solar photovoltaics, there would be an increased demand for low-temperature, energy-saving, lead-free techniques.

Although there are many methods that can be used to suppress hot tear cracks, there is little research on how to control the hot tear cracks caused by the low-temperature soldering of Sn–Bi in laptop applications. The authors studied the hot tear cracks that developed during the world’s first mass production of 50 million personal laptops based on low-temperature Sn–Bi alloy solder pastes. By controlling the Bi content, redesigning the solder paste printing process (e.g. through a printer’s stencil) and adding dispensing processes, the authors obtained reliable and stable experimental data and conclusions.

The purpose of this paper is to present the implementation of Lean Six Sigma (LSS) to reduce medication errors, by using four case examples. The paper will also suggest appropriate Lean and Sigma tools to improve the medication process.

The authors critically analyze four case examples that used LSS projects, to demonstrate the approach, benefits, success factors and lessons learnt.

LSS is a powerful process improvement methodology that could be applied by health-care sectors to reduce medication errors, increase patient safety and reduce operational costs. Common Lean and Six Sigma tools play a significant role in improving and sustaining the medication process.

It is necessary for the project team to select the most appropriate LSS tools to address medication process problems. Adoption of a LSS roadmap could help health-care organizations in the successful implementation of LSS.

The paper is valuable for health-care professionals seeking to reduce errors in the medication process or other processes that need to be improved.

To propose a generic method to simplify the fuzzy logic‐based failure mode and effect analysis (FMEA) methodology by reducing the number of rules that needs to be provided by FMEA users for the fuzzy risk priority number (RPN) modeling process.

The fuzzy RPN approach typically requires a large number of rules, and it is a tedious task to obtain a full set of rules. The larger the number of rules provided by the users, the better the prediction accuracy of the fuzzy RPN model. As the number of rules required increases, ease of use of the model decreases since the users have to provide a lot of information/rules for the modeling process. A guided rules reduction system (GRRS) is thus proposed to regulate the number of rules required during the fuzzy RPN modeling process. The effectiveness of the proposed GRRS is investigated using three real‐world case studies in a semiconductor manufacturing process.

In this paper, we argued that not all the rules are actually required in the fuzzy RPN model. Eliminating some of the rules does not necessarily lead to a significant change in the model output. However, some of the rules are vitally important and cannot be ignored. The proposed GRRS is able to provide guidelines to the users which rules are required and which can be eliminated. By employing the GRRS, the users do not need to provide all the rules, but only the important ones when constructing the fuzzy RPN model. The results obtained from the case studies demonstrate that the proposed GRRS is able to reduce the number of rules required and, at the same time, to maintain the ability of the Fuzzy RPN model to produce predictions that are in agreement with experts' knowledge in risk evaluation, ranking, and prioritization tasks.

The proposed GRRS is limited to FMEA systems that utilize the fuzzy RPN model.

The proposed GRRS is able to simplify the fuzzy logic‐based FMEA methodology and make it possible to be implemented in real environments.

The value of the current paper is on the proposal of a GRRS for rule reduction to enhance the practical use of the fuzzy RPN model in real environments.

This study aims to provide a flexible and cost-effective solution of 3D heterogeneous integration for applications such as micro-electro-mechanical system (MEMS) applications and smart sensor systems.

A novel 3D system-in-package (SiP) based on stacked silicon submount technology was successfully developed and well-demonstrated by the fabrication and assembly process of a selected smart lighting module.

The stacked module consists of multiple layers of silicon submounts which can be designed and fabricated in parallel. The bonding and interconnecting process is quite simple and does not require complicated equipment. The 3D stacking design offers higher silicon efficiency and miniaturized package form factor. The submount wafer can be assembled and tested at the wafer level, thus reducing the cost and improving the yield.

The embedding design presented in this paper is applicable for modules with limited number of passives. When it comes to cases with more passive devices, new process needs to be developed to achieve fast, inexpensive and reliable assembly.

The presented 3D SiP design is novel for applications such as smart lighting, Internet of Things, MEMS systems, etc.

The purpose of this study is to investigate the effect of the adhesive force and density ratio using lattice Boltzmann method (LBM) during underfill process.

To deal with complex flow in underfill process, a framework is proposed to improve the lattice Boltzmann equation. The fluid flows with different density ratio and bump arrangement in underfill are simulated by the incorporated Carnahan–Starling (CS) equation of state (EOS). The numerical study conducted by finite volume method (FVM) and experimental results are also presented in each case at the different filling percentage for verification and validation purpose.

The numerical result is compared well with those acquired experimentally. Small discrepancy is detected in their flow profile. It was found that the adhesive force between fluid and solid was affected by the density ratio of the fluids and solder bump configuration. LBM has shown better adhesive force effect phenomenon on underfill process compared to FVM. LBM also demonstrated as a better tool to study the fluid flow in the underfill process.

This study provides a basis and insights into the impact of adhesive force and density ratio to the underfill process that will be advancing the future design of flip chip package. This study also provides superior guidelines, and the knowledge of how adhesive force is affected by flip chip package structure.

This study proposes the method to predict the adhesive force and density ratio effect for underfill flow in flip chip package. In addition, the proposed method has a good performance in representing the adhesive force during the underfill simulation for its natural physical basic. This study develops understanding of flow problems to attain high reliability for electronic assemblies.

Organizational Development; Change Management; Leadership; Healthcare Management Operations; Supply Chain.

MBA; Masters in Healthcare Management; Post-graduate Diploma in Leadership; MPhil in Strategic Leadership.

On April 16, 2016, the CEO of Prince Mshiyeni Memorial hospital, Kwa-Zulu Natal, South Africa, Dr Sandile Tshabalala reflected as he drove through the winding hills of the Cato range. In recent years, the hospital had been a subject of negative publicity with horror stories about patients collapsing while waiting for their medication at one of Durban’s largest hospitals. The case features a number of stakeholders and their demands and even threats. Contextual leadership intelligence requires accurate identification of relevant stakeholders and then involvement in solutions. The case illustrates how these demands had been listened to and how the stakeholders had been involved in finding solutions. A remarkable solution was to realize that the bottleneck at the pharmacy was actually caused by a problem early on in the process, for example, the late start of administrative staff who had to submit patients. A further solution was to utilize the primary health care clinics and even churches for dispensing chronic medicine.

Gaining insight and foresight into the operations and supply chain dilemmas in public health care. Developing understanding of the impact of various stakeholders in the healthcare sector. Understanding buy-in when leading change. Acquiring contextual leadership intelligence in the public health environment.

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CSS 7: Management Science.