Identification of root causes of clinical coding problems in Iranian hospitals

Background Improving the quality of coded data requires the identification and evaluation of the root causes of clinical coding problems to inform appropriate solutions. Objective The objective of this study was to identify the root causes of clinical coding problems. Method Twenty-one clinical coders from three cities in Iran were interviewed. The five formal categories in Ishikawa's cause-and-effect diagram were applied as pre-determined themes for the data analysis. Results The study indicated 16 root causes of clinical coding problems in the five main themes: (i) policies, protocols, and processes (lack of clinical documentation guidelines; lack of audit of clinical coding and feedback to clinical coders; the long interval between documentation and clinical coding; and not using coded data for reimbursement; (ii) individual factors (shortage of clinical coders; low-skilled clinical coders; clinical coders' insufficient communication with physicians; and the lack of continuing education; (iii) equipment and materials (incomplete medical records; lack of access to electronic medical records and electronic coding support tools; (iv) working environment (lack of an appropriate, dynamic, and motivational workspace; and (v) management factors (mangers' inattention to the importance of coding and clinical documentation; and to providing the required staff support. Conclusion The study identified 16 root causes of clinical coding problems that stand in the way of clinical coding quality improvement. Implications The quality of clinical coding could be improved by hospital managers and health policymakers taking these problems into account to develop strategies and implement solutions that target the root causes of clinical coding problems.

8D Problem Solving Methodology: Continuous Improvement in Automation Organization

The Eight Disciplines (8D) is a problem-solving technique methodology to identify the root cause of a problem, devise a short-term fix and implement a long-term solution to prevent recurring problems. 8D is a remarkable first step to enhancing Quality and Reliability when the product is defective or not satisfying the customer. The study was conducted in a manufacturing company producing and assembly wire harness. The data was collected for a period of Three months from July 2020 to September 2020, to identify defective percentage of wire harness and they were found to be high at the average rate of 51.39%. In this work the objective was set to investigates quality issues and provides a solution to reduce the rejection of wiring harness mainly in crimping process. In order to achieve this, 8D problem solving technique was used to analyze and solve the problem. Then, Pareto analysis was done to identify vital causes contributing defectives. From the Pareto analysis, it was found that functioning contact crimp condition with percentage 66.67% is the major cause for rejection. Further brainstorming sessions was held to identify the root causes. After the brainstorming session, cause and effect diagram was constructed and it was found to be variation in the that the connector near cable chain is moving area. Thus, the wire assembly with too high radius may caused external force to the wires when machine running with speed and the end of wire may break off when the wire stretched. The suggestions to reduce the rejection percentage were to install mounting bracket prevent wires shaking when machine running and use proper crimp tools. After implementing the suggestion, the total rejection for wire harness particularly contact crimp condition was reduced to 0.93% in December 2020, from average rejection of 66.67%. (3 months data).

PENERAPAN MODEL DEMING MENGGUNAKAN PERANGKAT FISHBONE CAUSE AND EFFECT DIAGRAM UNTUK PENINGKATAN MUTU TENAGA GURU

Mutu menjadi tuntutan pendidikan masyarakat di era globalisasi. Suatu sekolah dapat dikatakan bermutu apabila mampu memberikan layanan prima ke peserta didik. Tujuan penelitian ini untuk mengetahui masalah penyelenggaraan pendidikan menggunakan fishbone diagram yang selanjutnya diselesaikan melalui model peningkatan mutu menurut Deming. Metode yang digunakan dalam penelitian ini ialah pendekatan kualitatif dengan teknik wawancara, observasi, dan dokumentasi. Hasil dari penelitian menunjukkan bahwa di TK Kalam Kudus Malang perlu melakukan peningkatan mutu guru untuk mengembangkan kualitas pembelajaran sekolah.

Integrasi Statistical Process Control dan Failure Mode And Effect Analysis Guna Meminimalisasi Defect Pada Proses Produksi Pipa PVC

<p><em>Quality can be referred as fitness to use. Furthermore, Quality standard is considered as a way in order to meet customers’ need. PT AZ is a manufacture enterprise which produce polyvinyl chloride (PVC) pipes. This firm has been implementing a Standard Operating Procedure (SOP) in maintaining defect with no more than 2,5% reject product during process production. However, such defects have been happened in production line which were not meet company standards. This study aims to evaluate defect along production process in order to find suitable solution in improving product quality. Seven Tools and Failure and Mode and Effect Analysis (FMEA) were used as research method. The results showed that there were 3 types of defects, namely spot defect, sink marks ant scratch defect. Furthermore, the results of the Cause-and-effect diagram show that human error, </em><em>material</em><em>s and machine are considered as main factors in contributing such defect. In addition, result from FMEA analysis detect that analysis and calculation of the highest RPN 147, namely the human factor is considered as the highest Risk Priority Number with 147 score. This study suggest that further training and supervision should be give to employees in order to improve employers’’ knowledge</em></p><p><em><br /></em></p>

Analisis Risk Priority Number Cacat Produk Cup Air Mineral dengan Pendekatan Seven Tools Di PT. XYZ

PT. XYZ is a company engaged in producing bottled drinking water. To compete in the market, it is demanded to maintain the quality of the goods produced because of the quality products so that it has the aim of knowing the causes of significant product defects in the 240 ml cup packaging at PT. XYZ and knowing what factors cause defects in 240 ml cup packaging products at PT. XYZ Abstract is written in Indonesian as well as using the seven tools method. The results show that the cause of product defects is based on the cause and effect diagram of lid defects including: 1) leaking lid: Heater is not hot enough, heater is too hot, bucket with trimming is not center, seal disk is dirty and operators are less careful. 2) Broken lid: The lid is brittle and the handling is not good 3) Tilted lid: The position of the roll lid shakes and the operator is not careful. Keywords: Quality, product defects, Seven Tools Abstrak XYZ merupakan perusahaan yang bergerak di bidang memproduksi air minum dalam kemasan. Untuk bersaing di pasaran maka di tuntut untuk menjaga kualitas dari barang yang di hasilkan karena produk yang berkualitas sehingga memiliki tujuan untuk mengetahui penyebab kecacat produk yang signifikan pada kemasan cup 240 ml di PT. XYZ dan mengetahui Faktor-faktor apa yang menjadi penyebab ke cacat produk kemasan cup 240 ml di PT. XYZ Abstrak ditulis dalam Bahasa Indonesia segingga dengan menggunakan metode seven tools di dapatkan hasil bahwa Penyebab terjadinya kecacatan produk berdasarkan diagram sebab akibat cacat lid diantaranya: 1) bocor lid : Heater kurang Panas, heater terlalu panas, bucket dengan trimming tidak center, seal disk kotor dan operator kurang cermat. 2) Pecah lid : Lid getas dan handling kurang baik 3) Lid Miring : Kedudukan roll lid goyang dan operator kurang teliti. Kata Kunci: Kualitas, cacat produk, Seven Tools

Improving the Quality Management System in the Locomotive Repair Shops of the Trans-Baikal Railway

In the context of high competition in railway transportation market, quality management is becoming an important prerequisite for attracting customers and meeting their needs, gaining and retaining market share and increasing work efficiency. The current quality management system at the locomotive repair shops has a number of drawbacks that result in long-term idle time of the rolling stock for maintenance or repair and significant expenses. The article deals with the problems of defining the concepts “quality management” and “quality improvement” for locomotive repair shops. The authors analyze the current QMS in the locomotive repair shops of the Trans-Baikal Railway, make a SWOT-analysis, and develop a number of measures and management decisions for improving the quality. An objectives tree for QMS and Ishikawa's Cause-and-Effect-Diagram of inconsistencies are used to determine problems in the locomotive repair shops and propose ways of eliminating inconsistencies in each element of QMS.

PRINTING QUALITY CONTROL OF AICE PRODUCT PACKAGING AT PT TEMPRINA MEDIA GRAFIKA PACKAGING BEKASI

The process of controlling the quality of the packaging mold in this final project aims to determine the factors that must be considered, carry out the control process and perform problem solving using a fishbone chart cause and effect diagram. To achieve good print quality, it is necessary to know the problem factors that can affect print quality. This final project focuses on the process of controlling the packaging mold for Aice products. This control process is carried out from the process of icoming the raw materials to the out going of the finished product. This writing uses a descriptive method, which is a writing method that describes and describes the quality control of Aice's product packaging prints. Methods were collected from literature study and observation at PT. Temprina Media Grafika Packaging Bekasi about 3 months. Measurements in quality control use a check list form, color range and cause and effect diagrams fishbone chart. The results of this final project show that in the process of controlling the quality of a good packaging mold, it is necessary to pay attention to factors that can affect quality such as human, material, method, machine and environment. The control process is carried out in several stages, namely control of raw materials, control of the production process, sampling of packaged printed products, controlling the finished product, then solving problems using a fishbone chart cause and effect diagram. To maintain the quality of the products produced, it is necessary to add supporting components in the process of controlling the quality of the mold, increasing optimization of machine maintenance and increasing the skills of human resources. Keywords— Control, print quality, descriptive, fishbone chart

ANALISIS PENGENDALIAN QUALITAS PRODUK DENGAN METODE SQC (STATISTICAL QUALITY CONTROL)

Didalam perusahaan diperlukan penerapan system pengendalian kualitas yang tepat untuk memperbaiki kualitas produk, mengurangi jumlah cacat produk (defect) serta dapat meningkatkan kepuasaan terhadap pelanggan. Pada PT. Sentral Bra Makmur ditemukan beberapa defect tertinggi yang menjadi permasalahan kualitas produk tidak sesuai standar. PT. Sentral Bra Makmur merupakan perusahaan yang bergerak dibidang textile yang memproduksi spesialis pakaian dalam wanita. Tujuan pada penelitian ini adalah untuk menganilisis proses pengendalian kualitas pada PT. Sentral Bra Makmur dan mengetahui seberapa besar produk cacat yang terjadi pada proses produksi, serta menganalisis faktor penyebab cacat. Metode yang digunakan dalam penelitian ini adalah metode SCQ (Statistical Quality Control), yang dilakukan dalam 4 (empat) tahapan yaitu, tahapan pemeriksaan dengan menggunakan lembar pemeriksaan atau (check sheet), menghitung dengan peta kendali, identifikasi defect dengan menggunakan diagram pareto (patero analysis) dan pemecahan masalah dengan analisis diagram sebab akibat (cause and effect diagram) hasil penlitian pada tahap deskripsi lembar Chceck sheet ditemukan jumlah produk bagus yang diperiksa sebanyak 34.260 pcs dengan jumlah defect sebanyak 3.722 pcs dan persentase sebesar 10.95%. dengan perhitungan peta kendali pada data sebagian benda diluar peta kendali. Kemudian dengan menggunakan diagram pareto ditemukan beberapa defect tertinggi yaitu benang panjang, soil/kotor. Puckering/kerut dan jahitan loncat/skipped stitches. Dan diagram sebab akibat atau diagram fishbone dapat diketahui bahwa faktor utama kegagalan produk adalah faktor manusia dan faktor mesin. Dana melakukan perbaikan yang dapat digunakan, yaitu memberikan pelatihan terhadap operator serta meningkatkan penjadwalan dalam perawatan mesin.

Overall Equipment Effectiveness to Increase Productivity of Injection Molding Machine: A Case Study in Plastic Manufacturing Industry

In line with the unstable market conditions in Indonesia, especially the plastic manufacturing industry, the companies need to be well prepared to survive. There were two research goals. First, it was to find out why the Overall Equipment Effectiveness (OEE) rate at the company did not meet the expected standard. Second, it was to determine what improvement should be made to increase the OEE for the machine. The research applied a case study in one of the plastic manufacturing industries located in Tangerang, Indonesia. It focused on the performance of Toshiba injection molding machine number 42/IS 450 GSW. The analysis was performed by applying Failure Mode and Effect Analysis (FMEA) with support from other tools such as Pareto chart, Cause and Effect Diagram (CED), and six big losses. By following the whole framework of the research, it finds causes of why the OEE does not meet the target. Then, from the results, it can be concluded that the implementation of the methods has a positive impact on the company. The OEE rate increases from an average of 26,43% to 78,87%. It means the OEE rate has achieved the company target of 75%.

Risk Management in the Context of COVID-19 Pandemic in an Enterprise – Ishikawa Cause-and-Effect Diagram

Business continuity depends on the quality of management of individual processes. The management team strives to anticipate all possible threats and define protective measures. In the event of the COVID-19 pandemic enterprises were not prepared for such threats. Therefore, an important role is played by the health and safety inspector who should be involved in the company management process. The impact of the safety aspects of the work environment on the quality and efficiency of work is even more important in the event of an unexpected hazard that is difficult to completely eliminate. The purpose of the paper is to present the causes and effects of the COVID-19 biohazard according to the Ishikawa diagram on the example of a selected process in an enterprise.