NOTE:  4 pages paper should have an abstract, introduction, discussion (Discussion QUESTIONS 1, 2,3), a conclusion with no grammatical errors, good sentence formation, APA Format, in-text citations, references related to Operational excellence areas only

Discussion QUESTIONS

1 What are the most significant events in the story of how the plant survived because of its adoption of quality-based principles?

2 The plant’s processes eventually were brought under control. What were the main benefits of this?

3 SPC is an operational-level technique of ensuring quality conformance. How many of the benefits of bringing the plant under control would you class as strategic?

Below is the topic:

CASE STUDY:   Turnaround at the Preston plant.

Introduction:

‘ Before the crisis, production monitoring was done to please the client, not for problem solving. Data readouts were brought to Production meetings, we would all look at it, but none of us were looking behind it .’ (Chief operating officer (COO), Preston Plant). The Preston plant was located in Preston, Vancouver. Precision-coated papers for specialist printing uses accounted for the majority of the plant’s output. The plant used state-of-the-art coating machines that allowed very precise coatings to be applied to bought-in rolls of paper. After coating, the coated rolls were cut into standard sizes.

The curl problem

In the spring of 2008 Hewlett Packard (the plant’s main customer) informed the plant of problems it had encountered with paper curling under conditions of low humidity. There had been no customer complaints. HP’s own personnel had noticed the problem, but they took the problem seriously. Over the next eight months the plant’s production staff worked to isolate the cause of the problem and improve systems that monitored processing metrics. By January 2009 the process was producing acceptable product, yet it had not been a good year for the plant. Although volumes were buoyant the plant was making a loss of around C$10 million a year. In October 2008, Tom Branton was appointed as COO.

Slipping out of control

Although the curl project was solved, productivity, scrap and rework levels were poor. In response to this, operations managers increased the speed of the line in order to raise productivity . ‘ Looking back, changes were made without any proper discipline, there was no real concept of control and the process was allowed to drift. Our culture said, “If it’s within specification then it’s OK”, and we were very diligent in making sure that the product which was shipped was in specification. However, Hewlett Packard gets “process data” which enables them to see exactly what is happening right inside your operation. We were also getting all the data but none of it was being internalized. By contrast, HP has a “capability mentality”. They say, “You might be capable of making this product but we are thinking two or three product generations forward and asking ourselves, do we want to invest in this relationship for the future?” (Tom Branton) The spring of 2009 was eventful. First, HP asked the plant to carry out preliminary work for a new paper to supply its next generation of printers, known as the Viper project. Second, the plant was acquired by the Rendall Group, which was not impressed by what it found. The plant had been making a loss for two years and had incurred HP’s disapproval over the curl issue. The group made it clear that, if the plant did not get the Viper contract, its future looked bleak. Meanwhile, in the plant, the chief concern was plant productivity, but also HP was starting to make complaints about quality levels. Yet HP’s attitude caused bewilderment in the production team. ‘ When HP asked questions about our process the operations guys would say, “Look we’re making roll after roll of paper, it’s within specification and we’ve got 97 per cent up-time. What’s the problem?” ’ (COO, Preston Plant). But it was not until summer that the full extent of HP’s disquiet was made clear. ‘ I will never forget that day in June of 2009. I was with HP in Chicago and during the meeting one of their engineers handed me some of the process data that we had to supply with every batch of product, and said “Here’s your latest data. We think you’re out of control and you don’t know that you’re out of control and we think that HP is looking at this data more than you are.” He was absolutely right. ’ (Tom Branton)

The crisis

Tom immediately set about the task of bringing the plant back under control. The plant first of all decided to go back to the conditions which the monitoring system indicated had prevailed in January, when the curl problem had been solved and before productivity pressures had caused the process to be adjusted. At the same time, Production worked on ways of implementing unambiguous ‘shut-down rules’ which would indicate to operators when a line should be halted if they were in doubt about operating quality. ‘At one point in May of 2009 we had to throw away 64 jumbo rolls of out-of-specification product. That’s over $400,000 of product scrapped in one run. That was because operators had been afraid to shut the line down. Either that or they had tried to tweak the line while it was running to get rid of the defect. The shut-down system says, “We are not going to operate when we are not in a state of control.” Prior to that, our operators just couldn’t win. If they failed to keep the process running we would say, “You’ve got to keep productivity up.” If they kept the machines running but had quality problems as a result, we criticized them for making garbage. Now you get into far more trouble for violating process procedures than for not meeting productivity targets. We did two further things. First each production team started holding daily reviews of processing data and some “first pass” analysis of the data. Second, one day a month we brought all three shifts together, looked at the processing data and debated the implications of production data. Some people got nervous because we were not producing anything. But for the first time you got operators from the three shifts, together with the Production team talking about operating issues. We also invited HP up to attend these meetings. Remember these weren’t staged meetings, it was the first time these guys had met together and there was plenty of heated discussion, all of which the Hewlett Packard representatives witnessed.’ (Engineer, Preston Plant) In spite of the changes, morale on the shop floor was good. At last something positive was happening. By September 2009 the process was coming under control, the efficiency of the plant was improving, as was its outgoing quality level, its on-time delivery, its responsiveness to customer orders and its inventory levels. Yet the Preston team did not have time to enjoy its emerging success. In September of 2009 HP announced that the plant would not get the Viper project because of its discomfort about quality levels, and Rendall formally made the decision on the future of the plant. ‘We lost ten million dollars in 2009. We had also lost the Viper project. It was no surprise when they made the decision to shut the plant down. I told the senior management team that we would announce it, in April of 2010. The irony was that we knew that we had already turned the corner. It would take perhaps three or four months, but we were convinced that we would become profitable.’ (Tom Branton)

Convincing the rest of the world

Notwithstanding the closure decision, the management team in Preston set about the task of convincing both HP and Rendall that the plant could be viable. The team figured it would take three things. First, it was vital that the plant continue to improve quality. Second, costs had to be brought down further. Third, the plant had to create a portfolio of new product ideas. Improving quality further involved establishing full statistical process analysis in the process monitoring system. It also meant establishing quality-consciousness and problem-solving tools throughout the plant. ‘We had people out there, technologists and managers, who saw themselves as concerned with investment projects rather than the processes that were affected. But taking time out and discussing process performance and improvement, we got used to discussing the basic capabilities that we needed to improve.’ (Tom Branton) Working on cost reduction was inevitably going to be painful. The first task was to get an understanding of what should be an appropriate level of operating costs. ‘We went through a zero-based assessment to decide what ideal processes would look like. By the way, in hindsight, cutting numbers had a greater impact on cost than the payroll saving figures seems to suggest. If you really understand your process, when you cut people it cuts complexity and makes things clearer to understand. Although most staff had not been told about the closure decision, they were left in no doubt that the plant had its back to the wall. We were careful to be very transparent. We made sure that everyone knew whether they would be affected or not. I did lots of walking around explaining the company’s position. There were tensions and some negative reactions from the people who had to leave. Yet most accepted the business logic of what we were doing.’ (Tom Branton) By December of 2009 there were 40 per cent fewer people in the plant than two months earlier. All departments were affected. Surprisingly the quality department shrank more than most, moving from 22 people down to 9. ‘When the plant was considering down-sizing they asked me, “How can we run a lab with six technicians?” Remember that at this time we had 22 technicians. I said, “Easy. We get production to make good products in the first place, and then we don’t have to control all the garbage.’ (Quality Manager, Preston Plant) Several new product ideas were investigated, including some that were only possible because of the plant’s enhanced capability. The most important of these became known as ‘Ecowrap’, a recyclable protective wrap, aimed at the Japanese market. It was technically difficult, but the plant’s new capabilities allowed it to develop appropriate coatings at a cost that made the product attractive.

Out of the crisis

In spite of the trauma in the fall, the plant’s management team faced Christmas of 2009 with increasing satisfaction, if not optimism for the plant’s future. In December it made an operational profit for the first time for over two years. By spring of 2010 even HP, at a corporate level, was starting to look more favourably on the Preston plant. More significantly, HP had asked the plant to start work on trials for a new product – ‘heavyweight’ paper. April 2010 was a good month for the plant. It had chalked up three months of profitability and HP formally gave the heavyweight inkjet paper contract to Preston, and was generally more upbeat about the future. At the end of April, Rendall reversed its decision to close the plant.

The future

The year of 2010 was a profitable year for the plant, by the end of which it had captured 75 per cent of HP’s US printing paper business and was being asked to work on several other large projects . ‘ Hewlett Packard now seems very keen to work with us. It has helped us with our own suppliers also. We have already given considerable assistance to our main paper supplier to improve their own internal process control procedures. Recently we were in a meeting with people from all different parts of HP. There were all kinds of confidential information going around. But you could never tell that there was an outsider (us) in the room. They were having arguments amongst themselves about certain issues and no one could have been there without feeling that basically we were a part of that company. In the past they’ve always been very close with some information. Basically the change is all down to their new found trust in our capabilities .’ (Tom Branton)

 

 

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If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

To Prepare:

• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

 

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Purpose: The purpose of this two-step exercise is for you to conduct inductive and deductive research using qualitative methods. Note: it is important that you conduct the observations as two distinct events during this class; ‘recalling’ past observations is not the same as purposefully observing your surroundings from a sociological perspective, and applying two different types of reasoning to one observation will not be ‘truthful’ or successful.The purpose of this exercise is for you to observe one social setting or social artifact to begin to detect patterns in human behavior – observance of norms and potentially behaviors that deviate from the norm.  This week’s exercise includes two parts.  First, without any prep work, you will need to go to one publicplace (or conduct content analysis with your social artifact) and observe the people/artifact for 25 minutes.  Social Setting: Note people’s behavior, their demeanor, their reactions/interactions to/with each other.  Social artifact: from second to second (for TV), or page to page (for print), Note themes, sounds (i.. music), texture of page (i.e. ads in magazine), etc.Second, you will develop a research design with research problem, hypothesis and operational definitions for variables; then you will conductanother 25 minutes of observations.Part 11)      Choose whether or not you will be conducting non-participant observation in a social setting, or content analysis of a social artifacta.       Social setting: this should be a public place such as a park, mall, restaurant, etc.b.      Social artifact: this may be ads in a particular magazine; one television show, a time-block of commercials, etc.2)      For your inductive approach, you will simply choose a time and location/artifact for where you are going to conduct your observationsa.       Social Setting: Go to the specified location and proceed with your observations.                                                               i.      You must be a keen social observer; a ‘peeping Tom’ in the sociological sense.  Take handwritten (recommended) and/or mental notes of: 1.      details about your chosen location (time of day, lighting, furniture, plants, sounds, temperature, smell, vibe/energy, etc)2.      the people around you, not only their behavior but general information about their sociodemographic characteristics (age, race/ethnicity, gender, SES, etc);3.      your thoughts and feelings while making observations Social Artifact: At a specified time (i.e. when a particular show is), carefully observe your social artifact                                                              i.      Content analysis provides a sustained, systematic way to observe and measure the portrayal of that reality, as opposed to the quick, impressionistic way that we normally read consume media.  Take handwritten notes of:1.      Details about the setting in the images you see (lighting, furniture, background, vibe/energy portrayed); if audio-visual (note sounds such as pitch of voice, music, etc)2.      Note details about the people portrayed, not only their behavior but general information about their sociodemographic characteristics (age, race/ethnicity, gender, SES, sexuality);4)      When you have returned from you observation, type up your notes.  Review your notes for patterns in behavior, socio-demographic characteristics, etc. 5)      Write-up your observations using ‘thick description’ of the location (i.e. building you were in (what is the architecture like), descriptions of people there (in terms of socio-demographic characteristics: age, race/ethnicity, gender, socio-economic status), sounds, smells, temperature, time of day and week, etc);6)      Analyze trends you identified in your observations/content analysis.  What is a possible sociological/theoretical explanation for the trends you observed?  This is best done by using peer-reviewed sources (journal articles no more than five years old) to provide credibility to your analyses. Include at least one.Part 27)       Based on your initial observations and written analyses, develop a specific research problem/question to be further investigated (i.e. the variation in behavior of males versus females when entering a store with a glass store front)8)      Identify the key variables you are going to be investigating, and develop an operational definition for each of them  (this should include at least two variables, but not more than four). Your operational definitions will help to provide parameters for how record variations in your observations.9)      Write a hypothesis for what you expect to observe in your second round of observations.10)  Repeat observations/content analysisa.       Social Setting – this should be done at the same social setting at approximately the same time of day (if you can do this one week later on the same day, it would be great!)b.      Social Artifact – this should be done at the same time (if commercial block), or with the same show, or with a different issue of the same magazine , etc.11)  When you have returned from you observation, type up your notes.  Review your notes for patterns in behavior, socio-demographic characteristics, etc. and how they corresponded with your expectations/hypothesis 12)  Describe observations using ‘thick description’ of the location (i.e. building you were in (what is the architecture like), descriptions of people there (in terms of socio-demographic characteristics: age, race/ethnicity, gender, socio-economic status), sounds, smells, temperature, time of day and week, etc);13)  Analyze your observations in terms of how they supported/did not support your hypothesis. 14)  What is a possible sociological/theoretical explanation for the trends you observed?  This is best done by using peer reviewed sources (journal articles no more than five years old)  to provide credibility to your analyses. Include at least one. 15)  Discuss the differences between your inductive observations and your deductive observations.  How did the way you were observing change?  How did what you observed change?16)  Briefly describe your thoughts/feelings in the two steps.  Did you prefer one approach to the other?  Why/why not?WRITING REQUIREMENTS: The essay should be 5-6pages. APA formatting should be used throughout this isnt included the 5-6 pages but needs a (cover page, running header, major heading, subheadings to identify each section, in-text citations, and reference page, 1′ margins, 12 point fonts, Times New Roman).Any time you paraphrase or directly quote a source, in-text citations should be used.  A full APA-formatted reference should be included at the end of the assignment. Academically, no more that 20% of the essay should be quoted. At least 80% should be in your own words.Within the 5 page essay, you will include the following subheadings: Observation Description Trends, Social Concepts, and Theories Research Problem/Question(s) Hypothesis Variables identified and operationalized Analysis Compared Inductive to Deductive Approach Reflection

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