saad project of operation & production management

8/6/2019 Saad Project of Operation & Production Management

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COMSATS Institute of Information And

Technology

11

Shaukat Khanum PathologyProject of Operations managemnet

Rohail Ahmad BBA/Fa08/A-10/090

Saad Sattar BBA/Fa08/A-10/091

Ali Hamza Shah BBA/Fa08/A-10/013

Umair Saeed BBA/Fa08/A-10/108

Shakeel Ahmad BBA/Fa08/A-10/097


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Acknowledgement:

All the praises are for Almighty Allah, Who blessed us with the power of working on this project

and completing it by time.

We are also thankful to our teacher Sir Nayyer Butt , who gave us the opportunity for working

on this project and a lot of help and guidance regarding the completion of the project.


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T ABLE OF CON T EN TS

TIT LE Pg.

y Introduction . 4y Transformational process ... 9y O perations at Shaukat Khanum Lab. 11

Volume .. 11 Variety .. 13 Variation .. 14

V isibility .. 15

y Performance objectives ... 17

Quality ... 18 Speed 20 Dependability 21 Flexibility 21 Cost 22

y Layout of SKL 23y Conclusion 26y P ictures 27y R eferences 28


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I ntroduction:

It is evident that every organization is trying to stabilize its operations. In order to increase

efficiency of work and for maintenance of proper frame work for its organizational functions,

every organization that established a separate department of operations management and an

operations manager is assigned for that purpose. The core task of operations manager is to ensure

that everything is going as it is prescribed by management.

O perations manager is liable for different and most critical task, mostly related to production and

stock management, which results in enhanced utilization of organized resources.

O perations management includes the activities, decisions, and responsibilities of managing the

production and delivery of products and services

Now we had taken a look on the operations management, lets start by applying the major tools

and functions of operations management to an organization. we have selected SHAUKA T

KHANAM LAB ORTORY for that purpose. Shaukat Khanum has an advanced pathology

department working for the search of accurate finding of disease. (See figure 1.1)

Medical S taff

At Shaukat Khanum department is staffed by highly trained pathologists, certified by the

American Board of Pathology and R oyal College of Pathologists with sub-specialization in areas

of oncologic pathology, cytopathology and hematopathology.All the lab staff works under the

close supervision of these pathologists, residents and the laboratory manager to ensure reliability,

accuracy and promptness of lab test results.


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Figure 1.1

Operation Management of Sh aukat K h anum

O erations Functions

Accounting &FinanceFunctions

TechnicalFunctions

Service &DevelopmentFunctions

MarketingFunctions

InformationSystemFunction

HumanResourceFunctions


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Facilities & S ervices

The department comprises Anatomical Pathology, C linical Pathology and the Blood Bank

The department consists of fully functional Anatomic and C linical Pathology sections. Anatomic

Pathology includes surgical pathology including frozen section diagnosis facility and

cytopathology which includes F NA procurement and analysis.

One of the specialized areas of anatomic pathology is Immunohistochemistry, which is offered

by only a few centers in Pakistan. C linical pathology includes hematology, immunology,

transfusion medicine, clinical chemistry, microbiology, coagulation, and molecular pathology.

The hematology service provides prompt and accurate diagnosis through microscopic bone

marrow and peripheral blood analyses and flowcytometry. The laboratory facilities are modern

with up-to-date, state of the art automated equipment and procedures. Fully active programs in

clinical specialties and sub-specialties provide material for approximately 39000 surgical

specimens, 9000 cytological cases, 2500 bone marrows and 2300000 clinical tests

annually.(Based on 2008 figures). The Shaukat Khanum Cancer Hospital laboratory provides a

very high quality, prompt and reliable diagnostic service for both cancer and non-cancer diseases

the lab facilities are also available to the general public through a nationwide network of

collection centers. The departments engages in Quality Assurance Systems including a Quality

Control Program, Quality Control Protocols, Equipment and test kit validation, Peer review and

the laboratory information system, which are integral parts of the laboratory function.

Range of services includes :

y Hematological studies and coagulation profiles


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y Bone marrow evaluations and Flow Cytometer

y Full range of clinical chemistry

y Hormonal studies

y Drug levels

y Tumor markers

y Serologic tests

y Microbiology - using standard and automated culture detection methods

y PCR for HB V , H IV , HCV

y

G enotype for H CV y Histopathology including

y Immunohistochemistry

y Frozen sections

y Cytopathology

y Electrophoresis

y Separation of blood components including Packed R ed Blood Cells, Fresh Frozen P lasma

and P latelets

y P latelet and granulocyte aphaeresis

y Screening of all donated products for H IV , malaria, syphilis, Hepatitis B and C

The Department of Pathology operates a S TAT lab at Karachi, for R outine Chemistry,

Hematology and R outine Microbiology.

T raining


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T ransforming processes in Sh aukat K h anum Lab

In SKL, a patient comes and advised by the reception .the reception and pay sub ordinate ask for

the kind of test to be taken. The patient tells the test types and pays for the specific type of the

test. Every type of test has different prices. After the summation of payment, the patient waits for

his/her turn and samples the blood are taken. Special safety measures are used by the staff in

order to ensure the transparency of tests. After the collection of samples, the sample tubes are

configured on electronic data so that there will not exist any confusion about the samples of

patients in future.

Figure 1. 2

Transformed resources

y Patientsy Blood samp lesy Disease

Transforming Resources

y M e d ica l Staff y M achineryy Chemica l

Invent o ry

Input resources The

Transformation Process

Findings of Patientsbloodsamples


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After entering the data, there is a services of operations that performed by the staff .firstly the

staff separates the samples tubes by the arrangement of test type .for using test there is separate

distinct staff and equipments and an advanced type of machinery is used for that purpose. In

abs-initio the staff tries to exaggerate the percentage of germs and a machine is used for the

purpose. After the establishment of those germs another machine is used which demonstrate the

type of disease a patient holds.

For test the staff makes different slides of blood sample and different machines are used for

different tests. With passage of different operations the qualified staff of SKL comes to results of

every test sample which is collected by the patient at mentioned data and time. (See figure 1.3)

Deep Look of Processes

The Flow of Patient in To the Hospital

Indoor

Out Door

Labs

Straight toDoctors

Checking ForPrevious

Patients Served

Customers

Figure 1.3

Samp leTaking

Pro cess

Checking

samp le

Coll ectingSamp le

Retesting

Samp leColl ecte d ByRequire d LAB

Samp le M o veFo rwar d Fo r

Further Testin

Rep o rtGenerati o n


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Now we will try to explain the operations of Shaukat Khanum Lab with the respect of 4 vs.

i.e.

y volume

y variety

y variation

y visibility

4 vs. basically tells us that what type of operations process an organization should adopt.

Volume:

Volume is the level or rate of output from a process a key characteristic that determines

process behavior .At SKL, by volume we means that how many no of patients usually

come to take test and what is the percentage of each type of test . SKL provides many

types of testes and some of them are highly function at SKL .for example a sample

regular blood test is taken more than 50% of all testes and purpose the staff assigned at

that task arise systemization of work where standard processes are set down in a manual

with instructions on how each part of the job should be carried out.

Volume also includes the degree of responsibility is high then there will be low cost far

a unit .if there will be a high %age of any test type at SKL it will ultimately result in the

reduction of unit cost i.e. per sample.


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But in other case there are some testes which are not taken by many of patients i.e.

unique tests. one of them unique test is H IV which is not taken by every patient .for a

HIV test SKL has built another section which carries a fare advanced technology, a much

more specialized staff is working at that section. So if the machinery and the staff will not

be working /used frequently it will increase cost of SKL. Such test are less open to the

systemization and the staff of such department generally demands higher salary.

Shaukat Khanum made many collections centers of blood samples and for the insistency

of patients SKL has its another department working in Peshawar and Karachi which

collects blood samples around the area and send it back to the SKL Lahore. In Lahore

there are more than of collections center which depicts the degree of test taken at SKL.

With the number of years passing through the pathology department has also increased its

number of patients (see figure 1.4). Thus the increased number of patients in pathology

demands more resources to be acquired. The administration of Shaukat Khanum has

asseverated that the pathology department should be expanded, either inside the hospital

or outside the hospital. At this time the pathology department is going through almost

800 tests per day of regular checkup patients. While the number of tests of immense

disease are also increasing. Similarly some of the test samples are also collected from

foreign countries like America, South Africa and Singapore, the reports of these tests areuploaded via internet on Shaukat Khanum web site. These tests are of immense


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importance and expensive thats why they are tested at Shaukat Khanum.

Figure 1.4

Variety:

Variety determines that how much an organizations product line is. A taxi company offers a

high variety service. At Shaukat Khanum the variety can be explained in terms of the number of

tests to be introduced by the Pathology department. Shaukat Khanum provides a high degree of

tests to its patients. Some of the most cardinal tests are: Hematological studies and coagulation

profiles, Bone marrow evaluations and Flow Cytometry , Full range of clinical chemistry ,

Hormonal studies , Drug levels , Tumor markers , Serologic tests , Microbiology - using standard

and automated culture detection methods , PCR for HB V , H IV , HCV , G enotype for H CV ,

Histopathology including ( Immunohistochemistry , Frozen sections , Cytopathology ,

Electrophoresis ), Separation of blood components including Packed R ed Blood Cells, Fresh

0

500,000

1 ,000,000

1 ,500,000

2,000,000

2,500,000

3,000,000

N o. Of patients in Pathology

1994-99

2000

200 1

2002

2003

200 4

2005

2006

2007

2008

200 9

20 10


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Frozen P lasma and P latelets , P latelet and granulocyte aphaeresis , Screening of all donated

products for H IV , malaria, syphilis, Hepatitis B and C .

Every test has a standardized procedure which the staff members have to follow, no discrepancy

is allowed. Some of the test sections are so critical that no one is allowed to go inside except the

prescribed staff members. These tests are PCR for HB V , H IV , HCV ,and G enotypefor H CV .

Because these tests include the germs and viruses of degree one so some special kind of safety

measures are adopted to make sure that no one is affected by any of these viruses which will

result in severe damages otherwise.

For pathology department it is very important that the staff has all the qualities required for the

carrying down of the operations i.e. tests of blood samples. Shaukat Khanum introduces the

training programs for its staff members to ensure their safety and enhance the reliability and

validity of the tests. R esearch center of Shaukat Khanum is working with full dedication for the

cure and accurate testing of their patients.

Variation:

Variation in demand is quite predictable at Shaukat Khanum Pathology department. In

morning the number of patients is at peak while at noon it just slows down and again rises up in

the evening. Weather change also comes into play in the variation of demand. When there is not

so much summer or winter the number of patients having plume or fever jumps up and some of

them are told to go through tests like malaria test danger viruses test.

On contrary, the variation in demand does not affect the operations of Shaukat Khanum Lab

because there are more than 500 collection centers around the Pakistan which at the end


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transferred to The Main Lab of Shaukat Khanum i.e. in Lahore. So due to that purpose the staff

members remain very busy at lab and there remain no unutilized work time or the resources.

Every machine remains on run all the 8 hour of a day and staff remain enacted.

Because of the low variation in demand the staff can be scheduled and all the operations can be

carried down in a routine and predictable manner. SKL also includes the test samples of patients

of its own hospital and many other small and private hospitals test samples. The degree of

variation does not affect SKL operations. If there is higher number of test samples then it is

tested in the following day. The ultimate goal of SKL is to do almost 1000 tests a day.

Visibility:

V isibility is a slightly more difficult dimension of operations to envisage. It means how much of

the operations activities its customer experience, or how much the operation is exposed to its

customers. Shaukat Khanum Lab involves a very low visibility. The patients come and contact at

reception provides information about the test to be taken and wait for its turn. On their turn they

give test samples to sample collector person and then go to their homes. Thats set, the simple

and a low visibility operation where the patient does not involve in the testing and processing

operation (see figure1.5). Hershel remain unfamiliar with the procedure of testing and at the

prescribed date the result of test are just taken from the lab center or may be viewed at SK site.

For SK it is of dense importance that the customers dont have to wait for a long period of time

to give their blood samples. For that purpose, SK has made a small lab outside of the main sector

of hospital where the test samples are also taken. For the assistance of customers Ski has

designed its blood collection centers and customers should not have to come from a far distant


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for their sample tests. Front office visibility is the term that best suits the visibility operation of

SK where only front office deals with the patients and they are kept unfamiliar from inside

operations.

Inquiry Section /Disease Testing

Figure 1.5

Inquiry

Counter

Patients

Patients

PatientsGetting Test

No

LAB SampleTaking Lab

Storage of Samples by

..T e

Sample Testing Labs

Classified into diff Sections

Coming Patients


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Performance Objectives for Sh aukat K h anum Lab:

All operations have a range of stakeholders. Stakeholders are the people and groups who may be

influenced by, or may influence, the operations activities. Broad stakeholder objectives form the

backdrop to operations decision making, but operations requires a more tightly defined set of

objectives that relates specifically to its basic task of satisfying customer requirements. There are

five performance objectives and they apply to all type of operations. In case of Shaukat

Khanum Lab , the operations manager would want to do things right; that is, he/she would not

want to make mistakes and would want to satisfy his/her customers by providing error-free

goods and services which are fit for their purpose. This is giving a quality advantage to the

Shaukat Khanum patients. Similarly the manager would want to do things fast, minimizing the

Stan d ar d ized H igh staff uti lizati o nCentra lizati o n

Stab leRo utinePre d ictab le

H igh uti lizati o n

Flexib leCo mp lex

H igh unit c o st

H ighrepeatabi litySpecia lizati o nSystemizati o n

Vol ume(H igh)

Variety(H IGH )

Visibi lity

(LOW)

Variati o n

(LOW)


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time between a patient asking for the test reports and the patient receiving them in full, thus

increasing the availability of staff and required equipment and giving the patients a speed

advantage. Now the manager would want to do things on time, so as to keep the delivery

promises you have made to your patients. If the operation can do this on time, it is giving a

dependability advantage to its patients. Now the manager would want to be able to change what

you can do; that is, being able to vary the operation activities to cope with unexpected

circumstances or to give patients individual treatment. Hence the range of tests which you

provide has to be wide enough to deal with all patients possibilities. Either way, being able to

change far enough and fast enough to meet patients requirements gives a flexibility advantage to

your customers. At the same time the operations manager would want to do things cheaply, that

is, produce tests at a cost which enables them to be priced appropriately for the market of

pathology while still allowing for a return of a good value to the taxpayers or whoever is funding

the operation. When the organization is managing to do this, it is giving a cost advantage to its

patients.

Now lets describe these performance objectives with more detail and how the Shaukat Khanum

uses these performance objectives in its operations efficiency.

Q uality:

Quality is consistent conformance to customers expectations. When quality means consistently

producing tests according to the specifications it not only leads to the external customer

satisfaction but makes life easier inside the operation as well. Satisfying internal customers can

be as important as satisfying external customers. All operations regard quality as a particularly

important objective. In some ways quality is the most visible part of what an operation does.


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When we talk about the quality in Shaukat Khanum Lab we are urged to achieve some objectives

like;

y Patients receive the most appropriate guidance

y Test are carried out in the standardized manner

y Patients are consulted and kept informed

y Staff are courteous, friendly and helpful

y There exist a reliability and validity in the test reports

y R eports does not interchange with any other patient

These objectives are at the utmost priority in Shaukat Khanum because the test reports are of

immense importance , on the basis of which any doctor make prescription and start his/her

treatment. If there exist any discrepancy in the reports there may be severe damage to the patient

so the reliability and accuracy of the tests is the supreme goal of Shaukat Khanum. The staff

makes sure that every patient is guided in a suitable manner and if the name of test on the

doctors prescription is not clear the patient is highly advised to concern his/her doctor so that the

correct type of test can be tested.

R egarding the behavior of staff a proper orientation is provided to the staff members that holds

all the necessary code of conducts. The staff members are told to behave in a friendly way to the

patients and make sure that no hurdle is created in their way because they are already facing

many troubles. Friendly environment is the motto of Shaukat Khanum.


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S peed:

Inside operation speed is also important. Fat response to external patients is greatly helped by

speedily decision making and speedily movement of materials and information inside the

operation. Shaukat Khanum is widely spread and has many collection centers working in

different cities so in order to do testing and make reports the staff has to follow certain strategies

which increase the speed of the operations. One of the important advantage to the speed

objective is it decreases the risks associated with the future. If the operations of SKL will be

adopted the speed strategy i.e. the tests quota required for a day is fulfilled before the set time

then the management will be able to look deep inside of its operations and formulate the further

strategies.

So while following the speed strategy the ultimate objective of SKL will be:

y The time required between taking test sample and providing reports kept minimum.

y The time required for taking test samples must kept minimum.

y The test reports must be uploaded at SK site as early as possible.

Some of the tests of pathology require much more time than other tests. For example, the tests of

HIV or HB V take time much more than any other tests. The test section for this kid of tests is

separate and worked under highly qualifies and experienced staff. If the test results are positive

of any patient then for the surety purpose the test are revised twice to ensure the accuracy of

reports.


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Dependability:

Dependability means doing things in time for patients to receive their

Test reports exactly when they are needed, or at least when they are promised. Patients might

judge the dependability of an operation only after the test reports have been delivered. There are

certain benefits of depenabilitylike it saves time, saves money, and gives stability. Keeping the

operation of everyday up to date provides efficiency in operations.

At SKL the objective of dependability will be:

y Proportion of appointments which are cancelled kept to a minimum

y Keeping to appointment times

y Test reports are returned as promised

Dependability can enhance the trust of patients on the operations of the SKL. They can perceive

that the reports will be delivered to them on the promised date and thus enhancing the goodwill

of the operations of the SKL.

Flexibility:

Flexibility means being able to change the operation in some way. This mean changing what the

operation is does, how it is doing it or when it is doing it. Specifically, patients will need the

operation to change so that it can provide four types of requirements which also serve as the

objectives of SKL in the case of flexible strategy:

y Test type flexibilitythe operations ability to introduce new or modified type of tests.

y Mix flexibilitythe operations ability to produce a wide range of test types.


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y Volume flexibilitythe operations ability to change its level of output or activity to

perform different quantities or volumes of tests over time.

y Delivery flexibilitythe operations ability to change the timing of the delivery of its test

reports.

Developing a flexible operation can also have advantages to the staff within the operation, in the

form of speed up response, saves time, maintains dependability.

Cost:

Cost is the last objective to be covered, although not because it is the least important. Not

surprisingly, low cost is a universally attractive objective. The ways in which operations

management can influence cost will depend largely on where the operation costs are incurred.

The operation will spend its money on staff (the money spent on employing people), facilities,

technology and equipment (the money spent caring for, operating and replacing the operations

hardware) and materials (the money spent on bought in materials consumed or transformed in the

operation). Although comparing the cost structure of different operations is not always

straightforward and depends on how costs are categorized. Many of the Shaukat Khanum Lab

costs are fixed and will change little for small changes in the number of patients. In Shaukat

Khanum Lab the cost function could mean:


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Layout of Sh aukat K h anum Hospital Laboratories :

The layout of Shaukat Khanum hospital laboratories is basically Functional Fixed Position. The

machines are located at fixed places because they are very delicate indeed it is very difficult to

move them.

The patients first attended the reception to get enrolled after that they are allowed to move

towards the testing labs where different type of disease samples are taken. Once the sample is

taken then that sample is further moved away for different type of testing through different labs

and procedures, Machines and doctors consult. Like Bone testing, blood testing, urine testing,

cancer testing, H IV aids testing, routine chemistry testing, micro biology section etc.

Key Features of Shaukat Khanum laboratories Layout.

1. C lose distance between entrance and reception so that patients can easily get enrolled

without wasting time

2. Multiple members on reception

3. The length of flow of samples from testing lab (sample taking lab) to integrated labs are

too short, this save their time on each patients and make them able to provide fast results.

Cost in SKL

Staff c o sts

Techn olo gy an d faci lities c o sts

Bo ught in materia lsan d services


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4. The short distance also save the sample test tubes from breakage

5. The layout consist of a sample storage section where all the samples are first collected, so

it makes the doctor able to classify different samples and then further shift them to

integrated sections

6. The lab consist of very delicate machines so they are fixed and the samples move section

by sections

7. The doctors are provided with safety cloths so that they can keep themselves from

diseases, Like Masks, Doctor Over coats, gloves etc.

8. The flow of samples is absolute clear because units are arranged position by position

consisting Machines and related Doctors.

9. The lab is located away from regular indoor and outdoor units to keep it a little bit away

from population. and from noise

10. Each machine is regularly repaired, maintained and washed.

11. A special eye is kept to keep the lab a bit open area wise. So that the flow can be make

easier.

12. Lab has a flexible layout and has space for further increment. So that in future case the

lab can be increased by ability.

13. The lab has a complete computer data base system to keep a close look on processes and

maintenance.


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Rece ti o n

SamplingTesting Lab

Doo r

Bone Testing Section

Blood Testing Section

Urine testing section

Cancer Testing Section

HIV Aids testing section

Routine Chemistry Section

Micro Biology Section

Temporary sample

stora e Section


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Conclusion and Findings:

We have visited the pathology of SK with a critical view

and find out that they have established their pathology department in very manageable way. All

the operations incurred inside the department are inter-related so every function should be

efficient for the purpose of greater performance. The staff is very friendly and every belittle issue

is discussed in a very charming environment. The patients are of great importance to the staff

and they are always there to help them. Now if we talk about some recommendations for SKL,

we will be able to say that the layout of SKL is very time consuming. Some of the major sectors

are situated on the 2 nd and 3 rd floor which eventually increases the time period of the testing

operation and hence costing it in the form of more staff. We recommend that the operations of

different components of tests should be close so that the time factor can be removed.


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Pictures:


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References:

R ichard B. C . And R obert. J (2005), O peration Management for Competitive

advantage 11 th Special Indian edition Page reference, 1 section, 535

Nigel .S and Stuart . C (2007), O perations Management 11 th Special Indian edition

Page reference, Library Catalog, Page reference 4218

Levitt, Theodore J. Production-Line Approach to Service can manufacturing.

Harvard Business Review, September-October 1972, Page reference 4152.

Mark. L. K. Services operation management: return to roots . Warwick Business

School, U.K, Revised July 1998, page reference 104 - 117

Muhammad. A. (2009, October) Selected works. R etrieved April 21, 2011, from

http://works .bpress.com

saad project of operation & production management

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