“NHS medication errors contribute to as many as 22,000 deaths a year”

This was this morning’s headline news in the press and on TV and radio.  So given that this is a mainstream operations management issue, I thought I’d look into it.  It raises some interesting points.

I started by trying to find the ‘Report’ from which these news stories originated (always go to the original source).  I could not.  This is because the stories are based on a pre-released speech that Jeremy Hunt, the Health Secretary, is going to make today.  Apparently (according to the EEPRU’s website) the report is called “Prevalence and economic burden of medication errors in the NHS England“.  The EEPRU (Policy Research Unit in Economic Evaluation of Health & Care Interventions) is a joint research centre of the University of Sheffield and University of York.  They worked with University of Manchester to undertake the research into medication errors.  As far as I can tell the report is not yet in the public domain.  All the EEPRU website has is one short paragraph.  The University of Manchester website says much the same as the news story and provides a link to the ‘Report’, which turns out to be simply a link to the EEPRU website.  This is because “The report, funded by the UK Department of Health Policy Research Programme, will be unveiled at the World Patient Safety Science and Technology Summit”.  And it turns out this event is taking place right now in London and it is where Jeremy Hunt will be making his speech.

What is the public domain is a report commissioned by the Department of Health and Social Care entitled “The Report of the Short Life Working Group on reducing medication-related harm“.  This report has none of the statistics in it reported in the new stories, but it does make 15 recommendations designed to address medication errors.  Here they are*:

  • “Improved shared decision making so that patients and carers are encouraged to ask questions about their medications and health and care professionals actively support patients and carers in making decisions jointly, including when to stop medication.
  • Work closely with NHS Digital and others to improve information for patients and families, and improve access to inpatient medication information.
  • Encourage and support patients and families to raise any concerns about their medication.
  • Improved shared care between health and care professionals; with increased knowledge and support.
  • Professional regulators must ensure adequate training in safe and effective medicines use is embedded in undergraduate training, and professional leadership bodies, working with professional regulators must ensure continuing professional development adequately reflects safe and effective medicines use too.
  • Professional regulators and professional leadership bodies should also encourage reporting and learning from medication errors.
  • Work with industry and MHRA to produce more patient friendly packaging and labelling.
  • Work with pharmacy dispensing computer system suppliers to ensure that labelling contributes to safer use of medicines and does not hinder, for example by labels being stuck over packaging or by using unfamiliar language.
  • Build on work to identify and increase awareness of ‘look alike sound alike’ drugs and develop solutions to prevent these being introduced.
  • The accelerated roll-out and optimisation of hospital e-prescribing and medicines administration systems.
  • The roll-out of proven interventions in primary care such as PINCER.
  • The development of a prioritised and comprehensive suite of metrics on medication error aimed at improvement.
  • Development of a repository of good practice to share learning.
  • New research on medication error should be encouraged and directed down the best avenue to facilitate positive change.
  • A programme on medication safety and error should be established, in line with the domains and early priorities set out by WHO”.

So it seems the data on the scale and significance of the problem is being revealed at the same time as the steps deemed necessary overcome the problem.  Neat.  This has not stopped the media from trying to identify a single cause for this error rate – in most cases the funding of the NHS.

And the OM issues… where do I start?  Six sigma? Empowerment without training? Lean? Organisational learning? It seems that the Short Life Working Group have never read anything on error-free quality management or spoken to anyone working in industry with expertise in this field.  Heaven help us all!

*I am advised that I “may re-use the text of this document (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence”.

Posted in Chap 09 Quality, Sector: Public Services & Charities | Tagged , , | Leave a comment

Operations Insight: selling ice cream in the winter

I’ve not blogged about seasonality recently and given the weather we are forecast I thought I should.  Ice cream seems to be the obvious product to talk about at this time of year.  So where better place to look than Canada, which has both very cold winters and a plethora of ice cream manufacturers and stores.  Here’s some ideas I’ve come across from strolling the Internet.

Accentuate the negative – one way to deal with the low season is to confront it head on with your brand name.  That is what Rain and Shine ice cream have done in Vancouver.

Offer new flavours – to spark interest and stimulate demand.  Right now McKay’s in Cochrane, Alberta is promoting its Haskep Berry  and its Keso flavours (Haskep berries come from a honeysuckle like plant grown locally and Keso is a cheddar cheese based ice cream sprinkled with Cheddar cheese).  This is where our friends in Calgary always take their visitors to try their ice creams – I can attest to their quality!

Offer new toppings – ice cream is now being topped or rolled in nearly every kind of crushed biscuit or breakfast cereal you can think of.  This February Sweet Tooth Ice Cream in Calgary has pink sea salt and lychee jelly as toppings.

Modify containers and packaging – operators are beginning to offer ice cream not just in cones, wafers and tubs but in more original ways, such as rice based wafers.

Menu extension into hot drinks – apparently children like ice cream at any time of the year, but adults less so.  So offer adults something that they prefer in winter – like coffees, teas and hot chocolate – when they bring their youngsters to the store.

Diversify into new and related products – the long established example of a ‘new’ product is ice cream cakes.  But one ice cream store in Canada sells its own ‘cookbook’ with recipes for dishes that include ice cream.

Diverse markets – a feature of the Canadian ice cream market is that many stores make their ice cream on site.  These operators therefore can not only rely on customers coming to their store, they can become a supplier to the local restaurant industry.  Ice cream is often a basic item on any restaurant menu throughout the year.

Create occasions or become a ‘destination’ – many operators promote children’ birthday parties in their stores, but they also have special promotions related to social occasions such as Christmas, New year and Valentines Day.

Off site events – ice cream can also be sold off site. Rain or Shine will “send two scoopers to your (wedding, convention or party) venue to serve our ice cream to your guests out of either our cart or branded coolers”.  They also have a truck to go to larger a outdoor events.

Pop-ups –  carts and trucks can be located temporarily where there is customer footfall.  In Canada that means all weather shopping malls.

Social media – nearly all the operators I look at had a Facebook page and Twitter feed.  Sweet Jesus ice cream stores in Toronto have 63,000 Instagram followers.

Me-tailing – collaborate with customers in new product development and promotion. La Diperie, a small Canadian chain, names some of its ice creams and sundaes after the customer who ‘invented’ it.

PS  And some operators simply close down during the low season.

Posted in Chap 07 Capacity and demand, Sector: Manufacturing, Sector: Retail | Tagged | Leave a comment

The impact of digitisation on container shipping worldwide

Fifty years ago McKinsey was commissioned by the British Transport Docks Board to write a report on containerisation and the implications this would have for that sector.  Naturally enough the report concluded that containers were a disruptive technology that would transform how goods were shipped around the world.  And of course they were proved right.

In this article from McKinsey, rather than consider the last fifty years, they look forward to what the shipping industry might look like in fifty years time.  And they focus on the impact that digital transformation will have on this sector.  Their major predications are as follows:

  1. the volume of container traffic will have increased by at least twofold;
  2. container ships will be larger, but there may also be “drone” containers i.e. containers that float and move autonomously;
  3. short-haul intraregional traffic will increase, as manufacturing will be more dispersed;
  4. there will be consolidation in the industry with four or five large players emerging, due to their adoption of digital technologies that make them more customer oriented;
  5. the whole transport chain (loading, stowage, sailing and unloading) could become autonomous.
Posted in Chap 05 Supply chain | Tagged , , | Leave a comment

‘New Retail’ – a fully integrated online and in-store experience

This video by Alibaba showcases their concept of ‘New Retail’, which turnings shopping into both an online and in-store experience.

Posted in Chap 04 Location and design, Chap 10 Processes and technology, Sector: I.T. & ecommerce, Sector: Retail | Tagged , , | Leave a comment

Thinking about changing corporate culture in a different way – maybe?

This article on the Bain website is called “Culture’s Role in Corporate Transformation“.  But I draw it to your attention because it develops a pragmatic approach to managing culture (in as much as culture can ever be “managed”).  It proposes four things:

  1.  “Moving from values to behaviours”.  I am all for this.  Have you ever noticed how people state their values then consistently behave in ways inconsistent with these?  Michels (2017) proposes that leaders should change their behaviours if they really want to influence culture.
  2. “Move from communications to engagement”. As well as CEO speeches, corporate newsletters and etc. create a message board for employees that not only enables them to state their ideas and concerns, but is also clearly and consistently responded to.
  3. “Moving from HR to the line”.  For thirty years I have banged on about recruitment, selection, induction and training being done by the operations people (facilitated by HR).  And here’s Michels (2017) saying if you want to transform the culture work with the ops people, do not delegate to HR.   Music to my ears.
  4. “Move from top down to bottom up”.  This is a no brainer.  But I like the idea of ‘micro-battles’ discussed here – “specific, time-boxed, winnable objectives that are run by cross-functional, fully dedicated, agile teams”.

Like many ‘new’ ideas it ain’t.  There is a (possibly apocryphal) story about the turnaround in fortune of the Harley Davidson motorcycle company in the 1980s.  Vaughn Beals and his leadership team had taken over at a time when the Japanese were significantly outperforming US manufacturers in terms of price and quality.  Hence they went to Japan to find out about JIT, TQM, and empowerment, and brought back these ideas to implement in their factories.  At first this was met with scepticism and disbelief by the workforce, who were used to a culture where quality was low on the agenda.  So on a visit to the factory Beals handed out his business card to workers on the shop floor and told them they had his permission to stop the production line and phone him they identified a quality problem.  No one did immediately and the quality problems went on, until one worker got so fed up with this, he decided to take Beals up on his request.  Beals took the call and immediately went to the factory to see what the problem was.  The worker was not fired but praised for his action, and from then on the culture was transformed.  True or not, it is a perfect example of what Michels (2017) proposes – different behaviour, engagement, delegation to the line, and bottom up.

Posted in Chap 11 Jobs and people | Tagged | Leave a comment

Why did the chicken NOT cross the road? It ain’t no joke KFC.

KFC have set up a web page (here) to inform customers which of their restaurants are open.   They have also headlined their home page with a link to this page.  All because yesterday an estimated 750 of their 900 outlets were closed because they had no chicken.  This what they have to say about it…

“We’ve brought a new delivery partner onboard, but they’ve had a couple of teething problems – getting fresh chicken out to 900 restaurants across the country is pretty complex!  We won’t compromise on quality, so no deliveries has meant some of our restaurants are closed, and others are operating a limited menu, or shortened hours.

We know that this might have inconvenienced some of you over the last few days, and disappointed you when you wanted your fried chicken fix – we’re really sorry about that. Shout out to our restaurant teams who are working flat out to get us back up and running again.  Hope to see you in our restaurants soon”.

Given that 80% of their outlets are run by franchisees I’m not sure that this cheery message will appease them very much.

It seems that KFC switched their logistics from BidVest, who specialise in food supply, to DHL.  The logistics software in this supply chain was developed by Quick Service Logistics (QSL).  It seems that DHL’s systems and QSL’s systems are not in sync.  DHL have issued a press release saying “Due to operational issues, a number of deliveries in recent days have been incomplete or delayed. We are working with our partners, KFC and QSL, to rectify the situation as a priority and apologise for any inconvenience”.

Oh dear, oh dear, oh dear!  This is going to make a great case study to discuss in class when it is written up….

Posted in Chap 05 Supply chain, Sector: Hospitality & Tourism | Tagged , , , | Leave a comment

The IoT provides a data fest, but what to do with it all?

Apparently an oil rig has 30,000 sensors on it, but only 1% of these generate data that is analysed.  This is because most sensors are reporting, as frequently as every second, that the device or machinery being monitored is performing to expectations.  In other words, there is a huge amount of redundant data.  This can make the Internet of Things (IoT) very inefficient, which is why this article from BusinessInsider UK explains the growth and importance of two technologies that help resolve this problem – edge computing and digital twins.

Cloud computing has emerged over the last decade as the best way of storing and handling data, due to economies of scale and security.  But, somewhat ironically, this is not the best way to handle data being generated by the IoT.  Instead of the data being sent to the cloud, it should be retained and analysed at the ‘edge’ i.e. on the oil rig, in the factory, or whatever operation that is being monitored.  The advantages of this are that the data can be processed on site so that action in response to this analysis can be taken more quickly.  This decentralisation may also lower costs and reduce the risk of a systemwide shutdown.

I have blogged about concept of digital twins before.  This is the idea of a digital simulation of a physical asset.  This uses the data generated by the asset, but enables the operator to test improvements or modifications to its performance on the simulation before implementing them on the asset itself.

Posted in Chap 03 Processes and life cycles, Chap 15 Lean and agile, Sector: Construction, Sector: Energy & Utilities, Sector: I.T. & ecommerce, Sector: Manufacturing | Tagged , , , , | Leave a comment

Will “vitality” become the next big idea in management theory?

How Vital Companies Think, Act and Thrive” is an interesting article from the BCG Henderson Institute.  It caught my eye because of two assertions it makes (based on their research):

  1. “…there is a statistically significant relationship between innovation and diversity in its many dimensions”.
  2. future-oriented strategic thinking … is positively correlated with long-term revenue growth“.

So what is “vitality”?  According to Reeves et al (2018) it includes a sense of urgency, a tendency to act pre-emptively, the development of capacity for growth in new areas, and a willingness to reinvent the organisation, or parts of it.  This requires organisations to:

  1. develop a pipeline of new business ideas and options on a continuous basis;
  2. to think about strategy differently (i.e. not focus on maximising short term shareholder return);
  3. have a merger and acquisition policy that not only acquires smaller, faster moving companies, but also transfer this energy into their existing operations;
  4. encourage diversity in terms of age, experience, gender, ethnicity and etc.;
  5. invest in new and emerging technologies.

What I particularly like about the five bullet points above is their synergy*.  Each one is congruent with, and reinforces, the other four.

*I might blog about the concept of synergy.  It fits neatly with the recent blogs I’ve done on thinking and theories.

Posted in Chap 14 Operations strategy | Tagged , , , | Leave a comment

“It’s only a theory” – why anyone that says this does not know what a theory is

What makes a tree grow?  To help you out I will give you three possible answers – water, air and soil.  The answer is at the bottom of this blog…

Clearly this blog is not strictly speaking about Operations Management.  But these thoughts have been banging about in my head for months now and I need to share them with you, prompted by my recent blog about ‘thinking’ and a video I just saw on my Facebook page.

A lot of people (non-scientists) consider theory and reality to be opposites.  Nothing could be further from the truth.   All theories are grounded in reality.  Indeed that is their purpose.  Theories are devised to express in relatively simple terms what is happening in the complex world around us.  This misunderstanding arises because theories are often described as hypothetical.  And people think of a hypothesis as something that may or may not be true.  So if something is only maybe so, then any other alternative view is equally valid, however unfounded it might be.

This situation is made worse by the media, especially the public service broadcasters, who feel obliged to give equal air time to two opposing views.  You see this especially with regards climate change.  Despite the fact that 99.9% of scientists believe that climate change is happening, whenever they are invited onto a TV or radio programme to talk about it, some politician is always invited on to deny that this is so.

What many non-scientists do not understand is that ‘everything is a theory‘.  This is because a theory is deliberately stated so that it can be tested.  Tests (experiments) are then conducted (if possible – sometimes it’s not possible) to see if the hypothesised outcomes are achieved.   If they are then the theory is a good theory, and likely to be ‘true’.  But all scientists live with the idea that there may be circumstances when the theory does not hold ‘true’ and hence it remains ‘theoretical’ however many times it is proven to be ‘true’.  Nonetheless scientists do relabel theories that have proven time and time again to hold true by referring to them as ‘laws’ (e.g. Boyle’s Law, etc).  But remember, even such ‘laws’ are still ‘theoretical’.

A good example of this is Newton’s three laws of motion.  To all intents and purposes these were held to be ‘true’ for hundreds of years.  And even today they can be used effectively to measure and explain phenomenon.  But when Einstein developed his theory of relativity, Newton’s laws were found to not apply to things of very large mass and/or things moving at or near the speed of light.  Likewise when the science of quantum mechanics was developed Newton’s laws were also found not to hold ‘true’.

Hence if everything is a theory, then it makes no sense to talk about something being “only a theory”.  Which brings me back to the question “what makes a tree grow?”.  The answer is of course air.   We all learned this in school.  Trees take in carbon dioxide from the atmosphere converts some of it into carbon (i.e. wood) and expels oxygen.  This process is called photosynthesis.  If you got the right answer well done!  But a high proportion of adults do not get it right, as test after test has shown.  Why?  Because people prefer to believe what they see with their own eyes (their ‘common sense’) rather that get their heads around a ‘theory’ – even if that theory actually does explain what is happening in the world around them.  (Don’t get mad if you said water or soil – I know trees need these things too, but they are the fuel that makes the process work, not the actual process itself).

This completes my ‘Rant of the Month’.



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“The Art of Thinking”! Why didn’t I think of that?

Twenty years ago I became a professor.  It was an intensive two day interview process.  When I went home and announced to my family over the supper table that I had been appointed to the role, the first question my then 10 year old daughter asked was “What does a professor do?” .   It was the toughest question I’d been asked in the last two days, so there was quite a long pause before I replied.  I said to her “I’m paid to make people think”.

I was reminded of this when I came across this article from the MITSloan Management Review – ‘The Lost Art of Thinking in Large Organisations’.  You might like to read it.  It only takes four minutes.  It might make you think!

I have three thoughts that follow on from this…

First, the value of a university education is often being questioned these days, especially by a government that has revised the school curriculum, so that children learn more facts and are tested on what they can remember.  This is not what a university does – it teach students to think, a skill which is becoming even more important than ever today.  Not just because the changes to the school curriculum have been detrimental to young people learning to think, but also because the pace of technological and social change is such that thinking will be a necessity in the future.  And if you think that everyone can think and they do not need to be taught how to do it, it ain’t so – something I learned very quickly after becoming an educator.

Second, academics are sometimes asked to serve as consultants to companies.  Not often, because the perception is that academics only deal with ‘theories’ and do not understand the real world*.  And it is true that a consultancy undertaken by a team of academics will not be the same as professional consultants.  Whereas the latter will come into an organisation in order to analyse a situation and make recommendations as to how to achieve the best outcomes, academics will not do that.  Because what they are good at is making people think.  So they come into an organisation and get the people in the organisation to think about the problem and assists them to develop solutions. (I’m exaggerating of course, but you get my drift).

Finally, I hope this blog also gets you to think.  I try to post stuff without comment and let you make up your own mind.  I try to be open about my own personal biases (for instance my belief that organisational culture is hugely powerful in creating and sustaining successful organisations).  I try to post a wide variety of material, even if it is a topic I’m not expert in, or an industry sector I know little about.  But I admit to one shortcoming, namely not encouraging more comments and hence discussion – so let’s try harder.  I would welcome your comments on this post….

* I’ll write another blog on why most people have no idea what a theory really is nor what purpose they serve.

Posted in Operations Management | Leave a comment