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Q1. A hospital investigates low show-rate for medical appointments. The hospital loses money due to patient as they miss the opportunity to schedule the appointment for someone else. A brainstorming process reveals the following potential causes of the problem.

Potential Causes
•    Staff does not give patient printed appointment card
•    Patients unaware of appointments
•    Lack of childcare for patients who brings their children with them
•    Staff gives patient wrong appointment information
•    Difficult to reach patients directly by phone due to wrong number
•    Computer system taken down for routine maintenance
•    Appointment cards do not include exact clinic address
•    Reminder calls placed by someone patient doesn’t know
•    Computer can only print reminders for appointments within 3 months
•    No procedure in place to reschedule appointments
•    Remote location of clinic
•    Only one appointment can be listed on appointment card

Use the standard Fish bone diagram to describe the cause and effect analysis of the problem. Classify the causes into (Environment, equipment, Procedure and People).

Q2. The following are the activities a bank customer has to do to withdraw cash from a teller. The withdrawal process. Draw the process chart to describe

1. Customer arrives to bank
2. Take a number from the machine
3. Fill a withdrawal form
4. A teller checked for ID. If not valid service stop
5. If Id valid, teller check for balance. If no adequate balance, service stop
6. If balance adequate, teller check if the amount accepted according to bank policy
7. If policy permits, the teller counts the amount and gives it customer. Else the customer is asked to get permission from the operations manager then come back to the teller to receive cash.

Q3. In an emergency room a patient arrive waits 15 minutes before admitting to the Triage (Nurse Office to determine the patient illness). The patient then sent for registration where he waits 10 minutes before registration. After registration the patient asked to go to a waiting room until a nurse takes him for vital signs checks. The vital sign check takes 5 minutes. After that the patient goes waiting room to see a doctor where he waits 20 minutes. The doctor examination takes 5 minutes. The patient then go to lab for test where he has to wait 30 minutes before taking the lab test. The lab test takes 15 minutes. The patient then goes to a waiting room where he waits 30 minutes before going to Doctor to see results. It takes the Doctor 5 minutes to see the results and order medication. The patient wait 15 minutes before he is serviced by the pharmacist which take 5 minutes to locate the medicine in the shelf and given it to patient. Draw the value stream map for this process.

Q4. A bank is investigating the delay associated with processing credit card applications. Different factors were identified. Data Analyst, collected the data in the last 3 months for 500 delayed applications. The following shows the frequency of each factors delaying the process. Draw the Pareto chart showing the factors that contributed to 80% of the delayed. Suggests any improvement to the process.

Factors                                                            Frequency
The client forget to sign the application          240
Residential address cannot be verified             120
Non-legible hand writing                                     80
Already a customer                                             48
others                                                                     12

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