background recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a lean methodology, namely – an adaptation of value stream mapping (vsm) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding.   methods over an 18-month time period, staff applied a patient-cen...

Over the last decade all kinds of e-government processes have been developed. Governments are seeking rationalization of these processes in order to save money while maintaining or improving service levels. In the private sector Lean methods have been used to achieve these goals, whereas these are hardly explored for egovernment. The goal of this paper is to translate the concept of Lean to the...

polycystic ovary syndrome (pcos) is a common endocrine / metabolic disorder in women of reproductive age .abdominal adiposity and obesity are frequently present in pcos. it now appears that, obesity is associated with a low-grade inflammation of white adipose tissue. adipokines play a significant role in the pathogenesis of a low-grade inflammation associated with obesity. among variety of adip...

This paper gives a pictorial view of the relevance of lean thinking, particularly the applicationof muda as a supplement to the sustainable improvement diagnosis technique of existing public office buildings,for a fuller assessment of users’ requirement in Nigeria. The impact of perceived muda was related to the triplebottom line of sustainable development on perceived job productivity and desi...

Indices for lean and fat mass adjusted for height derived from bioelectrical impedance for children aged 7 years have been published previously and their usefulness in the clinical assessment of undernutrition has been demonstrated. However, there is a need for norms that cover a wider age range and to explore their functional significance. The aim of the present study is to derive lean and fat...

BACKGROUND The demand for cataract surgery is rising, calling for pathways that have good access and are cost-effective. Lean thinking is a management strategy, aimed at improving quality while reducing costs. Lean production processes are designed to identify gaps between expected and actual performance. AIM To analyse the efficacy and efficiency of a lean cataract pathway. METHODS Lean ca...

Executive Overview Toyota’s Production System (TPS) is based on “lean” principles including a focus on the customer, continual improvement and quality through waste reduction, and tightly integrated upstream and downstream processes as part of a lean value chain. Most manufacturing companies have adopted some type of “lean initiative,” and the lean movement recently has gone beyond the shop flo...

Body composition, fat distribution and bone mineral density were examined in lean women suffering from polycystic ovary syndrome (PCOS) and compared with body composition and fat distribution characteristics of weight-matched lean controls. Ten women with PCOS and a body mass index (BMI) below 25.00 (kg/m(2)) and 10 healthy women with a BMI below 25.00 (kg/m(2)) matched for age and weight and B...

An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line ma...