Assignment 4
Lara Mascini S4420969
Luuk Spanjaards S413296
Thomas de Vries S4626230
4.1 Precision medicine: value adding processes
4.1.1.
Value proposition: in a VAP business model, the value proposition consists of an efficient
and standardized treatment. In the case of the cataract treatment at UMC-Lent, this is
clearly the case: the process of treatment is the same for every patient and is constructed in a
very efficient way. Therefore, the value proposition of the cataract treatment at UMC-Lent
matches a VAP business model.
Profit formula: in a VAP business model, the profit formula is about standardization and
economies of scale, and the payment of the product or service is a fixed price. In the case of
the cataract treatment at UMC-Lent, it is clear that the process is constructed in a standardized
manner. In addition, the process is focused on treating as many patients as possible, as fast
and efficient as possible (as already stated above). Therefore, the profit formula of the cataract
treatment at UMC-Lent matches a VAP business model.
Processes: in a VAP business model, the processes are divided into sequential parts. In the
case of the cataract treatment at UMC-Lent, the treatment of cataract is clearly divided into 5
steps (intake, preparation, anaesthesia, operation and recovery) which follow a fixed
sequence. Therefore, the processes of the cataract treatment at UMC-Lent match a VAP-
business model.
Resources: in a VAP business model, the resources consist mainly of personnel with
relatively low expertise and supporting tools. In the case of the cataract treatment at UMC-
Lent, the processes of which the treatment consists require relatively low expertise, due to the
fact that it is such a standardized procedure. Therefore, the resources of the cataract treatment
at UMC-Lent match a VAP-business model.
4.1.2.
a. The place and role of the planning team mostly match De Sitter’s Parameter 4: the level of
separation between operational and regulatory transformations. The reason for this is that the
, planning department performs all regulatory tasks that are required for the nurses to perform
their (operational) tasks. This means that the value of this parameter is high, as the operational
and regulatory tasks are separated among different departments.
b. Because the planning of the treatments and the provision of the required resources are
separated from the operational tasks, there’s a very high level of alignment necessary between
the departments. This means that there’s a relatively high probability of cycle time being
longer than expected due to misalignment. For example, some tasks may take longer than the
time the planning department plans or the planning department may make mistakes in
providing the right resources. This also means that the cycle time is not reliable: it may differ
significantly for each treatment, depending on how well the planning department performed
its task. In addition, there’s a relatively low control of quality, again because the high level
of alignment required leads to a high probability of mistakes (or disturbances in terms of De
Sitter): if the planning department does not provide the right resources (which is likely as they
are not the ones who do the operation and therefore have low knowledge of the required
resources), the treatment can’t be performed well and thus the quality of the treatment is low.
Lastly, the learning opportunities are low, because everyone is continuously performing the
same small tasks which leave very little room for learning.
c. I would integrate the planning department within the operational unit by letting the nurses
plan their own treatments. The best solution would even be to train the nurses so that they can
perform the whole treatment by themselves instead of only one of the 5 steps. This way, each
nurse does the intake with the patient, immediately plans the treatment (because they only
have to consider their own schedule) and performs the whole treatment themselves, including
the preparation. This leads to a lower value on all of De Sitter’s parameters and an
improvement in the 3 Q’s because there will be much more control over the process and also
much more room for individual learning. This is in line with three principles of Lean:
1. Design production flows: because every nurse is responsible for the whole treatment, less
alignment is required which leads to less waste (mainly of time). This will transform the steps
from the process into a steady, continuous flow.
2. Aim for perfection through relentless reflection, regular maintenance and continuous
improvement: especially continuous improvement is made possible through this solution. For
example, it will become very clear which of the nurses performs the least surgeries, which
could mean that there’s room for improvement within that nurse’s performance.
Lara Mascini S4420969
Luuk Spanjaards S413296
Thomas de Vries S4626230
4.1 Precision medicine: value adding processes
4.1.1.
Value proposition: in a VAP business model, the value proposition consists of an efficient
and standardized treatment. In the case of the cataract treatment at UMC-Lent, this is
clearly the case: the process of treatment is the same for every patient and is constructed in a
very efficient way. Therefore, the value proposition of the cataract treatment at UMC-Lent
matches a VAP business model.
Profit formula: in a VAP business model, the profit formula is about standardization and
economies of scale, and the payment of the product or service is a fixed price. In the case of
the cataract treatment at UMC-Lent, it is clear that the process is constructed in a standardized
manner. In addition, the process is focused on treating as many patients as possible, as fast
and efficient as possible (as already stated above). Therefore, the profit formula of the cataract
treatment at UMC-Lent matches a VAP business model.
Processes: in a VAP business model, the processes are divided into sequential parts. In the
case of the cataract treatment at UMC-Lent, the treatment of cataract is clearly divided into 5
steps (intake, preparation, anaesthesia, operation and recovery) which follow a fixed
sequence. Therefore, the processes of the cataract treatment at UMC-Lent match a VAP-
business model.
Resources: in a VAP business model, the resources consist mainly of personnel with
relatively low expertise and supporting tools. In the case of the cataract treatment at UMC-
Lent, the processes of which the treatment consists require relatively low expertise, due to the
fact that it is such a standardized procedure. Therefore, the resources of the cataract treatment
at UMC-Lent match a VAP-business model.
4.1.2.
a. The place and role of the planning team mostly match De Sitter’s Parameter 4: the level of
separation between operational and regulatory transformations. The reason for this is that the
, planning department performs all regulatory tasks that are required for the nurses to perform
their (operational) tasks. This means that the value of this parameter is high, as the operational
and regulatory tasks are separated among different departments.
b. Because the planning of the treatments and the provision of the required resources are
separated from the operational tasks, there’s a very high level of alignment necessary between
the departments. This means that there’s a relatively high probability of cycle time being
longer than expected due to misalignment. For example, some tasks may take longer than the
time the planning department plans or the planning department may make mistakes in
providing the right resources. This also means that the cycle time is not reliable: it may differ
significantly for each treatment, depending on how well the planning department performed
its task. In addition, there’s a relatively low control of quality, again because the high level
of alignment required leads to a high probability of mistakes (or disturbances in terms of De
Sitter): if the planning department does not provide the right resources (which is likely as they
are not the ones who do the operation and therefore have low knowledge of the required
resources), the treatment can’t be performed well and thus the quality of the treatment is low.
Lastly, the learning opportunities are low, because everyone is continuously performing the
same small tasks which leave very little room for learning.
c. I would integrate the planning department within the operational unit by letting the nurses
plan their own treatments. The best solution would even be to train the nurses so that they can
perform the whole treatment by themselves instead of only one of the 5 steps. This way, each
nurse does the intake with the patient, immediately plans the treatment (because they only
have to consider their own schedule) and performs the whole treatment themselves, including
the preparation. This leads to a lower value on all of De Sitter’s parameters and an
improvement in the 3 Q’s because there will be much more control over the process and also
much more room for individual learning. This is in line with three principles of Lean:
1. Design production flows: because every nurse is responsible for the whole treatment, less
alignment is required which leads to less waste (mainly of time). This will transform the steps
from the process into a steady, continuous flow.
2. Aim for perfection through relentless reflection, regular maintenance and continuous
improvement: especially continuous improvement is made possible through this solution. For
example, it will become very clear which of the nurses performs the least surgeries, which
could mean that there’s room for improvement within that nurse’s performance.
