Re-Examining

Hospital
Workflows
IS4250: IT-Enabled Healthcare
Solutioning
Lecture 2
19 August 2024
Outline

• Questions about the syllabus/projects

• Lean Thinking
• Recap of tools for examining hospital workflows (from last
class)
• Value Stream mapping
• Hospital IT systems
• Deaconess case
Syllabus/Projects
• Any questions about the syllabus, deliverables?

• Note: Development projects are proof of concept – standalone, no

integration needed, but > prototype / Figma mockups

• By Wednesday, 21st August (11:59 pm)

• Register your groups online (Canvasà Peopleà Project Group)
• Indicate your project interest under Group Project sign up (Canvasà
Quizzes)
• Only 1 submission per group is needed
• I will do my best to give you 1 of your top 3 choices
• If you don’t have a team, indicate the projects of your interest on the
survey and I will contact the group assigned to try to match you
• By Friday, 23rd August, I will link you up with SingHealth
Learning outcomes

• Insight into flow of information and workflows

• Describe ways to learn about various processes in the hospitals

• Lean Thinking, Value Stream Mapping
• Examine how these tools are used in process design, analysis and
improvement of individual work and systems of collaborative, independent
work
Lean

https://www.youtube.com/watch?v=F5vtCRFRAK0
Benefits of Lean Thinking
• Goal of Lean Thinking: Remove waste and variability
• Reduces lead time by streamlining and standardizing processes,
eliminating unnecessary steps, and ensuring smoother transitions
between steps

• By reducing lead time, you can improve other metrics, such

as:
• Inventory (medications, space, value, stock outages)
• Productivity
• Patient access, cost, reduced waiting time
• Safety via improved communications
• Improved staff and patient satisfaction
Goals of Lean

• Remove waste and variability

• Reduces lead time by streamlining and standardizing processes,
eliminating unnecessary steps, and ensuring smoother transitions
between steps
• Reduce time taken
• Reduce total costs
• Improve quality
• Understand its customers' wants and needs (i.e., value)

Exemplars in the healthcare space: e.g. Virginia Mason

(https://www.virginiamasoninstitute.org/)
Sample tools in Lean Thinking

• Use of observation / analysis to understand

the “current condition/state”
• Value Stream Mapping
• Data collection (times, capacity of clinic
etc.)
• Spaghetti diagram
• Kanban/ 5 S
• Sort, straighten, scrub, standardize, sustain
(i.e. Marie Kondo-ing your workspace)
Value stream symbols
Information Process performed
Inventory
Customer system used

IT Process I
Customer

Manual Information Flow Digital Information Flow Manual process

• For more info about the symbols: https://www.lucidchart.com/pages/value-

stream-mapping/value-stream-mapping-symbols?a=0
 Note: In this class, exact
Value Stream Mapping (VSM) symbols are not critical in the
exam/ final project as long as
you have a legend to
• A key workflow improvement tool distinguish

• Visual depiction of a complete stream (material

and information flow) where waste and customer
value can be identified and where action plans
are created

Doctor writes order Pt med Pt billing

record system
Patient

I
I I
Nurse administers
Pharmacy fills order Nurse verifies order
drug(s)

Administration of prescription drug

 I Sources of “inventory"

• Transactional queues
• Patient Sign in sheets
• Charts waiting on to be completed
• Clinical
• Patients in waiting room
• Supplies to be put away
• Services waiting
• Clinicians waiting for test results
• Nurses waiting for room cleaning
• New employees waiting for orientation
Sample data to collect about the processes
• Defects (e.g. deaths, OR late starts), efficiency
• Time to complete a product or service from start to finish
• Cycle time: Time to perform all work elements within a particular
step on a single item. May include value-added (VA) and non-value
added (NVA) time. Excludes wait time. Include time to set up.
• Value added time: Time to perform value-added work (in the eyes of the
customer)
• Non-value added time: Time spent that does not impart additional value to the
product, but still required (e.g., double checking, clerical task, insurance
verification)
• Lead time: Time to complete a product or service from start to finish

Draw blood Process blood sample Provide test

sample in centrifuge results
VA: 5 min VA: 30 min VA: 5 min
NVA: 10 min NVA: 15 min NVA: 3 min

Goal: remove non-value added / wait time

 Dissecting the data

Equipment, Services, Processes and/or steps

Symptoms # of daily Primary Acute Urgent Treatment
Product / Services

cases Triage Care care room

Headache 8 X X
Minor 2 X X X
contusions
Chest pain 20 X X

Frequency/ Document the steps required

Quantity information for each item (steps from VSM)
Zooming into specific steps: e.g., Primary triage
Primary Triage
Observations
VSM step Task VA 1 2 3 4 Avg Wait Dist trav. Notes
description step? Time time
Primary Check chart
triage
Primary Ask if hit head X
triage recently
Primary Ask if dizzy or X
triage blurred vision
Primary Obtain pain
triage severity and
type
Questions to ask when observing the process

• How do you do this work? Why do you do this?

• How do you know you are doing this work correctly?
• What do you do if you have a problem?
• What data/information do you need? From whom do you get this
info?
• How are requests for data/work/materials made?
• Who gets the output?

Remember:
• If your tasks are too big: limits ability to analyze later, difficult to accurately
classify work, less visibility to improvements
• If they are ioo small : overly time consuming , increased opportunity for error
Hospital Workflows: Deaconess
Preparing for cases

• Thinking, not reading, is key

• Develop an opinion!
• Continually question opinions and conclusions
• Participate actively in class discussion
• Listen critically to the class discussion, including those who disagree
with you
Preparing for case analyses

These are real cases, real people, real problems.

• Don’t try to “cheat” by googling what the firm did, because there is no
one ”right” answer
• No dumb questions
• Take notes! “Answers” to cases will not be provided
Processes covered in this Deaconess case

• Nurses’ responsibilities
• Example: https://www.youtube.com/watch?v=-q5QJW8q7qc
• Medication administration
• Example: https://www.youtube.com/watch?v=FifaSTgtaBU
• Pharmacists’ responsibilities
• Example: https://www.youtube.com/watch?v=Js0a_d6lRVU
• Nursing Handoffs
• Example: https://www.youtube.com/watch?v=Yl9v6PDwPnM
• Example of docs: https://www.youtube.com/watch?v=O4x0Rk_r-rs
MEDICATION ORDER

MEDICATION RECONCILIATION

MEDICATION ADMINISTRATION (MAR)

MEDICATION ORDER
MEDICATION ADMINISTRATION (MAR)
MEDICATION RECONCILIATION
What problems did Carter discover?
Deaconess (A): The problem

• Highly skilled, highly motivated individuals could not ensure his well-
being
• The problems he had been trying to solve lay in the system by which
people’s efforts came together, not in the people themselves.
• As a colleague later observed:
“We lose so much value in the hand-offs.”
Deaconess (A)
• What solutions do you think he will propose to John Dalton,
president of the hospital and to Julie Bonenfant, the hospital’s vice
president?
Deaconess (A)
• Suggestions (continued):
What happened in the end?
• Over the next two weeks, they (Carter, Dalton, Bonenfant and the
managers) each tried to observe the work of people involved with
medication administration.
• Saw for themselves the difficulties presented by the current pathways,
and activity designs
• Decided to create a learning unit
• Solicited the cooperation of two doctors – one a surgeon, the other an internist (both
with high numbers of patients at DGH) and an experienced nurse for each of the three
shifts who worked full- time at the hospital.
• Began by focusing on problems the learning unit was experiencing on a
day to day basis
• Without trying to anticipate all contingencies or solutions to deal with the difficulties
that they had expected.
What is the problem?
Rule Hypothesis Outcome observed Response

1: The person or machine can do The activity is not done as Determine the skill level of the person/
Capability the activity as specified specified capability of the machine and train or
modify as appropriate.

If the activity is done as The outcome is defective Modify the design activity
specified, the good or service
will be defect free
2: Customer’ request will be for Responses don’t keep pace Determine the true combination of the
Efficiency goods and services in a specific with requests; or if the demand and capability of the supplier;
combination supplier is idle retrain, modify activities or reassign
tasks as appropriate
3: Every supplier is connected to A person or machine is not Determine why the supplier was
Configur- the workflow is required. actually needed unnecessary and redesign the workflow
ation Learn why the non-specified supplier
Any supplier not connected to A non-specified supplier was actually required and redesign the
the path is not needed provides an intermediate flow path
good or services
4: A specific change will improve The actual result is different Learn how the activity was actually
interven- the cost, quality, lead time, from the expected result performed. Determine the true effect
tion safety etc. by a specific of the change. Redesign the change
outcomes amount
Activity 1: Designing the future state

• Now that we’ve identified the inefficiencies in the current state, let’s
visualize the “future state”
• Spend the next 20 minutes in groups and find a process (or part of the
process) you want to fix
• Draw your “optimized” workflow
 Deaconess-Glover Hospital (C) For the exclusive use of S. LIM, 2020.
602-028
Deaconess-Glover Hospital (C) 602-028

602-028 Deaconess-Glover Hospital (C)

Exhibit
Exhibit 1 1: Medication
Medication Administration
Administration Flow Chart Decision flow
Exhibit 1charts
(continued) (Current State)
NEW
Exhibit 1 (continued)
Admission from ED Patient in Direct Admit
System

Nurse Review Stat

Information from: Stat Order Yes Orders No
Patient Patient
Patient After Flagged?
Caregiver Arrives
arrives Yes
Documentation No
Hours
Nursing on Floort
on Floor
VNA Nurse Notes Order/
Pharmacy Pulls NCR Sheet
Patient Arrives Secretary Notes Order/
Patient Arrives at ED/
Secretary/Nursing at Admitting/ Pulls NCR Sheet
Patient Demographic Do cumentation? No (after hours)
Meds Currently Demographic
Nurse
Data Taken Prepares Chart Volunteer Takes
Data Taken Secretary Places
Taking? Patient/ NCR to
Pulls Order Tab NCR Sheet in
Family Bring in Pharmacy for
Pick Up Box Place Flagged
and Documented Notice No Paperwork; Pharm Records
Yes Chart in
Nurse Calls MD Orders Rack
Arrive Call Admit- Office/or ED Arrive
Nurse Reviews With Initial
No ting MD/Take GetMake Note
Admitting Orders No With
Tab Placed on MAR
Initial Documentation
Orders? Orders?
Packet Packet Placed atVerbal Orders (MAR in Med Room) After
ED Works Up Patient
Nursing Station Hours? RN Reviews Order
ED Determines Meds
MD Yes and Pulls Order Tab
Yes Telephone Yes
Order gets info to
Nurse Sees Nurse
Patient Placed NO
Patient in Medicine
in Room Information Gathered from:
Room Available on
ED Doc Orders Patient Admitting Calls
Floor? Pharmacist, Tech Tab Placed
Meds--Often Verbal ED Calls Floor Caregiver Fax Floor or Volunteer
with Nurse/ Patient Coming Ö on MAR
Patient Coming... Nursing MD Pick Up Sheet
Preferred Written on Review of Meds Currently Coming No Orders No
NursingVNA
Writes on Secretary Bring to Pharmacy
Med Order Sheet Taking/Allergies, etc. In
Order Pharmacy
Sheet & Signs: Receives Hourly Runs
Patient/Family May
TO RN/MD Name Orders/
Bring in Meds. Nurse Call/Page Nurse Delivery Time
24 Hours Co-sign Gives to RN After
NurseStayGets Meds Nurse Documents No Yes Supervisor Assigned by
During Inpatient Hours? Pharmacist Standards
Admitting MDFrom Locked
Arrives Reviews Order
Checks Chart Cabinet Admitting MD Checks Against
If Narcotics,
Lab Results Secretary/Nurse Arrives Patient Profile
Sees Patient prepares Chart Nurse Call Pharmacy Nurse Supervisor
Double-Locked Sees Patient
Writes Orders Stat Dose for: to Floor MAR Sheets in
Patient Name Pick Up NCR Sheet Med Room
Room Number
Nurse Medication Name
New Administers Orders Yes
Yes and Strength Nurse Supervisor
Orders? Flagged?
Meds to Pharmacy
Pharmacist Takes
No
Telephone Order
Checks Against Gets Meds, Fill Patient Bag
Chart in ìNO Yes Anything
Nurse Documents on Patient Profile Label and Hand Write Yes
ORDERSî Questionable?
Nursing Flow Sheet No Patient Name and
Section Room Number
Meds Given
of Rack

Anything Mark on NCR

Questionable?
Yes
Hourly Secretary/ # Took of WhatMed
RN Checks and Sign
MD Determines
to Make Sure Leave for Pharmacist
Admit/Writes NO ORDERS
Admitting Orders/ (off hours 1-2X/night)
including Meds
Call MD for Details No Call MD for Details
Next Morning
Correct Profile Lock Pharmacy Up Correct Profile
Chart in Pharmacist Reviews
Patient Sent to ìORDERSî Deliver Med
Orders Yes with Patient Profile
Floor with Found? Section
Documentation, of Rack No
Pharmacy Corrects
if any Pharmacy Corrects Anything Questionable
Profile and Signs:
Profile and signs: Call Nurse
TO MD/RPh
TO MD/RPh Fill Out Incident
24 Hours Co-sign
24 Hours Co-sign Report

This document is authorized for use only by SHI YING LIM in 2020.
5
3
This document is authorized for use only by SHI YING LIM in 2020.

This document is authorized for use only by SHI YING LIM in 2020.
602-028 Deaconess-Glover Hospital (C) Deaconess-Glover Hospital (C) 602-028

Exhibit 1: Medication Administration Decision flow charts (Current State)

Exhibit 1 (continued) Exhibit 1 (continued)

STAT NON_STAT
PO/ IV Adminx PO/
Med Order Med Order Searches for Med
Parenteral Procedure Parenteral Medication
Type? Type? Yes and Dose
No
Present?
in Other Cassettes
Prepares 24 Hour
Pharm Tech Supply for Next
IV Admix
Checks Sheets Cassette
Procedure
from Last Night Exchange
Any Mixing Medication After
Copy Sheet onto Card Pharmacist Yes Yes No Yes
Required? Present? Hours?
Pts Name Picks Med
Room Number Prepares and Labels Copy Sheet
Med/Dose (create unit dose if onto Card If Tech Prepares/
Signature needed) Pts Name RPh Checks No No
Room Number
Med/Dose
Pharmacist RN Makes Pink
Write Up Label Nurse Gathers Secretary
Nurse Places Meds Delivers Med to Call Pharmacy Slips for
Medicine and Notifies
in Plastic Cup Unit in for Med Nurse
Write Up Label Solution Nurse
Med Room Supervisor

Tech Prepares
Stat Dose and
Volunteer Delivers Pharmacist
Adds Label Prepares 24-Hour Verifies Mixture Page
Med to Unit Reviews Order
Supply for Next Ratio Pharmacist Nurse
Leaves at Pharmacist
Cassette Exchange Supervisor
Nursing Station Checks Profile
Add Label
Pharm/Tech
(If Tech Prepared)
Delivers Next Dose to
RPh Final Checks
Medicine Room on Unit Nurse
Prepared Dose If Tech Prepared Pharmacy Picks
Try to Notify Nurse Any Supervisor to
RPh Checks Mixes Medicine/ Nurse to Med
Problems? Who Floor
Prepared dose Prepares Bag Patients Room Volunteer Prepares and
Delivers? Picks up
with NCR Sheet Labels
Pink Slips

Yes

Nurse
No Supervisor
Pharmacist Fixes At Bedside
Discusses Nurse Confirms to Locked
with Tech Patient ID Pharmacy

RN Checks to
see STAT Dose Pharmacy
Available Personnel Delivery
to Unit Cart/Med Nurse Explains
Refrigerator Reason for Meds

Replace Cassettes
Nurse Teaches Nurse Administers/
Send Extras Back Nurse Notes on
Patient and Observes Patient
to Pharmacy MAR Time
Family as Administrator
If Delayed, Why?
Appropriate? Medications

Back at Pharmacy/
Credits Patient for
Searches for RN Reviews MAR Unused Meds
Correct Med for Specific
and Dose in Delivery Times Source: Deaconess-Glover Hospital.
Cassette/Fridge Charts Still Flagged?

6 ≈ 7

This document is authorized for use only by SHI YING LIM in 2020. This document is authorized for use only by SHI YING LIM in 2020.
Hospital Information Systems
An introduction to the key IT systems in the hospitals
Hospital Information Systems (HIS)

• Both clinical and administrative systems

• Consists of complex arrangement of multiple individual systems i.e.,
departmental information systems
• e.g., hospital could have 60-400 different software
• Out-patient facilities have fewer e.g., 2-6 systems
administrative

Clinical systems: Can be limited to a

single disease or comprehensive https://www.essindia.com/enterprise-automation/hospital-
over all aspects of patient care management-system
Why multiple Information Systems?

• The IT department may follow two different approaches to

information systems:
• Integrated systems approach uses systems from one vendor
• Best-of-breed approach chooses software based on departmental needs
• Certain hospital departments may have more influence and select
their own software
• Some equipment may come with own software required for
operation
• CAT scan, MRIs, PET, biomedical devices
 Range of digitization of healthcare IT systems

Paper Partial Digitisation Full Digitisation

Drivers

Costs Repeatability (Automation)

Quality Regulations

Source:
CAREliberate
by tecKopi Pte Ltd
https://www.himss.org/sites/hde/files/2022-01/emram-criteria.pdf
Clinical Systems
There is no topic in health informatics as important, yet controversial, as the
electronic health record (EHR)

In spite of fledgling EHRs being around for the past 35-40 years they are still
controversial in the eyes of many
Key Clinical Systems: Definitions
Definitions
Definitions
• Electronic Medical Record (EMR): “An electronic
• Electronic Medical
• Electronic RecordRecord
record of Medical (EMR)
health-related (EMR):
information on “An electronic
an individual
record
that of
• “An electronic health-related
canrecord informationmanaged
of health-related
be created, gathered, oninformation
an individual
and on
that can
an individual be created,
that can
consulted gathered, managed
be created,clinicians
by authorized gathered, andand
managed
staff Electronic Health Record
consulted
and consulted
withinby by authorized
authorized
one clinicians
healthcareclinicians and staff
and staff
organization.” Electronic Health Record
within one healthcare
within one healthcare organization.”organization.”
• Electronic Health Record (EHR): “An electronic
• Electronic Health
record ofRecord
• Electronic health-related
Health Recordinformation
(EHR):on an electronic
“An individual
• “An electronic
that of
record recordtoofnationally
conforms health-related
health-related information
an individual on
recognizedoninteroperability
information
an individual thatand
thatstandards
conforms conforms
tothat torecognized
can be
nationally nationally
created, recognized
managed and
interoperability
interoperability
standards andstandards
consulted by and
authorized
that can be that can
created,cliniciansbe created,
managed and staff
and
managedconsulted by authorized clinicians and staffand
and
across consulted
more than by
oneauthorized
healthcare clinicians
organization.”
staff across
acrossmore
morethanthanoneone healthcare organization.”
healthcare organization.”
• Personal Health Record (PHR): “An electronic
• Personal Health
record Record (PHR)information
of health-related (next class)
on an individual
Personal
• “An•electronic HealthtoofRecord
record
that conforms (PHR):
recognized“An
health-related
nationally electronic on
information
interoperability
record
an individual ofthat
health-related
standards conforms
and information
that can be todrawn fromonmultiple
nationally anrecognized
individual
sources
interoperability
that conformsstandards
while being to and
nationally
managed, that can
recognized
shared, and be drawn from
interoperability
controlled by
multiple sources
standards andwhile
that
the individual.”canbeing
be managed,
drawn from shared,
multiple and
sources Personal
controlled
whileby themanaged,
being individual.”shared, and controlled by Health
the individual.”
• --National Alliance for Health Information Technology Personal
Record
Health
• --National Alliance for Health Information Technology Record
Source: National Alliance for Health Information Technology
Key Capabilities of an Electronic Health
Record (EHR) System
Institute of Medicine identified 8 core care delivery functions of EHRs:
• Health information and data (e.g. reduce redundant tests)
• Result management (e.g. timely access to test results)
• Order management (e.g. clinical effectiveness of CPOE)
• Decision support (e.g. alerts, reminders and prompts)
• Electronic communication and connectivity (e.g. emails among care partners
or with patients)
• Patient support (e.g. patient education)
• Admin processes and reporting (e.g. improved services)
• Reporting & population health (e.g. key indicators)

Source: US Institute of Medicine - > Health and Medicine Division

Top EHR vendors

https://www.curemd.com/top-ehr-vendors/
EPIC

• A key reason why Epic Systems has become a technology leader with
healthcare organizations is that they built an integrated platform
almost all areas of care.
• E.g., When Epic sees the need to advance technology in a new specialty, they
develop what they “modules” that are built on the same platform and data
structure as all of their other products.
• Sample modules include:
• ER Module (with ability to track room occupancy)
• Epic Beacon Oncology (for cancer treatments)

https://www.epic.com/software
 AthenaHealth: Cloud Based System

https://www.youtube.com/watch?v=H_oqpkrd3Tw
https://www.youtube.com/watch?v=vIYSq6Kublk
 Athena More Disruption Please/Marketplace

https://www.globenewswire.com/news-
release/2017/05/18/987746/0/en/athenahealth-s-More-
Disruption-Please-MDP-Program-Launches-MDP-Labs-to-
Accelerate-Health-Innovation-Entrepreneurs-onto-National-
Cloud-Platform.html

https://www.youtube.com/watch?v=L4g9iVrt9AY
Other Ancillary Systems
E.g. Lab, radiology, pharmacy
Smart Lab Program: https://www.ihis.com.sg/SmartLab_Programme
 Workflow of Electronic Lab Orders and Results

images stored /
captured on PAC
system

LIS generates printed lab Some tests are performed with

report; also sends to EHR automated instruments: receive
if interfaced orders from LIS; send results back
Uses HL7 interface standard to Anatomic pathology findings/ non- to LIS
connect with HIS/HMS, CPOE,
Workflowautomated
EHR, other healthcare systems
of electronic
tests lab orders
entered and results
manually
Inventory control e.g., autopsies
Billing of services
https://issuu.com/tomorrows_medicine/docs/tmnews_4th_issue_fa_final/5
Other Medication-Related Technology
• Bar Coding Medication Administration (BCMA): patient, drug and
nurse all have a barcoded identity
• Automated Dispensing Cabinets (ADCs): like ATM machines for
medications in a ward
• Pharmacy Dispensing Robots: bottles filled automatically
• Electronic Medication Administration Record (eMAR): electronic
record of medications integrated with EHR and pharmacy
• Home Electronic Medication Management System: home
dispensing, particularly for the elderly or non-compliant patient
• Intravenous (IV) Infusion Pumps: regulate IV drug dosing accurately
Identifying your IT systems
Let’s go back to the Deaconess Case. You now have the green light for
an IT investment plan.
• What kinds of IT systems will you purchase to address the problems?
• What information will each IT system collect/provide?
• What functionality do you need from each system?
• How will they fit in your workflow?
Which solutions to consider?
1. Quick Wins / Low hanging fruit ?
• E.g. need for training, integration, change management
2. Bottlenecks
3. Most central systems (with most interdependencies/ links)
• Hierarchy
• Interdependencies – can you isolate problem and fix it?
• e.g., information/tech interdependencies
• Task interdependence (coordination needed, decision decomposition, role interdependence)
4. Major sources of risks (e.g., data security, patient privacy)
5. Hype?
6. Financial returns (e.g. using quantitative and qualitative methods to
evaluate which projects should be funded, such as net present value,
internal rate of return, etc).
• Calculations of cost savings (from efficiency gains) or benefits
Questions to Ask in Structuring Debates/
Scoring Alternatives
• User/Market impact: How will users use the product? What new benefits?
Impact on patient care/ patient safety?
• Compatibility and ease of use: Will the change be compatible with existing
products? Will the product require significant new learning by the users?
What is the perceived ease of use?
• Technical feasibility: How long will the project take to complete? Is a new
technology a desirable strategy? Are the complementary technologies well
developed? Level of investment needed?
• Existing capabilities: Will the project render some existing competencies or
resources obsolete? Do you have a transition strategy? Will the firm need to
hire employees with new skills? Is it compatible with existing systems?
• Competitors’ capabilities: Is this something the competitors have?
• Future capabilities: Will the project help build new capabilities that will
allow it to achieve its strategic intent? Or lead to family of new services?

(Adapted from Schilling 2017)

Weighted Decision Matrix

Options
criteria

Source: https://venngage.com/templates/
Project Map

Breakthrough project:
revolutionary new product
and process technologies

Fundamental improvements in
cost quality and performance of
technology over previous
generations
Incremental changes
in products and/or
processes

(Adapted from Schilling 2017)

Conclusion

Information and operational flows are often key bottlenecks

• Importance of understanding the current workflows
• Observe how the process works in actual practice, not in idealized,
hypothesized form.
• Need to achieve common understanding amongst all stakeholders
• Use of value stream mapping and its role in identifying inefficiencies
+ opportunities for improvement
Next Class

• SKIM chapter 3 of textbook

• Survey: complete the student survey if you haven’t

• Project groups:
• Please register online by Wednesday (21 Aug) 11:59pm and complete
the project survey for your top 3 choices for those projects (1 per team)

• Next class:
• Guest speaker (10:40am): Mr Aloysius Chen, Director (Product
Management, Planning and Strategy), Synapxe