How to Get Your Supply Chain Math Right the First Time

Everyone by now, must have heard about the USA being downgraded to AA rating by Standard & Poor’s, but how many know that S&P made a $2 trillion dollar math error when reporting their downgrade to the Treasury Department?

Specifically, S&P projected the gross domestic product instead of projected inflation to calculate what the U.S. government spending and total U.S. Debt would be for the next 10 years.  These kinds of math errors aren’t unusual in the fast paced business environment.

Mathematician, Thomas R. Nicely says “The best method of preventing (errors) is to have two or more independent procedures for determining or checking the same result.”

This is done in our analytics work every day.  For example, when a download of purchasing history is received for one year from the clients and it’s calculated, it is cross checked with the client’s accounting department’s calculation.  If they don’t match, the source is checked to find out the reason.

Another way is to run the numbers (this is called a draft report) by the party to verify your assumptions, calculations and results before the final report is published.  This is how S&P uncovered the $2 trillion dollar error.  The numbers were run by the Treasury Department and the Congressional Budget Office, before releasing publically, and then adjusted downward the USA’s projected future budget shortfalls once the error was caught. 

Lastly, it is found that fact-checking for the “reasonableness’ of the numbers works as well.  It’s been the policy for years that if one of our analysts discovers savings for the clients of 50% or more on any SKU it is thrown out or considered as an outlier. The reason being, that it is not realistic or credible in most situations to present the clients with a number that is unlikely to save them money.

All said and done, everyone makes math, spreadsheet and calculation mistakes; however it should be as infrequent as possible. Only by having more than one fact-check, submitting draft reports and inspecting the numbers for reasonableness can one reduce math errors to the lowest number possible.

7 Techniques to Better Sense and Shape Demand

Demand-driven value networks sense and shape demand to deliver the profitable demand response. This is a stark contrast to traditional supply chains that match demand with supply, but are blind to profitability and true market demand. Companies that are demand driven, sense and align the value network for demand changes five times faster, and they are better at balancing growth and efficiency goals. But, how do they do it? What steps do they take?

1. Design for demand variability: Sounds simple, but it is not. Traditional supply-based network design techniques optimize costs, but do not account for demand variability in the design of networks. Companies that have done this well are Coors and Dow Chemical. If demand variability is not accounted for there are two primary issues:

a) Is the design feasible? The strategic optimization engines give an average response, that may or may not be a feasible response. Simulation tools help to see if the strategic network design technologies are giving a feasible response. For supply chains with demand swings, this is an important check.

b) Does it reflect the best design? For companies seeking to be demand-driven, what if analysis needs to include the probability of demand and the impact of demand ranges and patterns for important products. Demand variability is a strong determinant of push/pull boundaries. Currently, I only see 15% of companies including demand variability in network design calculations.

2. Focus on market-drivers: These leaders model the ship-to environment (not the traditional ship-from SKU-location) based on market drivers (weather, consumption drivers, consumer take-away, etc.) Great examples of companies making this transition are Cisco, Del Monte and DuPont. I loved Peter Murray, DuPont quote at the S&OP IBF conference in May in Chicago, “ The hardest change was changing to focus on market drivers. When we did this, our work on S&OP reversed a 12 year slide in margin. The downturn made us believers in strong horizontal processes at the executive level.”

3. Get clear on baseline forecasts. Increasingly, organizations are turning to supply chain to own the forecast. It has bounced around in organizations from function to function over the past ten years, but there is now a trend to return it to the supply chain function. Why? Marketing and sales groups tend to have a greater bias, and the supply chain group is seen as able to be a better litmus test of the true forecast. Best in class groups focus on understanding the baseline forecast–true market demand if there is no demand shaping (price, trade promotions, or marketing programs)– and become great modelers on true lift predictors. In calls, 95% of companies struggle with an accurate representation of baseline forecasting.

4. Take a holistic approach to demand shaping. For 40% of companies, price is managed separately than trade promotions, and new product launch has a significant percentage of trade promotion and marketing activities. Look at the impact of the multiple demand-shaping techniques through the use of strategic modeling tools like M-Factor, Thinkvine or the Henry model from IRI (now Symphony).

5. Move away from rules-based consumption: Traditional Advanced Planning Systems used rules to split a monthly forecast into smaller “buckets” for expected daily demand. However, supply chains are unruly. The spread of the forecast is hard to predict through fixed rules. As a result, 21 Fortune 500 companies have substituted statistical engines like those from JDA, Oracle, and Terra Technology to get a better predictor of daily demand. This has improved daily item forecast accuracy at a distribution center by at least 30%.

6. Give your Data a Scrubbing: Like a spring and fall cleaning, order and shipment data needs continual cleaning to align history, account for returns, and item changes. Clean data is an important foundation for demand-driven initiatives.

7. Where possible use Channel Data: Channel data helps to reduce demand latency (the time to sense true consumption in the channel). The more steps that a company is back in the value network, the more important to take this step.

A Look at 4 Advanced Practice Nurse Programs

One of many ways RNs may specialize is by taking advanced practice nurse programs. When doing this, they have 4 options to choose from. The 4 different kinds of advanced practice nurse you can train to be in the United States are certified nurse midwives, nurse practitioners, clinical nurse specialists and certified registered nurse anesthetists.

Advanced practice nurses do a wide variety of preliminary health services, especially in areas of screening as well as preventive health care. Within these 4 distinct types, individuals specialize in fields like:

OB/GYN

Rehab Services/Long Term Care

Coronary Care

Pulmonary Care

Emergency and Trauma Care

Surgical Specialties

Community Health

This listing is in no way a full list. Various advanced practice nurse programs offer a variety of specialized areas in which one can train.It doesn't matter which kind of advanced practice nurse someone decides to be, they will need to fulfill fairly strict training and certification requirements, combined with taking continuing education on a regular basis to keep their certification up to date. These kinds of experts have very high standards, which are monitored by organizations like the American Association of Nurse Anesthetists, the American College of Nurse-Midwives, and the National Association of Clinical Nurse Specialists.

Let's have a look at nurse practitioners first. The schooling and licensing these medical professionals receive let them do a variety of things that registered nurses simply aren't certified to perform. As an example, nurse practitioners are trained to examine and diagnose patients and may also prescribe medications.

Most individuals who are planning to follow this particular career path will become a registered nurse and will then return to school to either obtain a master's degree, or a doctorate in nursing. Nurse practitioner programs primarily target one specialty area like adult, women's health, acute care, pediatrics. In addition to being licensed by the nursing board in their state, nurse practitioners hold a certificate within their specialty areas.

Another career field requiring advanced practice nurse programs is the occupation of clinical nurse specialist. Clinical nurse specialists are found in roles like consulting, teaching, research, clinical practice and management. Just like other advanced practice nurses, they must get a Master's degree in nursing.

There are two accrediting organizations providing appropriate accreditation for this specific purpose; they are the Commission on Collegiate Nursing Education and the National League for Nursing Accreditation Commission. Any advanced practice training curriculum that's accredited by one of these  organizations is appropriate.

The third type is certified nurse midwives, these nurses provide primary health care to women as well as infants. In addition to giving primary care, certified nurse midwives perform treatment, evaluation, referral and assessment.

Certified nurse midwives will have to be RNs before they're able to enter an approved program and get either a certificate or a Master's degree. Upon finishing all of the educational prerequisites, candidates will need to pass a written exam administered by the American College of Nurse Midwives.

The last kind of nurse we are going to be taking a brief look at will be the certified registered nurse anesthetist.  Before signing up for an accredited program, the prospect will need to be an RN. After completing their training with one of the many advanced practice nurse programs, these trained professionals will be nationally certified.

Top 10 Traits Every Nurse Should Have

Nursing is a field that demands much of those who pursue it. Long hours and the strain of working with ill and stressed people on a daily basis can make it a very difficult challenge. If you are currently in the nursing field or are considering pursuing this career, here is a list of the top 10 traits every nurse should have/be:

1. A Caring Nature:If a person cannot care about the people they are serving, they will not excel as a nurse. Nurses deal with the sick and injured and their families on a daily basis, and they need to be able to show them that they truly care about their situation.
2. Be Empathetic:Nurses regularly deal with people who are scared and in pain. They must be able to put themselves in their patients’ shoes if they are going to give them the quality of care that a good nurse provides.
3. Be Detail-Oriented: Nurses must remember to write everything they do on patients’ charts. They must also remember to bring medications at the correct times. Being an organized detail-oriented person is therefore crucial for someone in this career field.
4. Be Emotionally Stable:Nurses feel the joy of seeing a new baby born, followed by the pain of losing a long-term patient who had become a friend. Emotional stability is crucial in order to survive the roller coaster ride of emotions nurses must endure on a daily basis.
5. Be Adaptable: No day is quite like the next when you work as a nurse, so they need to be able to adapt to circumstances. People are unpredictable at the best of times, but under stress become even more unpredictable, so a nurse’s typical workday will require flexibility and adaptability.
6. Have Physical Endurance:Breaks for nurses are few and far between. They are on their feet all day, sometimes for 12 or more hours at a time, so nurses must have good physical endurance to succeed in nursing.
7. Be a Quick Thinker: When a nurse notices something is not right with a patient, they need to be able to make decisions quickly and put their plans into action instantly. Nursing is not the career for someone who needs time to think about a situation before responding, because even a fraction of a second can mean the difference between life and death.
8. Have Great Judgement: A nurse must be able to look at a patient’s current state and accurately assess what is or is not needed. This must happen quickly during emergencies. Nurses therefore need sound judgment and maturity.
9. Be Hard-Working: Nursing is a never ending job. Someone is always ill and in need of some sort of aid or attention. Its also unusual for a hospital or medical centre to be overstaffed, which of course means more workload on each nurse in the unit. Being a hard worker is therefore a very important trait.
10. Have Great Communication Skills: Nurses communicate with each other, doctors, patients, and patients’ families on a daily basis, so being able to communicate clearly and effectively, and to read people is necessary for people in this career

It’s going to be a record-breaking year for mergers and acquisitions (M&A)

It’s going to be a record-breaking year for mergers and acquisitions (M&A) in the healthcare industry, according to a recent report from Irving Levin Associates.

In its Health Care M&A Report, the Norwalk, Conn.-based company reported that the dollar volume committed to merger and acquisition activity in the healthcare industry during the second quarter of 2011 surged over the comparable figures in the first quarter (up 44 percent) and those of second quarter 2010 (up 61 percent).

Based on the numbers revealed to date, a total of $73.5 billion was spent to finance 243 mergers and acquisitions in the healthcare industry in the second quarter of this year. With regard to dollar volume, M&A activity is on track to break all previous records in this market.

The largest M&A sectors were medical devices with over $33 billion being spent (up 45 percent) and pharmaceuticals with over $27 billion being spent (up 37 percent).

There are a few reasons for the uptick in healthcare M&A activity, according to Sanford Steever, editor of the report. He says that the healthcare industry is fragmented in many sectors. Hospitals and physicians practices are undertaking M&A for economies of scale, to create more efficient provider networks and to contain costs.

Another reason is that investors see certain areas like medical devices as smart investment opportunities. He is of the opinion that, the investors believe there is a good chance of (return on investment) in the area. The older the population gets the more medical devices they will need.

Among the services sectors, M&A activity remains robust in facility-based sectors, such as hospitals and long-term care, both of which led the sector in deal volume.

Stephen M. Monroe, managing editor at Irving Levin Associates stated that hospitals continue to digest the new healthcare reform law and to wrestle with its implications. He said, the one conclusion they drew is, that there is strength in numbers.

Monroe also added, they are buying other hospitals and physician medical groups to build up local and regional systems, implement ACOs and share financial risk and reward through a more diversified provider network.

For the first half of 2011, the healthcare M&A market has posted 472 deals worth a combined total of nearly $125 billion. Annualizing these figures supports the prediction that 2011 will end with approximately 950 deals worth $250 billion, which would set a new record in dollars spent on M&A in the healthcare industry.

Will this M&A trend continue beyond 2011? Steever thinks so.

Transforming Nursing to improve Healthcare

The noble field of nursing is ever growing and expanding. For most professionals nursing is a lifelong commitment, rather than just a job. The healthcare industry thrives because of dedicated and round the clock services of nurses. To further improve the patient care industry, technology and innovation have constantly tried to transform and improve nursing, to make itmore organized and systematic.

A new application has been adopted by many nurses to do the tedious work of administration. It has been developed to keep a tab on all items from delivery to sale, to maintain records and keep staff informed about recalled products. This has completely transformed the field of nursing and now, nurses are able to concentrate on patient care rather than on other activities. This has revolutionized the industry where vendor tracking technology keeps a record of all transactions and a handheld picking device scans all items and uploads a printout on the case cart for reference.

This new application has proven to be more beneficial and less time consuming for nurses. This ensures there is never a shortage of items when in need and promotes greater transparency, system wide. 

Sharon Nixon-Crenshaw   

Inventory Specialist Team Lead at Management Health Solutions, Inc.

Release Yourselves from the Bondage of Stress, Part 2

Although stress is a real problem for many nurses, it can be controlled and managed. The first step is to learn what the personal stressors are and why they stress you. This can be accomplished through a process that is termed Meditation Moment, which only takes a couple of seconds to complete, however, it provides an immediate strategy to emotionally deal with the stressful situation. It includes the concepts of assessment, analysis and strategy. To begin incorporating this discipline in your life, a template is included to chart out your stressful experiences and plan to deal with them real-time. Once you are comfortable with the process, this can be accomplished through conscious 

thought processes at the time of the incident.

Steps in the Meditation Moment Process

Assessment      

Steps in the Meditation Moment include first of all an assessment of what just happened to create stress, or in other words, a quick evaluation of the situation at hand. Rush hour traffic is very stressful for some people as evidenced by an increase in road rage. During stressful situations such as rush hour traffic, the first step is realizing that the rush hour traffic is the event that is causing the stress.

Analysis          

The next step in the Meditation Moment process incorporates the concept of analysis or why is this event causing stress. In this example, it may be being late for an event or work, or excessive fatigue resulting in your desire to move more quickly. This could relate also to your ego in relation to the desire not to look irresponsible. Regardless of the cause of the reaction, the key to minimizing stress is the understanding of the source so that you can adapt your attitude appropriately for the situation.

Strategy

Lastly, the next step is to develop a plan for the stress and enact the plan which allows for you to emotionally release the stress. For instance, in this case, a call to the boss or reorganization of schedules may be the answer. Once the experience is shared and dealt with, you can get on to the rest of your life.

Conclusion

The lives of nurses continue to become more complex every day. The economic environment will continue to be a challenge for most people for times to come. Global forces and concerns will also continue to contribute to the litany of issues the nation faces on a day-to-day basis. Many of these issues are reasons for concern and stress. The goal should be to control the personal emotional response to the stressors in the best possible way. It can be done with a little discipline and planning. Controlling stress can tremendously improve the health, mental fortitude, and have positive effects on people around us.