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IE327 - Introduction to Work Design

Lab Case Studies

Instructor: Dr. Andris Freivalds


TA: Jay(Jaehyun) Cho

Spring 2012 Semester

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Contents

Introduction 5

Lab & Grading Policies 7

Case Study Writing Guide 9

Case Study Report Checklist 11

Tips for a Successful Case Study Report 13

Case Study #1 (Mini)


- Gilbane Gold (Ethics and Societal Concern) 15

Case Study #2 (Mini)


- Job/Worksite and Flow Process Analysis Guide 19

Case Study #3 (Maxi)


- Biomechanical Analysis of Lifting 27

Case Study #4 (Maxi)


- CTD Analysis, Workplace/Tool Design and Ethics 33

Case Study #5 (Mini)


- Sensory and Environmental Analysis 35

Case Study #6 (Maxi)


- Information Processing and ATM Design 43

Case Study #7 (Mini)


- Visual Inspection - Signal Detection 47

Case Study #8 (Maxi)


- Ultrasound Transducer Design 55

Case Study #9 (Maxi)


- Need for CPOE? Productivity, Delays & Medical Errors 65

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4 CONTENTS

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Introduction

Instructor Information

Professor: Dr. Andris Freivalds


Email: axf@psu.edu
Phone: 863-2361; Fax: 863-4745
Office: 216 Leonhard Building
Office Hours:

TA: Jay(Jaehyun) Cho


Email: jvc5439@psu.edu
Phone: 865-8011
Office: 343 Leonhard Building
Office Hours:

Lab Structure
The lab will be structured as though students work for independent consulting firms.
Each firm will consist of four students.
Each group will develop a name for the firm that will be used on all reports. You can also develop a logo if
desired.
Students will complete all Case Studies with their firms (with the exception of Case Study #10 - Time Study).

Lab Meetings (all sections meet in 235 Leonhard)


Section 1: Monday 3:35-5:30 PM
Section 2: Tuesday 2:30-4:25 PM

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6 INTRODUCTION

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Lab & Grading Policies

Lab Policies
Lab attendance is mandatory. Attendance will always be taken. The attendance sheets serve as a record if
any questions arise later.
Excusable and foreseeable absences (religious observances, job interviews, school related trips, and etc.) should
be discussed with the TA prior to missing lab. Emergency or unforeseeable absences (sickness, family emergency,
etc.) should be discussed with the TA as soon as possible. Some labs will need to be made up to receive credit
(only when related to an excused absence). There will be no make-ups for unexcused absences.
Be on time for lab. The lab will be discussed at the beginning of each class and tardiness will reduce the amount
of time available for the lab. I will not start lab until a majority of each group is present (this may delay the start
of lab if a whole group is not there on time).
During lab time, you are expected to work and contribute in your group on the lab. Working on other assignments
will not be tolerated.
Please pick up after yourself. Do not leave behind scrap paper, newspaper, lab equipment, etc. Return all lab
equipment and manuals to their proper place upon completion.
This course has eleven Case Study Lab Activities that require either the completion of a Form (called mini-cases,
worth 2%) or the writing of a short Lab Report (called maxi-cases, worth 5%)
The mini-case studies are due at the end of the lab session. Maxi-case studies require a report in which students
will have one week to complete. The reports are due at the beginning of the next lab session (unless otherwise
noted). Each group will turn in only one report. Print your reports before coming to lab.

Grading Policy
Lab is worth 40% of your grade.
The TA will grade homework and Case Study reports. The instructor will grade exams.
Refer to the Laboratory Report Writing Guide and Laboratory & Project Evaluation Form for further infor-
mation regarding how Case Study reports will be graded. The TA will grade the reports based on adherence to
format guidelines, completed deliverables (as stated in each Case Study handout), and proper writing techniques.
Late homework and labs will not be accepted.
Appeals to individual homework or lab grades must be made to the TA within one week. The TA may re-grade
the entire assignment. Also, the TA will not accept appeals based on grading comparisons.

Any rules or other grading policies established in the class syllabus also apply.

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8 LAB & GRADING POLICIES

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Case Study Writing Guide

Please type your report and staple in the upper left-hand corner. Do not otherwise bind the report or use report covers. Include
the name of the case study, section, all group members and the date on a cover sheet. The report will include the following
sections. Overall length should not exceed 3-4 pages, plus tables and figures.

Your completed Lab Report will be evaluated and graded by the instructor using this Case Study Evaluation Form.

Title Page (3 pts)


Include the report title, all group members, section number, and the date. This title page serves as the cover sheet for
the report.
Executive Summary (15 pts)
1. A concise summary of the key points of your project: problem, methods, results, conclusions, benefits.
2. Written for a top executive who doesnt have the time to read the whole report, but who is interested in what was
done (methods, results, conclusions) and why it was done (problem, expected benefits)
3. Present specific results and numbers
Introduction (7 pts)
1. Problem description: background information describing the problem
2. Expected benefits of the project
Objectives (3 pts)
State explicitly the specific objectives of the study (why did you do the study?)
Methods (7 pts)
1. A short sequential list of steps that you took to examine and solve the problem
2. Any assumptions or limitation on methods (e.g. time limitations for running STORM, time slots not observed due
to class conflicts for work sampling project, etc.)
Results (30 pts)
1. All key findings that were generated in meeting objectives
2. Presented as summaries in tables or figures and mentioned in the text
3. Raw data goes into appendix
4. Discuss results with regard to trends in data, comparison of results between different methods, etc; but do not
draw conclusions
Discussion (15 pts)
1. Give specific recommendations, improvements and specifications of design
2. Suggestions for further study
3. Make sure these conclusions relate to the problem and objectives
Conclusions and Recommendations (10 pts)
Quantitative and subjective conclusions justified by your results

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10 CASE STUDY WRITING GUIDE

Overall Quality (10 pts)


1. Good professional appearance
2. Nicely printed text
3. Good graphical output for figures
4. Spelling and typographical errors corrected
Tables and Figures
1. Go in results section
2. Must have headings, above the table for tables, below for figures
3. Must be mentioned and described in text, otherwise it should not be included
4. Should be placed beneath or on the page immediately following the point at which they are first described

Figure 1: Sample of Case Study Evaluation Form

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Case Study Report Checklist

Title Page
Do I have my title page with the name of the case study, team, members, section, and date?
Executive Summary

Do I have the ACTUAL NUMBERS showing all the results of interest? For example, the original method
measurements, the redesign measurements, the costs changes from the original to the improved method, and the
cost to implement the new design, and etc.
Did I make it too long? Make it concise, but be sure to show the results, analyses, and recommendations. Execu-
tives in a firm do not have time to go through everything in the material.
Did I place the executive summary at the beginning of the report?
Did I make it too short?
Introduction
Did I explain the background and current situation properly?
I should NOT show the results of the case study, just explain the expected benefits of the project.
Objectives
Did I use bullets to properly list the objectives?
Did I miss some of the objectives?
Methods
Did I show the steps on how I solved the problem? The actual software I used, which methods I used to come up
with a redesign, and etc.
Did I list the assumptions or limitations on the methods?
I should NOT use bullets or simply just list the steps.
I should NOT show the results. Just explain what methods were used.
Results
Do I have the ACTUAL NUMBERS showing all the results of interest? For example, the original method
measurements, the redesign measurements, the costs changes from the original to the improved method, and the
cost to implement the new design, etc.
Did I meet the objective?
Did I show the summaries of the results in tables or figures, if applicable?
Did I put the raw data into the appendix?
I should NOT discuss my results here, but just present them.

11

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12 CASE STUDY REPORT CHECKLIST

Discussions
Do I have the ACTUAL NUMBERS of interest to be used for discussion? For example, the original method
measurements, the redesign measurements, the costs changes from the original to the improved method, and the
cost to implement the new design, etc.
Did I explain the redesign in details by giving the specifications? For example, dimensions of the new product,
the measurements of the workstation, the methods of the new time schedule, and etc.
Did I make any suggestions for further study?
Did I make the conclusions relate to the problem and objectives?

Conclusions and Recommendations


Do I have the ACTUAL NUMBERS of interest to make conclusions and recommendations? For example, the
original method measurements, the redesign measurements, the costs changes from the original to the improved
method, and the cost to implement the new design, etc.
Did I subjectively explain and justify why my conclusions and recommendations should be implemented?
Overall Quality
Did I proofread?
Did I make everything consistent?
Did I type everything neatly? Did I make the text align, write in consistent font, give equal line spacing, and etc.
Did I label the figures? Did I label them individually?
Did I write in third person perspective?
Some categories might not be applicable to certain case studies

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Tips for a Successful Case Study Report

Follow the IE 327 Lab Report Writing Guide. The reports are graded according to this guide. If items are not included
or done incorrectly, points will be deducted.
Answer all questions on the Case Study handout. Be sure to check the problem description for questions.

Remember that you are working as a consulting firm. Write the report as if you were reporting data to the companys
CEO. Be professional and try to write in third person (do not use I at all you are a group not an individual, and try
not to use We that much).
Make sure the firms name and the section number is on the title page. Group members names can also be included.
Write the Executive Summary last. This will help ensure the information in the summary matches the report.
SPELL CHECK. Both with the word processor AND by reading the report.
GRAMMAR CHECK. There is an option in Word to have the program also check writing style. (Under Tools,
Options, Spelling and Grammar tab, change Writing Style to Grammar & Style. You can also click on the
Settings box to change what Word examines)
READ the report before turning it in, preferably by more than one group member. Make sure the different sections
fit together and the information is consistent throughout the report. Also make sure the margins are set correctly
(everything fits on the page; a table is not split on two pages; etc.).
If you have any questions about any part of the report, ask.
Turn the report in on time.

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14 TIPS FOR A SUCCESSFUL CASE STUDY REPORT

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Case Study #1 (Mini)
- Gilbane Gold (Ethics and Societal Concern)

Introduction
The videotape, Gilbane Gold, presents a hypothetical case involving a young engineer, David Jackson, who faces a problem
posed by discharges from his plant, Z Corp, which is located in the town of Gilbane. Put yourself in the position of David and
ask yourself what you would do in this situation, realizing that your job may be on the line.The cast of characters include:

Diane Collins - Z Corp plant manager, reports to corporate headquarters


Frank Seeders - engineer in charge of plant operations, reports to Diane
Phil Port - manager of environmental operations, not an engineer
David Jackson - young engineer responsible for environmental measurements, reports to Phil
Dan Martin - Z Corp corporate lawyer
Tom Richards - environmental engineer fired by Z Corp, quite knowledgeable about discharges
Lloyd Bremen - former state environmental commissioner who oversaw original regulations, now farming using
Gilbane Gold and is concerned
Dr. Winslow Massin - Professor of Engineering Emeritus
Maria Renato - TV reporter doing close up on Z Corp

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16 CASE STUDY #1 (MINI) - GILBANE GOLD (ETHICS AND SOCIETAL CONCERN)

Procdure
Answer the following questions (one or two sentences for each is sufficient) as they lead into your final decision.
1. Should the presentation of the case by TV reporter, Maria Renato, affect Davids decision?

2. Should the fact that Davids boss, Phil Port, is not an engineer affect Davids decision?

3. Does Prof. Massin provide any useful insights into Davids dilemma? Would you turn to a former professor for
assistance?

4. Would you look to your professional society (The Institute of Industrial Engineers) for assistance?

5. Do you think the plant manager, Diane Collins, has received conflicting information from her employees? How could
David better present his concerns?

6. Do you think Z Corp is poisoning the soil through its present levels of discharge? What if they increase it 500% as
projected with the new contract?

7. Do you think David is deceiving the town of Gilbane if he does not revel the results of a new test? Is there any situation
in which failing to report such test results justified?

8. Do you think Dianes actions are unfair to David?

9. Do you think the town of Gilbane is treating Z Corp. unfairly? Should they bear some of the responsibility and expense
of complying with its strict standards?

10. Do the actions of the ex-consultant Tom Richards seem completely above board?

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Final Two Crucial Questions (with longer answers)


1. How would you advise David to proceed? Support your advice.

2. What would you do if you were in his shoes? What is your main ethical principle (duty, virtue, utilitarianism)? Why?

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18 CASE STUDY #1 (MINI) - GILBANE GOLD (ETHICS AND SOCIETAL CONCERN)

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Case Study #2 (Mini)
- Job/Worksite and Flow Process Analysis
Guide

Introduction
Use the Job/Worksite Analysis Guide to identify potential problems and further analyses to be used on two different jobs
(available on Angel): the hot end of glass molding for picture tube funnels and a flashlight assembly job. Write a one-
paragraph summary indicating what appears (in this stage of your course learning) to be the worst problems of these jobs i.e.
what would you focus your efforts on?

In the second job (flashlight assembly), there are variety of parts, components, and tools that enter the assembly area. Develop
a Flow Process Chart for the current job (focus on the event types and description). Then devise an improved method and
develop the resulting improved flow process chart. Briefly discuss your improvements.

Procedure
For the Hot end glass video
1. ONE Job/Worksite Analysis form
2. ONE paragraph describing what concerns you about this job and any suggestions you may have
For the Flashlight Assembly video
1. ONE Job/Worksite Analysis form
2. TWO Flow Process Charts
Actual Process
Proposed Process
3. ONE paragraph summarizing your concerns and describing the recommendations that led you to your Proposed
Process

19

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20 CASE STUDY #2 (MINI) - JOB/WORKSITE AND FLOW PROCESS ANALYSIS GUIDE

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22 CASE STUDY #2 (MINI) - JOB/WORKSITE AND FLOW PROCESS ANALYSIS GUIDE

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24 CASE STUDY #2 (MINI) - JOB/WORKSITE AND FLOW PROCESS ANALYSIS GUIDE

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26 CASE STUDY #2 (MINI) - JOB/WORKSITE AND FLOW PROCESS ANALYSIS GUIDE

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Case Study #3 (Maxi)
- Biomechanical Analysis of Lifting

Introduction
Overexertion injuries from lifting and other manual materials handling activities account for 25% of industrial accidents
involving 12 million lost days and $14 billion in costs. In this lab you will observe a videotape of a typical palletizing
operation (video clip 17) in industry and use two PC programs to predict the stresses on the low back. The stacker is
palletizing boxes of powdered detergent (20x16x8) weighing 23 lbs at a rate of 5 boxes/min for a full 8-hour shift. There
are four layers of 12 boxes per layer lying on pallet, the surface of which is 4 from the floor. The boxes are taken from
a conveyor of height 30 from the floor with minimum H distance. For simplicity, assume 45 degree twisting and that the
laborer completes one layer before progressing to the next layer, otherwise a stack may topple (although the handler doesnt
always do that). Calculate H and V based on box sizes and level palletized.

Figure 2: Palletizing Boxes

27

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28 CASE STUDY #3 (MAXI) - BIOMECHANICAL ANALYSIS OF LIFTING

Figure 3: Dimension of the Box

Procedure
1. Calculate RW L and LI based on the 1991 NIOSH lifting guidelines for the lowest layer by hand for the origin,
destinationin , and destinationout .

Recommended Weight Limit 1

RW L = LC HM V M DM AM FM CM

Where:

LC = Load Constant = 51lbs


HM = Horizontal Multiplier = 10/H
V M = Vertical Multiplier = 1 0.0075|V 30|
DM = Distance Multiplier = 0.82 + 1.8/D
AM = Assymetry Multiplier = 1 0.0032 A
FM = Frequency Multiplier = refer to Frequency Multiplier Table
CM = Coupling Multiplier = refer to Coupling Multiplier Table

H = Horizontal location of the load cg forward of the midpoint between the ankles, (10 H 25 inches)
V = Vertical Location of the load cg, (0 V 70 inches)
D = Vertial travel distance between the origin and destination of the lift, (10 D 70 inches)
A = Angle of asymmetry between the hands and feet (degrees)

Lifting Index
Load Weight
LI =
RW L

1 For the metric version check: http://www.cdc.gov/niosh/docs/94-110/

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Frequency
Lifts/minute is determine by how many tasks you have. You have to divide the job into different tasks (10 max);
try to get the most difficult boxes to place on the pallet. To determine Task frequency (used in the calculations);
divide the TOTAL frequency by the number of tasks.

Total frequency
Task frequency =
#tasks

Table 1: Frequency Multiplier Table (FM)

Work Duration
Frequency (Lifts/min) 1 Hour > 1 but 2 Hours > 2 Hours but 8 Hours
V < 30 V 30 V < 30 V 30 V < 30 V 30
0.2 1.00 1.00 .95 .95 .85 .85
0.5 .97 .97 .92 .92 .81 .81
1 .94 .94 .88 .88 .75 .75
2 .91 .91 .84 .84 .65 .65
3 .88 .88 .79 .79 .55 .55
4 .84 .84 .72 .72 .45 .45
5 .80 .80 .60 .60 .35 .35
6 .75 .75 .50 .50 .27 .27
7 .70 .70 .42 .42 .22 .22
8 .60 .60 .35 .35 .18 .18
9 .52 .52 .30 .30 .00 .15
10 .45 .45 .26 .26 .00 .13
11 .41 .41 .00 .23 .00 .00
12 .37 .37 .00 .21 .00 .00
13 .00 .34 .00 .00 .00 .00
14 .00 .31 .00 .00 .00 .00
15 .00 .28 .00 .00 .00 .00
>15 .00 .00 .00 .00 .00 .00

Table 2: Coupling Multiplier Table (CM)

Coupling Type Coupling Multiplier


V < 30 inches (75 cm) V 30 inches (75 cm)
Good 1.00 1.00
Fair 0.95 1.00
Poor 0.90 0.90

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30 CASE STUDY #3 (MAXI) - BIOMECHANICAL ANALYSIS OF LIFTING

Figure 4: Decision tree for coupling quality

2. Calculate the Composite Lifting Index (CLI) using Design Tools


Confirm the hand calculation by using the Design Tools computer program. Also include all four layers and compute
the Composite Lifting Index (CLI). Is this acceptable? Note: You must not exceed allowed ranges for H, V , and D.
(e.g. if H > 25 inches, put H = 25.)
(a) Type in Task name and then add task (can enter all task names before entering data)
(b) Edit task to change values
i. Click on the Destination box (toward top-right)
ii. Make sure all values are correct (change each to be sure the numbers match the slider - sometimes they are
wrong)
iii. Compute the Task LI before going to next task
iv. Click Next Task to enter data for the next task
(c) When you are finished entering all the tasks, go back to the job entry and click compute job
Be sure to record the CLI for the whole job and the LI for each task.
Look at the multipliers. You may want to print these out since you will need them for your redesign.
Remember that you must consider both the origin and the destination.

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31

3. Use 3DSSPP to Calculate Strain in the Lower Back


Use the University of Michigan 3D Static Strength Prediction Model (3DSSPP) to calculate the minimum % capable of
lifting the load and the lower back (L5 /S1 ) compressive forces for stacking the box on the top and bottom layers (the
worst cases!).

Assumptions
Ignore twisting for this part
Use measurements (H and V measurements) from the previous section to determine hand position for the
origin, lowest-inner layer, and highest-inner layer

(a) Set the body view - easier to see in 3-D with an oblique view
3-Views - Human Figure - Flesh - Render - Shaded or Solid
Oblique View - Human Figure - Flesh - Render - Shaded or Solid
(b) Enter the body size - either chose 50th percentile or enter preferred weight and height
Task-Input - Anthropometry
(c) Enter the hand positions (H and V ) for the origin into the program (must be in 3-D mode) - mark semiprone
Task-Input - Posture Prediction
(d) Enter the load for each hand (the load is distributed equally in each hand - divide by 2). Do not change the
direction of load.
Task-Input - Hand loads
(e) Calculate the L5 /S1 disk compression and the % capable
Reports - Analysis Summary
(f) Print out the ANALYSIS SUMMARY report to use later (or just write them down)
Reports - Print Reports
(g) Copy and paste SIDE view of posture into Word or other program TO PUT INTO THE REPORT
Maximize the SIDE view window - then you can select all, copy, paste
(h) Repeat steps c through g for the lowest-inner and highest-inner levels
(i) You should have a total of 3 Side Views and analysis summaries

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32 CASE STUDY #3 (MAXI) - BIOMECHANICAL ANALYSIS OF LIFTING

4. Redesign the task to minimize the stress on the worker.


Recalculate both the CLI and the low back compressive forces to demonstrate that you have improved the task (Target
the ideal CLI value). Consider both expensive (but very safe) options (such as hoists that eliminate lifting completely)
vs. relatively inexpensive modifications that may not eliminate lifting.

Review the multipliers in the RW L formula: What can be improved?


Review the measurements: What can be improved? (H,V, A, F)
Repeat procedure 2 (calculating CLI using Design Tools)
Repeat procedure 3 (Using 3DSSPP to calculate strain in the lower back).
This is the method that you recommend to the company. Redesigning the process for loading the boxes.
Limitations for the redesign
Productivity should not change significantly
Cant fire the worker
Cant change the size of the box
5. Discuss the cost-benefits of your redesigns; i.e. the risk of injury vs. the cost of redesign. Explain why your redesign
is better than the existing process. Also, dont forget productivity!
Cost-benefits - look on the web for prices, estimate wages, increases in productivity, etc. Does not need to be exact, but
a fairly good analysis (more than it will cost a lot at first, but save money in the long run)

Extra Checklist for the Report


Besides all the sections required for the report in the Report Writing Guide, make sure that you include the following:

Results section
MAKE YOUR OWN TABLE with values from Design Tools (what you feel is relevant) - do not just attach
printouts
MAKE YOUR OWN TABLE with L5 /S1 compressive forces and % capable - do not just attach printouts. The %
capable refers to what percentage of the population can perform the job safely - look at the joints (elbow, shoulder,
knee, etc.)
Figures in the Appendix:
LABEL the side views as FIGURES and with the HAND POSITION IN THE TITLE (e.g. Figure 1. Lowest
layer body posture - hands: H = 19 inches, V = 14 inches)
Only need to put the body posture figures together (same pages) and attach them to the end of the report (dont
have to refer to them in the report - I just want to see them). If you do decide to put them in the report, be sure to
mention them in the text.
Extra Credit
Find and include an outside source (book, paper, etc.) and cite and reference it correctly. (Class textbook is not
accepted)
Make sure that Tables and Figures are labeled correctly according to the handout provided.

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Case Study #4 (Maxi)
- CTD Analysis, Workplace/Tool Design and
Ethics

Introduction
ClipCo, a major manufacturer of flashlights and spotlights for both first responders and hunters, is concerned about the large
number of cases of cumulative trauma disorders (CTDs) in its Wilkes Barre, PA plant. Of its 200 assemblers, 29 have had
some kind of an injury requiring at least one lost work day. Ten of these individuals have required carpal release surgeries
with an average of eight weeks of recovery time. Medical costs for surgery average $5,000/case. Annual Workers Comp
costs have almost reached $1,000,000. Furthermore, although not a high rate, the workers are paid $7.50/hour (this is a
rough average, starting wage is $6.50/hr and, with enough seniority, workers can reach $9.00/hr). Because of the continuing
injuries, medical costs, and labor costs, ClipCo is seriously considering shipping the assembler jobs down to a maquiladora
(contracting in Spanish) plant in Ciudad Juarez, Mexico. There, Mexican workers, typically women, are paid only $.60/hr
and the parent company (i.e. ClipCo) is not responsible for injuries and Workers Comp costs. Your IE manager has asked you
(as consultants) to evaluate and suggest redesigns to the assembler job, workplace and tools. However, she also adds Dont
spend too much time on it. We would need to get at least a 20% improvement in productivity to keep these jobs. Thats
probably not possible, so those jobs are probably going to go away anyway. What do you do?

Procedure
1. Observe the videoclip and perform a CTD Risk Analysis on assemblers right hand (the right hand is more active than
the left hand). Comment on the score obtained in terms of relative risk. (Think - Would you want your parents working
on this job?)

2. For the Force Factor, estimate how much force (as %of max) is required to do the job, but focus on the wire cutter.
To estimate the force required by the wire cutter:

(a) Cut several wires, and then squeeze the grip dynamometer equally hard (this may require several tries to get an
equal feel). Repeat several times to estimate an average value of grip force required to cut a wire.
(b) Then measure maximum grip force on the dynamometer.
(c) Divide #a by #b to find percent of maximum grip force used on the job. Scale resulting value by 15% and use as
the Force Factor.

3. Although there are a total of five different tools utilized for this job (wire cutter, needle-nose plier, hammer, screwdriver,
electric glue gun), focus only on the wirecutter and screwdriver. You may wish to examine the screwdriver handle and
recommend a handle that produces greatest torque capability (i.e. for a given amount of force required for the screw,
the operator will need to use the lowest % of total voluntary capability). The screwdriver will not be part of the CTD
Risk Analysis Form, though.
You may wish to try out various handles and the max torque that each can produce using the Torque Tester (use the
Reset button between trials to reset the readout to zero). There are about 10 different screwdrivers/handles available.
Dont test all; decide on a good subset based on your knowledge and only test those (JUSTIFY before starting!).

33

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34 CASE STUDY #4 (MAXI) - CTD ANALYSIS, WORKPLACE/TOOL DESIGN AND ETHICS

4. Finally, using your knowledge of ergonomic design and various checklists (Workplace, Tool Evaluation), suggest an
overall redesign of the job, tools, and workplace and calculate the CTD Risk for the redesigned job.
What effect would a 20% increase in productivity through a faster pace only (no design changes) have on CTD risk?
Be specific.

Extra Checklist for the Report


Besides all the sections required for the report in the Report Writing Guide, make sure that you include the following:

Include present, +20%, and redesign CTD Risk Analyses, any checklists used and any drawings of redesigns.
Highlight the ergonomic features of your redesigned wire cutter and screwdriver.
Estimate the costs for redesigning both tools, as well as any other changes to the assembler job/workplace?
Discuss the reductions in CTD risk and any increase in productivity obtained with these changes.

Given your answers to #3 and #4, do you think that this is sufficient to keep the Wilkes Barre plant open?
Discuss the overall economic and ethical implications. Consider the costs to modify and maintain the jobs in Pennsyl-
vania. Consider shipping the jobs to Mexico, the loss to the Wilkes tax base, and also effects on the Mexican workforce.
What is your final recommendation to your manager?

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Case Study #5 (Mini)
- Sensory and Environmental Analysis

Introduction
In this lab you will perform five basic sensory and environmental analyses to determine baseline operator capabilities and
whether existing conditions are acceptable for efficient operator performance.

Audiometric Testing
Using the Maico MA-21 audiometer ($800), perform air conduction tests using the headphones (Red on right ear).

1. Set frequency = 1,000 HZ, HTL = 0 db, Right = IN, Masking = OFF, Power/mode = Tone.

2. Press tone button such that subject does not observe. Subject should raise hand to indicate when the tone is heard.

3. If subject does not respond, increase HTL until subject does respond. Repeat with frequency set at 4,000 Hz.
HTL (1,000 Hz)
HTL (4,000 Hz)

4. Comment on the difference between the two hearing thresholds. What would you expect?

35

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36 CASE STUDY #5 (MINI) - SENSORY AND ENVIRONMENTAL ANALYSIS

Noise Levels
Use the sound level meter (precision = $3,000, cheap = $40) to find the following.

1. What is the existing noise level in dBA?

2. Given that the operator is exposed to this level for 6 hours and at 95 dBA for 2 hours, what is the noise dose (according
to OSHA calculations)?

3. Is this acceptable to OSHA?

4. If not, how many hours would the operator be allowed to drill so as to be at the threshold dose of 100%?

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Visual Acuity
Use the Snellen Eye Chart to determine visual acuity of the left and right eye (i.e. cover the other eye), with and without
visual correction, at a distance of 20 feet. Have the subject start at the top E and move downwards until a row can not be read
correctly (a miss of up to two letters can be disregarded).

Without Correction

Left Eye Right Eye

With Correction

Left Eye Right Eye

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38 CASE STUDY #5 (MINI) - SENSORY AND ENVIRONMENTAL ANALYSIS

Illumination Level
Use the light meter ($1,500) to measure the illumination levels in two different areas [e.g. hallway or bathroom (Category A-
C) and classroom or lab (Category D-F)] and determine if the existing levels are appropriate for the expected speed/accuracy,
age, and reflectance using the tables below2 .

Table 3: Recommended Illumination Levels for Use in Interior Lighting Design

Category Range of illuminance (fc) Type of activity Reference area


A 2-3-5 Public areas with dark surroundings.
B 5-7.5-10 Simple orientation for short temporary visits. General lighting throughout
room or area.
C 10-15-20 Working spaces where visual tasks are per-
formed only occasionally.
D 20-30-50 Performance of visual tasks of high contrasts
or large size, e.g., reading printed material,
typed originals, hand-writing in ink and xerog-
raphy; rough bench and machine work; ordi-
nary inspection; rough assembly.
E 50-75-100 Performance of visual tasks of medium con- Illuminance on task.
trast or small size, e.g., reading medium-pencil
handwriting, poorly printed or reproduced ma-
terial; medium bench and machine work; dif-
ficult inspection; medium assembly.
F 100-150-200 Performance of visual tasks of low contrast
or very small size, e.g., reading handwriting
in hard pencil on poor-quality paper and very
poorly reproduced material; highly difficult in-
spection
G 200-300-500 Performance of visual tasks of low contrast
and very small size over a prolonged period,
e.g., fine assembly; very difficult inspection;
fine bench and machine work; extra fine as-
sembly.
H 500-750-1000 Performance of very prolonged and exacting Illuminance on task via a
visual tasks, e.g., the most difficult inspection; combination of general and
extra fine bench and machine work; extra fine supplementary local light-
assembly. ing.
I 1000-1500-2000 Performance of very special visual tasks of ex-
tremely low contrast and small size, e.g., sur-
gical procedures.

Table 4: Weighting Factors to be Considered in Selecting Specific Illumination Levels within Each Category of Table 3

Weight
Task and worker characteristics 1 0 +1
Age < 40 40 55 > 55
Reflectance of task/surface background > 70% 30 70% < 30%
Speed and accuracy (only for categories D-I) Not important Important Critical

2 Adapted from IESNA, 1995

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39

First Area Category

Existing illumination level (foot candles)

Acceptable illumination level

Task and worker characteristics Weight


Age
Reflectance of task/surface background
Speed and accuracy (only for categories D-I)

Discuss if the existing conditions are acceptable.

Second Area Category

Existing illumination level (foot candles)

Acceptable illumination level

Task and worker characteristics Weight


Age
Reflectance of task/surface background
Speed and accuracy (only for categories D-I)

Discuss if the existing conditions are acceptable.

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40 CASE STUDY #5 (MINI) - SENSORY AND ENVIRONMENTAL ANALYSIS

Heat Stress
Use the Heat Stress Monitor ($1,500) to measure the following in two different locations/conditions.

1. Assume the operator is assembling widgets while sitting (metabolic expenditure = 200 kcal/hr).

Category Temperature
WB
DB
GT
WBGTIN

What is the required rest per hour?

2. Assume the operator is de-palletizing a boxcar load outdoors (metabolic expenditure = 600 kcal/hr).

Category Temperature
WB
DB
GT
WBGTIN

What is the required rest per hour?

3. Using the figure on the next page, what is the relative humidity?

Indoors Outdoors

4. EXTRA CREDIT (1pt)


Find another source where you can find the outside humidity. Name the source, write down the value and compare it
to the one you obtained above.

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41

Figure 5: Psychrometric Chart

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42 CASE STUDY #5 (MINI) - SENSORY AND ENVIRONMENTAL ANALYSIS

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Case Study #6 (Maxi)
- Information Processing and ATM Design

Introduction
The primary purpose of an ATM is for quick withdrawal of cash from the bank. Your objective is to redesign the ATM
panel (if necessary) for optimum speed of cash withdrawal using your knowledge of information theory and information-
processing/decision-making. Design parameters that may affect performance include:

Form of layout: Square layout as on a keypad vs an in-line layout as on a typical keyboard


Type of layout: Calculator keypad vs. phone keypad (compare the two on your own calculator and cell phone)
Type of entry: Physical keys vs. virtual keys on a screen activated by mouse (as on the Fitts Tapping Task and Choice
Reaction Time modules in Design Tools)
Size of layout: size of keys and spacing of keys

For the purpose of this exercise, assume the minimum number of steps to remove FAST CASH. Once your ATM card is
inserted, there are only 6 buttons to press (using your index finger only):
4 digits for your ATM pin number
ENTER to confirm entry of pin number
FAST CASH to withdraw the automatic $60

Procedure
1. Calculate the index of difficulty for a square layout and in-line layout. Assume that the home position for the index
finger while entering the pin number is digit 5 (since the numbers could be random for a general case). Disregard 0,
ENTER, and FAST CASH.

Index of Difficulty  
2D
ID = log2
W
D: the average distance from home button (5) to every other number.
W : the width of one button.

2. Determine the best layout, either square or in-line layout, by using the Index of Difficulty. Only the best layout will be
used for further work.
3. Pick one person of your group to act as the typical ATM user. He/she will perform all the necessary information
processing activities.

43

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44 CASE STUDY #6 (MAXI) - INFORMATION PROCESSING AND ATM DESIGN

4. Use the Fitts Tapping Task module in Design Tools to find the processing time for movements between different size
keys and key spacing.
Choose two combinations and run two trials each. Select the best combination.

5. Perform the Fitts Tapping Task physically based on the best combination that was chosen above. Draw the boxes with
the appropriate dimensions and the distance on a piece of paper and use a stopwatch for timing.
time to perform the 100 taps
tavg =
100 #errors

6. Consider the tradeoff in the index of difficulty, i.e. larger keys are faster to hit, but a greater distance which slows down
the response.

7. Perform the Simple Reaction Time module in Design Tools to find the intercept of the Hick-Hyman Plot.
Any color, 20 trials
Record the average reaction time
8. Perform the Choice Reaction Time module in Design Tools to find three other data points for the Hick-Hyman Plot.

Perform the three tests, 20 trials each


Record the average reaction time
9. Plot data in Excel and calculate the equation of the line. You will get a linear equation like y = mx + b, which is
RT = a + bH in this case. (RT is the reaction time)
10. Use the RT equation that you got to calculate
Cannel capacity (bandwith)
Response time for 10 equally likely alternatives
Response time for 4 successive digits (not equally likely alternatives)
(T 1) Response time for the following 6 key strokes: 4 random digits, ENTER, and FAST CASH
11. (T 2) Redesign the ATM layout to what you think would be a better one. Have your ATM user mock the 6 key strokes
(4 random digits, ENTER, and FAST CASH) and record the time it took the user to do it with a stopwatch. (The
experimenter reads the (random) numbers right before the subject enters it into the keypad, since that is the procedure
that you predicted. Obviously, you can enter own pin number more quickly, since you have practiced the task; but that
wouldnt be a fair comparison.) The drawing is EXTRA CREDIT.
12. (T 3) Have your ATM user go to a real ATM. Have the user mock the 6 key strokes (4 random digits, ENTER, and
FAST CASH) and record the time it took the user to do it with a stopwatch (T3). (The experimenter reads the (random)
numbers right before the subject enters it into the keypad, since that is the procedure that you predicted. Obviously,
you can enter own pin number more quickly, since you have practiced the task; but that wouldnt be a fair comparison.)

13. Compare T 1, T 2, and T 3, recommend the best one and comment why you think it is the best.

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45

Extra Checklist for the Report


Besides all the sections required for the report in the Report Writing Guide, make sure that you include the following:

A table with the two values of index of difficulty


Average tapping times from Fitts tapping tests (there should be at least 3 values)

A table with the average reaction times that you got from the Simple Reaction Time test and the three Choice Reaction
Time tests
The Hick-Hyman plot of your ATM user

The four calculations using the RT equation. Channel capacity, Response time for 10 equally likely alternatives,
Response time for 4 successive digits (not equally likely alternatives), Response time for the following 6 key strokes:
4 random digits, ENTER, and FAST CASH
Your new ATM layout design
A table that contains the three different reaction times that you are supposed to compare (T 1, T 2, and T 3)

A discussion about the 3 reaction times.


Discuss the final performance test. How close were you? If its not that close, why not?

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46 CASE STUDY #6 (MAXI) - INFORMATION PROCESSING AND ATM DESIGN

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Case Study #7 (Mini)
- Visual Inspection - Signal Detection

Introduction
Visual inspection of defects is a classic signal detection task. Consider the Visual Inspection of Resistors in Design Tools and
offer recommendations on how the task can be improved to increase overall performance (decrease errors, i.e. decrease false
alarms and misses).

Figure 6: A 15K Resistor

Procedure
1. Have one group member start out as the inspector. Practice several times so that you get the hang of the task (more
technically, until you have flattened your learning curve, about which you will learn more later in the course). Record
your results in the following way (form provided).

Table 5: The Four Basic Outcomes in Signal Detection Theory

Lead Lengths
Response Equal Unequal
Equal Hit False Alarm
Unequal Miss Correct Rejection

2. Vary the length of the resistors. How does that change the results?

47

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48 CASE STUDY #7 (MINI) - VISUAL INSPECTION - SIGNAL DETECTION

3. Have the other members repeat the steps above.


(a) Who is the best inspector in terms of accuracy? Provide numbers if necessary.

(b) In terms of speed? Provide numbers if necessary.

4. Is there a speed-accuracy tradeoff? If your group does not show a trade-off, what do you think this trade-off should be?

5. Complete one calculation of sensitivity (d 0 ) for each group member, for the same lead length. Show calculations. Who
is the best inspector now?

6. How would you improve the inspection task for optimum overall performance (fast and least errors)? Consider: 1) the
length of resistors (from direct data), 2) % difference in lead length (indirectly given in print outs), 3) the length of
the leads (subjectively, is it easier with long leads or short leads). Is there anything else (not necessarily shown in the
computer module) that you would change in the inspection task to improve task performance? So, what is your overall
recommendation for improving the visual inspection of resistors?

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49

Adjusting Factors for calculating d 0


1. If the number of misses is 0,
#hits 0.5
P(Hit) =
#hits
2. If the number of false alarms is 0,
0.5
P(False Alarm) =
#Correct Re jection
3. If the number of hits is 0,
P(Hit) = 0.1

4. If BOTH the hit rate and the false alarm rate are either 0 or 1,

d 0 = 0.5

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50 CASE STUDY #7 (MINI) - VISUAL INSPECTION - SIGNAL DETECTION

Name Name
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Average Response Time Average Response Time


Length Length

Lead Lenghts Lead Lenghts


Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Name Name
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Average Response Time Average Response Time


Length Length

Lead Lenghts Lead Lenghts


Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

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51

Name Name
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Average Response Time Average Response Time


Length Length

Lead Lenghts Lead Lenghts


Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Name Name
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

Average Response Time Average Response Time


Length Length

Lead Lenghts Lead Lenghts


Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal
Average Response Time Average Response Time
Length Length
Lead Lenghts Lead Lenghts
Response Equal Unequal Response Equal Unequal
Equal Equal
Unequal Unequal

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52 CASE STUDY #7 (MINI) - VISUAL INSPECTION - SIGNAL DETECTION

Figure 7: Cumulative Probabilities for the half of the Standard Normal Distribution

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Figure 8: Cumulative Probabilities for the other half of the Standard Normal Distribution

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54 CASE STUDY #7 (MINI) - VISUAL INSPECTION - SIGNAL DETECTION

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Case Study #8 (Maxi)
- Ultrasound Transducer Design

Introduction
Sonography is a diagnostic medical procedure that uses high frequency sound waves (ultrasound) to produce dynamic visual
images of organs, tissues, or blood flow inside the body. This type of procedure is often referred to as a sonogram or ultra-
sound scan. Sonography can be used to examine many parts of the body, such as the abdomen, breasts, female reproductive
system, prostate, heart, and blood vessels. Sonography is increasingly being used in the detection and treatment of heart
disease, heart attack, and vascular disease that can lead to stroke. It is also used to guide fine needle, tissue biopsy to assist in
taking a sample of cells from an organ for lab testing (for example, a test for cancer in breast tissue).

Figure 9: Ultrasound Transducer Against the Patients Skin

55

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56 CASE STUDY #8 (MAXI) - ULTRASOUND TRANSDUCER DESIGN

The process involves placing the ultrasound transducer against the patients skin near the body area to be imaged. The
transducer works like a loudspeaker and microphone because it can transmit sound and receive sound. The transducer sends a
stream of high frequency sound waves into the body that bounce off the structures inside. The transducer detects sound waves
as they bounce off the internal structures. Different structures in the body reflect these sound waves differently. These sounds
are analyzed by a computer to make an image of the structure(s) on a television screen or that can be recorded on videotape,
e.g. ultrasound images of a fetus, the gall bladder, liver, and kidney.

(a) Fetus (b) Gall Bladder

(c) Liver (d) Kidney

Figure 10: Various Ultrasound Images

Musculoskeletal disorders (MSDs) are common amongst sonographers. A survey distributed to three different trade orga-
nizations (British Columbia Ultrasonographers, Canadian Society of Diagnostic Medical Sonographers, American Registry
of Diagnostic Medical Sonographers) resulted in 1,621 responses with the following findings: anatomical sites of discomfort
(Figure 11), percentage of sonographers affected (Figure 12), and types of activities leading to discomfort and pain (Fig-
ure 13). A survey by Smith et al. (1997) found a positive relationship between musculoskeletal pain and ultrasonographer
height (< 63 inches), between frequency of scans (> 100 per month), between scan time (> 25 minutes per patient), and
between use of manually propelled machines. Similarly, a survey by Mirk et al. (1999) showed that muscular efforts of
gripping the transducer, applying sustained pressure and scanning with a flexed or hyperextended wrist were significantly
correlated with increasing severity of symptoms in the hand, wrist and forearms. As can be seen from these surveys, the
common causal factors for these MSDs are similar to those leading to CTD risk: overall posture during exertion, type of
grip, force of exertion,and repetition of exertion. Sustained, static exertions experienced during sonography also play a crit-
ical role. Some examples of typical postures during sonography are: sitting with bed high (Figure 14), sitting with bed low
(Figure 15), standing with bed high (Figure 16), and standing with bed low (Figure 17). Examples of the typical grips used
during sonography are: pinch grip (Figure 18), pinch/power hybrid (Figure 19), and another pinch grip (Figure 20). There
are considerable hand/wrist deviations (Figure 21) during the maneuvers and considerable forces exerted (Figure 22) while
applying the transducer on the patient.

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Figure 11: Anatomical Sites of Discomfort in Sonographers

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58 CASE STUDY #8 (MAXI) - ULTRASOUND TRANSDUCER DESIGN

Figure 12: Percentage of Sonographers Reporting Consequences of Pain and Discomfort

Figure 13: Tasks that Aggravate Musculoskeletal Symptoms (Mean Scores on a 5 Point Scale)

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59

Figure 14: Sitting Work Posture Chair Height Adjustable, Bed Height Non-Adjustable

Figure 15: Sitting Work Posture Chair, Bed and Chair Height Adjustable

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60 CASE STUDY #8 (MAXI) - ULTRASOUND TRANSDUCER DESIGN

Figure 16: Standing Work Posture, Bed Height Non-Adjustable

Figure 17: Standing Work Posture, Bed Height Adjustable

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61

Figure 18: Pinch Grip Used for Sonography

Figure 19: Pinch/Power Hybrid Grip Used for Sonography

Figure 20: A Different Pinch Grip Used for Sonography

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62 CASE STUDY #8 (MAXI) - ULTRASOUND TRANSDUCER DESIGN

Figure 21: Summary of Postural Data for All Transducers

Figure 22: EMG and Measured Thrust Force

Note that EMG refers to the grip force to hold the ultrasound transducer, while the thrust force is the force used to push
the transducer down on the patients stomach.

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63

Although not addressed quantitatively in the scientific literature3 but mentioned often anecdotally in the mass media, there
also appears to be the potential for medical errors during the diagnosis of the ultrasound images. From the above images,
one can easily see that individual specks or darkening could easily be misconstrued as either false positives (false alarms as
termed in the medical field) causing unnecessary surgery or false negatives (misses) of tumors resulting in major disease com-
plications that were undiagnosed. These are issues that the medical industry doesnt willingly publicize and, consequently,
there isnt much information available for analysis.

Your assignment, based on your classroom preparation both in physical ergonomics and cognitive work design, is to
produce a better integrated, design of ultrasound sonography. Address both the physical, musculoskeletal issues of the
physical device itself as well as the sensory detection and cognitive processing of the images that it produces.

Procedure
The main purpose of this Case Study, which requires a complete report, is to make you use several concepts that you have
learned in class to evaluate and redesign a specific task; in this case, an ultrasound (or sonogram) technician. You will need to
consider 1) the overall postures in designing a better overall workplace; i.e. location and posture of the ultrasound technician,
placement of the patient, placement of the monitor, etc. 2) the design of the physical ultrasound transducer; i.e. the size,
weight, shape, handle, texture, etc. 3) the image sent to the monitor; i.e. signal-detection aspects of the targets, feedback to
the technician, warnings, etc. The following steps describe what you are expected to do in order to evaluate the task of an
ultrasound technician and what you should include in your report.

Read the whole description carefully. There, you will find several keywords that are linked to images.
First you need to know what are the physical complaints of the technicians who perform this type of task, what type of
activities and hand movements cause discomfort or pain, etc. This last one should give you a hint on a certain form,
which we have used before, that you can use to evaluate. You will also find a couple of images and figures that will
help you with the data you need, but there may be things you need to estimate.
There are also examples of typical postures used by the technicians. Use all of them as the scenario that you are going
to target and evaluate.
As we learned in Case Study #7, Signal Detection Theory (SDT) does not necessarily have to be used to assess the
performance of human subjects. Thus, also consider SDT for the signals received from the transducer to the computer.
you may find more info in the internet.
After you consider this and you gather at least some data to prove that there are risks to the existing task, you have
to come up with a redesign of the whole task. You should redesign everything from the transducer to the whole
workstation. Try to be as cost-efficient as possible.

3 http://www2.ie.psu.edu/Freivalds/courses/ie327new/l003.pdf or check on ANGEL IE327 Lab Case Study 8

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64 CASE STUDY #8 (MAXI) - ULTRASOUND TRANSDUCER DESIGN

Extra Checklist for the Report


Besides all the sections required for the report in the Report Writing Guide, make sure that you include the following:

Results Section
Include any data that you may have calculated
Make a table that summarizes the costs of your redesign and compare to the costs of an injury
Present a drawing (does not have to be too professional) at least of your proposed redesign of the workstation
DO NOT include any images or figures that are prepared in the material. If it is necessary, include them in the
appendix section

Appendix
Include any forms that were used to evaluate the task
Discussion
Be sure to discuss what concerns you about this task and give convincing support to your suggestions for the
redesign
Extra Credit
Try to find someone in the Healthcare industry that is knowledgeable of this task that can give you their personal
opinion and some suggestions. You will have to include some of what they say in your writing and you will also
need to write down in the appendix the full name, the place he/she works and the way you got in touch with that
person.

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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
Case Study #9 (Maxi)
- Need for CPOE? Productivity, Delays &
Medical Errors

Introduction
Susque Medical System (SMS, as many other medical centers around the country) is currently considering implementing a
computerized physician order entry (CPOE) system for its inpatient acute nursing units. Presently, the physician (MD) writes
the patient orders (could be several per one patient chart) by hand on a paper order form. This form is that placed in an
in-box for clerks, who then enter it into the computer, from where the order is sent either to the Lab for various tests to be
performed on the patient (e.g. blood tests), to Radiology for various X-rays to be performed, or to the Pharmacy for various
drugs to be prescribed and administered. Presently, the orders are printed out at the other end and processed appropriately.
Obviously there can be considerable delays in the above process. With CPOE, the physician would enter the orders directly
onto a PC (or perhaps a PDA, which then is connected to PC and the data uploaded, similar to what you will do in time study).
By implementing CPOE, it is believed that there could be four major effects:
an increase physician productivity (i.e. decrease the time the physician spends writing up patient orders)
decrease unit clerk staffing requirements
a decrease in delay times currently involved for the clerk to enter the hand-written data into the computer and for orders
to be printed out
a decrease in medical errors (see how big the problem is in To Err is Human or the full text)
Your assignment is to analyze the physician order times and lab/radiology/pharmacy unit wait times to determine the
potential benefits of implementing CPOE for Susquehanna Health Systems. An IE 327 intern has collected such data (using
time study, which is your next study topic) in this Excel file. There are three columns:
Column 1 = Record Number
Column 2 = MD Time (sec) is the time it took for the physician to process one patient chart which could have several
orders
Column 3 = Number of orders per patient chart. There are a total of 116 patient charts or physician data points (but
507 total orders)
Column 4 = Order Wait Time (min) is the wait time for each of 709 unit orders. This column is separate from the other
three columns. Do not try to match this column with the other three.

Procedure
1. Calculate the average physician time per chart and per order. Consider a distribution of the data and, perhaps, some
outliers can be eliminated.
2. Calculate average wait time per order. Again consider a distribution of the data. Perhaps outliers (lost order, yikes!!)
can be eliminated.

65

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66 CASE STUDY #9 (MAXI) - NEED FOR CPOE? PRODUCTIVITY, DELAYS & MEDICAL ERRORS

Extra Checklist for the Report


Besides all the sections required for the report in the Report Writing Guide, make sure that you include the following:

Include your results either in tables or graphs.


Address each of the three main expected goals:

Can a change in physician productivity be expected? I.e. is it reasonable to expect the physician to enter the data
more quickly using a keyboard, than by hand? Use your experience from Case Study #8 (ATMs) for this part.
How much of a decrease in wait times can be expected?
Perhaps most importantly (but perhaps most difficult), could there be reduction in medical errors? Consider all
the possibilities for errors under the old paper and clerk data entry system vs. CPOE. Is there still potential for
error in CPOE? You may need to check the Web for data on medical errors. It may be difficult to find, since health
systems are probably reluctant to admit to such problems.
Finally consider costs issues. How much would such a CPOE system cost? (You may need to search the Web. A rough
value is around $2,000,000 for both software and hardware) However, there would be a decrease in the need for data
input clerks. Consider that SMS had 24 clerks paid $12.00/hr, which eventually could be reduced by roughly 50% once
the system is fully functioning and most physicians utilizing it. How long of pay back period would there be?
Extra Credit: Build a Value Stream Map that details the flow of information before and after implementing CPOE.
Count how many steps can be eliminated and which ones were the potential sources of errors.

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