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Philwoong Kang – Junhong Kim Hyoyoung Kim – James Morrison Industrial and Systems Engineering ICSSSM11 – June 25-27, 2011 – Tianjin, China Improving Dental.

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Presentation on theme: "Philwoong Kang – Junhong Kim Hyoyoung Kim – James Morrison Industrial and Systems Engineering ICSSSM11 – June 25-27, 2011 – Tianjin, China Improving Dental."— Presentation transcript:

1 Philwoong Kang – Junhong Kim Hyoyoung Kim – James Morrison Industrial and Systems Engineering ICSSSM11 – June 25-27, 2011 – Tianjin, China Improving Dental Service via Communication During Treatment

2 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Contents Motivation Objectives Handheld communication device prototype Experiment to test the device effectiveness Results Concluding Remarks

3 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Who enjoys going to the dentist?!

4 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, I do… !

5 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Because, I found … Kenneth Palm, DDS

6 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Quotes 1 from his patients: 1

7 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Quotes 1 from his patients: This is the only dentist office I ever enjoyed coming to! 1

8 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Quotes 1 from his patients: This is the only dentist office I ever enjoyed coming to! Dr. Palm and his staff are absolutely wonderful people! 1

9 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Quotes 1 from his patients: This is the only dentist office I ever enjoyed coming to! Dr. Palm and his staff are absolutely wonderful people! The best dentist… EVER! 1

10 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Quotes 1 from his patients: This is the only dentist office I ever enjoyed coming to! Dr. Palm and his staff are absolutely wonderful people! The best dentist… EVER! – I just added that one from me 1

11 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Why do people like Dr. Palm?

12 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Why do people like Dr. Palm? I honestly do not know if his technical skills are better than others. I suppose they may be…

13 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Kenneth Palm, DDS Why do people like Dr. Palm? But, his communication skills – humor, caring, clarity – are truly extraordinary!

14 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Motivation (1) How important is communication to most patients? Survey to assess the perceived value of communication Ability of dentist primarily depends on communication [1] 76% of patients consider communication the most important factor [1]A review of patient satisfaction: 2.Dental patient satisfaction: an appraisal of recent literature, P.R.H. Newsome G.H.Wright, 1999

15 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Motivation (2) Is there a low hanging fruit communication opportunity? Surveyed dental patients to ask about ease of communication Express difficulty to communicate during treatment 1 = Very hard to communicate 5= Very easy to communicate

16 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Research Objectives PROBLEM: Patients feel it is difficult to communicate during treatment No communication device existing No device to solve this problem was found in the literature GOAL: Create a hand-held device to aid communication during treatment Measure how much the service quality at dental clinics improves

17 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Prototype Design: Methodology Prototype designed with the Axiomatic Design methodology Concept: Handheld device with buttons to communicate Functional RequirementsFR1. Take input data from patients FR2. Transfer the input data into output data FR3. Provide output data to dentist and patient Design ParametersDP1. Patient input deviceDP2. Data transferring systemDP3. Sound data output device

18 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Prototype Design: Buttons Four buttons use to receive the input from the patient – Selected the most commonly desired: Survey & discussion with dentists – Button shape and feeling chosen for intuitive feeling – Button location based on frequency of use (thumb is most favored digit) – BUTTON 1: Patient is in pain – BUTTON 2: Patient would like suction of fluids – BUTTON 3: Patient wants to pause/stop the treatment – BUTTON 4: Patient want to express thanks or enough [2] [2]

19 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Prototype Design: Considerations from the Literature Data from mouse, remote control, keyboard was used to determine: size, tactual feedback, sensitivity, weight etc. [1] Hand data of Koreans, US army, and Jordanians were used when designing the prototype Right hand dimension data of Jordanian [2] Average length of wrist to finger for US army and Korean [3] [1] Donghun Lee, Min K. Chung, Jung Young Kim. An Investigation of Using Practices for Universal Design of Information Technology Products. Journal of the Ergonomics Society of Korea Vol. 28, No. 3 [2] Yunis A.A. Mohammad. Anthropometric characteristics of the hand based on laterality and sex among Jordanian. International Journal of Industrial Ergonomics 35 (2005) 747–754 [3] Wonsup Lee, Kiyo Jung, Heecheon You. Development and Application of a Grip Design Method using Hand Anthropometric Data Korea Industrial Engineering Conference / KORMS

20 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Prototype Design: CAD Models Three prototype designs Selected the bean-pod model (middle) Light and fits comfortably into hand Design was drawn with SolidWorks 2010® Prototype shell was made with a Rapid Prototype Machine Input device prototype designs Bean-pod input device shell

21 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Prototype Design: Sound Options Microprocessor: Detects button push and emits audio signal Wireless earphones emit a sound in response to the signals Three categories of sound outputs were recorded Equipment details – Two sets of Kimson® KS-1040S Bluetooth Wireless Headset and Hands-Free were used – Wireless headsets are connected to the mp3 microprocessor board with the iBluon BT- TD03 stereo Bluetooth Dongle Type of soundPain buttonStop buttonSuction button Enough (Thank you) button Human voiceIm in painStopI need suction Thank you(meaning enough) Alerting soundHuman ouch soundCar klaxon soundStrong wind soundBell sound Natural soundWaterfall soundCuckoo sound

22 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Experiment to Test Device Effectiveness (1) GOAL: Determine if the device improves dental service METHOD: Experiment from 2010/11/30 – 2010/12/09 – Patient control group did not use the device during their treatment Modified SERVQUAL surveys given before and after treatment – Patient experimental group did use the device during their treatment Modified SERVQUAL surveys given before and after treatment Data recorder sat in the procedure room during the treatment Additional questions about the feel and use of the device Input device was wiped with sanitizing tissue after every use

23 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Experiment to Test Device Effectiveness (2) Conducted in dental offices in Daejeon, South Korea Population: 88 without, 87 with the device Modified SERVQUAL survey consisted of 21 SERVQUAL questions, 4 overall quality questions and demographics Expectation and perception questions 5 point Likert scale: Statistical hypotesis tests conducted – Wilcoxon [1] signed-rank test (paired sample test) in SAS 9.1 – Alternative to paired patients t-test since distribution is not normal Not important at allVery important [1] Wilcoxon, F. (1945). Individual comparisons by ranking methods. Biometrics, 1, 80-83

24 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, SERVQUAL Survey sheet Tangible Reliability Responsiveness Assurance Empathy

25 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Results: SERVQUAL Gap score = Perception score - Expectation score Service Without Device With Device Service Without Device With Device Up to date Equipment High-skilled dentist Clean and neat office Respect Neat appearance of dentist Safe treatment Hygiene Equipment Honest and trustworthy Precise appointment time Communicate a lot Service bill demand Easy access via phone Accurate treatment record Waiting time Treatment time notice-0.32 Convenient location Willingness to help Record requirements Quick response from dentist Recognize customers Feedback

26 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Results: SERVQUAL Dimensions H0: no difference in measurements H1: difference in measurements Using 0.05 level of significance, if z> 1.96 or z<-1.96, H0 is rejected Without DeviceWith Device Tangible Reliability Responsiveness Assurance Empathy Service Without Device With Device Z-valueSignificance Quick response from dentist O Communicate a lot O Unweighted SERVQUAL average gap score for each dimension

27 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Results: Overall Questions Service Without DeviceWith Device Overall service Communication during treatment Kindness of employees Treatment result Average score for overall question ServiceZ-valueSignificance Overall service X Communication during treatment2.1138O Kindness of employees X Treatment result X

28 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Concluding Remarks SERVQUAL results of statistical significance – Increase in quick response from dentist (Responsiveness dimension) – Increase in communicate at lot (Empathy dimension) Overall results of statistical significance – Increase in communication during treatment – Not significant: Overall service, kindness and treatment result In part due to device training, presence of data recorder, longer survey Anticipate that a communication device during treatment will improve overall dental customer experience 28

29 T hank You. Any Questions ? Please visit us on the web at

30 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Appendix 30 [Table 8] Hypothesis Testing for all questionnaire

31 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Appendix [Figure 9] Hypothesis testing

32 © P. Kang, J. Kim, H. Kim, J. Morrison – ICSSSM11 – June 25, Appendix [Figure 9] Hypothesis testing


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