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Answer :   Observation techniques

 

Direct observation produces more reliable information than interviews on actual behaviour. The researcher can see which medicines are being sold, prescribed or used, or are available in medicine cabinets; what information on their use the seller or doctor provides; whether drugs are purchased on prescription, etc. The most common observational techniques to study drug use are:

– simulated client visits

– inventories of community drug outlets and medicine cabinets.

 

 

How to conduct simulated client visits

 

Observational research is often done to describe drug distribution patterns in informal drug outlets and pharmacies. However it is difficult to carry out because drug sellers may not want to have an onlooker present. They may feel that it will disrupt or even endanger their business, particularly if some transactions are illegal. If they have a researcher present, they may do business in a more ‘correct’ way than they normally would, and they may feel that their professional competence is being tested.

 

This problem can be solved by conducting simulated client visits. A researcher or an assistant can pose as a patient or client. The advantage is obvious; it gives an unbiased picture of normal procedures. Simulated client methods are often used to measure the quality of prescribing and dispensing drugs in health facilities, pharmacies and drug shops. It involves a researcher posing as a client and going to a health centre or pharmacy with a complaint. The objective is to determine how a sample of providers react to the complaint; what treatments they recommend, and what information they give.

 

Posing as a patient or client, however, reduces the amount of information that can be gathered. The researcher can only observe his or her own visit, and in pharmacies at most a few drug purchases while waiting in turn. Furthermore it is difficult to pose many questions and make notes, without revealing one’s true identity. To counter this restriction, researchers can combine unobtrusive observation with interviewing. This approach was used by Woofers (1987), who had assistants visit 28 pharmacies to buy tetracycline over the counter, and then let other assistants interview the pharmacy personnel about tetracycline a few days later. You may also consider using different kinds of ‘clients’, representing the diversity in wealth, gender, age and ethnicity of people visiting the facility.

 

The method is somewhat controversial. One can question how ethical it is to conduct such visits without asking health workers and/or drug sellers for informed consent. The ethical issue can be resolved by asking the respondents or their professional organization for consent before conducting the visits and without giving details on when the visit will take place, to avoid bias. In the fieldwork it is recommended to use the simulated client visit to observe what information and advice drug sellers give. If a drug is bought during a visit, funding and accountability measures are needed.

 

An advantage of the simulated client visit is that it is a rapid method. A typical transaction does not last more than five minutes. It can also be used to evaluate the effects of rational drug use interventions, such as to measure information provided on drugs before and after an intervention. Ross-Dogman and colleagues (1996) tested the effects of a face-to-face education outreach intervention in Kenyan and Indonesian pharmacies.

 

Using trained surrogate patients posing as mothers of a child under five with diarrhoea, they measured sales of oral rehydration salts; sales of ant diarrhoeal drugs; and history taking and advice to continue fluids and foods. Sales of oral rehydration salts in intervention pharmacies increased by an average of 30% in Kenya, and 21% in Indonesia, compared to controls. Discussion of dehydration during pharmacy visits increased significantly in Kenya.

 

When planning to use simulated client visits as a method, you need to take decisions on how to sample the drug outlets and how many observations to do per outlet (see 6.2). It is important to consider the usual opening hours and the volume of transactions each day. For example, on market day pharmacies may be very busy and minimal advice given.

 

The guidelines provided in box 7 will help you to conduct effective simulated client visits.

BOX 7. GROUND RULES FOR CONDUCTING GOOD SIMULATED CLIENT VISITS

 

– Simulating a client requires insight into how clients usually behave. This can be obtained by conducting unobtrusive observations in pharmacies; or by asking informants during semi-structured interviews how they would ask for medicines and present a complaint at a pharmacy.

 

– Don’t step out of your role.

 

– Consider also the details of the transactions: will the advice be followed and a medication bought? What if the medicine is very expensive? Does the client then ask for a cheaper alternative?

 

– Make a realistic ‘script’.

 

– Make sure the ‘client’ looks like a real client. What will the client wear?

 

 

On recording:

 

– You cannot record what happens during the visit, as that would be unnatural, but this should be done immediately afterwards. Design a form for this purpose to make sure that all relevant information is covered.

 

Record the results of the simulated client visits systematically. It is helpful to make a simple form to be filled in immediately after the visit. However, as with non-formal interviewing, the researcher has to be alert for the unexpected. The analysis and interpretation of the data depends on the extent to which the observations are structured. In some cases the analysis is quantitative, for example, when reporting in how many cases prescription drugs were sold over-the-counter. In other cases the observation is less structured, for example, focusing on the communication during the drug transaction. The researcher then has to categorize and analyse the findings in much the same way as with semi-structured interviews (see Chapter 6 for more information on analysis).

 

Strengths and weaknesses of simulated client visits

 

The strengths of simulated client visits are:

 

– they can provide more reliable information than interviews

– drug use and distribution in its natural context can be observed

– if done well, this method gives information on what drug sellers really do

– a representative sample of pharmacies/health centres can be observed.

– results can be generalized

– results can be quantified

– they can be used to evaluate effects of training of pharmacy sellers and health workers

– they can be used as a participatory method. You can ask people living in the communities that you are studying to act as surrogate clients, and collect data.

 

 

The weaknesses of simulated client visits are:

 

– data are sometimes hard to interpret

 

– it is difficult to do a lifelike simulation, especially if you are playing a type of client you are not so familiar with (female students acting as mothers, for example)

 

– the observation period is short (the time needed to buy the drug, or consult a health worker)

 

– it is difficult to probe on why advice is given

 

– the depth of information collected is limited

 

– the findings need to be complemented by interviews.

 

 

 

 

The accuracy of data about the method study problem is important for the development of improved method. The following techniques are used for the collection of information / data about the task under consideration. These are not exclusive of each other, and for any particular method study problem, some or all the techniques may be employed.

 

–  Observation. It is a common technique used for collecting information about the present method or the existing problem. The method study person visits the site where the work is currently being done and observes various steps in the method being followed. There are many instances where all the data needed is obtained by only observing the work or work site.

 

–  Discussion. Discussion with those who do or who supervise the work can frequently provide information not obtainable by observation. The discussion technique is commonly used where irregular work is involved or where one is trying to analyze past work in order to improve efficiency of work to be done in future.

 

Even where observation by itself may accomplish the data collection task, discussion may be used for developing good human relations.

 

–  Records. Valuable information can be obtained from past records concerning production, cost, time, inventory and sub-contracts. For certain type of information concerning the past practice, sometimes this is the only way to obtain authentic data.

 

–  Motion Pictures or video Films. Accurate and most detailed information can be obtained by taking motion pictures or video film. Information obtained by this procedure can easily be transmitted / forwarded to all levels in the organization and if needed, can be used directly for training purposes. The film can be used to focus attention at particular point or motion in an operation. For obtaining information concerning those types of work that involve large crew size, it is probably the only procedure.

 

Information Recording Techniques:

 

There are three main types of information recording techniques. These are

 

–  Process Charts

 

–  Diagrams

 

–  Templates

 

A Process Chart is a graphic means of representing the activities that occur during a manufacturing or servicing job.

 

There are several types of process charts. These can be divided into two groups.

 

(I) Those which are used to record a process sequence (i.e. series of events in the order in which they occur) but do not depict the events to time scale.

 

Charts falling in this group are

 

–  Operation process chart

 

–  Flow process chart — (man / material / equipment type)

 

–  Operator chart (also called Two Handed Process Chart)

 

(ii) Those which record events in the sequence in which they occur on a time scale so that the interaction of related events can be more easily studied. Charts falling in this group are

 

–  Multiple activity chart

 

–  Simon chart

 

Diagrams. A diagram gives pictorial view of the layout of workplace or floor on which locations of different equipment, machines, etc. are indicated. The movement of subject (man or material) is then indicated on the diagram by a line or a string. The diagrams are valuable in highlighting the movement so that analyst can take steps to simplify or reduce it and thus effect saving in time or reduction in collisions / accidents.

 

Two types of diagrams are common: Flow diagram and string diagram.

 

Templates and 3-D models:

 

Two-dimensional cut outs made from thin card sheet representing machinery, furniture, etc. can be used for developing new layouts and methods. The templates may have pieces of permanent magnet attached to them, so that when used on iron board; they remain glued on the board whenever placed.

 

A scaled 3-D model of a working area helps easy understanding of lighting, ventilation, maintenance and safety aspects that may be important in a method. Such models are often of great value in demonstrating the advantages of the proposed changes to all concerned. However, their use is limited because of higher cost involved. Some computer software’s are available which help in constructing the layout and possibility of visualizing the working of process in a systematic way.

 

Before taking up descriptions of these charts or diagrams, it is necessary to know the various elements of work.

 

Elements of Work:

 

There are five basic elements of work: Operation, Inspection, Transportation, Delay, and storage. Table gives the definitions and symbols by which these elements are represented. Also given in the Table are examples of each element.

 

Sometimes, more than one element occur simultaneously. It is shown as combined element with combined symbol. Examples are “Operation in combination will inspection”, and “Inspection in combination with Transportation”.

 

Operation Process Chart:

 

An operation process chart provides the chronological sequence of all operations and inspections that occur in a manufacturing or business process. It also shows materials used and the time taken by operator for different elements of work. Generally a process chart is made for full assembly, that is, it shows all the operations and inspections that occur from the arrival of raw material to the packaging of the finished product.

 

Flow Process Chart:

 

A flow process chart is used for recording greater detail than is possible in an operation process chart. It is made for each component of an assembly rather than for the whole assembly.

 

A flow process chart shows a complete process in terms of all the elements of work. There are two main types of flow charts: product or material type , and the operator type . The product type records the details of the events that occur to a product or material, while the operator flow chart details how a person performs an operational sequence.

 

An important and valuable feature of this chart is its recording of non-productive hidden costs, such as delays, temporary storages, unnecessary inspections, and unnecessary long distances travelled. When the time spent on these non productive activities is highlighted, analyst can take steps to minimize it and thus reduce costs.

 

Operator Process Chart :

 

It is also called Left Hand — Right Hand chart and shows the activities of hands of the operator while performing a task. It uses four elements of hand work: Operation, Delay (Wait), Move and Hold. Its main advantage lies in highlighting un-productive elements such as unnecessary delay and hold so that analyst can take measures to eliminate or shorten them.

 

Multiple Activity Chart:

Worker-Machine process chart and gang process chart fall in the category of multiple activity charts. A worker-machine chart is used for recording and analyzing the working relationship between operator and machine on which he works. It is drawn to time scale. Analysis of the chart can help in better utilization of both worker and machine time. The possibility of one worker attending more than one machine is also sought from the use of this chart.

 

 

A gang process chart is similar to worker-machine chart, and is used when several workers operate one machine. The chart helps in exploring the possibility of reducing both the operator time and idle machine time.

 

Simon Chart:

 

A Simon chart is another Left-Hand Right-Hand chart with the difference that it is drawn to time scale and in terms of basic motions called therbligs. It is used when the work cycle is highly repetitive and of very short duration.

 

 

 

Q2. Describe the various algorithms for balancing material flow.

Q3. a. Differentiate between EDI, EPOS and Bar Coding

Answer  :

Electronic Point of Sale (EPOS) System Introduction

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If you work in retail or hospitality, one of the most important business tools you can have is an effective electronic point of sale system (EPOS or POS). At its most basic level, an EPOS system is a

 

b. Explain in brief the four way classification in generic operations strategies

Answer  :   Porter (1980) classifies three generic enterprise strategies: overall cost leadership, differentiation, and focus. We will substitute the term segmentation for focus, since focus is used to

 

 

Q4. Discuss the various approaches used to determine the quality of the product/services

Answer :    Quality Improvement

 

 

 

Q5. What is EOQ? Explain EOQ model of inventory and state its assumptions

Answer  : E.O.Q

. is a deterministic type of inventory model. The object of inventory control is to avoid the situation of over as well as under investment. The level of inventories should be maintained at the optimum

Q6.a. What are the various descriptive statistics measures of central tendency

Answer :  Descriptive Statistics – 1: Measures of Central Tendency