PurposeThe purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.Design/methodology/approachIn this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.FindingsThe results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).Research limitations/implicationsThis study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.Practical implicationsThis study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.Originality/valueThis is the first study to apply Lean methodology in the workers’ compensation field.

Class imbalance can adversely affect the performance of machine learning for prediction and classification. One approach to address the class imbalance problem is synthetic minority oversampling. Oversampling approaches can be broadly categorized as either being structural or statistical in nature. Structural approaches generally have the advantage of identifying and oversampling those minority data points that best facilitate class separation, while statistical approaches model the underlying distribution from which the minority samples can be drawn. In this paper, we formulate a distance-based approach which generates samples by both modeling the underlying minority class distribution and by geometrically considering those borderline samples entangled in the majority class. We demonstrate the efficacy of our approach operating on the Class-Imbalance data set from UCI by comparing its mean accuracy, AUC and F 1 -score performance against both statistical and structural synthetic minority oversampling methods.

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The National Aeronautics and Space Administration (NASA) established the Exploration Systems Mission Directorate (ESMD) in the 2004 timeframe to manage a new portfolio of programs and projects aimed at lunar return. To ensure an effective transfer of knowledge from NASA legacy programs, such as Apollo, International Space Station, and Space Shuttle, ESMD took an integrated approach towards managing risk and knowledge. This case study examines the implementation of ESMD’s integrated risk and knowledge management (IRKM) framework in the 2005-2012 timeframe. An important and novel aspect of this approach was using risk records to identify knowledge gaps and support the creation and transfer of both tacit and explicit knowledge. This explanatory case study describes how the integration of knowledge management and risk management, at both the enterprise and project-level, creates value to both processes and can assist any organization in more effectively pursuing its goals. The case also investigates how coupling these two business processes can garner broader-based organizational support for knowledge management activities. This paper is about enhancing risk management but at the same time it is a front-line investigation of what it takes to successfully implement and sustain a knowledge management enabled learning organization.

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