Problem Solving: The P in PDSA

Problem Solving: The P in PDSA

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Author & Speaker: Karen Martin, President

The Karen Martin Group, Inc.

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PDSA – Big and Small


A3 Management

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Problem Countermeasures / Implementation Plan- �32% of customers dissatis fied with office space cleanl ines- 80% of emergency service requests are to wrong contact - Standard work for restroom cleaning

- Standard work checklist for non-routine items- Service levels vary by bui lding - Standard process for measuring & mixing chemicals- 10% of da i ly s taffing ava i lable i s a l located to travel/check in time - Restroom cleaning log

- Standard facil ity service plan (Plan A & Plan B)

Current Condition - Modify & standardize process for unplanned absences- 31 Facil ity areas require custodial services - Modify starting points and schedules to reduce transportation waste

- Evaluate fleet availabil ity to reduce waiting waste

Effect Confirmation

Target Conditions/Measurable Objectives- 80% Daily staffing availabil ity- 50% Improvement - customer satisfaction with restroom cleanliness- Defined standard work (for custodial staff and customers)

Follow Up Actions

Root Cause & Gap Analysis- Undefined level of service (office parties, special events)- No defined process for unplanned absences (call ing in, redistribute work, etc.)- Inconsistent availabil ity of communication tools (vary by building)- No defined process for requesting/responding to emergencies- Variation in cleaning schedules versus facil ity operating schedules- Unpredictable daily staffing- Travel time + Check in Time = 16.00 hrs/day = 2 FTE- Customer requested personalized service (newspaper delivery, parties, trash)

CUSTODIAL SERVICESA3

Plan Do, Check, Act

- 22% of customers dissatis fied with restroom cleanl iness

8%

20%

8%14%

17%

33%

0%5%

10%15%20%25%30%35%

Phone Callto

Custodian

Phone Callto CustodialSupervisor

Phone Callto Custodial

Manager

Phone Callto PublicWorks

Dispatch(x6000)

Emai l NotifyCustodial

Staff On Site

Survey: When you require emergency services, how do you request them?

32%

22% 19% 18%

6%

0%

10%

20%

30%

40%

Office Spaces Restrooms CommonAreas

Overall ConferenceRooms

Survey: Custodial Services - Areas of Dissatisfaction

Travel/ Check In Time

16.00 10%

Absent Staff 24.00 15%

Vacancies 24.00 15%

Special Events2.00 1%

Staff Available94.00 59%

Daily Staffing Availability(Hours)

41% of daily staffing is

unavailable for custodial tasks

Title # Staff Hrs/Wk Hrs/Day

Lead Custodian 4 160 32

FT Custodian 8 520 64

FT Custodian (Vacant) 2 80 16

PT/Perm (avg 30 hrs each) 3 90 24

PT/Temp (avg 20 hrs each) 3 60 24

Total 20 910 160

Current Actual Result

State (+ 60 days)

Customers dissatis fied with restroom cleanl iness 22% <10%

Avg minutes per restroom cleaning 35 30

Avg hours per day cleaning restrooms (184 restrooms) 107 92

Dai ly s taffing ava i labi l i ty 59% 80%

Dai ly travel/check in time (hours/day) 16 8

Travel mi les per day 139 <70

Metric Projected

Remaining Actions Owner 1 2 3 4 5 6 7 8 9 10 11 12

Explore options to improve cell phone availability Mark R.

Define process for requesting and responding to emergencies Custodial Supvs

Equip carts for recycling Mark R.

Process mapping for specialized facilities Mark R.

Standardize Cart Equipment & Supplies Custodial SupvsProcess improvement for other facility types, e.g. offices, common areas, etc.

Mark R.

Consider alternative staffing models (floaters, modified shifts) Mark R.

Actively manage vacancies Mark R.

Implementation Schedule (Months)

• Report reflects the thinking; serves as conversation tool

• Problem owners learn

disciplined problem-solving by working with a skilled coach


Purpose of A3 Reports

• Communicate progress

• Deepen understanding

• Build consensus • Spread learning • Reduce resistance

to change

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Detailed Steps

1. Define and break down the problem.

2. Grasp the current condition.

3. Set a target condition.

4. Conduct root cause & gap analysis.

5. Identify potential countermeasures.

6. Develop & test countermeasure(s)

7. Refine and finalize countermeasure(s).

8. Implement countermeasure(s).

StudyEvaluate Results

9. Measure process performance.

10. Refine, standardize, & stabilize the process.

11. Monitor process performance.

12. Reflect & share learning.

Adjust

Do

Clarifying the PDSA Cycle

PlanDevelop

Hypothesis

Conduct Experiment

Refine Standardize

Stabilize

PhaseNew

Problem

Adjust

Adjust

Often 50-80% of the total

time

Adopt Adapt

Abandon

9

Detailed Steps














Adjust

Do


PlanDevelop

Hypothesis

Conduct Experiment

Refine Standardize

Stabilize

Phase

Nailing the Plan stage of PDSA is the most

important element in the entire cycle.

The Nature of

10

At times…perplexing, confounding, frustrating, and taxing

Investigation Takes Many Forms

11

P/U

AFrame

Power Pole

o st g Up Spag ett ag ae o e a e t p o e e ts

st ated d sta ce a ed du g g Up 3095 tag a o o s t e oo a d a d does ot c ude o g t e a e

g Up e 90 utes

Water

12

Detailed Steps














Adjust

Do


PlanDevelop

Hypothesis

Conduct Experiment

Refine Standardize

Stabilize

Phase

Iterative Problem Definition &

Scoping

13

Truth Truth Truth Truth Truth Truth Truth

CLARITY 14

15


1. Define and Breakdown the Problem • Example: “Data integrity problem”

– Says who? What are they saying SPECIFICALLY? Go interview!

– Are we talking about inaccurate data, missing data, incomplete data, data in wrong location, similar but slightly different data stored in different locations, incorrect conclusions about accurate data, or…?

• Example: “No control of refrigerant inventory (controlled substance)”

– Is this true in all locations? All types of refrigerant?

– Is physical inventory quantity higher, lower, or both when compared to computer numbers?


Problem Definition: Clarify, Qualify, Justify, Quantify

1. Is the problem clear and focused or vague and diffuse?

2. Why is this a problem? 3. How do we know it’s a problem?

What evidence or proof exists? 4. How big is the problem? 5. Which aspect of the problem are

we going to address?


Example: Iterative Problem Definition

1. Lack of a patient-centered care culture 2. Improve the patient experience 3. Reduce nursing turnover

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2. Grasp the Current Condition • Understand the

details behind the problem.

• Options – OBSERVATION – Interview – Data analysis – Video analysis – Document review – Value stream or

process mapping, – Etc.


3. Set a Target Condition • Describe the future. How does “better” look

and feel? • From/to: “If not this, then what?” • Must be measurable

– Surveys enable you to convert anecdotal feedback into quantifiable data

• Should stretch the organization/team/problem owner (improvement is largely a mind game)

• Level of aggressiveness depends on : – Urgency – Timeframe – Available resources – Consensus around the problem – Degree of focus


4. Conduct Root Cause & Gap Analysis • What’s stopping you

from performing at the target condition NOW?

• Consider all obstacles: – Physical / Environmental – Mechanical – Process-related – Psychological / cultural – Resource-related

CauseCause--andand--Effect DiagramEffect Diagram

Machine Measurement Environment

People Material / Info Method

Budgets Submitted Late

Lack of experience

Time availability

No sense of import

No stnd spread sheet

Email vs. FedEx

No standard work

Input rec’d late

Forecast in other system

Manual vs. PC

System avail.

No milestones

$ vs. units

Weather delays

Dispersed sales force

Changing schedule

Machine Measurement Environment

People Material / Info Method

Budgets Submitted Late

Lack of experience

Time availability

No sense of import

No stnd spread sheet

Email vs. FedEx

No standard work

Input rec’d late

Forecast in other system

Manual vs. PC

System avail.

No milestones

$ vs. units

Weather delays

Dispersed sales force

Changing schedule

5 Why’s Why?

Why?

Why?

Why?

Why?


5. Identify Potential Countermeasures • Standard work • Quality at the Source

/ Error proofing • 5S / Visuals • Pull systems

• One-piece flow • FIFO lanes • Kanban

• Cells / co-location

• Level loading • Work/line balancing • Batch size reduction • Setup reduction /

changeover • Work segmentation • Autonomation • Cross-training / multi-

functional workers


Problem Owners/Teams have to work with a seasoned Coach!


Karen Martin, President 858.677.6799

@karenmartinopex

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Problem Solving: The P in PDSA