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© Kim Marques 2014
1
Lean Basic Intro
April 9, 2015
Kim MarquesKimberly Dawn, Inc.
© Kim Marques 2014
2
What LEAN Looks Like
© Kim Marques 2014
3
Lean Applications
© Kim Marques 2014
4In Process On Radar
Area Task / Issue Description
Blast Improve Lighting and Reduce Daily Maintenance
Engineering Capacity and Scheduling of Resources
Engineering Dryer Documentation Book - Accuracy and OTD
Engineering Weld Traveller Documentation
Engineering BOM Accuracy - ECN / Parts Late
Final Assy PC's In Production
Hydro Hydro Test SMED Event
Inventory Storage Trailer Inventory Reduction
Material Handling Desiccant Filling of Dryers Hoppers vs Bags
Material Handling Welders Material Handling
Material Handling Material Handling Study
Metrics Create a 360 Degree Metrics Board for Daily
Paint Post Paint Staging
Planning Scheduling Shop Floor
Quality Dock to Stock Purchased Items
Quality Rework Non Conformance
Utilities Switchgear Power Study and Billing Errors
Warehouse Parts Presentation
Warehouse Point of Use "C" Items for Assembly
Warehouse Valve Assembly Kanban
Weld & BRAIR New Tag/Label Printing Machine
© Kim Marques 2014
5
Six Sigma Lean Fundamentals
1. Specify value in the eyes of the customer.
2. Identify the value stream and eliminate waste.
3. Make value flow at the pull of the customer.
4. Involve and Empower employees.
5. Continuously improve in pursuit of perfection.
PLAN DO
CHECKACT
Lean is Logical
© Kim Marques 2014
6
Lean + Six Sigma = Success
LeanFlow5SWaste EliminationCICustomer PullWork Concentration
6 SigmaVariation ReductionScrap / Rework EliminationProcess ControlCICritical Thought
Together…A Force Multiplier.
SPEED + ACCURACY = $$$
StandardWork
© Kim Marques 2014
7
A1
A3
A4
A5
A6
A7A2
Remember: Pilot A Met The Specification. Was That Good Enough?
Given: seven landing points, similar conditions, two pilots.
So… pilot A or pilot B?
Choose The Pilot
B1B3
B4B5
B6
B7B2
The Effect Of Variation
© Kim Marques 2014
8
Six Sigma
A statistical term that defines the amount of variation exhibited by a given process, symbolized by the Greek letter “s” (“σ”).
Quality levels:
6 sigma = 2 parts per million (PPM) defective
5 sigma = 230 PPM defective
4 sigma = 6,210 PPM defective
3 sigma = 308,000 PPM defective
1 sigma = 690,000 PPM defective
© Kim Marques 2014
9
House DetailsCustomer• VOC
• Takt
• QFD
Just
In
Time
Built
In
Quality
Quality Systems• Autonomation
• Mistake-proofing
People• Policy Deployment
• HPWO• values
• HP Org design
• Steering Comm
• Design Teams
• Kaizen
• Multi-process
• Safety• process improvement
• ergonomics
Materials Systems• Production Smoothing
• Flow / Pull• Line Design
• Kanban
• SMED
• P-O-U
Stability• Six Sigma
• 5S - Visual Controls
• Standard Work
• DFM
• TPM
© Kim Marques 2014
10
Lean 2012 Fishbone
10Choose Tools to Align with GOALS!
© Kim Marques 2014
11Successful Product Delivery Results From Connected Processes.
Customer
Engineering
Suppliers
Production
TestSupport
F L O W
Supplier Engineering Materials Manufacturing
Administration Support
Customer
Customer
The Customer Focused Value Chain
© Kim Marques 2014
12
Order
Entry
Order and
Delivery of
Components
Subassembly
Manufacturing
Unit Assembly
and TestDistribution A/R
TIME
Consider the cumulative effect
All processes have Raw Materials and Finished Goods
Every process has value- and non-value added time:
RM FG
Find the REAL Opportunities
Looking At The Whole Business
© Kim Marques 2014
13
Value Added:☻ Transforms fit, form, or function
☻ Is done right the first time
☻ Increases value from the customers perspective
☻ Customer is willing to pay for
Non-Value BUT needed:Required by the customer.
Required by the process or design.
Necessary with current technology.
Non-Value WASTE:No value created.
Undone or redone within the value stream.
Could be immediately avoidable.
The Value Stream
Problem Solving * Information Management * Transformation
© Kim Marques 2014
14
Non-Value Add Activities
Definition: unnecessary effort (processes, communication, requests, etc.) that serves no purpose or function
Examples:Doing something the way it was previously done even though new faster, more efficient technology has been installed
Doing something because someone thinks it is important
Functions that add no value to the product
NVA activities often times get added to processes instead
of dealing with the root cause. For example, adding extra
checks and paperwork to catch errors instead of dealing
with the reasons they happened in the first place.
© Kim Marques 2014
15
AdministrationInformation Incomplete
Information Inaccurate
Information Interpretation
Clarifying Information
Unnecessary Information
Wrong Information
Wrong format of Information
Handoffs
Checks/Double checks
Barriers to Communication
Data Entry
Call backs
Keypunching
Reading E-mails
Non-Value Add Examples
• Receiving
• Unpacking
• Stocking
• Transporting
• Estimating
• Ordering
• Scheduling
• Planning
• Inspecting
• Packing
• Shipping
• Expediting
• Customer Approval
• Work Order Release
• Warehousing
• Invoicing
• Collections
• Bill Paying
• Forecasting
• Facility Maintenance
• Management
Manufacturing
© Kim Marques 2014
16
A tool for visually
depicting information
on a process or
operation to identify
opportunities for
improvement or
problems.
When you want to
visually depict or
understand steps in a
process, flow of
information and/or
key metrics.
Value Stream Map (VSM)
16
© Kim Marques 2014
17
Time Value And Opportunity
Value Added Steps
Non Value Added Steps
DAY 0 DAY 76
Value Added
2 Days
Total VA and NVA Activity = 4.5 Days
Non-Value Added
2.5 Days
Queue
A ‘Faster Machine’ Does Not Get Us To The Finish Line.
Tim
e: 76 D
ays
Queue
© Kim Marques 2014
18
The 8 Wastes
The acronym DOWNTIME will help us remember the 8 Forms of Waste:
1. Defects
2. Overproduction
3. Waiting
4. Non-Utilized Talents/Skills
5. Transportation
6. Inventory
7. Motion
8. Extra (Over) Processing
© Kim Marques 2014
19
Cost of Poor Quality
1. Prevention ?5%
2. Appraisal ?47%
3. Internal Failure ?46%
4. External Failure ?2%
TypicalEnterprise
Lean 6σEnterprise
© Kim Marques 2014
20
As set of repeatable steps, actions and/or tools the
PLAN – DO – CHECK – ACT cycle grows culture
when inter-woven into various tasks across
multiple departments
• Plan a change or test aimed at
improvement, once the root
cause is determined
• Do carry out the change or the
test, preferably in a pilot or on a
small scale
• Check to see if the desired result
was achieved, what or if anything
went wrong and what was
learned
• Act to adopt the change if the
desired result was achieved. If
results not favorable, repeat the
cycle
Deming Cycle
© Kim Marques 2014
21
DMAICSix Sigma projects follow the same process in a systematic and uniform methodology known as DMAIC – an acronym made up from the first letters of each element:
Define – sets the context: scope, problem statement, etc.
Measure – baseline metrics & process constraints recorded
Analyze – metric review, root cause analysis completed
Improve – solutions developed and deployed
Control – control plans and required documentation to sustain improvement(s) created
© Kim Marques 2014
22
Kai = To take apart Zen = To make good!
Kaizen = Continuous Improvement
What can be Taken Apart and Improved?
Administrative Business Processes
Manufacturing Processes
Supply Chain Processes
Services
Distribution Center Processes
Anything!
Kaizen
© Kim Marques 2014
23
The Blitz or Event is a focused, intense, short-term project to improve a process.
Substantial resources- Engineering, Maintenance, Cell Operators, and others are available for immediate deployment.
An event starts with an approved charter, includes training followed by analysis, design, and re-engineering of a process, service, product line or area. A Leader orchestrates with the support of a Sponsor and a Lean Facilitator
The Event (start to end) normally takes 2-5 days. Outstanding actions are noted (a Newspaper) and
completed within 2 weeks. The results are immediate, dramatic and satisfying.
Kaizen Blitz
© Kim Marques 2014
24
Kaizen Principles1. If there is no need or no goal, there is no kaizen. Fully
understand the present state and the goal to fully understand what is needed to close the gaps to success.
2. Establish a Kaizen Cadence -follow the same process for the event and report out. Rank is checked at the door.
3. Anyone can improve by spending money – try first to think of improvements that are free. Rally for ideas.
4. Look for wisdom from ten people rather than one. Value diversity in teams and have respect for the knowledge of others. Teach, learn, improve simultaneously!
5. Help others see waste constructively. The more you improve together, the more opportunity for improvement for all to see.
6. Do it now, during the kaizen – follow PDCA, measure immediate results – adjust process. It is much harder to get it done later. Quick and crude is better than slow and elegant.
7. Be persistent to eliminate all muda (waste).
© Kim Marques 2014
25
Repeatable CI Grows Culture4 Week Project Cycle
Week 1 – Charter Completion, Approvals & Mgmt
Reviews, Event Selected – Funnel Review
Week 2 – Team Initialize/Charter Review and
Pre-Work Completion, Initial Gemba
Week 3 – Event/Kaizen Week with Mgmt Report-
Out
Week 4 – Project Brainstorming, Review Ideas
Submit ted, Create CI Project Charters,
Sustainment Walk, Close Newspaper items
GM and Senior Staff commitment to support a
repeatable process is CRITICAL to success!
© Kim Marques 2014
26
Ocala Engineering Excellence Team
RAPID IMPROVEMENT EVENTS (KAIZEN)
Derek Murray, PE, CSSBB Senior Engineer Management Engineering Consulting Services (MECS)
Agenda
• MECS Overview
• Rapid Improvement Event
• Root Cause Analysis Tools
• Solution Selection Tools
• Interactive Kaizen Event
–Needle Localization Surgical Process
Management Engineering Consulting Services (MECS)
• Originated in 1968
• 9.0 FTE’s (Currently) • Director
• Senior Engineers
• Staff Engineers
• Internship Program
• Ad-Hoc Projects with MHA Interns, Student project groups
• Educational Background • Minimum BSIE required
• Various Masters Degrees in Management and Engineering
Rapid Improvement Event (Kaizen)
• Focused on SPECIFIC problem solving events achieving gradual, orderly, and continuous improvement
• Carefully planned, well structured team-based activity focused on solving problems in a process
• Usually multi-disciplined
– Very effective to break down cultural barriers in solving problems
Rapid Improvement Event (Kaizen)
• Customer-driven and is based on a plan, do, check, act approach to problem solving
• Very intensive full day workshops or broken up into multiple short sessions
– Analyzes a process and implements change
– Individual roles, responsibilities or expectations are outlined
Rapid Improvement Event (Kaizen)
• Preparation for the Event
– Current metrics
• Metrics that quantify the current situation
– Process Flows
• How does the current system look?
– Stakeholder Identification
• Who impacts or is impacted by the situation?
– Agenda
• What is the agenda/objectives for the meeting that will ensure maximum results?
Rapid Improvement Event (Kaizen)
• Resources available:
– Projector, computer, printer
– Name plates, flip charts and Post-It notes
– Wall space
Rapid Improvement Event (Kaizen)
• Typical agenda:
– Introductions and opening
– Set event rules and review current state
– Define process gaps and root causes
– Brainstorm opportunities
– Define optimal future state process
– Discuss measures for success
– Design implementation plan
– Determine barriers and resolution for implementation
Root Cause Analysis
• 5-Why’s
• Fish Bone Diagram
Recognizing the Root Causes
• First Order:
– A quick temporary fix
– Does nothing to prevent the problem from repeating
• Second Order:
– Gets at the root cause
– Solves the problem for future patients and clinicians
– Aligns with process improvement
Plan
Do Check
Act
5 Whys
• Simple probing tool that helps you get to the root
cause of a problem
• At each level of explanation, ask “Why?” until you
get to the true underlying reasons
• Never take the first answer as the true reason
Why?
Why?
Why?
Why? Why?
5 Whys Example
A patient failed to respond to therapy and his condition deteriorated
Why? • The patient received the wrong medication
Why? • Because the nurse gave it to him by mistake
Why? • Because she misread the drug name
Why? • Because we have two drugs with similar names stored side by side
Why? • Because we store them in alphabetical order so we can find them quickly
Source: http://phprimer.afmc.ca/Part3-PracticeImprovingHealth/Chapter13AssessingAndImprovingHealthCareQuality/Investigatingquality
5 Whys Example
There is a delay in patients being moved from the emergency unit to the ward
Why? • Because there are no more beds in the ward
Why? • Because there are still patients waiting to be discharged
Why? • Because they are waiting for their medication and discharge documentation
Why? • Because the courier has not delivered the prescription to the pharmacy and the
patient’s file to the central records office
Why? • Because they are waiting for the nursing manager to initiate the process
Source: http://www.phcfm.org/index.php/phcfm/article/viewFile/598/860/6587
Fishbone
• Cause and Effect Diagram
• Visual tool to determine root cause
• The resulting diagram illustrates the main causes and sub-causes leading to an effect
Fish Bone Diagram Process
• Agree on a problem statement (effect)
• Brainstorm the major categories of causes of the problem
• Some generic categories are:
Fish Bone Diagram Process
• Brainstorm all the possible causes for each category
– Continually Ask: “Why does this happen?”
• When the group runs out of ideas, focus attention to places on the chart where ideas are few
Fish Bone Diagram Example
Solution Selection
• Time-Impact Matrix
Time Impact Matrix
• A simple diagramming technique that helps you choose which activities to prioritize (and which ones you should drop) if you want to make the most of your time and opportunities
Time Impact Matrix – Process
1. Brainstorm problem areas within your objective
2. After the list is generated, assess for time and impact
a. Impact – When this problem is solved, what kind of impact would it have on your objective?
b. Term – How long would it take to implement it?
3. According to your determinations, find where each problem would fall in the matrix
Prioritization Tools Time Impact Matrix – Example
Needle Localization Rapid Improvement Event
Project Background
• Patient flow complaints occurred regarding the Needle localization process in the South Tower Operating Room (OR)
• FMEA was conducted by Risk Management
– Needle localization patients were experiencing increasing wait times on surgery days.
FMEA Findings
Multidisciplinary Team Organized to Analyze Contributing Factors:
• OR Day: – Multiple locations were needed for multiple procedures
– Timing of procedures was restricted by involved department schedule
– Limited half-life of nuclear isotope needed for lymphoscintigraphy
– Unexpected Surgical or Radiology delay
– Not Up-to-date consents
• Scheduling: – Scheduling multiple appointments in multiple locations requires precise
coordination—exposure to a cascade of delays
• OR Day Prior Notification: – Multiple calls/notifications regarding surgery schedule by multiple
people
Breast Surgery – Coordination of Care
Patient arrives at clinic Determination for
surgery made.
Doctor orders: 1. Surgery
2. Needle Loc 3. Lymphocentigraphy (if
necessary)
Patient arrives at the OR
Radiology (Needle Loc and
Lymphocentrigraphy (if necessary) are
performed
Pre-Op (Consents, IV, etc.)
Patient goes to surgery
CLINIC
SURGERY DAY
Multiple systems inform the
patient of schedule. (My Chart, OR, Radiology,
Clinical Coordinatorl
Different departments had different schedules not
coordinated to the surgery schedule.
As the next patient arrives surgery wait times increase
throughout the day.
Patient Number vs. Time Between Needle Loc End and OR Case Start
(Wheels In) - Fiscal 2013
0
10
20
30
40
50
60
70
80
90
100
0:00
1:00
2:00
3:00
4:00
5:00
6:00
1 2 3 4 Total
Box and Whisker Plot
Nu
mb
er o
f P
atie
nts
Tim
e B
etw
een
Nee
dle
Lo
c En
d
and
OR
Cas
e St
art
(h:m
m)
Patient Number
Patient Number 1 2 3 4 Total
Number of Patients 59 21 6 2 88
Average Time Between Needle Loc End
and OR Case Start (Wheels In) (h:mm:ss)1:08:07 1:31:26 2:03:10 2:48:30 1:19:43
Agenda
• Introductions, rules, and opening • Define process gaps and root causes - current state
– We will concentrate on each discipline and explore root causes of how patient wait time is affected by each function individually.
• Brainstorm opportunities for improvement • We will concentrate on each discipline and explore
opportunities to improve patient wait time for each function individually.
Meeting Rules
Stay on track Goal: Identify opportunities to improve patient flow within the units
Focus only on identifying the root causes to:
Patient Wait time on Surgery Day
Open mind Minimize the use of “No, that won’t work”
Everyone’s opinions are equally valuable and can lead to solutions
Full participation All ideas are welcome
Eliminate (or minimize) use of cell phones
Minimize small group conversation The best ideas might be missed if the rest of the group cannot hear it
Brainstorming Key Issues
People Do they possess the necessary skills, training?
Material/ Information Does the material being used have poor quality? Is information easy to
understand and accurate? Are materials accessible?
Technology Does technology function properly? Is it reliable/ user friendly?
Process Is process defined/ easy to follow? Is there a standard process?
Performance Measurements Are performance expectations defined/ communicated/ monitored?
Work Environment Is there adequate space? Physical locations?
Comfortable atmosphere?
Patient wait times on
the day of surgery
Measurement Process
Technology Environment
Materials
People
IMP
AC
T
TIME
I II
III IV
Actual Results from the Project
Solutions Implemented
• Day of Surgery – All pre-surgical procedures are performed on 1st floor radiology
– 1st case lymphoscintigraphy performed day prior to surgery.
– Timing of surgery individualized to each surgeon
– Needle localization procedures were linked with OR surgery schedule time – Patients to arrive 2 ½ hours prior to surgery.
– Final surgical planning and consenting completed at pre-surgical visit.
– Designated a pre-operative “Breast” nurse
– Scripts developed for patient communication
Solutions Implemented
• Scheduling – Created Inter-departmental access to OR/Radiology
schedule
– Linked procedure times in Optime
• Prior Day Notification of Surgery – Surgery Notification completed by OR staff only
– Scripts developed for patient communication
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A
vera
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Patient Arrival to Needle Loc End (Hours)
Average: 2.32 Hrs Goal: 2.50 Hrs
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t 3
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/6 -
Pat
ien
t 4
8
/8 -
Pat
ien
t 1
8
/13
- P
atie
nt
1
8/1
3 -
Pat
ien
t 2
8
/13
- P
atie
nt
3
8/1
5 -
Pat
ien
t 1
8
/22
- P
atie
nt
1
8/2
2 -
Pat
ien
t 2
8
/25
- P
atie
nt
1
8/2
7 -
Pat
ien
t 1
8
/29
- P
atie
nt
1
9/3
- P
atie
nt
1
9/3
- P
atie
nt
2
9/3
- P
atie
nt
3
9/8
- P
atie
nt
1
9/5
- P
atie
nt
1
9/1
2 -
Pat
ien
t 1
9
/12
- P
atie
nt
2
9/1
7 -
Pat
ien
t 1
9
/22
- P
atie
nt
1
9/2
2 -
Pat
ien
t 2
9
/22
- P
atie
nt
3
9/2
4 -
Pat
ien
t 1
9
/24
- P
atie
nt
2
9/2
4 -
Pat
ien
t 3
9
/24
- P
atie
nt
4
9/2
6 -
Pat
ien
t 1
9
/26
- P
atie
nt
2
9/2
9 -
Pat
ien
t 1
A
VER
AG
E
Needle Loc End to Surgery Start (Hours) BASELINE AVERAGES
Average = 1.21 Hours
Median = .65 Hours
Takeaways from Metrics
• Patient Arrival to Needle Loc end
– Process Goal: 2.50 hours
– Process Average (first 5 months post go live): 2.32 hours
• Needle Loc End to Surgery Start
– Process shows consistent patient wait times less than 1 hour
• 57 of 87 occurrences less than 1 hour (66%)
• 30 of 87 occurrences greater than 1 hour (33%)
– Majority of outliers (greater than 1 hour) pertained to previous surgery delay.
Questions