Wheelchair Repair Service

John Colvin, WESTMARC

West of Scotland Mobility and

Rehabilitation Service

WESTMARC

Serves 52% of the population of Scotland

West of Scotland Mobility and

Rehabilitation Service

WESTMARC

Appointment Locations

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70%80%

90%

100%

GG&C LAN FV A&A D&G Argyll

External

Home Visits

Local Clinics

Westmarc Technical Services - Yoker Depot

Repairs 12,000Refurbishments 2,600

Modifications 6,500 Deliveries 11,000

Collections 6,400Total 38,500

120 homes per day

Improvements to Repair Service

• Brought “in-house” April 2005– Included better staff conditions– Reduced costs allowing internal investment– Increased vans to improve capacity

• ReTIS introduced in Sept 05

• Van tracking introduced April 06

• Sept 06 to 08 improved technician training

• 06/07 major refurbishment of Yoker site

2007 Repair Completion Rates

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100%

Days

1st Qtr

2nd Qtr

3rd Qtr

4th Qtr

Customers

Clinician job sheet/fax, letter

Patient (phone)

Health Boards Consortium

Steve Gray

ØRepair

ØOther

Schedule Job to Technician (Call centre)

Admin phone Pts. Added in by coordinator

Detailed Scheduling

1. Add more work 2.Chg schedule for geography or eng disability

- Print Job Sheet- ID Parts req’d- Pass for stores

-Work out Part numbers - RETIS-- Check stock available

Got Stock:-Pick-Update job sheet-Bag (copy Job sheet)-MARSMAC -trolley

Not Got Stock:

- Salvage- Source

Engineer-Collect trolley each morning-Some-check trolley -> tale problems to the stores-Plan route am/pm

Admin-Take AM/PM plan from engineer- Some patients call in

Collect deliveries Mobile

Target 9.30

Arrive Pt-Inspect chair-Check got right parts/what’s wrong-Do repair

Stores: remove part for salvage (ownership unclear): sometimes workshop

- Check Part number (RETIS) ->manuals/CVS net-Rolling stock-Non standard stores

- Get quote from supplier (if non-standard)- Place Order (RETIS)

Central Purchasing Dept-> Move to another System -> PECOS? CEDAR -> fax to supplierSupplies dept GRI

6. Supplier Leadtime

Yoker expediteBook in stores -> flag up Patient Job sheet

Stores -> move job to scheduling-Van schedule(Coordinator)

Admin: Match delivery Note -> POSupplies: Authorise Payment

Customer

Complete Repair-Fill in job sheet-Pt signed

time

Patient

Return Job SheetReturn unused Parts-> Stores -> back into stock

AdminClose job on RETIS -> data entry

END

Can’t complete repair- Update reason on job sheet

Return job Sheet (Admin)-Update RETIS/special circumstances-Phone/letter to Patient-Job on hold-Back to scheduling RETIS

If eng finds reqt for further repair – NEW Job sheet!

Production Control

Call Centre (Admin-Check user name/dob/contact details-What’s wrong with w/c-Determine Priority (U.P, R)-Raise Job Sheet-Identify chair ID number-Initial scheduling (next available slot) -Give date to user

-Pt records

-W/C records

-Scheduling post code

RETIS

START Order = w/c faulty

Promise = engineer visit date

Demand Analysis: 12 mth sample

No Urgent Jobs : 4% - 496

No Priority Jobs 12% - 1610

No Routine Jobs : 84% - 11282

Total no Jobs: 13388

An average Day

- 61 repair Jobs

- 3 urgent

- 7 priority

- 51 routine

- 4 jobs per day for 14 engineers

-Waiting

If capacity not clear on schedule cannot easily ‘shoehorn’ in

-Coordination 8 scheduling Waste

-Waiting – 2 days delay built into process

-Waiting

-If engineer is sick whole zone shut

-If job incomplete paperwork waits one day

-- Processing

-Confusion of roles

-Who owns checking of vans etc

-Time spent coordinating

-Always catch up

--Rework

-Coordinators 8 drivers checking over double work?

-Repeat jobs – why?

-Transportation

-Return to base to retock

-Hard to see if van in ‘resion??’ for filler

-Move work:

-2nd visits

-Non-scheduled work

-Deliveries

-Van routing 8 schedules. Cannot see all areas in one go. Schools a hassle

-Cannot do all areas every week -H2 ID

Parts? -> picking accuracy

Don’t schedule:

-outlying areas

-Holidays

VAN RUNS PLANS

Some salvage is inappropriate

-Not clean

-Not safe/Q

Stock Mgt-Obsolescence-Disposing of chairs

Stores

-Motion: Location of manuals, fax, m/c

Processing: over picking, multiple job sheets, patient parts ‘straight to store’

Inventory: runners out of stock

No info on stock outs

Stores: Waste

-Waiting: pick lists wait one day

-Waiting: part ID delays, no parts, try to salvage – delay, supplier response times

-Waiting: delay to quality check, delay driver returning parts, delays chair return

Order authorised… No order confirmation…

Don’t have times in system RETIS

Sometimes booked into stock without reference to patient order

Parts come in – JOB Done! Parts have been salvaged….

What time do you actually get mobile?

Patient does not respond/ not there -> leave card…

Stock Data

No Salvage Jobs: avg 5-7 per day

No stock outs: avg 12-15 per day

Slow moving stock ---

Supplier/Parts

Order Data

4867 part nos on shelf

No Stocked parts 1962

No non-stocked parts ~5000

No supplier contracts ~29

2 parts nos in system 7106

Supplier lead time data – contract

0-2 days – 4

3-5 days – 6

6-10 days – 10

>10 days - 7

No contract time - 3

Repair Response time

Type Target %

Urgent - 1 day 33%

Priority 3 days 53%

Routine 5 days 69%

First time Fix Data

%jobs fixed first time = 74%

2nd Visit Reason Data:

-Pt not home 48%(pt cancels 7.5%

-Wrong parts/chair/spec – 31%

-Follow on repair 2.5 %

-B.E.R 9%

-Engineer no time 2.5%

-No explan 3.5%

Call Centre Waste:

-Waiting: patients can’t get through; only office hours

-Rework: double handling; callbacks; no protocols or diagnostics

Stores Data

No Picklists per day: 16

No parts/per day: 50-75

Cycle time/picklist: ~20mins

No. staff (repair picking): 3

1 driver ~ 10 jobs per day

5 mins

DP = Thursday

Noon, weds

8.30/9am Thu

+1 day, don’t know

Rapid Improvement Event defined Current State

RIE defined Next Future State (within 6 months)

Customers

Clinician (advocate)

Patient (phone)

(Production Control)

Call Centre

Manual Chairs/Uni

-Check part details

-Create job sheet

-Check chair configuration

-Fault diagnosis

-ID parts required and part nos

-Check and allocate stock

-Confirm Engineer available

-Agree appointment/ Urgent Routine

-Accurate Data

-Patient record

-Chair details and config

-Stock records

Training Matrix

J F M A

Other Chairs

- check part details

- Create job sheet

- Check chair config

- Fault diagnosis

URGENT ROUTINE

Job owned by coordinator

Parts id; allocate; schedule

RETIS

UNI Call centre Manual

Call centre trained on product range, repairs and part numbers

Order = w/c faulty

Better phone system

-> patient can wait & queue

Response Promise

GPS SYSTEM ON

Update calls during the day

•Opening hours – Patient Access

Demand for extended hours will be understood [V.O.C. analysis]

•Performance Targets

1. Repair response time

URGENT = 1 DAY = 75% achieved

ROUTINE = 5 DAY = 90% achieved

2. First time fix

TARGET = 90%

•Ways of working

1. Measure our business and share with staff

- daily team reviews (short/sharp)

- monthly team meetings

2, Team Leader role

- Train staff

- coach people to continuously improve performance

3. Personal accountability

Engineers Supported by:

-Product training

-Better tooling

-Better VAN STOCK

Parts for urgent repairs

- castors

- wheels

- brakes

- Better comms with Admin

Training Matrix

J F AManu

al

Suppliers

Admin

Allocate to driver via GPS txtFix via van stocksOr ID parts reqd

…ORRefurb engineer takes job from depot

Complete repair-Patient signs job sheet-Engineer texts adminCan’t fix\-Assist Pt as far as can-ID parts reqd-Text Admin pick parts\\

URGENT – SAME DAY

Van Schedule8:30am

URGENT – NEXT DAY

Pick Parts8:45am

Collect PartsMobile 9:30am

Complete Repair-Patient signs-Engineer texts admin

CUSTOMER

Van ScheduleDay 1

ROUTINE

Pick PartsDay 2

Collect PartsDay 3

Complete Repair-Patient signs-Engineer texts admin

CUSTOMER

Do preventive maintenance [schedule to be agreed]

Preventative maintenance formalisedMaximum 5 days: better if capacity

Bette

r cap

acity

plannin

g!

capacity

de

ma

nd

Identify part noCheck stock

got not got

Allocate

Confirm

delivery date

expedite

PARTS PLANNING PROCESS Confidence we have the parts…

STORES

80% 20%

K K K K K Better stock system

Training for stores

staff

Training Matrix

J F A

100% stock

accuracyMajor suppliers

on KANBAN FAST MOVERS

CUSTOMER

1 day target applies regardless of zone

The 6 month Action Plan

• Redefine job prioritisation• Write a repair script for admin staff• Call recording and appraisal of call handling• Improve communications with van guys• Introduce Kanban systems for stock control of parts• Redesign purchasing processes (remove Supplies Dept.)• Redefine van stock (essential rather than common items)• Stock Controller – (new role to define what part is needed)• Changes to ReTIS mainly to support stock management• Introduce Communication Cells• Improved supervisor training for performance

management

Weekly Volume of Repairs

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No of routine repairs

Total Repairs

Weekly Urgent Repair Performance

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% urgent within contractTarget within 1 dayNo of urgent repairs

Weekly Routine Repairs Performance

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1 2 3 4 5 6 7 8 9 10 1112 1314 1516 171819 2021 22

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% routine within 5 daysTarget within 5 daysNo of routine repairs

What was going wrong?

• Team coordinators did not believe in the data used in the Communication Cells or the Pareto analysis of causes of delayed repairs

• Calls that could not be programmed within target were not always highlighted to coordinators.

• There were more van zones than vans– Batching increases WIP and decreases efficiency– Reducing zones was counterintuitive to all mobile

engineers and coordinators

Weekly Urgent Repair Performance

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1 2 3 4 5 6 7 8 9 10111213141516171819202122

Weeks

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% urgent within contractTarget within 1 dayNo of urgent repairs

Weekly Routine Repairs Performance

0102030405060708090

100

1 2 3 4 5 6 7 8 9 10 1112 1314 1516 171819 2021 22

Weeks

Perc

enta

ge

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% routine within 5 daysTarget within 5 daysNo of routine repairs

2007 Repair Completion Rates

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Days

1st Qtr

2nd Qtr

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4th Qtr

May 08 %

Issues we still need to tackle

• Is Urgent/Routine defined properly?

• Closing weekends and bank holidays disrupts work flow.

• No out of hours emergency cover.

• Do our targets need to be revised?

• Repairs to seating are currently slower

• Getting access to the wheelchair.