Processing : Redundant and unnecessary process steps, excess processing, excess checking and inspection. Excess use of energy of all types. Inspection : Re-do’s, fix-ups, returns, mark-downs, managing complaints. Inventory : Idle in-progress or finished materials, ingredients, supplies, or information. Wait Time : Delays and queues of all types. Search Time: Time spent looking for information, people, supplies, and equipment. Transportation : Multiple handling steps and needless movement of material and information. Space : Storage of unneeded items, excess inventory or the general “mess” that builds up over time. Excess space required due to inefficient process flow. Complexity : Complex process flows. Confusing product and service choices. Organization boundaries which introduce inefficiencies and frustrate any sense of accomplishment. People: Underutilizing your work force’s knowledge, skills, and creativity.
There is an evolution that organizations and teams go through in establishing a lean system. This evolution is broken into four stages, which are listed on the slide.
Stage 1: Work is processed in functional departments Characteristics of traditional processing: Work or information travels between departments often in large batches (like “tossing it over the wall”) Incoming and outgoing queues are found at each department Similar work is often done by several people Waste is evident in the excess work in-process and the time spent in queues
Stage 2: Work is processed a cellular layout At this stage, representatives from each functional department are co-located and the sequence of work activities and the physical layout are planned and implemented. Characteristics of stage 2 are include: Less variation in work methods Waste of transportation is eliminated or minimized Several queues have been eliminated Items are easier to track and quality problems are more visible Cycle time is greatly reduced It is much like removing the walls between departments and therefore, people and workflow.
Stage 3: Standard, Steady Flow Processing in a Work Cell Characteristics include: Work process and methods are standardized and documented Visual systems and queues are in place to support daily operations Problems within the system become more visible The waste of time and inventory are reduced as queues and the number of items in queues are further reduced Cycle time is highly predictable and outcomes are reliable To get to this stage, you need to have standard work methods and be employing one-piece flow through the process. There is an even, steady pace and rhythm to the work.
Standardize the way in which work is performed in the cellular layout. Standardization means that the critical tasks in the process are always performed in the same order, and the task description is documented. Only when the process is standard and stable can people’s creativity thrive with improvement ideas. At this step, organizations often take initiative to shape customer demand to increase predictability. For example, a pediatric clinic calls parents throughout the year to schedule physicals rather than waiting for a late summer rush when children must have physicals and inoculations for school enrollment.
Customary batch processing creates stagnant pools, such as inventory or information queues. Explain this slide – Work meanders through the system as it meanders through the lake above. There are areas where water pools and piles up before it spills into a waterfall. Processes are similar in that there are often bottlenecks, places where work piles up. At these bottlenecks work piles up until it overflows the process.. The pipeline of Steady Flow Processing (SFP) creates smooth, level and fast-flowing processes.
Stage 4: Steady Flow Processing with Cross-Trained Employees Cross-Train everyone to balance the workload Characteristics include: (Buffer) Inventory eliminated Reduction in number of people in the cell is through cross-training, combination of tasks, and automation Work is balanced and pace is set to customer demand/need
What does quality mean to you? How would you define quality? (Note: quality can mean a number of things)
There are 5 Levels of Inspection – Level 1: Customer inspects Unfortunately, the customer often acts as the quality inspector for us. Although the root cause of the defect (an error) may have occurred far “upstream” of the customer, the resulting defect is not discovered until the product or service reaches the customer. “ What are some examples of a Level 1 Quality System?” Responses: Bus does not show up at the stop while you wait and check your watch. Belt is missing from dress that arrived after an on-line order. Cap for gas tank is missing after using the full serve island. What are the problems with Level 1?” Responses: Quick way to lose customers Difficult to find root cause—error occurred too far upstream Very costly “ What are some Level 1 examples from your work? What about from the process we are working on today?”
A Level 2 Quality System uses official or unofficial “checkers” who try to catch defects before they reach the customer (at the end of the process). These can be “company” inspectors or third party inspectors such as regulators. “ What are some drawbacks of Level 2?” Responses: Not reliable Not value-added Queues can develop Hard to determine the root cause of the defect “ What are some Level 2 examples from your organization?” Because Level 2 relies heavily on inspecting someone else's work, let’s test our assumptions about inspection.
In some cases, inspection occurs within a work unit or department at successive stages in the overall process. For example, a clerk on a hospital patient unit may “inspect” a lab requisition completed by a doctor before sending it to the lab. “ While Level 3 puts defect detection and error occurrence closer together in time and place, it still has drawbacks. What are they?” Responses: Can result in multiple rework loops Adds delay time Root cause is not always easy to identify “ What are some Level 3 examples from your organization?”
In Level 4, the person performing the task identifies the error as it occurs and before it is passed along . This is accomplished by “self inspection” and responding to process warning signals which are built into the process to trigger action. Self Inspection examples Repeating an address or order back to a customer before entering an order. Reviewing a checklist of required items on inside of envelope flap for credit card application before sealing the envelope. Use of Process Warning Signals examples Responding to warning signal that seat belt is not fastened. Responding to warning signal that copy machine needs toner. Responding to a signal on your Palm Pilot that reminds you of your best friend’s birthday. Responding to red line warning you of a misspelled words in word processing software. What are some Level 4 examples from your organization? What are some advantages of Level 4? Possible Responses: Less costly (no rework) Defects not passed on to next step Corrective action an be immediate
Characteristics of Level 5: Methods are in place to prevent problems before they occur. These methods have been developed as a result of repeated errors at a common spot in the process. Suppliers do not pass on errors. Preventive maintenance is used to eliminate equipment breakdowns. Process is designed with fewest number of steps and handoffs to reduce error opportunities. Process controls designed into a process, making it impossible to make an error. What are some examples of Level 5? Responses: Inability to move on to next data entry screen until all data fields are completed. “ Automatic “save” function built into software. What example of Level 5 do you have in your organization? What are the advantages of Level 5? Responses: Least costly Time saved on inspection and rework is redirected to value-added work Customer satisfaction is high
Stuff accumulates . Over time, everything – dirt, paper, electronic files, supplies, tools and equipment – piles up. In the workplace, this unrelenting “piling-up” steals space, causes clutter, and creates confusion. It is both cause and symptom of compromised performance, productivity and quality. Flow is the cure-all for chronic accumulation. Keep things moving! Keep the work flowing. Much of what we do in the workplace is in the way of disposition: deciding on or doing whatever it is that needs to happen to keep things moving toward their appointed goals. What we don’t dispose of – i.e., process, store properly, trash, etc. – accumulates.
The benefits of a 5S program, well-planned and –implemented, are potentially great: Decreased waste, cost and time Increased quality, safety, productivity, morale, and satisfaction (for both customers and employees)
1. Lean Principles Donna M. Daniel, PhD Performance Improvement QIO Support Center Qualis Health September 12, 2006
2. Defining Lean <ul><li>containing little or no fat – Webster.com </li></ul><ul><li>The least-wasteful way to provide value to a customer. </li></ul><ul><ul><li>Fewer resources </li></ul></ul><ul><ul><li>Fewer costs </li></ul></ul><ul><ul><li>Higher quality </li></ul></ul><ul><ul><li>Higher staff satisfaction </li></ul></ul><ul><ul><li>Shorter delivery time </li></ul></ul>
3. Lean Objectives <ul><li>Search For and Eliminate Waste </li></ul><ul><li>Reduce Time Waiting and Processing </li></ul><ul><li>Reduce Cost </li></ul>
4. How Will We Achieve These Objectives? <ul><li>Employees who do the work lead process improvement </li></ul><ul><li>Rethink work as producing a product or service to be used by other employees </li></ul><ul><li>Rethink work in terms of customers and suppliers </li></ul>
7. Defining Waste <ul><li>damaged, defective, or superfluous material produced by a manufacturing process – Webster.com </li></ul><ul><li>Something that consumes resources, but adds no value to a product or service. </li></ul>
9. Waste Exercise <ul><li>Rank your top three types of waste that you encounter in your daily activities. </li></ul>
10. Where are you? <ul><li>Unaware </li></ul><ul><li>All steps are necessary; individuals are reasons for inefficiency </li></ul><ul><li>Beginner </li></ul><ul><li>Inspection is necessary; starting to see process inefficiencies </li></ul><ul><li>Intermediate </li></ul><ul><li>Map processes; remove steps, inspections and queues; reduces distance and time; see handoffs as potential for error; able to identify ideas </li></ul><ul><li>Expert </li></ul><ul><li>Sees inventory, transportation, inspection, queues, unnecessary handoffs as waste; question all processes; able to implement ideas </li></ul>
11. Strategies for Reducing Waste <ul><li>Train all employees on lean </li></ul><ul><li>Establish leadership expectations </li></ul><ul><li>Implement a 5S program </li></ul><ul><li>Standardize work methods between people and departments </li></ul><ul><li>Smooth out processes for continuous flows </li></ul><ul><li>Eliminate wasteful steps </li></ul><ul><li>Ask “why” five times </li></ul>
12. Standardized, Steady Flow Processing
13. Four Stages to a Lean System <ul><li>Work is performed in silos, e.g: departments </li></ul><ul><li>Work is performed in a co-located team </li></ul><ul><li>Work is performed with a standardized steady flow to the process </li></ul><ul><li>Work is performed by cross-trained employees </li></ul>Adapted from Joan Wellman and Associates
28. Levels of Inspection 5. 4. 3. 2. 1. Level Prevention No one Instant Detection, Immediate Correction Individual Early Detection, Correction Workgroup Detection, Inefficient Correction Company Detection Customer Outcome Who Inspects?
29. Visual Cues
30. Visual Cues <ul><li>Use visual cues to… </li></ul><ul><ul><li>Display standardized methods in use </li></ul></ul><ul><ul><li>Identify abnormal conditions immediately </li></ul></ul><ul><ul><li>Communicate performance measures </li></ul></ul><ul><li>Who uses visual cues? </li></ul><ul><ul><li>The people working in the area </li></ul></ul><ul><ul><li>Those who support the people working in the area </li></ul></ul>
31. Implement a 5S Program <ul><li>5S is a systematic program for workers to take control of their workspace so that it actually works with and for them (and their customers) – rather than being a neutral, or as is quite common, a competing factor. </li></ul>
32. The 5Ss <ul><li>Sorting: Separate the needed from the unneeded, and remove the unneeded </li></ul><ul><li>Simplifying: A place for everything and every-thing in its place, clean and ready for use </li></ul><ul><li>Systematic Cleaning: Conduct regular cleaning and inspection; use mess prevention </li></ul><ul><li>Standardizing: Document and follow the best known methods </li></ul><ul><li>Sustaining: Hold the gains, continue to improve, and make 5S a way of life </li></ul>
33. Why 5S? <ul><li>Enhances present process by: </li></ul><ul><li>Reducing time wasted </li></ul><ul><li>Reducing errors </li></ul><ul><li>Reducing training time </li></ul><ul><li>Reducing excess inventory </li></ul><ul><ul><li>Increasing the visibility of problems </li></ul></ul><ul><ul><li>Improving workplace cleanliness </li></ul></ul><ul><li>Improving teamwork </li></ul><ul><li>Reducing safety hazards </li></ul>
36. <ul><li>Acknowledgments </li></ul><ul><li>Qualis Health would like to thank Joan Wellman & Associates, Inc. and Lean Enterprise Institute for the foundational materials used to develop this presentation. </li></ul><ul><li>For more information </li></ul><ul><li>Please contact the Performance Improvement Quality Improvement Support Center at [email_address] . </li></ul><ul><li>Disclaimer </li></ul><ul><li>This material was produced by the Performance Improvement Quality Improvement Organization Support Center at Qualis Health, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The content presented do not necessary reflect CMS policy. </li></ul>