What is your response to these questions from the perspective of manufacturing, healthcare, and service industry?

1. and, if so, are you ready for 6σ?

2. For starters, let’s consider the
sometimes tortured relationship
between Lean and Six Sigma…

3. “The typical approach to lean six sigma fits
Western thinking about simple cause-effect
relationships and the overall perspective that
the business is a technical system that needs
clever manipulation with the right tool kit to
achieve financial returns.
This type of thinking is totally alien to the
human systems underpinnings of Lean.”
- Jeffrey Liker
Professor of Industrial and Operations Engineering
University of Michigan

4. What is Six Sigma ?
 Achieve 3.4 defects per million opportunities
 Lead by Six Sigma Belts
 Strong emphasis on statistical analysis

5. What is Lean?
 Employee engagement philosophy
 Collection of process improvement tools
 Eliminate waste

6. Are they mutually exclusive ?
Lean 6σ
Culture Expert
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7. What they share
• Customer
Focus
Lean • Leadership
• Discipline
• Data driven
6σ
Culture • Teamwork
• Process Expert
Improvement
• Training
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8. How they coexist
Engage Senior Leadership &
Recognize Value Stream to
Lean Customer Lean
Leaders
Identify Gaps in Process
Performance as leading indicators Training
to achieve prosperity Lean
Employees
Engage Employees to Stabilize
Process and Reduce Waste
Six Sigma
Belts
Identify Six Sigma Projects to
6σ Reduce Process Variation
Blended
Sustain and Continuously
Improve Process
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9. How they achieve change
through projects
Continuous
Improvement
Six Sigma Black Belt
DMAIC
Six Sigma Green Belt
DMAIC
Kaizen
PDCA
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10. Questions to ask any site about
their ability to operate Lean
 Manufacturing
 Healthcare
 Service
How do you address this question
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11. Do you compromise safety for
your own comfort or to save time?
• Manufacturing
• Not wearing eye protection
• Healthcare
• Not using gloves
• Service
• Defying policy
Never is the time saving worth the additional risk.
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12. Do you clean up the place for a
special or ‘presidential’ visit?
• Manufacturing
• The CEO is coming
• Healthcare
• Joint Commission is coming
• Service
• Government Inspectors are coming
There should be no need since 5S is be sustained.
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13. Do you know if you are meeting
your daily production expectations?
• Manufacturing
• Meeting delivery schedules
• Healthcare
• Completing patient rounds
• Service
• Information exit rate
During work day there must be periodic oversight by the
operating supervisor to review performance to target. Gaps
and issues inhibiting attainment should be immediately
recognized and planned to be addressed. 13

14. How are issues escalated for higher
management involvement as time
increases to solve those issues?
• Manufacturing
• Key equipment down
• Healthcare
• Patient condition
• Service
• Customer complaints
Severity of the issue and the lapsed response time to solve the
issue must have a matrix to identify the level of management
involvement and posted for all staff to view. 14

15. Can you identify the input and output
locations for the process? How is non-
conforming product segregated from good?
• Manufacturing
• Quality rejects
• Healthcare
• Contaminated equipment
• Service
• Paperwork errors
Staged items to be processed and work completed can be visually
identified. Use separate area quarantined/segregated from
acceptable output that is clearly designated by RED. Use RED
sparingly throughout the worksite so it signifies the need for action
or attention. 15

16. Which processes are your least
reliable and how do those compare
to your most reliable?
• Manufacturing
• Machine operation
• Healthcare
• Lab / Nutrition / Housekeeping
• Service
• Call center response time
‘Bottlenecks’ to processing work have been identified by
the reliability of the resource and improvement planning
has been started. 16

17. Do you know your quality performance
in terms of customer reported defects?
• Manufacturing
• PPM and scrap
• Healthcare
• Staph infection rate and readmissions
• Service
• Satisfaction survey and loyalty rate
Metrics for quality performance are developed with
gap reduction targets and restoration plans.
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18. How much of your work effort produces
output from your process that does not
require additional effort to correct, rework,
or re-inspect?
• Manufacturing
• Know your First Pass Yield
• Healthcare
• Know your First Pass Yield
• Service
• Know your First Pass Yield
Using additional resources the customer will not pay for impairs
financial performance. This is referred to as ‘quality at the source’.
Do it right the first time and do not consume resources that could
be used to produce or deliver new output. 18

19. Who are the mentors for new hires
and how are they qualified?
• Manufacturing
• Skill Matrix, Apprentice - Journeyman
• Healthcare
• Certifications, Floor Nurse
• Service
• Shadow, Audit and Monitor
Get new hires to effectively contribute sooner. Select
mentors who are willing and capable of training
others using consistent, repeatable methods. 19

20. How do you compensate for long
change-over times on key processes?
What impact would shorter times have?
• Manufacturing
• Increase production lot size
• Healthcare
• More operating theaters
• Service
• Not a big issue
Long change-over time (typically hours or days) drive large lots to
justify the lost production time. Immediately, more capacity results.
Shorter time (preferably under 15 minutes) reduce lot size and WIP.
Pull systems demand quick changeover (referred to as SMED) to
improve response of fluctuating customer demand. 20

21. How long would it take a key product or
information item to wind its way through the
entire process if it were ‘walked’ past any In/Out
basket, WIP, or inventory storage?
• Manufacturing
• Hot or expedited order build
• Healthcare
• Heart catherization response
• Service
• High value irate customer resolution
This is the PROCESS TIME with all waste removed. Typically,
this is about 10% of the total LEAD TIME to deliver the
‘product/information’ to the customer that includes waste.21

22. Rather than looking at inventory in terms
of monetary value, ask how much time is
invested to deplete the inventory in terms
of customer demand?
• Manufacturing
• Raw materials and WIP
• Healthcare
• Consumable supplies
• Service
• In-basket accumulation
This reveals our confidence to deliver the process output.
Unreliable process or material sourcing is buffered by
response time accumulated as ‘just-in-case’ inventory. 22

23. How much information about operating
the process is endowed to key staff (tribal
knowledge) versus documentation?
• Manufacturing
• Knack to do work
• Healthcare
• Legacy practices
• Service
• Fiefdom of knowledge
Standardized processes require an identifiable documented
‘baseline’ to improve. Sharing this information permits
those involved to recognize its effect both downstream and
upstream of the process and engage to improve. 23

24. When do you believe Six Sigma (6σ)
would be appropriate for your process?
• Manufacturing
• A stable process - then reduce variation
• Healthcare
• A stable process - then reduce variation
• Service
• A stable process - then reduce variation
First, have a lean culture in place that will sustain change.
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25. Thank you for your attention!
Q&A
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