12/5/2013

An Introduction to Lean Six Sigma

We dont know what we dont know. We cant act on what we dont know. We wont know until we search. We wont search for what we dont question. We dont question what we dont measure. Hence, we just dont know. Dr. Mikel Harry

http://vimeo.com/24784020

Process Improvement
1. Initial Perception of problem 2. Clarify Problem 3. Locate Point of Cause 4. Root Cause Analysis 5. Design Solutions 6. Measure Effectiveness

Lean Six Sigma Process Improvement

Lean Six Sigma Seeks to improve the quality of manufacturing and business process by:
identifying and removing the causes of defects (errors) and variation. Identifying and removing sources of waste within the process Focusing on outputs that are critical to customers
Define Control Measure

7. Standardize

Improve

Analyze

Lean Six Sigma Process Improvement

LSS is a management philosophy that seeks to drive a quality culture change through a multi-level based program
Level Green Belt Training LSS Methodology and basic tool set Green Belt content plus advanced data analysis Black belt content plus program management, leadership skills, some advanced tools

Lean Six Sigma Timeline

Deming 14 Points 7 Deadly Diseases

Guinness Brewery

Shewhart Introduces SPC

1900
Ford Assembly Line

1930
Gilbreth, Inc. Management Theory Industrial Engineering

1950
Toyota Production System

Black Belt

Master Black Belt

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Lean Six Sigma Timeline

Motorola Introduces Six Sigma

Background on Lean
Lean comes out of the industrial engineering world Taiichi Ohno Toyota Production System.
1940s-1950s company was on verge of bankruptcy Dynamics of industry were changing moving from mass production to more flexible, shorter, varied batch runs (people wanted more colors, different features, more models, etc).

SPC

TQM

AlliedSIgnal GE Adapt LSS to Business Processes

1980
Just inTime

1990
Lean Mfg.

2000

Ohno was inspired by 3 observations on a trip to America

Henry Fords assembly line inspired the principle of flow (keep products moving because no value is added while it is sitting still) The Indy 500 Rapid Changeover The American Grocery Store led to the Pull system material use signals when and how stock needs to be replenished

Path To Lean
Theory Application Waste is Deadly 1. Define Value act on what is important to the customer 2. Identify Value Stream understand what steps in the process add value and which dont 3. Make it flow keep the work moving at all times and eliminate waste that creates delay 4. Let customer pull -- Avoid making more or ordering more inputs for customer demand you dont have 5. Pursue perfection -- there is no optimum level of performance Flow Focused Non-Value added steps exit Reduced cycle time

Waste Defined
Wastes
Transport Inventory Motion
1. 2. 3. 1. 2. 3. 1. 2.

Healthcare Examples
Moving patients from room to room Poor workplace layouts, for patient services Moving equipment in and out of procedure room or operating room Overstocked medications on units/floors or in pharmacy Physician orders building up to be entered Unnecessary instruments contained in operating kits Leaving patient rooms to: Get supplies or record Documents care provided Large reach/walk distance to complete a process step Idle equipment/people Early admissions for procedur es later in the day Waiting for internal transport between departments Multiple signature requirements Extra copies of forms Multiple information systems entries Printing hard copy of report when digital is sufficient Asking the patient the same questions multiple times Unnecessary carbon copying Batch printing patient labels Hospital-acquired illness Wrong-site surgeries Medication errors Dealing with service complaints Illegible, handwritten information Collection of incorrect patient information Not using peoples mental, creative, and physical abilities Staff not involved in redesigning processes in their workplace Nurses and Doctors spending time locating equipment and supplies Staff rework due to system failures

Waiting Over-Production Over-Processing Defects

Focus Assumptions Results

Skills

1. 2. 3. 1. 2. 3. 4. 1. 2. 3. 1. 2. 3. 4. 5. 6. 1. 2. 3. 4.

Lean Foundations
Standardized Work people should analyze their work and define the way that best meets the needs of all stakeholders.
The current one best way to safely complete an activity with the proper outcome and the highest quality, using the fewest possible resources Standardized not Identical mindless conformity and the thoughtful setting of standards should not be confused Written by those who do the work.
Select Clarify Organize Run Evaluate

Lean Methods
Kaizen Events (or SCORE events)
Planned and structured process that enables a small group of people to improve some aspect of their business in a quick, focused manner.

5S this methodology reduces waste through improved workplace organization and visual management
Sort, Store, Shine, Standardize and Sustain

Level loading smoothing the workflow and patient flow throughout the hospital. Kaizen continuous improvement

Kanban a Japanese term that can be translated as signal, card, or sign.

Most often a physical signal (paper card of plastic bin), that indicates when it is time to order more, from whom, and in what quantity.

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Lean vs. Six Sigma

Lean tends to be used for shorter, less complex problems. Often time driven. Focus is on eliminating wasteful steps and practices. Six Sigma is a bigger more analytical approach often quality driven it tends to have a statistical approach. Focus on optimizing the important steps reducing defects. Some argue Lean moves the mean, SixSigma moves the variance. But they are often used together and should not be viewed as having different objectives.
Waste elimination eliminates an opportunity to make a defect Less rework means faster cycle times

VOC vs. VOP

Sigma Capability Defects per Million Opportunities % Yield

2 3 4 5
Voice of Customer Voice of Process

308,537 66,807 6,210 233 3.4

69.15% 93.32% 99.38% 99.98%

99.99966%

Six Sigma training might be specialized to the quality department, but everyone in the organization should be trained in Lean

The Voice of the Process is independent of the Voice of the Customer

Whats good enough?

99% Good (3.8 Sigma) 20,000 lost articles of mail per hour (based on 2,000,000/hr) Unsafe drinking water for almost 15 minutes each day 5,000 incorrect surgical operations per week 2 short or long landings daily at an airport with 200 flights/day 2,000,000 wrong drug prescriptions each year No electricity for almost 7 hours each month 99.99966% Good (6 Sigma) 7 articles lost per hour 1 unsafe minute every 7 months 1.7 incorrect operations per week 1 short or long landing every 5 years 680 wrong prescriptions per year 1 hour without electricity every 34 years

Goals of Lean Six Sigma

LSL USL Defects LSL USL Defects Customer Target Defects

Customer Target

Prevent Defects by Reducing Variation

LSL

USL

Prevent Defects by Centering Process

Customer Target

Meet Customer Requirements

What Makes a Good Lean Six Sigma Project?

There is no known solution The root cause is not known The problem is complex and needs statistical analysis The problem is part of a process The process is repeatable A defect can be defined Project will take 3-6 months There are data available

The DMAIC Methodology

Define describe the problem quantifiably and the underlying process to determine how performance will be measured. Measure use measures or metrics to understand performance and the improvement opportunity. Analyze identify the true root cause(s) of the underlying problem. Improve identify and test the best improvements that address the root causes. Control identify sustainment strategies that ensure process performance maintains the improved state.

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Define
Define Scope of the Problem
Document the Process Collect and Translate the Voice of the Customer

Define (continued)
Create Project Charter
Confirm Improvement Methodology Define Project Roles and Responsibilities Identify Risks Establish Timeline Managerial Buy-in

Determine Project Objective and Benefits

Define Metrics and Defects Establish Preliminary Baseline Develop Problem & Objective Statements Estimate Financial Benefit

Focus here is on the problem

Measure
Measure what is measurable, and make measurable what is not so Galileo

Analyze
Identify Potential Causes (Xs) Investigate Significance of Xs
Collect data on xs Graphical/Quantitative analysis
Pareto Chart Fishbone Diagram (cause and effect) Chi Square Test Regression Analysis Failure Mode Effects Analysis

Define As Is process
Value stream map/process flow diagram

Validate Measurement System for Outputs

Dont assume your measurements are accurate measuring system must accurately tell what is happening

Quantify Process Performance

Collect data (Ys) Examine process stability/capability analysis

Identify Significant Causes to focus on (y=f(X))

Evaluate the impact of xs on y

Here you identify the critical factors of a good output and the root causes of defects or bad output.

Improve
Generate Potential Solutions Select & Test Solution Develop Implementation Plan

Control
Create Control & Monitoring Plan
Mistake proof the process Determine the xs to control and methods Determine Ys to monitor

Implement Full Scale Solution

Revise/develop process Implement and evaluate solution

Finalize Transition
Develop transition plan Handoff process to owner