Lean Six Sigma in the Lab Kansas City CLMA Friday, March 1, 2013 Scott Bolen Master Black Belt Quest...

Lean Six Sigma in the LabKansas City CLMA

Friday, March 1, 2013

Scott Bolen

Master Black Belt

Quest Diagnostics – Midwest Region

2

Agenda• Leadership

• LEAN versus Six Sigma

• Waste

• Flow

• Continuous Improvement

3

LEAN Leadership• LEAN Leaders

• Your experience?

4

Lean Six Sigma• Leadership


• Waste

• Flow


5

LEAN versus Six Sigma• Six Sigma is about meeting the customer

demand for accuracy (Quality)

• LEAN is about meeting the customer demand for timeliness (Speed)

• LEAN and Six Sigma complement each other.

• Each drives continuous improvement through the DMAIC methodology

6

LEAN Six Sigma Method:Improvement (DMAI2C) – Reduce variation and defects

in an existing process

Define the project, process, and customer requirements.

Measure the process to set baseline and quantify factors.

Analyze the data to determine root cause.

Innovate Improvements that address root cause.

Control improved process and determine effect.

7

• Six Sigma is about decreasing variation.

• Lean is about decreasing waste.

Customer Spec

Virtually No Defects

12

34

5

6

TargetCustomer Spec

Many Defects

6

12

34

5

Target

2.8 Low Quality10% Error Rate100,000 DPMO

High Quality0.00037% Error Rate3.4 DPMO

Good Bad Good Bad

Improving Operational Efficiencies

8

Most good companies are here

Six Sigma is “S..t..r..e..t..c..h Thinking”

6 Sigma

5 Sigma

4 Sigma

3 Sigma

2 Sigma

1 Sigma

99.9997%

99.977%

99.38%

93.3%

69.1%

30.9%

SigmaSigma YieldYield

3.4

233

6,210

66,807

308,538

691,462

Errors per million opportunitiesErrors per million opportunities

3 Sigma 93.3%66,807

6 Sigma 99.9997%3.4

9

Six Sigma: The Highest Quality

• 50 newborns harmed at delivery, every day

• 5,000 incorrect surgical operations a week

• 200,000 wrong drug prescriptions a year

• No electricity for almost 7 hours a month

• 20,000 lost articles of mail per hour

• Unsafe drinking water almost 15 min. a day

• 528,000 checks deducted from the wrong bank accounts every day

At Quest Diagnostics, we perform nearly 350 million

tests a year.

If we did 99% of them right:

3.5 Million Tests would have an error!

We want Six Sigma Quality:

99.9997% of tests done correctly!

Less than 1200 would have an error

99% Good Means: Quest Diagnostics Quality:

10

How do we control Processes?

UCL=0.101493

LCL=0.088782

CEN=0.095137

UCL=0.085759

LCL=0.07426

CEN=0.080009

UCL=0.054193

LCL=0.045126

CEN=0.04966

0

0.02

0.04

0.06

0.08

0.1

0.12

0.14

Target = .05(50,000 DPMO)

Proportion of Patients Waiting >15 Min.

Off Target & Inconsistent

Consistent butOff Target

Consistent &On Target

Control Chart

11

What the Customer Wants

14.513.512.511.5

50

40

30

20

10

0

Minutes Waiting

# Pa

tient

sAverage = 13 MinutesAverage = 13 Minutes

12

Which is Better?

Average = 11 Minutes Average = 13 Minutes

The average wait timeis decreased by 2 min.

The # of patients waiting >15 min.has increased from zero to ~20 But….

Most customers don’t experience the average!

13

LEAN Six Sigma• Leadership


• Waste

• Flow


14

Reduce or eliminate waste

DOTWIMP1. Defects

2. Overproduction

3. Transport

4. Waiting

5. Inventory

6. Motion

7. Extra Processing

DOWNTIME

1. Defects

2. Overproduction

3. Waiting

4. Non-Utilized Employees

5. Transport

6. Inventory

7. Motion

8. Extra Processing

15

Perspective

• From the Function/Provider: Everyone is very busy

• From the patient: Hurry up and wait

• From the specimen: Sit, Sit, Sit, Test, Sit

16

What is Value?

17

Value Added: Definition

• Must Physically Change the product / information

• Must be Done Right the First Time (no rework)

• Customer is Willing to Pay For It NonValue Add

Value Add

Business ValueAdd

18

Lean Toolkit – 5S

What is it ??What is it ?? • A systematic way to improve your workplace and processes• Focuses on creating and maintaining a clean, well organized workplace• Easily distinguish between normal and abnormal conditions

• Highly dependent on employee involvement• Promotes defect reduction, cost reduction and a safe work environment

Goal:Goal:

• A self-explaining, self-ordering, self-regulating, and self-improving workplace where what is supposed to happen does happen on time, every time, day or night.

5S Parody

19

Current State

Before Warehouse Before Supply Cart

5S Exercise

20

5S - Circle the numbers in order from 1-50You have 60 Seconds

Current State

60 55 50 45 40 35 30 25 20 15 10 5

Time’s Up

5S Exercise

22

Work area less crowded

Less time needed to find things

Fewer part selection errors

Improved process flow

Reduced maintenance costs

Improved communication among employees

Implementation and Benefits of 5S

Sort Set in Order

Shine SustainStandardize

Sort - BenefitsSort - Benefits

Sort: “When in doubt throw it out”

Sort necessary from unnecessary itemsSort necessary from unnecessary items

Remove all unneeded items such as racks, tools, equipment, and excess inventory

Red tag method

• Attach red tags to unneeded items and remove them to a red tag area

• Evaluate and properly dispose of items in the red tag area

5S Exercise

23


1.SortGet rid of what you do not need. Keep only

what is needed. (Remove higher numbers)

60 55 50 45 40 35 30 25 20 15 10 5

Time’s Up

5S Exercise

25


Set in Order - BenefitsSet in Order - Benefits

Set in Order : “A place for everything and everything in its place”

The proper amount of space is designated to store items

Reduces time needed to find things, less searching

Everything is in its place and not on the floor – improved safety

Elimination of excess motion

Increased space / capacity

Sort Set in Order

Shine SustainStandardize

Arrange items so that they can be found quickly by Arrange items so that they can be found quickly by anyoneanyone

Everything that is movable should have a designated place when not in use

Arrange things so they are easy to find, easy to use and easy to put away

Most frequently used items should be close-at-hand

Items should always be in the same place

5S Exercise

26

Shine - Benefits Shine - Benefits

Shine: “A clean systematic organization results in increased safety and efficiency”

Less equipment breakdown.

Defects are easy to see

Improved efficiency

Safer work environment

Improved morale

Sort Shine SustainStandardize

Create a spotless workplaceCreate a spotless workplace

Keep what is left CLEAN and in good working condition

Perform a major cleanup

Assign daily housekeeping tasks at least 5 min./day

Set in Order

Implementation and Benefits of 5S5S Exercise

27

2. Set in OrderPut needed items in the proper place

(No sequential numbers in the same quadrant)

3. ShineKeep workplace neat and clean

(Clean up fonts)5S - Circle the numbers in order from 1-50

You have 60 Seconds

60 55 50 45 40 35 30 25 20 15 10 5

Time’s Up

5S Exercise

29


Standardize - BenefitsStandardize - Benefits

Standardize:“Do the right things the right way, every time”

Increased equipment life

Clean environment

Increased visibility of normal and abnormal conditions

Consistent delivery

Improved quality

Training of new employees is easier


Maintain the previous changes and continuously improveMaintain the previous changes and continuously improve

Standardize your processes

Incorporate sorting, storage, and shining activities into daily routines

Use aids to control what happens and when it happens

Set in Order

5S Exercise

30

Standardized Taping Scheme5S Exercise

31


4. StandardizeImplement, train and maintain

best practices(Define a standard order)

60 55 50 45 40 35 30 25 20 15 10 5

Time’s Up

5S Exercise

33


Sustain - Benefits Sustain - Benefits

Sustain: “5S Ingrained in everyday work life”

Higher employee pride and ownership

Work place is maintained in an organized fashion without clutter

Detailed tasks are documented to make the process more efficient

Customer appeal / boosts professional image

Saves time, money on over orders & reduces out of stocks


Ensure the systematic organization, visual placement and cleanliness are maintainedEnsure the systematic organization, visual placement and cleanliness are maintained

Follow the rules you set

Involve workers in every aspect of the 5S process including checklists and job charts

Practice and repeat until it becomes a way of life

Continuously improve through regular assessments (audits)

Fully train existing and new employees on 5S and your expectation

Set in Order

5S Exercise

34

Warehouse Before / After 5S Photos

Before:Before: After:After:

5S Exercise

35

Supply Cart Before / After 5S Photos

Before:Before: After:After:

5S Exercise

36

LEAN Six Sigma

• Leadership


• Waste

• Flow


37

Flow

• Video

• What are the attributes of good process flow?

38

Lean in the Lab – Optimizing Flow

“Before” Spaghetti Map of Molecular

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Bio

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mixer inside

mixer & centri inside

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future ABI

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DML 2000

RapidCapture

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ViperViper

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labelprint

36"

36"

36"

30"

36"

36" 36"

36"

36"Phone

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D.I.

D.I.

Free standing unit by Quest

36"

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30" AmpliprepTaq 96

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pc 175

176

170

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179

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191.5

Waste

Specimen Arrival

Waste

39

“After” Spaghetti

Map of Molecular

Lean in the Lab – Optimizing Flow

Optimizing Cells helped

reduced “Transportation Waste” by 46% (1709’ vs 930’)

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Ampliprep Taq 96

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Waste

Specimen Arrival

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40

Value Stream Map

Oven

A010

.25Xylene Stainer

.25 .25

Xylene

.25

Cover Slip

1

Labeling / Folders Distribution

1 2

Pathologist

Total Volume: 1000 Reqs/DayIndividual Volume: 125 Samples to Drs: by 12PM (Goal 9AM)Specials to Drs: by 2:30PM

A020 A030 A040 A050 A060 A070

Cuttting

Start Cut: 12AM on StaggeredStop Cut: Staggered to 4PMBatch Size 20 MaxDaily Output 200 Blocks/DaySlides: 1-3 / Block Average

cutter

Aid

Operators Staff.25

Rework (%) %10

Production days/shift Shifts2

Production days/week Days5

Cycle Time Mins20

Batch Size Slide40

Operators Staff.25

Rework (%) %0



Cycle Time Mins6

Batch Size Slide40

Operators Staff.25

Rework (%) %1



Cycle Time Mins29

Batch Size Slide20

.25 .25

Operators Staff.25

Rework (%) %0



Cycle Time Mins6

Batch Size Slide20

.25

Operators Staff1

Rework (%) %5



Cycle Time Mins.1167

Batch Size Slide60

1

5Instruments Instruments

Operators Staff1

Rework (%) %0




Batch Size Slide12

Operators Staff2

Rework (%) %2




Batch Size Slide12

1 2

Cycle Time

Mins80

Total Slides

Slide160

Cycle Time

Mins15

Total Slides

Slide100

Cycle Time

Mins3

Batch Size

Slide60

Cycle Time

Mins6

Batch Size

Slide20

Cycle Time

Mins3.2

Batch Size

Slide140

Cycle Time

Mins16.7

Batch Size

Slide100

Cycle Time

Mins83.3

Batch Size

Slide500

41

Takt time = (time available)/(customer demand)

Example: 480 specimens arrive to the lab at 9 pm, are processed and delivered to toxicology at 10 pm. All results are due for release by 8 am. If an AU2700 can do 1 rack of 10.

How long should 1 rack take to meet the 8 am TAT?

Available time = 9 hours – 30 minutes for lunch – 2 x 15 minutes for breaks = (9*60) – 30 – 30 = 480 minutesCustomer demand = 480 specimens (assume no splits)Takt time = 480/480 = 1 minute = 60 seconds

1 rack = 10 specimens1 rack = 10 * 1 = 10 minutes

Takt time

What is the practicality of this?

42

Work Elements for the Histology Project

Operator Balance Chart

Operator StainerDistributionCover SlipperBarcode/Labeler

12

10

8

6

4

2

0

Sum

of To

tal C

T32

121110987654

Operation

Operator Balance Chart - Current State

Takt time = 11.36 sec.

What do you notice about this picture?

43

Operator Pizza Oven/Stainer/Cover SlipperDistributionBarcode/Labeler

12

10

8

6

4

2

0

Sum

of To

tal C

T

1211109842

Operation

Operator Balance Chart - Future State

Operator Balance Chart with Improvement

Note: We need to plan 85% - 95% of takt time to allow for variability in the process

11.36 X 85% = 9.66

Takt time = 11.36 sec.

Planned Cycle Time = 9.66 sec.

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Lean Six Sigma

• Leadership


• Waste

• Flow


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What is Kaizen?

Kaizen: the philosophy that continuous improvement takes place through small, incremental process improvements, repeated over and over again

Workshop:•A means of implementing process improvements•Short, 3-5 day events with intensive focus on one area and problem (for example cycle time or rework)•A cross-functional, participative implementation approach •Focus on substantial improvement (30-40%)

Workshop Objectives:

•Achieve results

•Bring new problem solving skills to the workforce

46

PDCA (Plan-Do-Check-Act?

Video

47

Questions?

Thank You!

Lean Six Sigma in the Lab Kansas City CLMA Friday, March 1, 2013 Scott Bolen Master Black Belt Quest...

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