Quality Clinic SM

Lean Six Sigma Foundational Training

DO-IT-YOURSELF KIT

1. To teach the essential, foundational concepts of

Lean Six Sigma

2. To change the way you perceive the work around you,

as well the opportunities for improvement

3. To introduce specific tools that are used to analyze

and address common business problems

4. Provide a step-by-step guide for problem-solving

5. To help you solve problems more effectively

Objectives

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The goal: Inform, equip and empower

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• Data-driven, structured approach to improving business performance and solving organizational problems

• Puts the customer first in judging quality and performance

• The marriage of two complementary philosophies & toolsets:

A powerful 1-2 punch for process improvement

1. Lean

• Reduces waste

• Improves flow / speed

• Visual tools

• Increases value-added nature of the work

2. Six Sigma

• Reduces variation / defects

• Strives for perfection

• Statistical / analytical tools

• Builds quality / value into the process from the start

What IS Lean Six Sigma?

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Lean + Six Sigma = Powerful Improvement Partnership

Lean Six Sigma is a proven methodology for: • Reducing cycle time -> YOU are not moving more quickly … your

PROCESS is • Reducing defects -> YOU are not trying harder … your PROCESS

is working better • Reducing delay -> YOU are not PUSHING things through … your

PROCESS is flowing and PULLING them • Boosting profits -> Your PROCESS is profitable … for the

organization, the customer and the community • And for gaining competitive advantage -> Your processes cost

less, your margins are higher and you solve problems more effectively

What Lean Six Sigma DOES

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This is what you can do with it.

The decision has been made

At a high level, Lean Six Sigma is the decision that you’re going to judge or measure your performance, and compare it to something meaningful, objective and far-reaching.

Then comes the question – what to compare to?

At this point, you realize that: • Your customers define your existence. • They define what Quality means. • Your Quality should vary as little as possible in their eyes,

and objectively; and • You should measure Quality the same way they do.

And so ultimately, Lean Six Sigma is the decision to define and measure Quality the same ways your customers do.

Lean Six Sigma, therefore, is not just a methodology, or a toolset, or a statistical measure … it is a decision.

The Decision

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You have no business having no process

“If you can’t describe your work as a process, you don’t know

what you’re doing.”

W. Edwards Deming American statistician, professor, author, lecturer and consultant

Work is a Process

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http://www.brainyquote.com/quotes/quotes/w/wedwardsd133510.html

• Process: A series of ordered steps designed to accomplish a specific goal or purpose

Lean Six Sigma focuses on the process

All work is – or should be – a process

Step A Start Finish Step B Step C Step D

Work is a Process

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Customers

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• Provides a bird’s-eye view of the process flow in its context • Allows team to brainstorm full range of customers/recipients/benefactors • Typically eye-opening when done with cross-functional team

S I P O CSuppliers Inputs Process Outputs Customers

Improves access to, and quality of, healthcare

Benefits of Flow

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How does Flow help a health system?

• Reduces harmful delays

• Reduces boarding

• Fewer off-service patients

• Eases ED overcrowding

• Improves safety and

effectiveness

• Shortens process cycle time

• Enhances customer service and satisfaction

• Lowers unit costs

• Increases productivity

The ultimate reason

for eliminating waste in a process

is to ensure that value can flow

to the customer as quickly as possible.

But your process gets in the way

The Goal

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VALUE

You want value to

flow freely …

… from your business

to your customers

?

Enemies of Flow & Value

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What gets in the way?

• Hand-offs • Decision points • Bureaucracy • Batching • Silos • Redundancy

• Variation • Errors • Complexity • Lack of a process • Out of the norm

(“cash vs. card”)

Uneven workload

Can you think of any examples?

The 8 Types of Waste

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D O W

N T I

M

E

efects

verproduction

aiting

ot utilizing employee ideas

ransportation

nventory

otion

xtra processing

• Just in case…

• We might need it…

• It’s possible…

• You never know…

Food-for-Thought

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Are there any bottlenecks or delays where you work? What types of inventory do you have?

What is/are the constraint(s)? How can you mitigate them?

How is your world similar to Alex’s?

Variation

• The way work is done tends to vary (person-to-person, day-to-day, etc.).

• This leads to variation in outcomes and Quality. (“Results may vary.”)

• To minimize defects, waste and errors, variation must be controlled.

• The goal of Lean Six Sigma is to reduce variation so that performance always meets customers’ requirements.

Variation is what we notice

Variation

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Where do defects come from? (Part 2)

Sigma (s) = Greek letter

used to represent variation

in set of numbers

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Why aren’t the

measurements

the same?

MATERIALS (Supplies, software)

MAN (People-related factors)

METHOD (Process, policy)

METRICS (Data, numbers)

MOTHER NATURE (Environment, culture,

regulations)

MACHINES (Equipment, computers)

How big is an index card?

• A simple description of how to consistently perform a particular process or task

– Safest

– Highest quality

– Only acceptable way

– Most efficient

• Provides guideline for time required

• Regularly reviewed, taught and improved

• Applied to all work areas

Standardization

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What is Standard Work?

What SHOULD be standardized? 16

1. Sort – Keep only what is necessary

2. Set in Order – Everything with a place …

everything in its place

3. Shine – Wipe, clean, polish, prepare all surfaces

4. Standardize – Make the first 3S’s a routine – at job & co. level

5. Sustain – Rewards, incentives, recognition, pictures, data

Why do we call it “5S?”

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Lean Six Sigma is the most robust methodology used today for solving

problems in an organization.

It ensures that a structured approach based on data is used so that the best

solutions are generated and that they are then embedded in an organization.

100% Effective Training

What is Lean Six Sigma?

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“

”

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OSSS LSS Green Belt v9.0 - Introduction

the business opportunity. What is the customer’s expectation of the process? What is the process that needs to be examined?

DMAIC starts and ends with the customer

Define

Measure

Analyze

Improve

Control

DMAIC

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the process current state. What are the key metrics for this process?

the data to determine root causes. How is this process currently performing? When, where, and why do defects occur?

the process by reducing variation and eliminating waste. What are the root causes? How can we fix the process?

and sustain the improvements. Are the customer needs met? How can we keep the process fixed?

Define

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KEY DELIVERABLES:

• VOC

• Customer CTQ

• Project Team

• Project Charter

• Observation

• SIPOC

GOAL: Define the problem

and the project

Measure

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KEY DELIVERABLES:

• Data Collection Plan

• Sampling

• Validation

GOAL: Collect appropriate

data

Analyze

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KEY DELIVERABLES:

• “Pictures” of the data

• Key statistics

• Process capability

• Root-cause analysis

• “Pictures” of the process

GOAL: Identify root causes … “peel the layers”

There are a thousand hacking at the branches of evil to one who is striking at the root. -Henry David Thoreau

Improve

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KEY DELIVERABLES:

• Prioritized list of potential solutions

• Standardized procedures

• Visual improvements

• Error-proofing steps

• Pilot

GOAL: Formulate specific improvements

that address root causes

Control

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KEY DELIVERABLES:

• Implementation Plan

• Control Plan

• Validation

• Assessment

GOAL:

Implement changes that last

A3

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Purpose of A3:

1. Document your improvement project 2. Tell your story 3. Gain buy-in 4. Guide your work 5. Track progress

Provides flow and clarity