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14 TECH508 Control
14 TECH508 Control
50800
QUALITY and PRODUCTIVITY in
INDUSTRY and TECHNOLOGY
Beforewebegin:
Turnonthesoundonyourcomputer.Thereisaudioto
accompanythispresentation.
Audiowillaccompanymostoftheonlinepresentation
materialsthroughoutthesemester.
TECH 50800
QUALITY and PRODUCTIVITY in
INDUSTRY and TECHNOLOGY
Week14
LeanSixSigmaBasics:ControlPhase
Define
Measure
Lean101
Analyze
Improve
Lean201
Control
Identify
Opportunities
SetTeam
GroundRules
Current
StateProcess
Map
Identify
Waste
Examine
Processand
Data
Finalize
KPIVs
Identify
Constraints
Determine
Process
ControlPlan
SelectProject
Voiceofthe
Customer
Analysis
Potential
KPIVs
Identified
QuickHit
Improve
ments
KPIVsVerified
Develop/
Evaluate
Solutions
Exploit
Constraints
Recognize/
Reward
Complete
Project
Charter
Determine
KPOVs
Data
Collection
LinkKPIVsto
KPOVs
Future
StateProcess
Map
Finalize
Financial
Estimates
Launch
Project
Team
LinkKPOVsto
CTQs
Create
BasicKPOV
Graphs
PilotStudy
Implement
ationPlan
Full
Implement
ation
Initial
Financial
Estimates
Control
Define
Measure
Lean101
Analyze
Improve
Lean201
Control
Process
Mapping
Process
Observation
Worksheet
KPIV
Analysis
Solution
Matrix
Theory
OfConstraints
ProcessControl
Plan
Affinity
Diagram
GroundRules
Worksheet
Project
Selection
Matrix
SIPOC
CTQTree
Ishikawa
Diagram
Spaghetti
Diagram
AdvancedPivot
Tablesand
Charts
Impact
Effort
Matrix
LittlesLaw
Recognize
Improvement
Achieved
ProjectCharter
Voiceofthe
Customer
Analysis
CreateData
CollectionPlan
5S
Advanced
Graphing
Techniques
FutureState
ProcessMap
Variability
Principle
ROI
Tool
CTQTree
Measurement
Systems
Analysis
Visual
Controls
ROI
Tool
BasicStatistics
Pilot
Implementatio
nChecklist
Project
Management
Process
Modelingand
Simulation
Implementation
Checklist
BasicGraphing
Techniques
Control
CONTROL PHASE
Control
Determine
ProcessControl
Plan
Recognize/
Reward
Finalize
Financial
Estimates
Full
Implementation
ControlPhaseSteps
1. DetermineProcessControlPlan
o PilotImplementation
o FullImplementation
2. Recognize/RewardTeam
3. FinalizeROI
4. PlanforFullImplementation
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CONTROL TOOLS
Step
Determine
ProcessControl
Plan
ProcessControl
Plan
Recognize/
Reward
Recognize
Improvement
Achieved
Finalize
Financial
Estimates
ROITool
Full
Implementation
Tool
Project
Management
Full
Implementation
Plan
WhatisaProcessControlStrategy?
o
Realtimemonitoringofoutput
metricsfollowingimplementation
Why?
o
Quantifytheimpactofprocessimprovements
Providerealtimenotificationifprotocol
compliancedriftsbelowtargets
Identifyadditionalopportunitiesforprocess
improvement
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Performance/OutcomesMeasures
HighLevelProcessMeasures
Measurementofsystem/facilityperformance
Measurementoftheprocessperformance
Moresensitivethanoutcomesmeasures
LowLevelProcessMeasures
o
Measurementofsubprocessperformance
UsedforPDSApre/postmeasures
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CONTROL PHASE
Step1:EstablishControlPlans
Aplanforimmediateandlongtermcontrolofthe
processKPIVs/KPOVs.
Frequencyofcontroliscritical.
o
Pilotrecommendation: measureveryfrequently
(hourly/daily)
FullImplementationrecommendation: Reduce
frequencyasprocessstabilizes.
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CONTROL PHASE
Step2:Reward/RecognizeTeam
Prepilotrecognition
o
Celebrateprojecttrainingcompletion
Buildmomentumandenthusiasmforpilot
implementation
Ideas:
TrainingCompletionCertificate
Lunch
Others??
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CONTROL PHASE
Step2:Reward/RecognizeTeam:
Postpilotrecognition
o
CelebratePilotSuccess
Buildmomentumforfullimplementation
Includeallparticipants,notjustteammembers
Ideas:
Resultsmeetingwithcake
Apparelwithprojectlogo
Others??
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CONTROL PHASE
Step3:Finalizethecostbenefitanalysis:
Documenttheactualandpotentialbenefits.
ROIAnalysisTool
Step4:FullImplementationPlan:
CompleteFullImplementationChecklist
Findadditionalapplicationswithinthe
organization.
BestKnownMethods(BKMs)
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CONTROL PLANS
WhatisaControlPlan?
KeepScore Establishprocessmeasuresthat
enable:
o
RealTime,ImmediateFeedback
Pilot:Daily/ShiftFeedback
LongTerm:Daily/WeeklyFeedback
Establishregularmeetings(daily/weekly)toreview
pilotprocessperformance
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NotethatallKPOVswheresolutionswereapplied
shouldbemonitoredaspartofthecontrolplan.
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http://www.dmaictools.com/wpcontent/uploads/2011/12/controlplancomplete3.png
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http://www.sixsigmamaterial.com/images/ControlPlanSample.GIF
IMPLEMENTATION PLAN
Theimplementationplanisbasedaroundthefuture
statemapandshouldincludeadetailedlistingof:
o Activities
o Costs
o Expecteddifficulties
o Schedules
o Resourcesneeded
o Responsibilities
o Plusanyotherinformationneededto
implementthechanges
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Ongoingfrequentmeasurementandreporting
o
Positivereinforcementforhighperformance
Accountabilityforlowperformance
Strongleadershipcommitmentandsupport
EarlyAdopter/championforeachunitinvolved
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WHAT is SUSTAINABILITY?
Definition:Thepersistenceofperformance
improvementovertime.
Philosophy:Thefirstruleofsustainabilityisto
alignwithnaturalforces,oratleastnottrytodefy
them.PaulHawken(author,environmentalistand
entrepreneur).
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EVALUATING SUSTAINABILITY
Excellent:Fullyimplemented,sustainedtogoalfor
greaterthan12months
Good:Significantorpartialimplementation,
sustainedtogoalforgreaterthan6months
Fair:Someimplementationoccurred,butdidnot
sustaintogoalforgreaterthan3months
Poor:NoImplementation,and/ordidnotmeetgoal
foratleast3monthsfollowingimplementationor
othersustainabilityissues
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SUSTAINABILITY EXAMPLE
Ventilator
Associated
Pneumonia
Standardized
protocols,education
andordersetsinplace
32
Weaningprotocol
withRTdriven
algorithm
implemented
Multidisciplinary
roundswithdaily
feedbacktostaff
Scaleschangedto
makebedangle
easiertodetermine
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Whatdoesthis
processlooklike
threemonths
later?
34
SUSTAINABILITY STRATEGIES
Maketheprocessasintuitiveaspossible
Thenaturaldefaultistherightaction thepathofleast
resistanceleadstotherightaction
Changeshouldbedrivenfromthelowestlevelpossible
withintheorganization
Changeshouldbegradual,beginningwiththelowestlevels
ofimplementationcomplexityandmigratingtohigher
levelsover46weeks
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Processperformancedatashouldbepresentedtothe
frontlinestaffmembersonaregularbasis(dailyis
preferred,reducingfrequencyasprocessstabilizes)
Performancemetricsshouldbemonitored.Supervisors
andfrontlinestaffmembersheldaccountabletolow
performanceandrecognized/rewardedforhigh
performance
Makesureeveryoneknowsaboutsuccesses
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TEST of SUSTAINABILITY
Mustansweryestothesequestions:
Istheimprovementbasedonarobust/reliableprocess?
Istheimprovementdrivenbythepeopleclosesttothe
process(es)?
Haveyouconductedsmallincrementaltestsofchange?
Haveinvolvedstaffreceivedregular(daily)feedback?
Haveperformancemetricsbeenmonitored?
Frontlinestaffandsupervisorsrecognized/praisedfor
highperformanceandheldaccountableforlow
performance?
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TheGoalisOwnership notBuyIn
HowtocreateOwnership:
Frontlinestaffinvolvementintheprocess.
Letstaffdecideonchanges notanoutsider.
Giveteamsthetoolsandencouragesolutions.
Involveasmanypeopleaspossibleinthetests
ofchange.
Makeownersaccountable.
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SPREAD
Theworkisnotdoneuntileveryoneiseither
followingthenewsystemorintheprocessof
improvingthenewsystem.
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SPREADING IMPROVEMENT
WhatisSpread?
o
Theapplicationoftoolsandtechniquesoutsideof
theoriginalprojectfocusarea
TheSpreadChallenge
o
Goingfromproofofconceptsuccessstoriesto
widescaleadoption
Organizationalbarriersareformidable
Rateofadoptionrestson:
o
Perceptionsoftheinnovation
Individualreadinessforchange
Organizationalculture
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SPREADING IMPROVEMENT
Characteristicsinfluencingspreadability
o
Clarityofadvantageforchange
Compatibilitywithcurrentsystem
Easeoftestingandimplementing
Visibilityofimpact
Visibilityofleadershipsupport
Frequentmeasurementandfeedback
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TESTS of SPREADABILITY
Mustansweryestothesequestions
Istherededicatedstafftotestinnewunit?
Isstafftimemadeavailabletoparticipateintesting?
Isthereleadershipcommitmentandsupport?
Arestaffmotivatedtomakethechange?
Willanimprovement
methodologybeused?
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Spreadshouldtakeplaceonlyaftertheinitialchangehasbeenwelltestedandimplementedinthepilotunit.
UseofapprovedProtocolsforInpatientWarfarinTherapyforOrthopedicPatientsonUnitA
Organization Team:
Areafor
Spread
OrthoUnitA
ReadinesstoChange*
(H,M,L)
OpinionLeaders
whocanaidspread
CommunicationPlan
ListSpreadBarriersand
withOpinion
SupportNeededtoOvercome
Leaders
Seeatmeeting
Timetoeducatestaffnurses.
Dr.Smith,OrthopedicSurgeon
Invitetolunch
NurseManager,Unit
Friendship
Relationship
ObtainsupportfromNurse
Managertoeducatenurses
duringshiftchange
*RatingStaffReceptivitytoChange(High,Medium,Low)
Thereisaclearadvantagetothechangecomparedtocurrentwayofdoingthingsespeciallyfor
thosedirectlyimpactedbythechange
Thechangeiscompatiblewiththecurrentsystemandvalues
Thechangeissimpleandeasytoimplement
Thechangewaseasytotest
Theimpactofthechangewasobservable(canplaceonaStoryboard)
ActionPlanforSpread
Scheduletimeforstaffnurseson
UnitAtomeetwithopinion
leadersfromUnitA
ArrangeforEducationstaffto
assistwithmaterialdevelopment
Terms
Testing
Achangetodetermineifthechangeisanimprovement.There
maybefourorfivecyclesoftestingneeded.Testwiththree
patientsorthreephysicians.Testunderdifferentcircumstances,
e.g.evenings,nightsandweekends.
Implementation
Takesplacewhentestingiscompletedandtheteamagreesthat
thechangewillbehowcareisprovided.
Thereisleadershipsupporttopromotethechangemakingspreadeasier
Spread
Takingatestedandimplementedinterventionfromtheoriginal
Thereisameasurementtotrackoutcomesofchangesandrateofspread
testareaorpilotunittoanewarea.Spreadshouldnotbefroma
Thereisfeedbackforaccountability,toencourageandsupportthoseinvolvedinmakingchanges,
pilotunit/populationtotheentirehospital.Thechangeshould
andtorefinetheprocessifneeded
betestedineachareatodetermineifadjustmentsareneeded.
Insomecases,adjustmentsmadeonaspreadunitmaybean
improvementforallareas.
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http://www.indianapatientsafety.org/images/Toolkit%20read%20only.pdf
EVALUATING SPREAD
Excellent: Principlesspreadtootherunitswithno
outsideassistance
Good:Principlesspreadtootherunitswithminimal
outsideassistance
Fair:Someevidenceofapplicationbeyondinitial
projectarea
Poor:Noevidenceofapplicationbeyondtheinitial
projectarea
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Manyorganizationscreateprojectdatabasestoserve
asrepositoriesofLeanSixSigmaprojectresults.If
thisisthecase,theprojectreportandtheassociated
documentationwillneedtofollowtherepositorys
specificrequirements.
Amajorpurposeofawelldocumentedfinalreportis
tomakesurethattheimprovementrationaleis
availableforfutureemployeesandtointerested
parties.
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Developaplanfortrackingtheoccurrenceof
problems
Developthebasisfor
decidingtheneedfor
furtherimprovement
initiativesinthefuture
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COMPLETE THE A3
Attheminimuminclude:
Futurestateprocessmap.
Maincontrolcharts,andothercharts,thatwillbe
usedformonitoringtheprocess.
Estimatedfiguresonperformanceimprovement
andsavings.
Listofteammembersandthenameoftheowner
ormanageroftheimprovedprocess.
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Assignment:
Presentation#4Improve/ControlPhase
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