TECH

50800
QUALITY and PRODUCTIVITY in
INDUSTRY and TECHNOLOGY
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TECH 50800
QUALITY and PRODUCTIVITY in
INDUSTRY and TECHNOLOGY
Week14
LeanSixSigmaBasics:ControlPhase

Lean Six Sigma Control Phase

Introduction

LEAN SIX SIGMA PROCESS

Champion

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

LEAN SIX SIGMA TOOLS

Champion

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
6

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

Lean Six Sigma Control Phase

Process Control

PROCESS CONTROL STRATEGY

WhatisaProcessControlStrategy?
o

Realtimemonitoringofoutput
metricsfollowingimplementation

Why?
o

Quantifytheimpactofprocessimprovements

Providerealtimenotificationifprotocol
compliancedriftsbelowtargets

Identifyadditionalopportunitiesforprocess
improvement
9

TYPES of CONTROL MEASURES

Performance/OutcomesMeasures

HighLevelProcessMeasures

Measurementofsystem/facilityperformance

Measurementoftheprocessperformance

Moresensitivethanoutcomesmeasures

LowLevelProcessMeasures
o

Measurementofsubprocessperformance

UsedforPDSApre/postmeasures
10

CONTROL PHASE
Step1:EstablishControlPlans

Aplanforimmediateandlongtermcontrolofthe
processKPIVs/KPOVs.

Frequencyofcontroliscritical.
o

Pilotrecommendation: measureveryfrequently
(hourly/daily)

FullImplementationrecommendation: Reduce
frequencyasprocessstabilizes.
11

CONTROL PHASE
Step2:Reward/RecognizeTeam

Prepilotrecognition
o

Celebrateprojecttrainingcompletion

Buildmomentumandenthusiasmforpilot
implementation

Ideas:

TrainingCompletionCertificate

Lunch

Others??

12

CONTROL PHASE
Step2:Reward/RecognizeTeam:

Postpilotrecognition
o

CelebratePilotSuccess

Buildmomentumforfullimplementation

Includeallparticipants,notjustteammembers

Ideas:

Resultsmeetingwithcake

Apparelwithprojectlogo

Others??

13

CONTROL PHASE
Step3:Finalizethecostbenefitanalysis:

Documenttheactualandpotentialbenefits.

ROIAnalysisTool

Step4:FullImplementationPlan:

CompleteFullImplementationChecklist

Findadditionalapplicationswithinthe
organization.

BestKnownMethods(BKMs)
14

Lean Six Sigma Control Phase

Control and Implementation Plans

15

CONTROL PLANS
WhatisaControlPlan?

KeepScore Establishprocessmeasuresthat
enable:
o

RealTime,ImmediateFeedback

Pilot:Daily/ShiftFeedback

LongTerm:Daily/WeeklyFeedback

Establishregularmeetings(daily/weekly)toreview
pilotprocessperformance
16

CONTROL PLAN TEMPLATE

17

CONTROL PLAN EXAMPLE

Insert Control Plan

NotethatallKPOVswheresolutionswereapplied
shouldbemonitoredaspartofthecontrolplan.

18

CONTROL PLAN EXAMPLE

19
http://www.dmaictools.com/wpcontent/uploads/2011/12/controlplancomplete3.png

CONTROL PLAN EXAMPLE

20
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

21

FULL IMPLEMENTATION CHECKLIST

22

FULL IMPLEMENTATION CHECKLIST

(continued)

23

IMPLEMENTATION PLAN TEMPLATE

24

IMPLEMENTATION PLAN EXAMPLE

25

IMPLEMENTATION PLAN TEMPLATE

26

IMPLEMENTATION PLAN EXAMPLE

27

Lean Six Sigma Control Phase

Sustainability and Spread

28

SUSTAINABILITY and SPREAD

Improvementinitiativesmustbespecificallydesignedto
encouragesustainabilityandspread:

Ongoingfrequentmeasurementandreporting
o

Positivereinforcementforhighperformance

Accountabilityforlowperformance

Strongleadershipcommitmentandsupport

EarlyAdopter/championforeachunitinvolved
29

WHAT is SUSTAINABILITY?

Definition:Thepersistenceofperformance
improvementovertime.

Philosophy:Thefirstruleofsustainabilityisto
alignwithnaturalforces,oratleastnottrytodefy
them.PaulHawken(author,environmentalistand
entrepreneur).

30

EVALUATING SUSTAINABILITY
Excellent:Fullyimplemented,sustainedtogoalfor
greaterthan12months
Good:Significantorpartialimplementation,
sustainedtogoalforgreaterthan6months
Fair:Someimplementationoccurred,butdidnot
sustaintogoalforgreaterthan3months
Poor:NoImplementation,and/ordidnotmeetgoal
foratleast3monthsfollowingimplementationor
othersustainabilityissues
31

SUSTAINABILITY EXAMPLE
Ventilator
Associated
Pneumonia

Hagg, Woodbridge 2008

Standardized
protocols,education
andordersetsinplace

32

SUSTAINABILITY EXAMPLE (continued)

Weaningprotocol
withRTdriven
algorithm
implemented

Multidisciplinary
roundswithdaily
feedbacktostaff

Hagg, Woodbridge 2008

Scaleschangedto
makebedangle
easiertodetermine

33

Whatdoesthis
processlooklike
threemonths
later?

Hagg, Woodbridge 2008

SUSTAINABILITY EXAMPLE (continued)

34

SUSTAINABILITY STRATEGIES

Maketheprocessasintuitiveaspossible

Thenaturaldefaultistherightaction thepathofleast
resistanceleadstotherightaction

Changeshouldbedrivenfromthelowestlevelpossible
withintheorganization

Changeshouldbegradual,beginningwiththelowestlevels
ofimplementationcomplexityandmigratingtohigher
levelsover46weeks

35

SUSTAINABILITY STRATEGIES (continued)

Processperformancedatashouldbepresentedtothe
frontlinestaffmembersonaregularbasis(dailyis
preferred,reducingfrequencyasprocessstabilizes)

Performancemetricsshouldbemonitored.Supervisors
andfrontlinestaffmembersheldaccountabletolow
performanceandrecognized/rewardedforhigh
performance

Makesureeveryoneknowsaboutsuccesses

36

TEST of SUSTAINABILITY
Mustansweryestothesequestions:
Istheimprovementbasedonarobust/reliableprocess?
Istheimprovementdrivenbythepeopleclosesttothe
process(es)?
Haveyouconductedsmallincrementaltestsofchange?
Haveinvolvedstaffreceivedregular(daily)feedback?
Haveperformancemetricsbeenmonitored?
Frontlinestaffandsupervisorsrecognized/praisedfor
highperformanceandheldaccountableforlow
performance?

37

OWNERSHIP vs. BUYIN

TheGoalisOwnership notBuyIn

HowtocreateOwnership:

Frontlinestaffinvolvementintheprocess.

Letstaffdecideonchanges notanoutsider.

Giveteamsthetoolsandencouragesolutions.

Involveasmanypeopleaspossibleinthetests
ofchange.

Makeownersaccountable.
38

SPREAD
Theworkisnotdoneuntileveryoneiseither
followingthenewsystemorintheprocessof
improvingthenewsystem.

39

SPREADING IMPROVEMENT

WhatisSpread?
o

Theapplicationoftoolsandtechniquesoutsideof
theoriginalprojectfocusarea

TheSpreadChallenge
o

Goingfromproofofconceptsuccessstoriesto
widescaleadoption

Organizationalbarriersareformidable

Rateofadoptionrestson:
o

Perceptionsoftheinnovation

Individualreadinessforchange

Organizationalculture

40

SPREADING IMPROVEMENT

Characteristicsinfluencingspreadability
o

Clarityofadvantageforchange

Compatibilitywithcurrentsystem

Easeoftestingandimplementing

Visibilityofimpact

Visibilityofleadershipsupport

Frequentmeasurementandfeedback
41

TESTS of SPREADABILITY
Mustansweryestothesequestions
Istherededicatedstafftotestinnewunit?
Isstafftimemadeavailabletoparticipateintesting?
Isthereleadershipcommitmentandsupport?
Arestaffmotivatedtomakethechange?
Willanimprovement
methodologybeused?
42

SPREAD TEMPLATE EXAMPLE

CHAPTER5RESOURCETOOLA
SpreadingImprovementWorksheet(Example)
We Wish to Spread:

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.

43

http://www.indianapatientsafety.org/images/Toolkit%20read%20only.pdf

EVALUATING SPREAD
Excellent: Principlesspreadtootherunitswithno
outsideassistance
Good:Principlesspreadtootherunitswithminimal
outsideassistance
Fair:Someevidenceofapplicationbeyondinitial
projectarea
Poor:Noevidenceofapplicationbeyondtheinitial
projectarea
44

Lean Six Sigma Project

CloseOut

45

FINAL PROJECT REPORT

Manyorganizationscreateprojectdatabasestoserve
asrepositoriesofLeanSixSigmaprojectresults.If
thisisthecase,theprojectreportandtheassociated
documentationwillneedtofollowtherepositorys
specificrequirements.

Amajorpurposeofawelldocumentedfinalreportis
tomakesurethattheimprovementrationaleis
availableforfutureemployeesandtointerested
parties.
46

FINAL REPORT COMPONENTS

Champion:Abackgroundoftheprojectandthebasisof
itsselection
DefinePhase:ProjectCharter,VOC,SIPOC
MeasurePhase:PotentialKPOVsandKPIVs,baseline
measuresofperformanceandwaste,summariesofkey
results
AnalyzePhase:Resultsofstatisticaltestsand
conclusions,discoveryofflowimpediments,rootcause
analysesanddocumentation
(continuedonnextslide)

47

FINAL REPORT COMPONENTS

ImprovePhase:Finalproposal,rationale/analyses
supportingtherecommendations,costbenefitanalysis
oftheimprovedprocess,ImplementationPlan,new
processdocumentation
ControlPhase:ControlPlan,recommendederror
proofingfeatures

48

PLAN for CONTINUOUS IMPROVEMENT

Beforebeingdisbanded,theprojectteamshouldmake
thefollowingadditionalcontributiontohelpthefuture
employeeswhowillroutinelyruntheimprovedprocess:

Developaplanfortrackingtheoccurrenceof
problems

Developthebasisfor
decidingtheneedfor
furtherimprovement
initiativesinthefuture
49

COMPLETE THE A3
Attheminimuminclude:

Futurestateprocessmap.

Maincontrolcharts,andothercharts,thatwillbe
usedformonitoringtheprocess.

Estimatedfiguresonperformanceimprovement
andsavings.

Listofteammembersandthenameoftheowner
ormanageroftheimprovedprocess.
50

END OF WEEK 14 MATERIAL

Assignment:
Presentation#4Improve/ControlPhase
51