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Deep & Wide Process

Spills are not acceptable.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Spill Data for GM Suppliers
350
Number of Spills

300 290

250
200
149
150
100 87

50
0
41
0
2000 2001 2002 2003 2004
Year

Our success depends on your


performance!
Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Recurrence Prevention Model

Drill Deep & Wide Workshop Training 5.0


Revision 5.0 03/08/04
Supplier Quality Model

Predict
Check/Act Plan
Planning process-
informational content
in FMEAs and CPs

Protect Prevent
Quality process- Manufacturing process -
containment
detection & & standardized work and
responsiveness error proofing

Do

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
SQ Recurrence Prevention Model
Problem on part

Why did the planning process

Issues
not predict the defect?
P1
Why? P2
Why? P3
Why? P4

Other Products
Why did the manufacturing Predict
process not prevent the Why? Pn Corrective Action
defect? M1
Predict Root Cause
Why? M2
Why? M3
Why? M4
Prevent
Why did the quality process
not protect GM from the Why? Mn Corrective Action
Q1
defect?
Prevent Root Cause
Why? Q2
Why? Q3
Why? Q4
Protect
Why? Qn Corrective Action

Protect Root Cause

Build the Base Drill Deep Drill Wide


(3x5Why) (Read Across)
Identify Metric & Predict Identify
Threshold (FMEA, PCP) Issues
Supplier Prevent Identify same
(Error Proofing, STW)
Identification Process
Protect
Toolbox (Error Detection, Implement
Application Responsiveness) Lessons

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Recurrence Prevention Model
Deep Investigation
Spills (Drill Deep analysis)

Wide
Implementation
(Read Across)

Emerging Emerging
Prevention Launch Issues Current Issues
should
start here
Functional Build
Issues Plant Issues

Supplier Process Issues


Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Recurrence Prevention Model

Spills
Spills / MD
Repeat EIs

Critical Suppliers for


Potential Spill
Emerging Emerging
Launch Issues Current Issues

Chronic Suppliers
Functional Build
Issues Plant Issues

All Suppliers
Supplier Process Issues
Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Drill Deep Training

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Analysis
What is the intent of the Drill Deep analysis?
Why did the planning process not predict
the defect?
Why did the manufacturing process not
prevent the defect?
Why did the quality process not protect
GM from the defect?

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Analysis
Key Points:
Drill Deep Analysis is not used to
understand what failed but rather why
the system failed.
Therefore, the technical root cause (i.e.,
the Red X in suppliers process) should be
known before the Drill Deep Worksheet is
completed.
3 x 5 Why <--> Drill Deep Analysis

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Visual
Defect on Part

Why did the planning process


not predict the defect? P1
Why? P2
Why? P3
Why did the manufacturing
Why? P4 Predict
process not prevent the Why? Pn Corrective Action
defect?
M1
Predict Root Cause
Why? M2
Why? M3
Why? M4
Prevent
Why did the quality process
not protect GM from the Why? Mn Corrective Action
defect?
Q1
Prevent Root Cause
Why? Q2
Why? Q3
Why? Q4
Protect
Why? Qn Corrective Action

Protect Root Cause

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Drill Deep Worksheet

Date: 02/24/04

GM Form 1927-84
Issue title: Product XYZ Fuel Tank Rollover Valve Assembly

Customer concern: Loose parts found in Product XYZ fuel tanks. PRR# 30011223-989898.

Defect on part: End cap not fully seated into window on valve.

5 Whys Corrective Action Owner Due Date


RPN number was not determined
P1
Why did the planning process not properly in PFMEA.
predict the defect? Occurrence and detection ratings
P2
were not determined properly.

P3

Predict P4
Planning process -
inf orm at ional cont ent P5
in FM EAs and CPs
FMEA training plan to be developed
Inadequate knowledge of FMEA
P-RC and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect? Positive stops were not adjusted
M2 correctly for the new, low permeation
family insert.
Control Plan was not updated to
Prevent M3 indicate recalibration for new family
insert.
M anuf act uring process - Manufacturing was not aware of a
st andardized w ork and M4
new family insert.
error proof ing
Poor communication between
M5 Product Development &
Manufacturing on design change.

Supplier XYZ Launch Planning Re-train employees and implement a


M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.

No detection error-proofing for "end


Q1
Why did the quality process not cap fully seated".
protect GM from the defect?
Q2

Q3

Prot ect Q4
Qualit y process -
det ect ion & Q5
responsiveness
False sense of security in error Re-evaluate prevention error-proofing
Q-RC proofing prevention of positive stops process and implement detection J. Smith 03/15/04
in tooling. error-proofing process.
Engineering change management Develop regular change control
What are the key findings based on K1 J. Smith 03/31/04
execution. meetings with entire team.
this quality issue and the above 5
Why analysis? Develop Supplier Change Request
K2 PPAP / PTR execution. J. Smith 03/31/04
audit process.
Re-evaluate prevention error-proofing
Insufficient error-proofing
K3 process and implement detection J. Smith 03/31/04
incorporated into valve assembly.
error-proofing process.
FMEA training plan to be developed
Inadequate knowledge of FMEA
K4 and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

K5

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Only add a corrective action next to each "Why" if applicable. Keep in mind that
the last "Why" needs a corrective action with an owner and a completion date.
Also, there can be more than one corrective action for a root cause and the
corrective action should include some form of verification or "Check".
Adjust row height as necessary.

5 Whys Corrective Action Owner Due Date

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect? Positive stops were not adjusted
M2 correctly for the new, low permeation
family insert.
Control Plan was not updated to
Prevent M3 indicate recalibration for new family
insert.
M anuf act uring process - Manufacturing was not aware of a
st andardized w ork and M4
new family insert.
error proof ing
Poor communication between
M5 Product Development &
Manufacturing on design change.

Supplier XYZ Launch Planning Re-train employees and implement a


M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Insert due date for
implementing each
Insert owner for corrective action.
implementing each
corrective action. Format MM/DD/YY.

5 Whys Corrective Action Owner Due Date

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect? Positive stops were not adjusted
M2 correctly for the new, low permeation
family insert.
Control Plan was not updated to
Prevent M3 indicate recalibration for new family
insert.
M anuf act uring process - Manufacturing was not aware of a
st andardized w ork and M4
new family insert.
error proof ing
Poor communication between
M5 Product Development &
Manufacturing on design change.

Supplier XYZ Launch Planning Re-train employees and implement a


M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Perform the 5 Why to the right. The first question to ask and Enter each why below. Insert a
answer to begin the Prevent 5 Why is the following: row for each additional why if
applicable.
Why did the manufacturing process not prevent the defect?
As a sense check, read the Whys
Example: backwards to make sure that the
Why did the manufacturing process not prevent the end cap analysis make sense.
not fully seated into window on the valve? Adjust row height as necessary.

Why? 5 Whys Corrective Action Owner Due Date

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect?
Why? Positive stops were not adjusted
M2 correctly for the new, low permeation
family insert.
Why? Control Plan was not updated to
Prevent M3 indicate recalibration for new family
insert.
M anuf act uring process - Why? Manufacturing was not aware of a
st andardized w ork and M4
new family insert.
error proof ing
Why?M5 Poor communication between
Product Development &
Manufacturing on design change.
Why?
M-RC
Supplier XYZ Launch Planning Re-train employees and implement a
J. Smith 03/31/04
System was not followed. layered audit of planning process.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Perform the 5 Why to the right. The first question to ask and Enter each why below. Insert a
answer to begin the Prevent 5 Why is the following: row for each additional why if
applicable.
Why did the manufacturing process not prevent the defect?
As a sense check, read the Whys
Example: backwards to make sure that the
Why did the manufacturing process not prevent the end cap analysis make sense.
not fully seated into window on the valve? Adjust row height as necessary.

5 Whys Corrective Action Owner Due Date

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect? Positive stops were not adjusted
Therefore. .
M2 correctly for the new, low permeation
family insert.
.
Control Plan was not updated to
Therefore. .
Prevent M3 indicate recalibration for new family
insert.
.
M anuf act uring process - Manufacturing was not aware of a
Therefore. .
st andardized w ork and M4
error proof ing
new family insert.
.
M5
Poor communication between
Product Development &
Therefore. .
Manufacturing on design change. .
Supplier XYZ Launch Planning Therefore. .
Re-train employees and implement a
M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.
.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Also, keep in mind that the technical root cause
(i.e., Red X in suppliers process) should be
captured in the Prevent 5 Why as shown below.

5 Whys Corrective Action Owner Due Date

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
Does not have to
not prevent the defect?
M2
Positive stops were not adjusted
correctly for the new, low permeation
be 5 Whys - ask as family insert.

many Whys as Control Plan was not updated to The last "why" is the underlying
Prevent M3 indicate recalibration for new family
insert. Root Cause. Please add a
necessary.
M anuf act uring process - Manufacturing was not aware of a
st andardized w ork and M4
new family insert. corrective action, owner, and
error proof ing
Poor communication between date to the right.
M5 Product Development &
Manufacturing on design change.

Supplier XYZ Launch Planning Re-train employees and implement a


M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Similar question can be asked for the Predict portion:
Why did the planning process not predict the defect?
Example:
Why did the planning process not predict the end cap not fully
seated into window on the valve?

Why? 5 Whys Corrective Action Owner Due Date


RPN number was not determined
P1
Why did the planning process not
Why?
properly in PFMEA. Therefore. .
predict the defect? Occurrence and detection ratings
P2 .
were not determined properly.
Therefore. .
Why?P3
.
Predict P4
Planning process -
inf orm at ional cont ent P5
in FM EAs and CPs
FMEA training plan to be developed
Inadequate knowledge of FMEA
P-RC and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Similar question can be asked for the Protect portion:
Why did the quality process not protect GM from the defect?
Example:
Why did the quality process not protect GM from the end cap not
fully seated into window on the valve?

Why?
No detection error-proofing for "end
Q1
Why did the quality process not cap fully seated". Therefore. .
protect GM from the defect?Why?Q2
.
Q3

Prot ect Q4
Qualit y process -
det ect ion & Q5
responsiveness
False sense of security in error Re-evaluate prevention error-proofing
Q-RC proofing prevention of positive stops process and implement detection J. Smith 03/15/04
in tooling. error-proofing process.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Are there any other key findings? Review the 5 Why analysis
above to uncover any common themes and document them to
the right.
A corrective action, owner, and date needs to be added for each
key finding.
Adjust row as necessary.

Engineering change management Develop regular change control


What are the key findings based on K1 J. Smith 03/31/04
execution. meetings with entire team.
this quality issue and the above 5
Why analysis? Develop Supplier Change Request
K2 PPAP / PTR execution. J. Smith 03/31/04
audit process.
Re-evaluate prevention error-proofing
Insufficient error-proofing
K3 process and implement detection J. Smith 03/31/04
incorporated into valve assembly.
error-proofing process.
FMEA training plan to be developed
Inadequate knowledge of FMEA
K4 and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

K5

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Worksheet
Drill Deep Worksheet

Date: 02/24/04

Issue title: Product XYZ Fuel Tank Rollover Valve Assembly

Customer concern: Loose parts found in Product XYZ fuel tanks. PRR# 30011223-989898.

Defect on part: End cap not fully seated into window on valve.

5 Whys Corrective Action Owner Due Date


RPN number was not determined
P1
Why did the planning process not properly in PFMEA.
predict the defect? Occurrence and detection ratings
P2
were not determined properly.

P3

Predict P4
Planning process -
inf orm at ional cont ent P5
in FM EAs and CPs
FMEA training plan to be developed
Inadequate knowledge of FMEA
P-RC and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

M1 Cylinder did not travel to full insertion.


Why did the manufacturing process
not prevent the defect? Positive stops were not adjusted
M2 correctly for the new, low permeation
family insert.
Control Plan was not updated to
Prevent M3 indicate recalibration for new family
insert.
M anuf act uring process - Manufacturing was not aware of a
st andardized w ork and M4
new family insert.
error proof ing
Poor communication between
M5 Product Development &
Manufacturing on design change.

Supplier XYZ Launch Planning Re-train employees and implement a


M-RC J. Smith 03/31/04
System was not followed. layered audit of planning process.

No detection error-proofing for "end


Q1
Why did the quality process not cap fully seated".
protect GM from the defect?
Q2

Q3

Prot ect Q4
Qualit y process -
det ect ion & Q5
responsiveness
False sense of security in error Re-evaluate prevention error-proofing
Q-RC proofing prevention of positive stops process and implement detection J. Smith 03/15/04
in tooling. error-proofing process.
Engineering change management Develop regular change control
What are the key findings based on K1 J. Smith 03/31/04
execution. meetings with entire team.
this quality issue and the above 5
Why analysis? Develop Supplier Change Request
K2 PPAP / PTR execution. J. Smith 03/31/04
audit process.
Re-evaluate prevention error-proofing
Insufficient error-proofing
K3 process and implement detection J. Smith 03/31/04
incorporated into valve assembly.
error-proofing process.
FMEA training plan to be developed
Inadequate knowledge of FMEA
K4 and monthly FMEA layered audit J. Smith 03/15/04
methodology.
review to be implemented.

K5

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep Summary
Drill Deep Analysis is not used to
understand what failed but why the system
failed.
Technical root cause (i.e., the Red X in
suppliers process) should be known before
the Drill Deep Worksheet is competed.
3 x 5 Why <--> Drill Deep Analysis.
t+T+E =S +

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Read Across Training

Drill Deep & Wide Workshop Training 5.0


Revision 5.0 03/08/04
Read Across Matrix (Drill Wide)

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Read Across Work Instructions
Record the GM Owner
(I.e. Supplier Process Development
Record the Supplier Information Metallic, Chemical, Electrical)
or CS2 Provider name and information.

SUPPLIER: PQE/SQE:
Name: XYZ Corporation Name: Jane Quality
Location: Springfield Phone: 321-555-1212
Duns: 12345789 GM location / Provider
Contact Name: John Doe Contact Phone:
Contact Phone: 123-555-1212 E-mail: jquality@gm.com

E-mail: john.doe@xyzcorp.com

Eight Week Period: Due Date:

For CS2 provider


only

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Read Across Work Instructions
LEGEND Place a letter in each box for each line item that applies

Mark with an O for the Originating location Mark with an X all locations where the defect may occur

O Original Location
X Another Location which contains the same process
R Repeat Issues Mark with an R if the problem was repeated at another location
N/A Not Applicable
Completed & 3rd Party/GM verified
Completed & Supplier verified only
Not Completed

Color code each box that has a letter in it according to this scheme

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Read Across Work Instructions
Record the Date the Drill Deep Analysis
Create one line for each PRR issued Was completed

Record the PRR issuing location

Part Name & GM Assy.


Number Plant Customer Concern Defect on Part 5 Why Analysis

Widget
Module Florida Knob shy Knob not secure 1/3/2004
22609999

Part Name & GM Assy.


Number Plant Customer Concern Defect on Part 5 Why Analysis

Record the Part Name and full Part Number


Record the DEFECT on the part
Record the issue as
described by the plant

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Read Across Work Instructions
Identify the Corporate
Record the full PRR number Champion responsible to
ensure implementation of
Record the number of non conforming parts the corrective actions
Identified on the PRR

Identify the Type and Status of any


Controlled Shipping action initiated
as a result of this PRR

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Read Across Work Instructions
Identify all supplier DUNS locations with similar products and processes

Identify all lines


within each duns
where corrective
actions may apply.
Also identify new
Products to apply
Lessons Learned.

Use letter code with


appropriate color to
identify applicable
locations and status

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Root Cause Pareto

Drill Deep & Wide Workshop Training 5.0


Revision 5.0 03/08/04
Root Cause Matrix
PRR Predict Prevent Protect Key Findings
(Planning Procces) (Manufacturing (Quality Process)
Process)
20030805-000001 FMEA - corrective actions
1 ineffective Assembly - not connected No detection
20030806-000002 FMEA - corrective actions
2 ineffective Assembly - not connected No detection
20030807-000003 Poor validation - design,
3 FMEA - not included No detection Poor validation - design
20030807-000004 Poor validation - design,
4 FMEA - not included No detection Poor validation - design
Include all20030811-000005
PRRs
5 FMEA - detection too low Assembly - JI not followed No detection
20030811-000006 Transfer the Root Causes for Predict,
Poor validation - design,
6 Prevent and Protect from the
FMEA - not included 3x5 Drill
No detection Poor validation - design
20030813-000007
Deep Worksheets
Assembly - part to this form.
7 FMEA - occurrence too low backwards, JI not followed No detection
20030819-000008 FMEA - corrective actions Assembly - dropped
8 ineffective screw No detection
20030821-000009
Poor validation - pack, No detection - occurs after
9 FMEA - not included Packaging pack Poor validation - pack
20030821-000010
Poor validation - design,
10 FMEA - not included No detection Poor validation - design
20030822-000011 Repair procedure not
11 FMEA - not included followed No detection
12 20030825-000012 Procedure - repair
20030826-000013
13 FMEA - detection too low Include any Key Findings
Error proofing fault
20030829-000014 No detection - occurs after
14 Validation - pack Packaging pack

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Root Causes Grouped
Predict Prevent Protect
Planning Process Manufacturing Process Quality Process Key Findings
FMEA - corrective actions Work Instruction
ineffective not followed Measurement/CP Poor validation - design
FMEA - corrective actions
ineffective Assembly - dropped screw No checks in CP Poor design
FMEA - corrective actions
ineffective Assembly - dropped screw No controls Poor design validation
FMEA - corrective actions No controls - latent, caused in
ineffective Assembly - dropped screw vehicle Poor validation - design
FMEA - corrective actions Group Like Root Causes and
ineffective Assembly Key
- JI notFindings
followed withinNo
each
inspection Poor validation - design
FMEA - corrective actions
ineffective Assembly -Column.
JI not followedAccount for
Poorall PRRs
controls Poor validation - design
FMEA - corrective actions
ineffective Assembly - JI not followed Poor measurement Poor validation - design

Assembly - missing parts Poor validation - design

FMEA - detection too low Assembly - not connected No detection

FMEA - detection too low Assembly - not connected No detection


Assembly - part backwards, JI
FMEA - detection too low not followed No detection
Assembly - part dropped and
FMEA - detection too low mishandled No detection
Assembly - tape in wrong
FMEA - detection too low position No detection
Assembly - wrong part, material
FMEA - detection too low handling location wrong No detection

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Predict
Root Causes Grouped Prevent Protect
Planning Process Manufacturing Process Quality Process Key Findings
FMEA - corrective actions Work Instruction
ineffective not followed Measurement/ CP Poor validation - design
FMEA - correct ive act ions inef f ect ive Assembly - dropped screw No checks in CP Poor design
FMEA - correct ive act ions inef f ect ive Assembly - dropped screw No controls Poor design validat ion
FMEA - correct ive act ions inef f ect ive Assembly - dropped screw No cont rols - lat ent , caused in vehicle Poor validat ion - design
FMEA - correct ive act ions inef f ect ive Assembly - JI not f ollowed No inspect ion Poor validat ion - design
FMEA - correct ive act ions inef f ect ive Assembly - JI not f ollowed Poor controls Poor validat ion - design
FMEA - correct ive act ions inef f ect ive Assembly - JI not f ollowed Poor measurement Poor validat ion - design
Assembly - missing part s Poor validat ion - design
FMEA - detection too low Assembly - not connect ed No detection
FMEA - det ect ion t oo low Assembly - not connect ed No det ect ion
FMEA - det ect ion t oo low Assembly - part backwards, JI not f ollowed No det ect ion
FMEA - det ect ion t oo low Assembly - part dropped and mishandled No det ect ion
FMEA - det ect ion t oo low Assembly - t ape in wrong posit ion No det ect ion
FMEA - det ect ion t oo low Assembly - wrong part , mat erial handling locat ion wrong No det ect ion
FMEA - det ect ion t oo low No det ect ion
FMEA - det ect ion t oo low Machine Set Up/ PM No det ect ion
FMEA - det ect ion t oo low Excessive solder, no PM No det ect ion
Incorrect set up of t est er No det ect ion
FMEA - not included Insuf f icient solder due t o poor wash No det ect ion
FMEA - not included Machine cycle int erupted No det ect ion
FMEA - not included No det ect ion
FMEA - not included Material Handling No det ect ion
FMEA - not included Mat erial Handling - damage due t o rack design No det ect ion
FMEA - not included Mat erial Handling - nonconf orming product mishandled No det ect ion
FMEA - not included Poor Mat erial Handling No det ect ion
FMEA - not included Poor Mat erial Handling No det ect ion
FMEA - not included Mat erial Handling process not f ollowed No det ect ion
FMEA - not included No det ect ion met hod
FMEA - not included Packaging No detect ion, no visual cont rols
FMEA - not included Packaging No det ect ion
FMEA - not included Packaging
FMEA - not included Packaging No detection - occurs after pack
FMEA - not included Packaging No det ect ion - occurs af t er pack
FMEA - not included No det ect ion - occurs af t er pack
FMEA - not included Procedures No det ect ion - occurs af t er pack
FMEA - not included Procedure - mishandling
FMEA - not included Procedure - repair
FMEA-not included Procedure - repair Visual inspection
FMEA - not included Procedure not f ollowed Visual inspect ion
Procedure not f ollowed Visual inspect ion
FMEA - occurrence too low Repair procedure not f ollowed Visual inspect ion
FMEA - occurrence t oo low Drill Deep & Wide Workshop Training 5.0 Visual inspect ion Revision 5.0
FMEA - occurrence t oo low 03/08/04
FMEA - occurrence t oo low
Root Cause Pareto Charts
Predict Prevent
Planning / Documentation Manufacturing Process

RC 3 7 RC 1 6
RC 5 5 RC 5 4
RC 4 4 RC 2 2
RC 2 2 RC 3 1
RC 1 1 RC 4 1

Insert the Root Cause and the frequency


For all Groups from the previous Worksheet

Planning / Docum entation Manufacturing System

0 1 2 3 4 5 6 7 8 0 2 4 6 8

RC 3
RC 1

RC 5 RC 5

RC 4 RC 2

The charts will automatically be generated


RC 2 RC 3

RC 1 RC 4

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Protect
Root Cause Pareto Charts Key Findings
Quality System

RC 5 3 RC 1 4
RC 1 2 RC 3 2
RC 2 1 RC 2 1
RC 3 1
RC 4 1

Repeat, to create the Protect and Key Findings Charts

Quality System Key Findings

0 1 2 3 4 0 1 2 3 4 5

RC 5 RC 1

RC 1 RC 3

RC 2 RC 2

RC 3

RC 4

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Predict Prevent
Planning / Documentation Manufacturing System

0 5 10 15 20 25 0 5 10 15

Work
FMEA - not included Instruction
not follow ed

FMEA - detection too


low Procedures

FMEA - corrective Material


actions ineffective Handling

FMEA - occurrence too Machine Set


low Up/ PM

Protect
Packaging
Key
Quality System Key Findings

0 2 4 6 8
0 5 10 15 20 25

Poor validation - design


No detection

Measurement/CP

Visual
inspection

No detection -
occurs after
pack

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Systemic Issues Read
Across

Drill Deep & Wide Workshop Training 5.0


Revision 5.0 03/08/04
Supplier Name
Systemic Issues Read O Original Product Line and Location
Location X Product Line and Location with Similar Process

Across N/A Not Applicable


Complete and 3rd party / Verified
Complete & Supplier Verified Only
Not Completed

Plant 1

Plant 2

Plant 3

Plant 4

Plant 5
Issue Corrective Actions Champion Due Date

Predict

Prevent

Protect

Key Findings

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Predict Prevent The TOP Bar of each
Planning / Documentation Manufacturing System Pareto represents the
0 5 10 15 20 25 0 5 10
Systemic
15
Issues which
Work
will require an initial
FMEA - not included Instruction
not follow ed
Read Across
FMEA - detection too
low Procedures

FMEA - corrective Material


actions ineffective Handling

FMEA - occurrence too Machine Set


low Up/ PM

Protect
Packaging
Key
Quality System Key Findings

0 2 4 6 8
0 5 10 15 20 25

Poor validation - design


No detection

Measurement/CP

Visual
inspection

No detection -
occurs after
pack

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Supplier Name
Systemic Issues RA
XYZ Corporation O Original Product Line and Location
Location Springfield, ZX X Product Line and Location with Similar Process

Supplier identification Example N/A Not Applicable


Complete and 3rd party / Verified
Complete & Supplier Verified Only
Not Completed
Read Across to Each Plan

Plant 1

Plant 2

Plant 5
Issue Corrective Actions Champion Due Date

The highest
Departmental frequency root cause
Review,
Predict Failure Mode Not Included Doe 2/30/04 O x x
from each
On-line Pareto chart is transferred here.
workshop

Include the Key Finding

Prevent Work Instructions not Followed Cross training matrix Doe 2/30/04 O x x

Develop plan to add


Protect No Error Detection error detection to new Doe 2/30/04 O x x
N/Cs

Assign a Champion and record a due date


Peer Reviews and
Key Findings Poor Validation/Design Standardizes Validation Doe 2/30/04 O x x
Plan

Define the Corrective Actions for each Systemic Issue


Drill Deep & Wide Workshop Training 5.0 Revision 5.0
03/08/04
Deep & Wide Workshop

Drill Deep & Wide Workshop Training 5.0


Revision 5.0 03/08/04
Spill Prevention Workshop
Purpose:
Process to teach the supplier the purpose and method of deep
investigation of known quality issues and wide implementation of
lessons learned in order to prevent spills.

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Prework: Roadmap
Teach key person at the supplier the Drill Deep concept
Select 25 PRRs or quantity issued in the last 12 months
SQE and Supplier complete the Drill Deep for 25 PRRs
Choose 3 to teach Drill Deep and read across in workshop
(representative failure mode and good for read across)
Complete an initial read across for selected PRRs
Complete the root cause matrix (including the other 22 PRRs)

Workshop:
Go through the presentation material
Work one Drill Deep in detail and review two Drill Deep with team
Review the read across for all three PRRs
Group the root causes for all PRRs
Complete the 4 root cause pareto charts (predict, prevent, protect & key
findings)
Start the systemic issues read these across
Confirm the workshop deliverables were met and review follow-up items

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Workshop Flow Chart
PRR List / Issues
(25 or 12 months)
Perform Drill Deep
Analysis on all Issues

Implement Corrective Action for


individual PRR and Read Across

PREDICT PREVENT PROTECT Key Findings


Root Causes Root Causes Root Causes Root Causes

Group & Pareto Group & Pareto Group & Pareto Group & Pareto
All Root Causes All Root Causes All Root Causes All Root Causes

Implement Corrective Action for


Systemic Issues and Read Across

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04
Workshop Follow-Up
Review Completed Read Across for individual PRRs
Review Completed Systemic Issue Read Across
Regular review of PRR Read Across and Systemic Read
Across Matrix for Implementation Completion

Drill Deep & Wide Workshop Training 5.0 Revision 5.0


03/08/04

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