An Introduction to Lean Six Sigma Welcome! Thank you for joining! Sound for the webinar will come through your computer speakers. Please feel free to submit your questions throughout the webinar using the chat feature. We will start momentarily. March 11, 2015 Wanda Williams, LSSBB Tacoma-Pierce County Health Department Moderated by Laura Arena, MPH QUALITY IMPROVEMENT TOGETHER.
Lean Six Sigma AN INTRODUCTION 2
Topics in this Session Brief history of quality improvement. What is Lean, Six Sigma, and Lean Six Sigma? Benefits of Lean Six Sigma. Introduction to DMAIC method. Compare Plan-Do-Study-Act (PDSA) cycle with DMAIC method. Examples from the field. Test your knowledge quiz. 3
History of Quality Improvement Walter A. Shewhart W. Edwards Deming Joseph J. Juran Philip Crosby Motorola 1920 s 1940 s 1950 s 1970 s 1980 s 1990 s Genichi Taguchi Toyota Motor Company Kaoru Ishikawa Taiichi Ohno Shigeo Shingo 4
Approaches to Quality Quality Approach Approximate time frame Quality Circles 1979-1981 Statistical Process Control Mid-1980s ISO 9000 1987 - present Reengineering 1996-1997 Benchmarking 1988-1996 Balanced Scorecard 1990s - present Baldrige Award Criteria 1987 - present Six Sigma 1995 - present Lean Manufacturing 2000 - present Lean Six Sigma 2002 - present 5
Key Concepts of Quality Process focus. Customer focus. Collaboration. Data driven management. Strategic planning for quality. 6
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WHAT is Lean? Systematic approach. Set of principles and practices. Way of thinking. 8
Lean Focuses on: Eliminating waste and non-value-added activities. Maximizing the value delivered to customers. Optimizing flow of products and services. 9
WHAT is value? Customer wants you to do it. The material or information is being transformed to final product or service. It is done right the first time. 10
WHAT is waste? Waste 1. Overproduction 2. Inventory 3. Transportation 4. Waiting 5. Motion 6. Over Processing 7. Correction or Rework 11
WHAT is Lean? Definition: A systematic approach to identifying and eliminating waste through continuous improvement by flowing the product or service at the pull of the customer in pursuit of perfection. Defined by National Institute of Standards and Technology (NIST) 12
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WHAT is Six Sigma? Philosophy Set of tools Methodology Metrics 14
Six Sigma Focuses on: Putting customers first. Reducing process variation. Enhancing process control. 15
WHAT is Six Sigma? Definition: A fact-based, data-driven philosophy of improvement that values defect prevention over defect detection. It drives customer satisfaction and bottomline results by reducing variation and waste, thereby promoting a competitive advantage. It applies anywhere variation and waste exist, and every employee should be involved. Defined by American Society of Quality (ASQ) 16
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WHAT is Lean Six Sigma? Method Engine Mindset Toolkit 18
Lean Six Sigma Focuses on: Delighting customers with speed and quality. Improving processes. Working together for the greater good. Basing decisions on data and facts. 19
WHAT is Lean Six Sigma? Definition: A fact-based, data-driven philosophy of improvement that values defect prevention over defect detection. It drives customer satisfaction and bottom-line results by reducing variation, waste, and cycle time, while promoting the use of work standardization and flow. It applies anywhere variation and waste exist, and every employee should be involved. Defined by American Society of Quality (ASQ) CONTROL IMPROVE DEFINE lean ANALYZE MEASURE 20
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WHY would you use Lean Six Sigma? Manage quality into the business process. Meet or exceed customer needs or requirements. Improve performance and effectiveness. Transform your organizational culture. 22
WHEN would you use Lean Six Sigma? Customers still complain about your products or services. Employees complain about the roadblocks to serving customers. Everyone blames the customers and/or employees. 23
Improvement Methods 24
PDSA Cycle Also called Plan-Do- Check-Act (PDCA) cycle Four-step model for carrying out change ACT PLAN DO STUDY 25
PDSA Cycle Recognize an opportunity and plan a change. PLAN ACT DO STUDY 26
PDSA Cycle Test the change. Carry out a smallscale study. PLAN ACT DO STUDY 27
PDSA Cycle Review the test. Analyze the results. Identify what you learned ACT PLAN DO STUDY 28
PDSA Cycle Take action based on what you learned. Use what you learned to plan new improvements. Begin cycle again. ACT PLAN DO STUDY 29
DMAIC Method Pronounced Duh-MAYick Structured problemsolving methodology Uses project management and statistical tools for each phase DEFINE MEASURE ANALYZE IMPROVE CONTROL Define the problem + what is required to satisfy customers Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem Sustain the improved results 30
DMAIC Method DEFINE Define the problem + what is required to satisfy customers MEASURE ANALYZE IMPROVE Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 31
DMAIC Method DEFINE Define the problem + what is required to satisfy customers MEASURE ANALYZE IMPROVE Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 32
DMAIC Method DEFINE Define the problem + what is required to satisfy customers MEASURE ANALYZE IMPROVE Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 33
DMAIC Method DEFINE Define the problem + what is required to satisfy customers MEASURE ANALYZE IMPROVE Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 34
DMAIC Method DEFINE Define the problem + what is required to satisfy customers MEASURE ANALYZE IMPROVE Map the current process to collect data Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 35
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STEPS to DMAIC Method PHASE 1: DEFINE Team and sponsors reach agreement: what the project is what it should accomplish Project team focus: Complete analysis of what the project should accomplish Confirm understanding with sponsor(s) 37
STEPS to DMAIC Method PHASE 2: MEASURE Project team focus: What is causing the problem to happen Collect data to answer question(s) Narrow down the problem Whatcom County Health Department 1000 900 800 700 600 500 400 300 200 100 0 32% WIC Nutrition Program - 2012 No Show per Appointment Type/ Whatcom CHD 54% Pareto Chart 74% 88% Second Contact Check Pickup Recertification Health Assessment 100% Registered Dietitian 120% 100% 80% 60% 40% 20% 0% Marc Findings: Analysis of all appointment types for the year 2012 show that the top five are Second Contact, Check Pick-up, Recertification, Health Assessment, and Registered Dietitian. Of these five appointment types: Second Contact, Check Pickup, and Recertification comprise 74% of the no shows. 38
STEPS to DMAIC Method PHASE 3: ANALYZE Project team focus: Identify the root causes for problem(s) Agency Customer Experience Employee 39
STEPS to DMAIC Method PHASE 4: IMPROVE Project team focus: Verify root causes Identify solutions & practical method Test and evaluate effectiveness and feasibility of proposed solution Implement permanently 40
STEPS to DMAIC Method PHASE 5: CONTROL Project team focus: Verify how much improvement was made, if any at all Confirm root causes have been reduced Implement fully Review indicators/measures from DEFINE phase Incorporate solutions into daily work Monitor process 41
How do they compare? 42
Comparison of methods DEFINE Define the problem + what is required to satisfy customers PLAN MEASURE Map the current process to collect data ANALYZE IMPROVE Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 43
Comparison of methods DEFINE Define the problem + what is required to satisfy customers MEASURE Map the current process to collect data DO ANALYZE IMPROVE Investigate and identify what causes the problem Implement a fix that will solve the problem CONTROL Sustain the improved results 44
Comparison of methods DEFINE Define the problem + what is required to satisfy customers MEASURE Map the current process to collect data STUDY ANALYZE IMPROVE CONTROL Investigate and identify what causes the problem Implement a fix that will solve the problem Sustain the improved results 45
Comparison of methods DEFINE Define the problem + what is required to satisfy customers MEASURE Map the current process to collect data ANALYZE IMPROVE Investigate and identify what causes the problem Implement a fix that will solve the problem ACT CONTROL Sustain the improved results 46
Comparison of methods DEFINE Define the problem + what is required to satisfy customers PLAN MEASURE Map the current process to collect data DO STUDY ACT ANALYZE IMPROVE CONTROL Investigate and identify what causes the problem Implement a fix that will solve the problem Sustain the improved results 47
PRINCIPLES to Lean Six Sigma Focus on the customer. Identify and understand how work gets done. Manage, improve and smooth the process flow. Remove non-value-adding steps and waste. Manage by fact and reduce variation. Involve and equip the people in the process. Undertake improvement activity in a systematic way. 48
From the field 49
Two Black Belts Nine Green Belts Ten White Belts Tacoma-Pierce County Health Department Roles & Responsibilities 50
Tacoma-Pierce County Health Department Quality Structure 51
Tacoma-Pierce County Health Department Quality Kanban 52
Tacoma-Pierce County Health Department Managing projects 53
Tacoma-Pierce County Health Department Managing projects 54
Tacoma-Pierce County Health Department Managing projects 55
TEST YOUR KNOWLEDGE Lean Six Sigma is a a) Mindset for solving problems b) Method for solving problems c) Toolkit for solving problems d) All of the above 56
TEST YOUR KNOWLEDGE Lean Six Sigma can help you solve problems with a) Delays b) Errors c) Variation d) All of the above 57
Wanda Williams, LSSBB Tacoma-Pierce County Health Department 253-719-3680 WWilliams@tpchd.org Defeo, Joseph (2014-05-09). Juran's Quality Essentials: For Leaders. McGraw-Hill Education. Kindle Edition. George, M., & Rowlands, D. (2004). What is Lean Six Sigma? New York: McGraw-Hill. George, M. (2010). The lean six sigma guide to doing more with less cut costs, reduce waste, and lower your overhead. Hoboken, N.J.: John Wiley & Sons. George, M. (2005). The lean six sigma pocket toolbook: A quick reference guide to nearly 100 tools for improving process quality, speed, and complexity. New York: McGraw-Hill. isixsigma: Six Sigma Resources for Six Sigma Quality Web site: www.isixsigma.com Kubiak, T., & Benbow, D. (2009). The certified six sigma black belt handbook (2nd ed.). Milwaukee, Wis.: ASQ Quality Press. Public Health Performance Management Centers for Excellence Web site: www.doh.wa.gov/phip/perfmgtcenters Womack, J., & Jones, D. (1996). Lean thinking: Banish waste and create wealth in your corporation (2nd ed.). New York, NY: Simon & Schuster WWW.PHCFE.ORG 58
WWW.PHCFE.ORG 59