TECH50800QUALITYandPRODUCTIVITYinINDUSTRYandTECHNOLOGYBeforewebegin:

Turnonthesoundonyourcomputer.Thereisaudiotoaccompanythispresentation. Audiowillaccompanymostoftheonlinepresentation

materialsthroughoutthesemester.

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Week14LeanSixSigmaBasics:ControlPhase

TECH50800QUALITYandPRODUCTIVITYinINDUSTRYandTECHNOLOGY

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LeanSixSigmaControlPhaseIntroduction

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LEANSIXSIGMAPROCESS

PilotStudyImplementationPlan

Champion Define Analyze Improve Control

VoiceoftheCustomerAnalysis

CompleteProjectCharter

CurrentStateProcess

Map

CreateBasicKPOVGraphs

Develop/EvaluateSolutions

FutureStateProcess

Map

DetermineProcess

ControlPlanFinalizeKPIVs

FullImplement

ation

Recognize/Reward

FinalizeFinancialEstimates

IdentifyOpportunities

SelectProject

DetermineKPOVs

DataCollection

ExamineProcessand

Data

KPIVsVerified

SetTeamGroundRules

Measure Lean101

IdentifyWaste

Lean201

QuickHitImprovements

IdentifyConstraints

ExploitConstraints

LinkKPOVstoCTQs

LaunchProjectTeam

PotentialKPIVs

Identified

LinkKPIVstoKPOVs

InitialFinancialEstimates

Control4

LEANSIXSIGMATOOLS

VoiceoftheCustomerAnalysis

ProjectCharter

ProcessMapping

BasicStatistics

MeasurementSystemsAnalysis

AffinityDiagram

ProjectSelectionMatrix

CTQTree

CreateDataCollectionPlan

ProcessObservationWorksheet

SIPOC

GroundRulesWorksheet

BasicGraphingTechniques

SpaghettiDiagram

5S

VisualControls

LittlesLaw

TheoryOfConstraints

VariabilityPrinciple

CTQTreeIshikawaDiagram

AdvancedPivotTablesandCharts

AdvancedGraphingTechniques

KPIVAnalysis

PilotImplementationChecklist

ProcessModelingandSimulation

FutureStateProcessMap

SolutionMatrix

ImpactEffortMatrix

ProcessControlPlan

RecognizeImprovementAchieved

ROITool

ProjectManagement

ImplementationChecklist

ROITool

Champion Define Analyze Improve ControlMeasure Lean101 Lean201

Control

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ControlPhaseSteps1. DetermineProcessControlPlan

o PilotImplementationo FullImplementation

2. Recognize/RewardTeam3. FinalizeROI4. PlanforFullImplementation

CONTROLPHASEControl

DetermineProcessControl

Plan

FullImplementation

Recognize/Reward

FinalizeFinancialEstimates

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Step Tool

CONTROLTOOLSProcessControl

Plan

FullImplementation

Plan

RecognizeImprovementAchieved

ROITool

ProjectManagement

DetermineProcessControl

Plan

FullImplementation

Recognize/Reward

FinalizeFinancialEstimates

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LeanSixSigmaControlPhaseProcessControl

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WhatisaProcessControlStrategy?o Realtimemonitoringofoutput

metricsfollowingimplementation Why?

o Quantifytheimpactofprocessimprovementso Providerealtimenotificationifprotocol

compliancedriftsbelowtargetso Identifyadditionalopportunitiesforprocess

improvement

PROCESSCONTROLSTRATEGY

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Performance/OutcomesMeasureso Measurementofsystem/facilityperformance

HighLevelProcessMeasureso Measurementoftheprocessperformanceo Moresensitivethanoutcomesmeasures

LowLevelProcessMeasureso Measurementofsubprocessperformanceo UsedforPDSApre/postmeasures

TYPESofCONTROLMEASURES

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Step1:EstablishControlPlans Aplanforimmediateandlongtermcontrolofthe

processKPIVs/KPOVs. Frequencyofcontroliscritical.

o Pilotrecommendation: measureveryfrequently(hourly/daily)

o FullImplementationrecommendation: Reducefrequencyasprocessstabilizes.

CONTROLPHASE

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Step2:Reward/RecognizeTeam Prepilotrecognition

o Celebrateprojecttrainingcompletiono Buildmomentumandenthusiasmforpilot

implementation

o Ideas: TrainingCompletionCertificate Lunch Others??

CONTROLPHASE

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Step2:Reward/RecognizeTeam: Postpilotrecognition

o CelebratePilotSuccesso Buildmomentumforfullimplementationo Includeallparticipants,notjustteammemberso Ideas:

Resultsmeetingwithcake Apparelwithprojectlogo Others??

CONTROLPHASE

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Step3:Finalizethecostbenefitanalysis: Documenttheactualandpotentialbenefits. ROIAnalysisTool

Step4:FullImplementationPlan: CompleteFullImplementationChecklist Findadditionalapplicationswithinthe

organization. BestKnownMethods(BKMs)

CONTROLPHASE

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LeanSixSigmaControlPhaseControlandImplementationPlans

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WhatisaControlPlan? KeepScore Establishprocessmeasuresthat

enable:

o RealTime,ImmediateFeedbacko Pilot:Daily/ShiftFeedbacko LongTerm:Daily/WeeklyFeedback

Establishregularmeetings(daily/weekly)toreviewpilotprocessperformance

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CONTROLPLANS

CONTROLPLANTEMPLATE

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Insert Control Plan

NotethatallKPOVswheresolutionswereappliedshouldbemonitoredaspartofthecontrolplan.

CONTROLPLANEXAMPLE

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

CONTROLPLANEXAMPLE

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http://www.sixsigmamaterial.com/images/ControlPlanSample.GIF

CONTROLPLANEXAMPLE

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Theimplementationplanisbasedaroundthefuturestatemapandshouldincludeadetailedlistingof:

o Activitieso Costso Expecteddifficultieso Scheduleso Resourcesneededo Responsibilitieso Plusanyotherinformationneededto

implementthechanges

IMPLEMENTATIONPLAN

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FULLIMPLEMENTATIONCHECKLIST

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FULLIMPLEMENTATIONCHECKLIST(continued)

IMPLEMENTATIONPLANTEMPLATE

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IMPLEMENTATIONPLANEXAMPLE

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IMPLEMENTATIONPLANTEMPLATE

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IMPLEMENTATIONPLANEXAMPLE

LeanSixSigmaControlPhaseSustainabilityandSpread

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Improvementinitiativesmustbespecificallydesignedtoencouragesustainabilityandspread:

Ongoingfrequentmeasurementandreportingo Positivereinforcementforhighperformanceo Accountabilityforlowperformance

Strongleadershipcommitmentandsupport EarlyAdopter/championforeachunitinvolved

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SUSTAINABILITYandSPREAD

Definition:Thepersistenceofperformanceimprovementovertime.

Philosophy:Thefirstruleofsustainabilityistoalignwithnaturalforces,oratleastnottrytodefythem.PaulHawken(author,environmentalistandentrepreneur).

WHATisSUSTAINABILITY?

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Excellent:Fullyimplemented,sustainedtogoalforgreaterthan12months

Good:Significantorpartialimplementation,sustainedtogoalforgreaterthan6months

Fair:Someimplementationoccurred,butdidnotsustaintogoalforgreaterthan3months

Poor:NoImplementation,and/ordidnotmeetgoalforatleast3monthsfollowingimplementationorothersustainabilityissues

EVALUATINGSUSTAINABILITY

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Hag

g, W

oodb

ridge

200

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SUSTAINABILITYEXAMPLE

Standardizedprotocols,educationandordersetsinplace

VentilatorAssociatedPneumonia

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Hag

g, W

oodb

ridge

200

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SUSTAINABILITYEXAMPLE(continued)

Multidisciplinaryroundswithdailyfeedbacktostaff

Scaleschangedtomakebedangle

easiertodetermine

WeaningprotocolwithRTdrivenalgorithm

implemented

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Hag

g, W

oodb

ridge

200

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Whatdoesthisprocesslooklikethreemonths

later?

SUSTAINABILITYEXAMPLE(continued)

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Maketheprocessasintuitiveaspossible Thenaturaldefaultistherightaction thepathofleast

resistanceleadstotherightaction Changeshouldbedrivenfromthelowestlevelpossible

withintheorganization Changeshouldbegradual,beginningwiththelowestlevels

ofimplementationcomplexityandmigratingtohigherlevelsover46weeks

SUSTAINABILITYSTRATEGIES

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Processperformancedatashouldbepresentedtothefrontlinestaffmembersonaregularbasis(dailyispreferred,reducingfrequencyasprocessstabilizes)

Performancemetricsshouldbemonitored.Supervisorsandfrontlinestaffmembersheldaccountabletolowperformanceandrecognized/rewardedforhighperformance

Makesureeveryoneknowsaboutsuccesses

SUSTAINABILITYSTRATEGIES (continued)

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Mustansweryestothesequestions: Istheimprovementbasedonarobust/reliableprocess? Istheimprovementdrivenbythepeopleclosesttothe

process(es)?

Haveyouconductedsmallincrementaltestsofchange? Haveinvolvedstaffreceivedregular(daily)feedback? Haveperformancemetricsbeenmonitored? Frontlinestaffandsupervisorsrecognized/praisedfor

highperformanceandheldaccountableforlowperformance?

TESTofSUSTAINABILITY

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TheGoalisOwnership notBuyIn HowtocreateOwnership:

Frontlinestaffinvolvementintheprocess. Letstaffdecideonchanges notanoutsider. Giveteamsthetoolsandencouragesolutions. Involveasmanypeopleaspossibleinthetests

ofchange. Makeownersaccountable.

OWNERSHIPvs.BUYIN

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Theworkisnotdoneuntileveryoneiseitherfollowingthenewsystemorintheprocessofimprovingthenewsystem.

SPREAD

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WhatisSpread?o Theapplicationoftoolsandtechniquesoutsideof

theoriginalprojectfocusarea TheSpreadChallenge

o Goingfromproofofconceptsuccessstoriestowidescaleadoption

o Organizationalbarriersareformidable Rateofadoptionrestson:

o Perceptionsoftheinnovationo Individualreadinessforchangeo Organizationalculture

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SPREADINGIMPROVEMENT

Characteristicsinfluencingspreadabilityo Clarityofadvantageforchangeo Compatibilitywithcurrentsystemo Easeoftestingandimplementingo Visibilityofimpacto Visibilityofleadershipsupporto Frequentmeasurementandfeedback

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SPREADINGIMPROVEMENT

Mustansweryestothesequestions Istherededicatedstafftotestinnewunit? Isstafftimemadeavailabletoparticipateintesting? Isthereleadershipcommitmentandsupport? Arestaffmotivatedtomakethechange? Willanimprovement

methodologybeused?42

TESTSofSPREADABILITY

CHAPTER5RESOURCETOOLASpreadingImprovementWorksheet(Example)

Spreadshouldtakeplaceonlyaftertheinitialchangehasbeenwelltestedandimplemented inthepilotunit.We Wish to Spread: UseofapprovedProtocolsforInpatientWarfarinTherapyforOrthopedicPatientsonUnitAOrganization Team:

AreaforSpread

ReadinesstoChange*(H,M,L)

OpinionLeaderswhocanaidspread

CommunicationPlanwithOpinion

Leaders

ListSpreadBarriersandSupportNeededtoOvercome ActionPlanforSpread

OrthoUnitA HDr.Smith,OrthopedicSurgeonNurseManager,Unit

SeeatmeetingInvitetolunchFriendshipRelationship

Timetoeducatestaffnurses.ObtainsupportfromNurseManagertoeducatenursesduringshiftchange

ScheduletimeforstaffnursesonUnitAtomeetwithopinionleadersfromUnitAArrangeforEducationstafftoassistwithmaterialdevelopment

*RatingStaffReceptivitytoChange(High,Medium,Low) TermsThereisaclearadvantagetothechangecomparedtocurrentwayofdoingthingsespeciallyforthosedirectlyimpactedbythechangeThechangeiscompatiblewiththecurrentsystemandvaluesThechangeissimpleandeasytoimplementThechangewaseasytotestTheimpactofthechangewasobservable(canplaceonaStoryboard)ThereisleadershipsupporttopromotethechangemakingspreadeasierThereisameasurementtotrackoutcomesofchangesandrateofspreadThereisfeedbackforaccountability,toencourageandsupportthoseinvolvedinmakingchanges,andtorefinetheprocessifneeded

TestingAchangetodetermineifthechangeisanimprovement.Theremaybefourorfivecyclesoftestingneeded.Testwiththreepatientsorthreephysicians.Testunderdifferentcircumstances,e.g.evenings,nightsandweekends.ImplementationTakesplacewhentestingiscompletedandtheteamagreesthatthechangewillbehowcareisprovided.SpreadTakingatestedandimplementedinterventionfromtheoriginaltestareaorpilotunittoanewarea.Spreadshouldnotbefromapilotunit/populationtotheentirehospital.Thechangeshouldbetestedineachareatodetermineifadjustmentsareneeded.Insomecases,adjustmentsmadeonaspreadunitmaybeanimprovementforallareas.

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

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SPREADTEMPLATEEXAMPLE

Excellent: Principlesspreadtootherunitswithnooutsideassistance

Good:Principlesspreadtootherunitswithminimaloutsideassistance

Fair:Someevidenceofapplicationbeyondinitialprojectarea

Poor:Noevidenceofapplicationbeyondtheinitialprojectarea

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EVALUATINGSPREAD

LeanSixSigmaProjectCloseOut

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ManyorganizationscreateprojectdatabasestoserveasrepositoriesofLeanSixSigmaprojectresults.Ifthisisthecase,theprojectreportandtheassociateddocumentationwillneedtofollowtherepositorysspecificrequirements.

Amajorpurposeofawelldocumentedfinalreportistomakesurethattheimprovementrationaleisavailableforfutureemployeesandtointerestedparties.

FINALPROJECTREPORT

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Champion:AbackgroundoftheprojectandthebasisofitsselectionDefinePhase:ProjectCharter,VOC,SIPOCMeasurePhase:PotentialKPOVsandKPIVs,baselinemeasuresofperformanceandwaste,summariesofkeyresults

AnalyzePhase:Resultsofstatisticaltestsandconclusions,discoveryofflowimpediments,rootcauseanalysesanddocumentation

(continuedonnextslide)

FINALREPORTCOMPONENTS

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ImprovePhase:Finalproposal,rationale/analysessupportingtherecommendations,costbenefitanalysisoftheimprovedprocess,ImplementationPlan,newprocessdocumentationControlPhase:ControlPlan,recommendederrorproofingfeatures

FINALREPORTCOMPONENTS

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Beforebeingdisbanded,theprojectteamshouldmakethefollowingadditionalcontributiontohelpthefutureemployeeswhowillroutinelyruntheimprovedprocess:

Developaplanfortrackingtheoccurrenceofproblems

Developthebasisfordecidingtheneedforfurtherimprovementinitiativesinthefuture

PLANforCONTINUOUSIMPROVEMENT

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Attheminimuminclude: Futurestateprocessmap. Maincontrolcharts,andothercharts,thatwillbe

usedformonitoringtheprocess. Estimatedfiguresonperformanceimprovement

andsavings. Listofteammembersandthenameoftheowner

ormanageroftheimprovedprocess.

COMPLETETHEA3

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Assignment: Presentation#4Improve/ControlPhase

ENDOFWEEK14MATERIAL

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