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TSgt Brent WhitbyNCOIC, Quality Assurance
375 Medical Group, Scott AFB, IL
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Let’s Draw a Pig
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AFSO21 Implementation Linking AFSO21 to Organizational Goals OODA Loop process of AFSO21
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Launched in 2005 Obstacles to deployment
◦ Quality Air Force Conundrum◦ Senior Leadership buy-in
AFSO21 vs. QAF◦ Value stream mapping vs. process mapping◦ Results
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5
Assess outlook/future path◦ Current state map◦ Future state map
Evaluate current organizational performance Review system change/improvement
capacity
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Which process needs the most attention Where can biggest cost savings occur How can quality be improved (to what
degree?)
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Customers are important Speed, quality, low cost are linked Variation/defects minimized Time trap elimination Data driven improvements Teamwork
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Q1 - Immediate attention
Q2 - Hardest decision Q3 - Sometimes
beneficial Q4 - Avoid
1 2
3 4
High
Low
Low High
Benefit
Effort
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Process elements Stakeholder analysis Customer data Quality function deployment Benchmarking
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Supplier (provide inputs) Input (services provided) Process (value added steps) Output (final product) Customer (internal/external)
Suppliers Inputs Process Output Customer
MLTs Perform Test Verify Patient Acceptable Specimen to analyze
Patient
Patients Provide Specimens Accession Test Accurate Results
Physician
Phlebotomist Collect specimens Collect Sample Timely treatment
Technical Supervisor Report Results Process Sample
Physician Put on Analyzer
Report Results
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Control resistance (reduce or remove)◦ Provide alternatives◦ Remove pitfalls◦ Ensure buy-in
Perceived value drives feedback ◦ Positive ◦ Negative
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Use Service Delivery Assessment data (customers define quality/expectation)
Listen to external/internal customers◦ WoW Forms◦ Internal customer surveys
CQFA◦ Cost◦ Quality◦ Features◦ Availability
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Often referred as “Voice of Customer” House of Quality
◦ Customer needs◦ Design features/technical requirements◦ Customer priorities◦ Benchmarking (targeted values)◦ Inter-relationship between design features
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Types◦ Process◦ Performance◦ Project◦ Strategic
Sequence◦ Determine current practices◦ ID best practices◦ Analyze best practices◦ Model best practices◦ Repeat
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Originated by Col John Boyd (USAF)
◦ Also known as Decision Cycle
Four Overlapping and Interacting Processes
◦ Observe Unfolding
Circumstances and Information
◦ Orient Analysis and Synthesis
◦ Decide◦ Act (and Test)
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1. Clarify The Problem
2. Break Down The Problem/Identify Performance Gaps
3. Set Improvement Target
4. Determine Root Causes
5. Develop Countermeasures
6. See Countermeasures Through
7. Confirm Results & Process
8.Standardize Successful Processes
Observe
Orient
Decide
Act
Plan
Act
Check
Do
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Logical Thinking Process Objectivity Focus on Results and Processes Synthesis, distillation, and visualization Alignment Coherence & Consistency Systems Viewpoint
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Strong emphasis on cause and effect Focuses organization to maximize
resources by focusing on the “critical few” Minimizes wasted time by management
by using a robust problem solving process
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Process drives employees to think with quantitative data as opposed to emotion and opinions
Fosters a collaborative process as opposed to a “silo mentality”
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Example:Insurance company is losing business due to
5 day turnaround on quotes.
Possible Solutions:1. Hire more people to reduce time2. Incentivize employees to work harder3. Find the root cause for lengthy
turnaround and implement permanent corrective action
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Minimizes “Death by PowerPoint” Forces brevity and clarity Only most vital points used for proper
understanding Utilizes graphs, pictures, and sketches to
promote understanding (visualization)
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3D Communication◦ Up and down the hierarchy◦ Horizontally across the organization◦ Back and forth in time
Heavy emphasis on consensus decision making
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Avoids: Tackling problems that are not important
to organizational goals Solutions that do not address root
cause(s) Incomplete implementation plans Omission of follow up plans and standard
work
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The impact of the proposed solution must not adversely impact other parts of the organization (i.e. transferring a problem from one department to another)
The good of the whole organization takes clear precedence over the individual departments
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SA&DSWOTVoice of CustomerVSMGo & See
KPI/MetricsPerformance Gap AnalysisBottleneck Analysis
Ideal StateFuture State MappingB-SMART
BrainstormingParetoAffinityFishboneControl Charts
A3Action PlansTimelinesFinancial Reporting Template
6S & Visual MgtStandard WorkCell Design / Variation ReductionError ProofingQuick ChangeoverTPM RIE
KPIs/MetricsPerformance MgtSA&DStandard Work Audit
Checkpoints / Standardization Tbl Report Out Theme StoryBroad ImplementationCPI Mgt Tool
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1. Clarify the Problem◦ Strategic Alignment and
Deployment◦ Voice of Customer◦ Value Stream Mapping◦ Go & See
2. Break Down the Problem and Identify Performance Gaps◦ Key Process Indicators / Metrics◦ SWOT◦ Performance Gap Analysis◦ Bottleneck Analysis
OODA
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Strategic Alignment & Deployment (SA&D)◦ Ensuring that activities are linked to the key
strategies and directives of the organization Strengths, Weaknesses, Opportunities & Threats
(SWOT) Analysis◦ Assessing the organization from a SWOT perspective
to identify areas of need◦ Needs to be rolled into SA&D at appropriate levels
Voice of Customer (VOC)◦ Understanding who the customer is and what they
need from the process or problem area Value Stream Mapping (VSM)
◦ Overview of Process to determine areas of needed focus
Go & See◦ Determine issues by actually walking the process or
problem area (Gemba or Genchi Genbutsu)
OODA
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1. Does this problem, when solved, help meet needs identified by the organization?
◦ Is it linked to the SA&D of organization?◦ Does it help satisfy customer needs (VOC)?
2. Does this problem, when solved, address key issues identified during SWOT analysis?
3. Has this problem been identified and directed by a Value Stream Map at the appropriate level?
◦ What does the “Future State” need?◦ What resources have been identified to address
this issue?4. What opportunities were identified or observed by
the process or problem area “walk”?◦ Will addressing or improving these issues deliver
results that relate to #1 or #2?◦ Will addressing or improving this problem deliver
the desired future state from #3?16
OODA
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OODA Gather and Review Key Process Indicators and Metrics◦ Problem Solving and Process Improvement begin
with Data◦ Understanding what data is necessary and what the
data means is critical to true “root cause” problem solving
Performance Gap Analysis◦ Once data has been gathered, analyzing the gap
between the current state and the desired state directs efforts
Bottleneck Analysis◦ Bottlenecks are inhibitors to the flow of the process◦ Understanding bottlenecks (TOC) is critical to flow
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1. Does the problem require more analysis or does leadership have enough information to execute a solution?
◦ Is this simply a leadership directive?2. If more data is needed, how do we
measure performance now?◦ What are the Key Performance
Indicators (KPI)?◦ What is the performance gap?
3. Does other “non-existent” data need to be gathered?
4. What does the data indicate are the potential root causes?
5. Does the data review indicate a bottleneck or constraint?
OODA
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Ideal State Map◦ Brainstorming “Could-Be” without
constraints Future State Mapping
◦ “Vision” of Future for Process B - SMART Action Plan
◦ Balanced◦ Specific◦ Measurable◦ Action Oriented◦ Results Oriented◦ Time-based
OODA
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Target characteristics◦ Must be measurable, concrete,
challenging and achievable Statement of a Target
◦ Do what: (examples include “decrease ____?”, “increase ____?”, eliminate ____?, reduce ____?)
◦ By how much: (measured in the same terms as the standard)
◦ By when: (specific date) Must be output oriented
◦ Things to be achieved, not things to do
OODA
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1. Is the Improvement Target measurable?2. Is it Concrete?3. Is it Challenging?4. Is the Target “Output Oriented”?
◦ What is the desired output?◦ Should be “things to achieve”◦ Should avoid “things to do”
– Will be addressed by Action Plans in “Develop Countermeasure”
5. The desired target should:◦ Do What?◦ By How Much?◦ By When?
6. If it is a Process Problem, what is the future state?◦ How will it be realized?
OODA
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Root Cause Characteristics◦ The root cause is the most likely source of the
discrepancy or greatest possible improvement target
◦ The root cause can be dealt with directly and a countermeasure can be planned to address it
◦ If root cause is addressed, it will address the performance gap
◦ The root cause must be verified by “go and see”Determining the Root Cause is easier with Data
OODA
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OODA Tools for Step 4◦ 5 Whys◦ Brainstorming◦ Pareto Analysis◦ Affinity Diagrams◦ Fishbone Diagrams (also called Cause & Effect)◦ Control Charts
Additional Data Gathering Tools◦ Check Sheets, Chonbo Charts, Scatter Diagrams
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1. What root cause analysis tools are necessary?◦ Why are these tools necessary?◦ What benefit will be gained by using them?◦ Who will need to be involved in the root cause analysis?
– 10 heads are better than one– Remember “cultural” issues related to problem
2. What is (are) the root cause(s) according to the tools?3. How will the root cause be addressed?4. Will addressing these address the performance gap?5. Can the problem be turned on or off by addressing the root
cause?6. Does the root cause make sense if the problem solving 5
Whys are worked in reverse?◦ Working in reverse, say “therefore” between each of the
“whys”
OODA
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OODA
Decide Stage – Develop Countermeasures◦ A3 Problem Solving and Reporting Format
Common Structure and Concise Reporting◦ Action Plans
SMART Action Items◦ Timelines & Project Management
Managing complex Problem Solving in a project fashion
◦ FM Tool Understanding the impact of the improvements
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OODA
Develop potential countermeasures◦ Tools and philosophies from Lean, TOC, 6 Sigma
and BPR as appropriate Select the most practical and effective
countermeasures Build consensus with others by involving all
stakeholders appropriately◦ Communicate, communicate, communicate
Create clear and detailed action plan◦ SMART Actions◦ Reference Facilitation Techniques as appropriate
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OODA
Process Improvement Philosophies◦ Lean, TOC, 6 Sigma, BPR
Lean and Process Improvement Tools◦ 6-S & Visual Management◦ Standard Work◦ Cell Design◦ Variation Reduction◦ Error Proofing◦ Quick Changeover◦ Total Productive Maintenance (TPM)◦ Rapid Improvement Events (RIE)
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OODA
Which philosophy best prescribes tools that address root cause(s)?
Which tools best address root cause(s)? Which method for implementation fits the
tool and improvement need?◦ Rapid Improvement Event?◦ Improvement Project?◦ Point Improvement or “Just Do It”?
If RIE or Project, create “Charter” and communicate
What training or education is needed? By Whom?
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OODA
1. How are we performing relative to the Observe phase (Steps 1 & 2)?
2. How are we performing relative to Step 3?3. How are we performing relative to FM Tool
projections?4. If we are not meeting targets, do we need to
return to OODA Step #4?◦ Most problem solving “breakdowns” occur relative
to improper root cause identification
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OODA
Checkpoints and Standardization Tables Report-out Storyboards Board Implementation Capture Results in Powersteering Sharing of Results
◦ Communication of Best Practices Restart OODA Loop
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OODA
1. What is needed to Standardize Improvements?◦ Tech Order changes?◦ Air Force Instruction changes?◦ Official Instruction changes?
2. How should improvements and lessons learned be communicated?◦ Powersteering◦ Key meetings?
3. Were other opportunities or problems identified by the Problem Solving Process?◦ Restart OODA Loop
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OODA
Checkpoints and Standardization Tables Report-out Storyboards Board Implementation Capture Results in Powersteering Sharing of Results
◦ Communication of Best Practices Restart OODA Loop
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OODA
1. What is needed to Standardize Improvements?◦ Tech Order changes?◦ Air Force Instruction changes?◦ Official Instruction changes?
2. How should improvements and lessons learned be communicated?◦ Powersteering◦ Key meetings?
3. Were other opportunities or problems identified by the Problem Solving Process?◦ Restart OODA Loop
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Problem Solving Process & Related Toolsets SA&D SWOT Voice of Customer Value Stream Mapping Go & See
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KPI/Metrics Performance Gap Analysis Bottleneck Analysis
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Ideal State Future State Mapping B-SMART
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5 Whys Brainstorming Pareto Affinity Fishbone Control Charts
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6S & Visual Management Standard Work Cell Design Variation Reduction Error Proofing Quick Changeover TPM RIE
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KPIs & Metrics Performance Management SA&D Standard Work
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Checkpoints & Standardization Table Report Out theme Story Board Implementation Powersteering Start OODA
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Effective Problem Solving must follow the Observe, Orient, Decide and Act process
Following OODA ensures actions will result in desired results
Following OODA ensures results will meet the needs of the organization
Meeting the needs of the organization will lead to a stronger Air Force (Culturally as well)
A stronger Air Force leads to a Safer Country!