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An Introduction to Lean Six
Sigma
“We don’t know what we don’t know.
We can’t act on what we don’t know.
We won’t know until we search.
We won’t search for what we don’t question.
We don’t question what we don’t measure.
Hence, we just don’t know.”
Dr. Mikel Harry
Process Improvement
1. Initial Perception of problem
2. Clarify Problem
3. Locate Point of Cause
4. Root Cause Analysis
5. Design Solutions
6. Measure Effectiveness
7. Standardize
Lean Six Sigma Process Improvement
• Lean Six Sigma Seeks to improve the quality
of manufacturing and business process by:
– identifying and removing the causes of defects
(errors) and variation.
– Identifying and removing sources of waste
within the process
– Focusing on outputs that are critical to
customers
Define
Control
Improve
Measure
Analyze
Lean Six Sigma Process Improvement
• LSS is a management philosophy that seeks to drive a
quality culture change through a multi-level based
program
Level
Training
Green Belt
LSS Methodology and basic tool
set
Black Belt
Green Belt content plus
advanced data analysis
Master Black Belt
Black belt content plus program
management, leadership skills,
some advanced tools
Lean Six Sigma Timeline
Guinness
Brewery
1900
Ford
Assembly Line
Shewhart
Introduces SPC
1930
Gilbreth, Inc.
•Management
Theory
•Industrial
Engineering
Deming
•14 Points
•7 Deadly Diseases
1950
Toyota Production
System
Lean Six Sigma Timeline
SPC
TQM
1980
Just – in–Time
Motorola
Introduces Six
Sigma
1990
Lean Mfg.
AlliedSIgnal
GE Adapt LSS to
Business Processes
2000
Background on Lean
• Lean comes out of the industrial engineering world
• Taiichi Ohno – Toyota Production System.
– 1940s-1950s company was on verge of bankruptcy
– Dynamics of industry were changing – moving from mass
production to more flexible, shorter, varied batch runs (people
wanted more colors, different features, more models, etc).
• Ohno was inspired by 3 observations on a trip to America
– Henry Ford’s assembly line inspired the principle of flow (keep
products moving because no value is added while it is sitting
still)
– The Indy 500 – Rapid Changeover
– The American Grocery Store – led to the Pull system – material
use signals when and how stock needs to be replenished
Path To Lean
Theory
Waste is Deadly
Application
1. Define Value – act on what is
important to the customer
2. Identify Value Stream – understand
what steps in the process add value
and which don’t
3. Make it flow – keep the work moving
at all times and eliminate waste that
creates delay
4. Let customer pull -- Avoid making more
or ordering more inputs for customer
demand you don’t have
5. Pursue perfection -- there is no
optimum level of performance
Focus
Flow Focused
Assumptions
Non-Value added steps exit
Results
Reduced cycle time
Waste Defined
Wastes
Transport
Inventory
Motion
Waiting
Over-Production
Over-Processing
Defects
Skills
Healthcare Examples
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Moving patients from room to room
Poor workplace layouts, for patient services
Moving equipment in and out of procedure room or operating room
Overstocked medications on units/floors or in pharmacy
Physician orders building up to be entered
Unnecessary instruments contained in operating kits
Leaving patient rooms to:
•
Get supplies or record
•
Documents care provided
Large reach/walk distance to complete a process step
Idle equipment/people
Early admissions for procedures later in the day
Waiting for internal transport between departments
Multiple signature requirements
Extra copies of forms
Multiple information systems entries
Printing hard copy of report when digital is sufficient
Asking the patient the same questions multiple times
Unnecessary carbon copying
Batch printing patient labels
Hospital-acquired illness
Wrong-site surgeries
Medication errors
Dealing with service complaints
Illegible, handwritten information
Collection of incorrect patient information
Not using people’s mental, creative, and physical abilities
Staff not involved in redesigning processes in their workplace
Nurses and Doctors spending time locating equipment and supplies
Staff rework due to system failures
Lean Foundations
• Standardized Work – people should analyze their work
and define the way that best meets the needs of all
stakeholders.
– “The current one best way to safely complete an activity
with the proper outcome and the highest quality, using the
fewest possible resources”
– Standardized not Identical – mindless conformity and the
thoughtful setting of standards should not be confused
– Written by those who do the work.
• Level loading – smoothing the workflow and patient
flow throughout the hospital.
• Kaizen – continuous improvement
Lean Methods
• Kaizen Events (or SCORE events)
– Planned and structured process that enables a small group of people
to improve some aspect of their business in a quick, focused manner.
•
•
•
•
•
Select
Clarify
Organize
Run
Evaluate
• 5S – this methodology reduces waste through improved workplace
organization and visual management
– Sort, Store, Shine, Standardize and Sustain
• Kanban – a Japanese term that can be translated as “signal,” “card,”
or “sign.”
– Most often a physical signal (paper card of plastic bin), that indicates
when it is time to order more, from whom, and in what quantity.
Lean vs. Six Sigma
• Lean tends to be used for shorter, less complex problems. Often
time driven. Focus is on eliminating wasteful steps and practices.
• Six Sigma is a bigger more analytical approach – often quality driven
– it tends to have a statistical approach. Focus on optimizing the
important steps – reducing defects.
• Some argue Lean moves the mean, SixSigma moves the variance.
But they are often used together and should not be viewed as
having different objectives.
– Waste elimination eliminates an opportunity to make a defect
– Less rework means faster cycle times
• Six Sigma training might be specialized to the “quality” department,
but everyone in the organization should be trained in Lean
VOC vs. VOP
Sigma
Capability
Voice of Customer
Defects per
Million
Opportunities
% Yield
2
308,537
69.15%
3
66,807
93.32%
4
6,210
99.38%
5
233
99.98%
6
3.4
99.99966%
Voice of Process
The Voice of the Process is independent of
the Voice of the Customer
What’s good enough?
99% Good (3.8 Sigma)
99.99966% Good (6 Sigma)
20,000 lost articles of mail per hour
(based on 2,000,000/hr)
7 articles lost per hour
Unsafe drinking water for almost 15
minutes each day
1 unsafe minute every 7 months
5,000 incorrect surgical operations per
week
1.7 incorrect operations per week
2 short or long landings daily at an
airport with 200 flights/day
1 short or long landing every 5 years
2,000,000 wrong drug prescriptions
each year
680 wrong prescriptions per year
No electricity for almost 7 hours each
month
1 hour without electricity every 34
years
Goals of Lean Six Sigma
LSL
USL
Defects
LSL
Defects
Defects
Customer Target
Prevent Defects by
Reducing Variation
USL
Customer Target
LSL
USL
Customer Target
Meet Customer
Requirements
Prevent Defects by
Centering Process
What Makes a Good Lean Six Sigma
Project?
• There is no known solution
• The root cause is not known
• The problem is complex and needs statistical
analysis
• The problem is part of a process
• The process is repeatable
• A defect can be defined
• Project will take 3-6 months
• There are data available
The DMAIC Methodology
• Define – describe the problem quantifiably and the
underlying process to determine how performance will
be measured.
• Measure – use measures or metrics to understand
performance and the improvement opportunity.
• Analyze – identify the true root cause(s) of the
underlying problem.
• Improve – identify and test the best improvements that
address the root causes.
• Control – identify sustainment strategies that ensure
process performance maintains the improved state.
Define
• Define Scope of the Problem
– Document the Process
– Collect and Translate the Voice of the Customer
• Determine Project Objective and Benefits
– Define Metrics and Defects
– Establish Preliminary Baseline
– Develop Problem & Objective Statements
– Estimate Financial Benefit
Define (continued)
• Create Project Charter
– Confirm Improvement Methodology
– Define Project Roles and Responsibilities
– Identify Risks
– Establish Timeline
– Managerial Buy-in
• Focus here is on the problem
Measure
Measure what is measurable, and make measurable what is not so” – Galileo
• Define “As Is” process
– Value stream map/process flow diagram
• Validate Measurement System for Outputs
– Don’t assume your measurements are accurate –
measuring system must accurately tell what is
happening
• Quantify Process Performance
– Collect data (Y’s)
– Examine process stability/capability analysis
Analyze
• Identify Potential Causes (X’s)
• Investigate Significance of X’s
– Collect data on x’s
– Graphical/Quantitative analysis
•
•
•
•
•
Pareto Chart
Fishbone Diagram (cause and effect)
Chi Square Test
Regression Analysis
Failure Mode Effects Analysis
• Identify Significant Causes to focus on (y=f(X))
– Evaluate the impact of x’s on y
• Here you identify the critical factors of a “good” output and
the root causes of defects or “bad” output.
Improve
• Generate Potential Solutions
• Select & Test Solution
• Develop Implementation Plan
Control
• Create Control & Monitoring Plan
– Mistake proof the process
– Determine the x’s to control and methods
– Determine Y’s to monitor
• Implement Full Scale Solution
– Revise/develop process
– Implement and evaluate solution
• Finalize Transition
– Develop transition plan
– Handoff process to owner