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March, 2010 1 Standardized Work. Transform Your Care 2 Solutions That Perform Page 2 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Implementation.

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Presentation on theme: "March, 2010 1 Standardized Work. Transform Your Care 2 Solutions That Perform Page 2 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Implementation."— Presentation transcript:

1 March, Standardized Work

2 Transform Your Care 2 Solutions That Perform Page 2 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Implementation Goal Anyone responsible for implementing and using Standardized Work will gain an appreciation for Standardized Work by learning: WHAT it is HOW it fits into the lean system WHY it can help in your daily job performance

3 Transform Your Care 3 Solutions That Perform Page 3 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Objectives Define Standardized Work State the reasons and benefits for implementing Standardized Work Compare and contrast current work performance to Standardized Work performance Identify barriers to implementing Standardized Work and develop ways to remove them Understand and learn how to develop Standardized Work

4 March, Standardized Work Defined

5 Transform Your Care 5 Solutions That Perform Page 5 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Work conditions, methods, and procedures that allow consistently repeatable results. Work-group generated Guided by documentation Starting point for Problem Solving Foundation for continuous improvement What is it ?

6 Transform Your Care 6 Solutions That Perform Page 6 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. History of Standardized Work Based on proven U.S. military methods Incorporated by T. Ohno during the 1950s at Toyota Part of Standardization, which is the foundation of Toyota Production System

7 Transform Your Care 7 Solutions That Perform Page 7 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Old Paradigm I dont care how you get the job done, just do it.

8 Transform Your Care 8 Solutions That Perform Page 8 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. New Paradigm Everyone does the job the same way each time. The Process not the Person Consistent working sequence, cycle time and standard in-process stock regardless of which team member is performing the job.

9 Transform Your Care 9 Solutions That Perform Page 9 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Traditional vs. Standardized Work Traditional Work Reacts to fires Searches for things Processes designed without input from staff Work is equipment- centered Uses a variety of individual methods Produces inconsistent results Standardized Work Prevents problems Finds things easily Processes designed by staff & supervisors Work is human-centered Follows and improves the standard process Produces consistent results

10 Transform Your Care 10 Solutions That Perform Page 10 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Allows for… Worksite Management: Abnormal situations can be easily identified Problem solving can occur based on the discrepancy from the Standard Efficient training that produces operators who perform to the Standard Continuous Improvement: Identification of waste in the process Team members can suggest improvements

11 Transform Your Care 11 Solutions That Perform Page 11 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Ensures… Built-in Quality at every process in the system. Just-in-Time processing The next process is provided with the right product and/or service, at the right time, in the right quantity

12 Transform Your Care 12 Solutions That Perform Page 12 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Summary Four Main Advantages 1.Prevents Over Processing (Waste) 2.Ensures Quality Requirements 3.Lowers/Stabilizes Cost 4.Establishes Normal vs. Abnormal Criteria

13 March, Standardized Work Pre-requisites

14 Transform Your Care 14 Solutions That Perform Page 14 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Pre-Requisites Repeatable Human Motion Reliable Equipment Quality Incoming Materials and/or Supplies Accurate Information – On Time

15 March, Standardized Work Components

16 Transform Your Care 16 Solutions That Perform Page 16 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Three Components of Standardized Work Takt Time Work sequence Standard In-process stock

17 March, Takt Time

18 Transform Your Care 18 Solutions That Perform Page 18 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Takt Time… Sets the pace Is…. 1.The time allowed to complete one procedure 2.Based on available time and demand 3.Computed and adjusted as demand changes

19 Transform Your Care 19 Solutions That Perform Page 19 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Takt Time Formula TT = Available Time Demand

20 Transform Your Care 20 Solutions That Perform Page 20 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Daily Available Time Total daily operating time: The total time to treat the demand MINUS the scheduled downtime EXAMPLE: ED department runs 24 hours per day Total available time in a day – 1440 minutes No scheduled downtime Daily Available Time = 1440 minutes

21 Transform Your Care 21 Solutions That Perform Page 21 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Daily Demand Rate The total processing requirement EXAMPLE: ED department is treating patients at the rate of 3,000 per month. Based on 30 days per month, 100 patients must be treated per day. Daily Processing Requirement = Patient Takt Time = 3,000 pts./month 30 days/month = 100 pts./day 1440 mins/day 100 pts./day = 14.4 mins/pt. Takt Time = 14.4

22 March, Work Sequence

23 Transform Your Care 23 Solutions That Perform Page 23 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Work Sequence Is… The repetitive performance of work elements that produce quality in an efficient manner: Work sequence can be work performed at multiple processes or multiple elements at a single process.

24 Transform Your Care 24 Solutions That Perform Page 24 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Example

25 March, Standardized Work Forms

26 Transform Your Care 26 Solutions That Perform Page 26 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Forms Time Study Sheet Standardized Work Chart or Spaghetti Diagram Standardized Work Combination Table Standardized Work Sheet Job Instruction Training Sheet

27 Transform Your Care 27 Solutions That Perform Page 27 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Time Study Start and stop point identified for accurate and consistent timing Time for each individual element captured Time given to operator is based on the average time of 10 separate studies per element Worker effort rated if standard data not used Person with knowledge of area review current state assessment to check for accuracy

28 Transform Your Care 28 Solutions That Perform Page 28 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Time Study Sheet

29 March, Spaghetti Diagram and Standardized Work Chart

30 Transform Your Care 30 Solutions That Perform Page 30 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Spaghetti Diagram or STW. Chart… Diagrams operator work sequence Documents: Walking patterns Sequence of job elements

31 Transform Your Care 31 Solutions That Perform Page 31 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Lab Process Current State Spaghetti Diagram Average time for lab process was 13 minutes with excessive walking Spaghetti Diagram for Lab Process PAT ENTRANCE3 PATIENTS 4 PAT lab walk time One patient 210 feet process PAT20 per day =4200 feet per dayWILMA 0.5 second per foot = 35 minutes walk time PAT 3 1 LAB AREA PAT Dispatch box labtube cubicles 7 lab 2 cubicles labcupboard 6 workbench cubicles lab cubicles 8 lab 5 cubicles

32 March, Standardized Work Combination Table

33 Transform Your Care 33 Solutions That Perform Page 33 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Combination Table Combines human and machine movements, based on Takt Time. Visually displays times for: Operator: Working Walking Waiting Automatic machine times Cycle Time compared to Takt Time Creates a timed picture of human work and process flow. Helps identify waste within the cycle.

34 Transform Your Care 34 Solutions That Perform Page 34 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Example

35 March, Standardized Work Sheet

36 Transform Your Care 36 Solutions That Perform Page 36 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Sheet

37 Transform Your Care 37 Solutions That Perform Page 37 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Example

38 March, Additional Uses for Standardized Work

39 Transform Your Care 39 Solutions That Perform Page 39 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Standardized Work Uses Safety Reduces ergonomic burden Highlights potential hazards Training Training New Team Members Cross-Training for Flexibility Problem Solving Pin Pointing Discrepancies Continuous Improvement Work Balancing Kaizen Activities

40 March, Job Instruction and Training

41 Transform Your Care 41 Solutions That Perform Page 41 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Purpose of Job Instruction Transfer the needed knowledge and skills to the team member so that Standardized work is performed resulting in the work being completed: Safely Correctly Consistently

42 Transform Your Care 42 Solutions That Perform Page 42 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Job Instruction Training Sheet Major Steps WHAT to do Discreet value- added actions Simple, Correct, Consistent Key Points HOW to do it Specific motion or information needed to perform the major step correctly Safety is always a key point Reasons – WHY to do it – Effects on: Safety Ergonomics Govt. Regs Quality Productivity Cost Other

43 Transform Your Care 43 Solutions That Perform Page 43 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. JIT Sheet

44 Transform Your Care 44 Solutions That Perform Page 44 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Job Instruction Methods 4 Step Approach Prepare Present Tryout Follow-up

45 Transform Your Care 45 Solutions That Perform Page 45 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Problem Solving Yamazumi Chart Seven Wastes Motion Kaizen Continuous Improvement

46 Transform Your Care 46 Solutions That Perform Page 46 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Yamazumi (Work Balance) Chart An effective tool for identifying: Waste Overburden Unevenness A graphical tool used to compare each staff members workload to Takt Time Compares all of the staff members workloads in one chart Used to calculate the quantity of staff members needed for a work area

47 Transform Your Care 47 Solutions That Perform Page 47 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Walk back to seat (15 feet) Place sheet to bin Walk sheet Back to Lab (15 feet) Stamp Top sheet Receive Top sheet Place sheet to bin Receptionist Process Current State Waste Reduced Future State Stamp Top sheet Receive Top sheet Stamp Top sheet Walk back to seat Walk sheet back to Lab WASTE Current state Cycle Time Future state Cycle Time Time (secs)

48 March, Seven Wastes

49 Transform Your Care 49 Solutions That Perform Page 49 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. What is Lean? A process of continuously identifying, reducing and eliminating waste (non-value added activity) Waste is defined as anything other than the minimum amount of equipment, materials, parts, space and worker's time which are absolutely essential to add value to the product Shoichiro Toyoda President, Toyota

50 Transform Your Care 50 Solutions That Perform Page 50 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Lean is… A system of thinking, not just a set of tools A learning system which encourages staff to perform better in technical operations, which, in turn, increases process performance. The relentless pursuit of waste!!

51 Transform Your Care 51 Solutions That Perform Page 51 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. 7 Wastes + 1 Correction /Rework Dirty instruments in Assembly, damaged instruments, bent instruments, aborted sterrad cycle Movement Searching for paperwork, walking long distance to printer or scanner, getting wrap, obtaining containers Waiting Waiting for scopes and light cords, waiting on sterile carts, waiting on cases to start Inventory Extra sets and instruments, excessive amounts of filters or supplies, extra containers Overproduction Cleaning and Assembly of several sets not needed for OR, Pulling OR cases by supplies days ahead of time Transportation Searching for sterile, stat, or distribution carts; extra trips for decon rounds, distribution of sets Over-Processing Second signature of assembled sets, two or more indicators in a set, extra instruments in sets People Not using peoples abilities to their fullest potential, improper training and education of staff

52 Transform Your Care 52 Solutions That Perform Page 52 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Causes of Waste Organizational issues Lack of workplace organization Lack of training Inconsistent performance measures Poor production planning and scheduling Operational issues Long setup time Lack of Preventive Maintenance Layout (distance) Work methods Incapable processes Supplier quality

53 Transform Your Care 53 Solutions That Perform Page 53 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Why Reduce Waste? Makes Work –Safer –Faster –Cheaper –Easier

54 Transform Your Care 54 Solutions That Perform Page 54 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. How Do We Reduce Waste ? E liminate: – Workstations, Complexity C ombine: – Workstations, Processes R educe: – Content, Complexity S implify: – Process

55 March, Motion Kaizen

56 Transform Your Care 56 Solutions That Perform Page 56 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Kai = Change Zen = for the Better A change for the better or continuous improvement Definition of Kaizen

57 Transform Your Care 57 Solutions That Perform Page 57 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Kaizen Events… Targeted Improvement Document Standardized Work Study through observation to improve Document and train new Standardized Work to maintain the improvement

58 Transform Your Care 58 Solutions That Perform Page 58 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Instructions for Work Kaizen Objectives In order to Kaizen, we look at the workers motions. The goal is not to make the individual tasks faster, but to develop smooth and repetitive motions with little waste. Priority of Work Kaizen vs. Equipment Kaizen: Work Kaizen can be done in little time Work Kaizen can be done with little investment If Kaizens are unsuccessful, other Kaizens can be easily tried

59 Transform Your Care 59 Solutions That Perform Page 59 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Kaizen Example: - Current State Lab Process Average time for lab process was 13 minutes with excessive walking Spaghetti Diagram for Lab Process PAT ENTRANCE3 PATIENTS 4 PAT lab walk time One patient 210 feet process PAT20 per day =4200 feet per dayPCA 0.5 second per foot = 35 minutes walk time PAT 3 1 LAB AREA PAT Dispatch box labtube cubicles 7 lab 2 cubicles labcupboard 6 workbench cubicles lab cubicles 8 lab 5 cubicles

60 Transform Your Care 60 Solutions That Perform Page 60 | Copyright ©2008, RWD Technologies, LLC. All rights reserved. Lab Process Future State Spaghetti Diagram Implemented efficient and standardized process focusing on waste reduction ( 54% Reduction in lab process time )


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