2 The ABC’s of PDCA, G. Gorenflo and J. Moran Plan Check/StudyIdentify andPrioritize Opportunities7. Develop ImprovementTheory1. Reflect on the Analysis2. Develop AIMStatement8. Develop Action Plan2. Document Problems,Observation, andLessons learned3. Describe the CurrentProcessDoImplement theImprovement4. Collect Data onCurrent ProcessAct2. Collect and DocumentThe dataAdoptStandardize5. Identify All PossibleCausesAdaptDo3. Document Problems,Observations, and LessonsLearned6. Identify PotentialImprovementsAbandonPlan
3 Some Tools To Help Create AIM Statements Current and Future State ModelAIM Work SheetForce Field DiagramForce and Effect Diagram
4 What is the current state? Driving Forces: Future State: Why is this important?What is it costing us time/dollars/staff/etc?What is the impact on our customer/clients?What is the impact on our division/agency?Driving Forces:Future State:What are the important aspects of the future state?What is driving us to this future state?What might be the consequences of not moving to the future state?What might change?What is the proposed timeline?PathwayConsequencesBenefits
5 (what will it improve and for whom?) AIM or Opportunity StatementAn opportunity exists to improve the________________________________________________________________________(name process, or area to work on)beginning with ___________________________________________________________(beginning boundary, starting point)and ending with __________________________________________________________.(ending boundary, finish point)This effort should improve______________________________________________________________________________________________________________________________________________(key characteristics of area the team is working on)for the ________________________________________________________________________________________________________________________________________.(customers, staff or those affected by the process under improvement)This process is important to work on now because_______________________________________________________________________(what will it improve and for whom?)
6 Desired State Current State Force Field Diagram - Basic Positive ForcesNegative ForcesDesired StateCurrentState
10 Flow Chart Symbols Flow Lines Manual Operation Start/End Bookends A ConnectorData BaseCommentCollectorActivity:Operation/InspectionWait/DelayDecisionDisplayStorageInput/OutputDataTransportManualInputThese symbols are in Microsoft Power PointDocumentInputPreparationFormsOutputUnfamiliar/Research10
11 Flow Chart Summary Matrix PHF E-News, March 2, 2010,ActualProposedFlow Chart Step NumberType of StepDelta+/-∑∑P D P T W P D STouch Point (√)CostFTEs/Person Hrs.Supplies RequiredEquipment RequiredSpace RequiredTimeCost of QualityPartnerships NeededEtc.Value addedType of Step: P – process, D – decision, T – transport, W – wait, S – storageDelta = Proposed – Actual – the more negative the subtraction the better – more savings
12 LSS5S is a visual method of setting the workplace in order. It is a system for workplace organization and standardization.The five steps that go into this technique:Seiri – sort – essential itemsSeiton – set in order – promote work flowSeison – shine – clean workplaceSeiketsu – standardize - consistencyshitsuke)- sustain – hold the gains
13 Definition of 8 Types of Waste: DescriptionPublic Health ExampleOverproductionItems being produced in excess quantity and products being made before the customer needs themInsurance filing or immunization record opened before all required information is receivedWaitingPeriods of inactivity in a downstream process that occurs because an upstream activity does not produce or deliver on time.Paperwork waiting for management signature or reviewUnnecessaryMotionExtra steps taken by employees and equipment to accommodate inefficient process layouts.Immunology testing equipment stored in cabinets far from specialist work area.TransportationHandlingUnnecessary movement of materials or double handlingDepartment vehicles stored in central facility, requiring constant movement of vehicles to and from other high traffic locationsOver-processingSpending more time than necessary to produce the product or serviceCombining client survey instruments into one form rather than develop specific instruments for each programUnnecessary InventoryAny excess inventory that is not directly required for the current client’s orderOver estimating vaccination support materials requiring additional locked storage cages, inventory counting and reconciliationDefectsErrors produced during a service transaction or while developing a product.Ineffective scripts for initial intake applications. Unclear directions for filling out required formsDuplicationHaving to re-enter data or repeat details on forms.Poorly designed client intake computer screens or services checklists
14 Cause and Effect Diagrams - Construction Generate ideas as to what are the main causes of the effectLabel these as the main branch headersOrganizes group knowledge about causes of a problem and display the information graphicallyHeaderHeaderEffectHeaderHeader
15 Root Cause Analysis Rating Form Impact on the ProblemPotentialRootCauseImprovedCustomerSatisfactionImprovedQualityReducedCostsOthersTotalScoreRankingImpact Scoring Scale: Low = 1, Medium = 3, High = 5
17 Solution and Effect Diagrams - Construction Generate ideas as to what are the main Solutions of the effectLabel these as the main branch headersSolutionSolutionEffectSolutionSolution
18 Root Cause Analysis Solution Impact Analysis PotentialSolutionsCorrectiveActionTypeVerificationMethodCostToFixBenefitOfFixCostBenefitRatioSelected?Y/NCorrective Action Type: Immediate but Interim – II, Short-term Temporary - ST,Permanent – Short Term – PST, and Permanent – Long Term - PLT
20 Intervention and Impact Form AIM Statement Description: 18.104.22.168.22.214.171.124.Intervention NumberDateWhat Was The Change?How Did It Impact The AIM?How Did Your Thinking Change?How Did It Impact Your Procedures?How Did It Impact Your Customer?How Do You Know?Measures
21 The following columns can be added to the Intervention and Impact Form when needed to track the impact of unintended consequences.9101112131415Unintended Consequence LetterUnintendedConsequenceDescriptionDate It HappenedImpact To Aim StatementNeed a Sub AIM Statement?Impact to CustomerModificationsMadeIntervention and Impact Form when needed to track the impact of unintended consequences.
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