Presentation on theme: "Lean 6S Training Mercy Medical Center Welcome to Lean 6S Training."— Presentation transcript:
1Lean 6S Training Mercy Medical Center Welcome to Lean 6S Training. 5046 LDLEAN6S - Version 8/20/2009Welcome to Lean 6S Training.
2What are the 8 Forms of Waste? What is 6S? How do I conduct a 6S? Examples of Mercy 6S resultsMost people think Lean means a formal week-long facilitated eventQ: But did you know that not everything requires a formal week-long event?Today you are going to learn about one of the Lean tools called 6S:
38 Forms of Waste WASTED HUMAN TALENT DEFECTS INVENTORY OVERPRODUCTION WAITING TIMEMOTIONTRANSPORTATIONPROCESSING WASTEAsk participants to provide an example of eachWASTED HUMAN TALENT – Staff members using their talent and skill to follow a broken process, instead of using the talent and skill to improve the process.DEFECTS – Hospital Acquired InfectionINVENTORY – Items expire, cost associated with storage and handlingOVERPRODUCTION – We need 3 IV Bags, but I have time so I will make up 10 (that may never get used).WAITING TIME – We need a bigger waiting room, we need scripting on why they are waiting, we need to update our magazines….Do we? Or do we need to find out why they are waiting.MOTION – Radiology would walk past each room to see if one was available. Now they have a light that lets them know a room is in use.TRANSPORTATION – Birthplace Facilities use to have a labor room, delivery room and a room for the hospital stay. New Moms were transported from room to room. Now they labor, deliver and stay all in the same room.PROCESSING - Marking through all of the patient names on the Well mark Report, except for the patient specific to the set of medical records
41. Wasted Human TalentI’ve made a few changes to the process.I wish someone would ask OUR opinion…!StaffStaffStaffManagerStaffStaffNot asking the staff that works the process how to improve it
5A negative outcome from process failure 2. DefectsAnother defect!!@*!!A negative outcome from process failure
63. InventoryDid I really order this much??Items in greater quantities than can be immediately processed or used.
74. Over Production Generating more work than is really required I didn’t get my order yet… I’ll send another fax.Hey…are these multiple orders for the samePharmacistStaffGenerating more work than is really required
85. WaitingPeople waiting for items (patients, supplies, specimens, etc.) to process
9Why can’t I get anything done? Unnecessary human movement 6. MotionWhy can’t I get anything done?Unnecessary human movement
107. Transportation Unnecessary movement or relocation of items Waiting AreaI have orders to run some tests.I’ll bring the patient right over.Sigh…..!!Unnecessary movement or relocation of items
118. Over Processing Please approve. Please approve. Please approve.
12Applying effort to activities that are not required in the process 8. Over ProcessingI’m the final approval.Please approve.+???The final approval?!!Applying effort to activities that are not required in the process
13What is 6S? Sort Straighten Scrub Standardize Sustain Safety The 6th S, Safety, is not a separate step. Safety should be a consideration as we do all of the other steps.Each of these steps will be explained in further detail in following slides.
14Separate the needed from the not needed Step 1: SortBeforeAfterThe first step is sorting…separating all the things you need from the things that you don’t.Q: How will this help the organization?A: Removes obsolete items and reduces excess inventory.It costs Mercy to store and manage inventory.If we have too many of anything, they may expire/become obsolete….costs $$$Separate the needed from the not needed
15A place for everything & everything in its place! Step 2: StraightenAFTERBEFORENow that you have sorted the needed from not needed items, designate a place for everything and move your sorted items into their new location.Tip: Prioritize where you place items by putting the items that are used most often in the most readily accessible spots.Heaviest on the bottom (safety)Most used – most readily accessible locationConsider height requirements - shortest & tallest usersPlace supplies next to equipment – where they will be used.A place for everything & everything in its place!
16Regularly “scrub” to ensure everything is in perfect working condition Step 3: Scrub (inspect)“Scrub” and inspect equipment to ensure it is in perfect working condition...Add inspecting equipment into your work routine.Use scrubbing and cleaning to make certain equipment is in perfect working order.Add equipment inspection into you regular work routine.Again, making certain everything is in working order allows you to reduce your inventory levels to a few good working units.Regularly “scrub” to ensure everything is in perfect working condition
17Step 4: StandardizeNote: Blue taped outlines and labels ensure equipment is quickly found and returned to the same spot every time.Before the 6S, equipment was just shoved into this room.One of the Radiologists talks about being sent here to locate equipment, searching for 15 minutes and still not finding what he needed.Note the labeling on the floor, now there is a place for everything and everything is in its place…every time.e can tell at a glance when something is missing.Q: What would this labeling do for a new employee?Don’t need to ask for help from someone else who is busy.Standard Work requires determining the best method then following that method every time.
18Note labels and instructions Step 4: StandardizeNote labels and instructionsStandardization applies to files, supply cupboards, forms, or even websites.Q: What if standard visual controls & labeling were used and everything was placed in the same location on every floor of the hospital?You can be assigned to a different floor and still find what you need without searching!Visual Controls ensure that anyone can find what they need in a matter of moments.
19Develop a method for sustaining your gains Step 5: SustainThe team will need to find a method for ensuring things don’t go back to the way they were prior to the 6S.Create diagrams like the ones above as guidesDetermine inventory par levels to indicate when items should be reorderedUse maintenance checklists to have the team share responsibility for keeping the area in orderDevelop a method for sustaining your gains
20Safety is a top priority in all that you do! Step 6: SafetySafety first when determining where items are to be located:Keep fire hydrants clearElectrical a safe distance from plumbingAll items accessible - Not too high, not too lowUncluttered traffic areas - no tripping hazardsEmergency phone numbers and procedures prominently postedThis chart is self explanatorySafety is a top priority in all that you do!
22Good preparation is the key to successful results! Observe the process first hand (Gemba walk)Create a spaghetti diagram - a hand drawn map of your process including:Tasks in the sequence they are doneLocation of supplies and equipmentMeasure distance traveled and time spent searching or waitingIn a Gemba walk it is important to observe:Movement of thingsMovement of staffMovement of patientsTime spent searchingDistance traveled between tasks or locating things.Good preparation is the key to successful results!
23Spaghetti Diagram Time & Distance Traveled - Before DedicatedStaffTime & Distance Traveled - Before15 min – searchingFor suppliesSupplyRoomChartRackPrinter20 min – searchingFor printer paperAncillaryTesting200 feet100 feet150 feet250 feet300 feet1,550 Feet108 min16 min11 min21 min1 min31 minPatient’sRoom15 min – searchingfor meds10 min – searchingfor PT chartMedRoomHave someone walk the process as it would normally be done.Observe:The number of steps that are taken (the average step is 30” in length)Time the person to see how long it takes to complete all tasksBe certain to note:When the person is spending excess time in any given areaThe location of equipment and suppliesTip: One of the best ways to analyze a process is by observation…watch the team during their normal work routine. Look for unnecessary steps and ways to creatively improve things for the workers.Nurse’sStationTubeStationReportRoom10 min – waiting formeds tube systemWhat forms of “Waste” can you identify?
24Applying 6S eliminates waste! How Can We Improve?What would you do to improve?Sort out the need from the not neededHave a place for everything so there is no searchingMove supplies or equipment closer to where they are neededCo-locate tasks or peopleChange the sequence in which tasks are doneBe creative with your solutions – you, after all, are the expert!Applying 6S eliminates waste!
25Spaghetti Diagram No Searching or Waiting - After DedicatedStaffI’ve found my “dream” job!30 sec – 6S onsupply roomSupplyRoom400 ft50 feet40 min1.5 min2 min1 min30 min60 sec – 6S onMed roomMedRoomReportRoomChartRackTubeStationAncillaryTestingPatient’sRoomNurse’sStationPrinterConducting a 6S on the areas that took up excessive time allows us to save time in the process…Note: We want to continue to spend time in the patient’s room, so that wasn’t touched (value added time)Now, we not only saved 1,150 feet of travel but also reduced our time by over an hour.What will these improvements do to our time at the bedside?30 sec – 6S onchart rack30 sec – Indicator lightinstalled on tube system30 sec – Paper checked@ end of each shiftReduced travel by 1150 ft & search time by 68 min.
26Suggest you insert some before and after pictures/examples of 6S results in the next few slides.
28Instructions to the Class WorkerGather White, Yellow and Blue sheets of paperPaper clip the sheets togetherPlace in a folderPlace post-it on the outside of the folderPlace folder and contents on the chair (to be picked up by a delivery person)ManagerCreate a spaghetti diagram:Draw the room layout, identifying the location of the supplies used in the simulationAs Participant #1 walks the process, trace his/her footsteps on the spaghetti diagramFacilitator InstructionsWorkerSheets must be in the following order:1 Blue Sheet1 White Sheet1 Yellow SheetPaper clip sheets together (landscape - upper left corner)Place clipped sheets in a RED folderPlace post-it on outside (upper left corner) of red folderPlace folder and contents on chair
29Instructions to the Class Efficiency Expert #1Count the number of steps Person #1 travels from beginning to end in the process.Efficiency Expert #2Track how much time Participant #1 takes to do the entire processTrack how much time is wasted waiting and/or searchingCustomerDo a quality inspection on the finished product against the sample provided to you by the InstructorCo-workers (Rest of Class)Identify the 8 Forms of Waste in our processIdentify possible ideas for improvement
30Quantifying the Results Capture the Results from Round 1The placement of the materials is probably the most critical piece of this very simple simulation (the entire simulation takes minutes max). Spread the paper, file folders, post-its, paper clips randomly around the room. Make certain nothing is in the sequence that it will be used. For example, don’t place the pieces of paper together – spread around the room (excess travel).The red folders are mixed in with other colored folders in a pile (searching). Paper clips are in a box with various other supplies. There are a couple of empty boxes of clips and only one full box on the bottom of the supply box (searching). I also use a stop watch to time the process. After the simulation, I ask the students to use what they've learned to improve the process. I capture the results pre and post on a the board to help students see the change: cycle time, travel (steps), search time , inventory levels, etc.
31What Are the Results? Manager Efficiency Expert #1 What does the spaghetti diagram show us?Efficiency Expert #1How many steps did it take for the worker to do the process?Efficiency Expert #2How much time did the entire process take?How much time was wasted waiting and/or searching?CustomerWas the customer happy with the service provided (quality inspection)?Rest of ClassIdentify forms of waste in the processInclude possible ideas for improvement
32What Waste Did You Observe? Wasted Human TalentDefectsInventoryOver ProducingWaitingMotionTransportationOver ProcessingCapture measurements and timings on flip chart paper.
33How Can We Use 6S to Improve? Sort – Separate the needed from the not neededStraighten – A place for everything and everything in its placeScrub – Ensure everything is in perfect working conditionStandardize – Determine the best method – visual queues, labeling, etc.Sustain – Develop Standard WorkSafety – Safety first at all times
35Instructions to the Class Now that you have identified the waste and the opportunities for improvement in the processPut your recommended improvements in placeWe’ll run the simulation a second timeThen we’ll measure the results…….and celebrate our success!!
36Quantifying the Results Capture the Results from Round 2The placement of the materials is probably the most critical piece of this very simple simulation (the entire simulation takes minutes max). Spread the paper, file folders, post-its, paper clips randomly around the room. Make certain nothing is in the sequence that it will be used. For example, don’t place the pieces of paper together – spread around the room (excess travel).The red folders are mixed in with other colored folders in a pile (searching). Paper clips are in a box with various other supplies. There are a couple of empty boxes of clips and only one full box on the bottom of the supply box (searching). I also use a stop watch to time the process. After the simulation, I ask the students to use what they've learned to improve the process. I capture the results pre and post on a the board to help students see the change: cycle time, travel (steps), search time , inventory levels, etc.