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TSgt Brent Whitby NCOIC, Quality Assurance 375 Medical Group, Scott AFB, IL.

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Presentation on theme: "TSgt Brent Whitby NCOIC, Quality Assurance 375 Medical Group, Scott AFB, IL."— Presentation transcript:

1 TSgt Brent Whitby NCOIC, Quality Assurance 375 Medical Group, Scott AFB, IL

2  Let’s Draw a Pig

3  AFSO21 Implementation  Linking AFSO21 to Organizational Goals  OODA Loop process of AFSO21

4  Launched in 2005  Obstacles to deployment ◦ Quality Air Force Conundrum ◦ Senior Leadership buy-in  AFSO21 vs. QAF ◦ Value stream mapping vs. process mapping ◦ Results

5 5 Linking AFSO21 to Organizational Goals  Assess outlook/future path ◦ Current state map ◦ Future state map  Evaluate current organizational performance  Review system change/improvement capacity

6 6 Key AFSO21 Questions  Which process needs the most attention  Where can biggest cost savings occur  How can quality be improved (to what degree?)

7  Customers are important  Speed, quality, low cost are linked  Variation/defects minimized  Time trap elimination  Data driven improvements  Teamwork

8 8 Benefit/Effort Matrix  Q1 - Immediate attention  Q2 - Hardest decision  Q3 - Sometimes beneficial  Q4 - Avoid High Low High Benefit Effort

9  Process elements  Stakeholder analysis  Customer data  Quality function deployment  Benchmarking

10  Supplier (provide inputs)  Input (services provided)  Process (value added steps)  Output (final product)  Customer (internal/external) SuppliersInputsProcessOutputCustomer MLTsPerform TestVerify PatientAcceptable Specimen to analyze Patient PatientsProvide SpecimensAccession TestAccurate Results Physician PhlebotomistCollect specimensCollect SampleTimely treatment Technical SupervisorReport ResultsProcess Sample PhysicianPut on Analyzer Report Results

11  Control resistance (reduce or remove) ◦ Provide alternatives ◦ Remove pitfalls ◦ Ensure buy-in  Perceived value drives feedback ◦ Positive ◦ Negative

12  Use Service Delivery Assessment data (customers define quality/expectation)  Listen to external/internal customers ◦ WoW Forms ◦ Internal customer surveys  CQFA ◦ Cost ◦ Quality ◦ Features ◦ Availability

13  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

14  Types ◦ Process ◦ Performance ◦ Project ◦ Strategic  Sequence ◦ Determine current practices ◦ ID best practices ◦ Analyze best practices ◦ Model best practices ◦ Repeat

15

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17  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)

18 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 DoDo

19 Elements of the 8 Step Problem Solving and A3 Approach  Logical Thinking Process  Objectivity  Focus on Results and Processes  Synthesis, distillation, and visualization  Alignment  Coherence & Consistency  Systems Viewpoint

20 Logical Thinking Process  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

21 Objectivity  Process drives employees to think with quantitative data as opposed to emotion and opinions  Fosters a collaborative process as opposed to a “silo mentality”

22 Focus on Results and Processes Example: Insurance company is losing business due to 5 day turnaround on quotes. Possible Solutions: 1. Hire more people to reduce time 2. Incentivize employees to work harder 3. Find the root cause for lengthy turnaround and implement permanent corrective action

23 Synthesis, Distillation, and Visualization  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)

24 Alignment  3D Communication ◦ Up and down the hierarchy ◦ Horizontally across the organization ◦ Back and forth in time  Heavy emphasis on consensus decision making

25 Coherence & Consistency 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

26 Systems Viewpoint  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

27 27 SA&D SWOT Voice of Customer VSM Go & See KPI/Metrics Performance Gap Analysis Bottleneck Analysis Ideal State Future State Mapping B-SMART Brainstorming Pareto Affinity Fishbone Control Charts A3 Action Plans Timelines Financial Reporting Template 6S & Visual Mgt Standard Work Cell Design / Variation Reduction Error Proofing Quick Changeover TPM RIE KPIs/Metrics Performance Mgt SA&D Standard Work Audit Checkpoints / Standardization Tbl Report Out Theme Story Broad Implementation CPI Mgt Tool

28 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

29  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

30 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

31  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

32 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

33  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

34  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

35 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

36  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

37  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

38 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

39  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

40 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

41 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)

42 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?

43 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

44 OODA  Checkpoints and Standardization Tables  Report-out Storyboards  Board Implementation  Capture Results in Powersteering  Sharing of Results ◦ Communication of Best Practices  Restart OODA Loop

45 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

46 OODA  Checkpoints and Standardization Tables  Report-out Storyboards  Board Implementation  Capture Results in Powersteering  Sharing of Results ◦ Communication of Best Practices  Restart OODA Loop

47 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

48 Problem Solving Process & Related Toolsets  SA&D  SWOT  Voice of Customer  Value Stream Mapping  Go & See

49  KPI/Metrics  Performance Gap Analysis  Bottleneck Analysis

50  Ideal State  Future State Mapping  B-SMART

51  5 Whys  Brainstorming  Pareto  Affinity  Fishbone  Control Charts

52  6S & Visual Management  Standard Work  Cell Design  Variation Reduction  Error Proofing  Quick Changeover  TPM  RIE

53  KPIs & Metrics  Performance Management  SA&D  Standard Work

54  Checkpoints & Standardization Table  Report Out theme Story  Board Implementation  Powersteering  Start OODA

55  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!


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