Standardized Work

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

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

1. Standardized Work Defined

What is it ? 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

History of Standardized Work Based on proven U.S. military methods Incorporated by T. Ohno during the 1950’s at Toyota Part of Standardization, which is the foundation of Toyota Production System

“I don’t care how you get the job done, just do it.” Old Paradigm “I don’t care how you get the job done, just do it.”

“Everyone does the job the same way each time.” 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. A proper method of problem solving is to repeatedly ask “Why?” something has occurred until you can get to a root cause of the problem.

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

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

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

Standardized Work Summary Four Main Advantages Prevents Over Processing (Waste) Ensures Quality Requirements Lowers/Stabilizes Cost Establishes Normal vs. Abnormal Criteria

2. Standardized Work Pre-requisites

Pre-Requisites Repeatable Human Motion Reliable Equipment Quality Incoming Materials and/or Supplies Accurate Information – On Time

3. Standardized Work Components

Three Components of Standardized Work Takt Time Work sequence Standard In-process stock

Takt Time

Takt Time… Sets the pace Is…. The time allowed to complete one procedure Based on available time and demand Computed and adjusted as demand changes

Takt Time Formula TT = Available Time Demand

Daily Available Time Total daily operating time: EXAMPLE: 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

The total processing requirement EXAMPLE: 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

Work Sequence

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.

Example

4. Standardized Work Forms

Standardized Work Forms Time Study Sheet Standardized Work Chart or Spaghetti Diagram Standardized Work Combination Table Standardized Work Sheet Job Instruction Training Sheet

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

Time Study Sheet

Spaghetti Diagram and Standardized Work Chart

Spaghetti Diagram or STW. Chart… Diagrams operator work sequence Documents: Walking patterns Sequence of job elements

Lab Process Current State Spaghetti Diagram Average time for lab process was 13 minutes with excessive walking Spaghetti Diagram for Lab Process PAT ENTRANCE 3 PATIENTS 4 PAT lab walk time One patient 210 feet process 20 per day =4200 feet per day WILMA 0.5 second per foot = 35 minutes walk time 3 1 LAB AREA Dispatch box lab tube cubicles 7 2 cupboard 6 workbench 8 5

Standardized Work Combination Table

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.

Example

Standardized Work Sheet

Standardized Work Sheet

Example

5. Additional Uses for Standardized Work

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

Job Instruction and Training

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

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 Gov’t. Reg’s Quality Productivity Cost Other

JIT Sheet

Job Instruction Methods 4 Step Approach Prepare Present Tryout Follow-up

Continuous Improvement Problem Solving Continuous Improvement Yamazumi Chart Seven Wastes Motion Kaizen

Yamazumi (Work Balance) Chart An effective tool for identifying: Waste Overburden Unevenness A graphical tool used to compare each staff member’s 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

Receptionist Process Time (secs) Current State Waste Reduced Cycle Time Walk back to seat (15 feet)   Place sheet to bin Walk sheet Back to Lab (15 feet) Stamp Top sheet Receive Top sheet Walk back to seat WASTE Place sheet to bin Future state Cycle Time Walk sheet back to Lab Place sheet to bin Time (secs) WASTE Receive Top sheet Stamp Top sheet Stamp Top sheet Receive Top sheet Current State Waste Reduced Future State

Seven Wastes

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

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!!

7 Wastes + 1 Correction/Rework Movement Waiting Inventory 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 people’s abilities to their fullest potential, improper training and education of staff

Causes of Waste Organizational issues Operational 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

Why Reduce Waste? Makes Work Safer Faster Cheaper Easier

How Do We Reduce Waste ? Eliminate: Combine: Reduce: Simplify: Workstations, Complexity Combine: Workstations, Processes Reduce: Content, Complexity Simplify: Process

Motion Kaizen

Kai = Change Zen = for the Better Definition of Kaizen Kai = Change Zen = for the Better “A change for the better” or “continuous improvement”

Kaizen Events… Targeted Improvement Document Standardized Work Study through observation to improve Document and train new Standardized Work to maintain the improvement

Instructions for Work Kaizen Objectives In order to Kaizen, we look at the worker’s 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

Kaizen Example: - Current State Lab Process Spaghetti Diagram for Lab Process PAT ENTRANCE 3 PATIENTS 4 PAT PAT lab walk time One patient 210 feet process PAT 20 per day =4200 feet per day PCA 0.5 second per foot = 35 minutes walk time PAT 3 PAT 1 PAT LAB AREA PAT Dispatch box lab tube cubicles 7 lab 2 cubicles lab cupboard 6 workbench cubicles lab cubicles 8 lab 5 cubicles Average time for lab process was 13 minutes with excessive walking

Lab Process Future State Spaghetti Diagram Spaghetti Diagram for Lab Process LAB Triage 1 PAT ENTRANCE 3 PATIENTS PAT Lab walk time One patient 15 feet process PCA LAB AREA Dispatch box lab tube cubicles 2 cupboard workbench 3 EXIT DOOR Implemented efficient and standardized process focusing on waste reduction ( 54% Reduction in lab process time )