lean principles donna m. daniel, phd

Lean Principles

Donna M. Daniel, PhDPerformance Improvement QIO Support Center

Qualis HealthSeptember 12, 2006

Defining Lean

• containing little or no fat – Webster.com

• The least-wasteful way to provide value to a customer.– Fewer resources– Fewer costs– Higher quality– Higher staff satisfaction– Shorter delivery time

Lean Objectives

• Search For and Eliminate Waste

• Reduce Time Waiting and Processing

• Reduce Cost

How Will We Achieve These Objectives?

• Employees who do the work lead process improvement

• Rethink work as producing a product or service to be used by other employees

• Rethink work in terms of customers and suppliers

Lean Principles

• Waste Elimination• Standardized, Steady Flow Processing• Inspection• Visual Cues

Waste Elimination

Defining Waste

• damaged, defective, or superfluous material produced by a manufacturing process – Webster.com

• Something that consumes resources, but adds no value to a product or service.

Types of Waste• Processing• Inspection• Inventory• Wait Time• Search Time

• Transportation• Space• Complexity• People

© 2002 Joan Wellman and Associates

Waste Exercise

Rank your top three types of waste that you encounter in

your daily activities.

Where are you?Unaware• All steps are necessary; individuals are reasons for inefficiencyBeginner• Inspection is necessary; starting to see process inefficiencies Intermediate• Map processes; remove steps, inspections and queues; reduces

distance and time; see handoffs as potential for error; able to identify ideas

Expert• Sees inventory, transportation, inspection, queues, unnecessary

handoffs as waste; question all processes; able to implement ideas

Strategies for Reducing Waste

• Train all employees on lean• Establish leadership expectations• Implement a 5S program• Standardize work methods between people and

departments• Smooth out processes for continuous flows• Eliminate wasteful steps• Ask “why” five times

Standardized, Steady Flow Processing

Four Stages to a Lean System• Work is performed in silos, e.g:

departments• Work is performed in a co-located team• Work is performed with a standardized

steady flow to the process • Work is performed by cross-trained

employees

Adapted from Joan Wellman and Associates

Stage 1

AHHH

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Stage 2

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Stage 3

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Standardize the Work• Critical activities performed in a standard

way• Documented, explicit, reliable methods• Leads to creativity and improvement

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Steady Flow Processing

• Customary Batch • Lean Processing

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Stage 4

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Benefits of Standard Steady Flow Processing

• Better communication

• Decreased response time to changes from the customer

• Increased productivity

• Reduced labor and space needs

• Opportunity to expand job skills

© 2002 Joan Wellman and Associates

Benefits of Standard Steady Flow Processing

• Less frustration and pressure for employees

• Identifies quality problems upstream in the process

• Visual cues makes it clear when to work, what to work on, and when to start and stop processing

• Process begins to manage itself

© 2002 Joan Wellman and Associates

Inspection

Level 1: Customer Inspects

Suppliers 1 2 3 4 Customers

Erroroccurs

Customer finds defect

Feedback

© 2002 Joan Wellman and Associates

Level 2: Company Inspects

5Suppliers 1 2 3 4 Customers

Erroroccurs

Inspector finds defect

Feedback

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Level 3: Work Unit Inspects

Suppliers 1 2 3 4 Customers

Erroroccurs

Defectdetected

5

© 2002 Joan Wellman and Associates

Level 4: Self Inspection and Correction

Suppliers 1 2 3 4 Customers

Errorcaused, detected and corrected

5

© 2002 Joan Wellman and Associates

Level 5: Eliminate Opportunities for Errors

Process controls and design prevent error

Suppliers 1 2 3 4 Customers5

© 2002 Joan Wellman and Associates

5.

4.

3.

2.

1.

Level

PreventionNo one

Instant Detection, Immediate Correction

Individual

Early Detection, CorrectionWorkgroup

Detection, Inefficient Correction

Company

DetectionCustomer

OutcomeWho Inspects?

Levels of Inspection

Visual Cues

Visual Cues• Use visual cues to…

– Display standardized methods in use– Identify abnormal conditions immediately– Communicate performance measures

• Who uses visual cues?– The people working in the area– Those who support the people working in the

area

Implement a 5S Program5S is a systematic program for workers to take control of their workspace so that it actually works with and for them (and their customers) – rather than being a neutral, or as is quite common, a competing factor.

The 5Ss• Sorting: Separate the needed from the unneeded,

and remove the unneeded• Simplifying: A place for everything and every-thing in

its place, clean and ready for use• Systematic Cleaning: Conduct regular cleaning and

inspection; use mess prevention• Standardizing: Document and follow the best known

methods• Sustaining: Hold the gains, continue to improve, and

make 5S a way of life

Why 5S?Enhances present process by:• Reducing time wasted• Reducing errors• Reducing training time• Reducing excess inventory

– Increasing the visibility of problems– Improving workplace cleanliness

• Improving teamwork• Reducing safety hazards

Why 5S?

Spirit of Improvement• Use our minds first, not our money• Challenge current thinking• Look for leadership at all levels• Substitute “we don’t know how to do it yet”

for “we can’t”• Remember that you are the experts

© 2002 Joan Wellman and Associates

•Acknowledgments•Qualis Health would like to thank Joan Wellman & Associates, Inc. and Lean Enterprise Institute for the foundational materials used to develop this presentation.

•For more information•Please contact the Performance Improvement Quality Improvement Support Center at piqiosc@waqio.sdps.org.

•Disclaimer•This material was produced by the Performance Improvement Quality Improvement Organization Support Center at Qualis Health, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The content presented do not necessary reflect CMS policy.