What it is A methodology and set of tools for process improvement What to use it for It is used for improving an existing process, redesigning a process, or creating a process where none existed How to use it

Doing Things Right Doing Right Things Tools • Brainstorming

Tools • Multivoting • Impact analysis

• Measurement matrix • Basic descriptive

charts • Contingency diagram • Benchmarking • Innovation transfer • Force-field analysis • Building individual

support • Action plan • Presentation • Input-output diagram • Flowchart • Fishbone diagram • Pareto analysis • Why Technique

1. Identify improvement opportunity

• Selection grid • Opportunity Statement • Team Charter • Team member

checklist • Roles and

responsibilities chart • Customer-supplier

network map • Customer requirement

chart • Impact analyzer • Survey • Check sheet

7. Measure and

monitor 2. Identify key

customers and suppliers

3. Establish agreed-upon requirements

4. Identify the gaps

5. Describe and analyze current

process

6. Develop and execute solutions

I. Brainstorming 3 II. Multivoting 3 III. Storyboarding 4 IV. Flowchart 5 V. Force-Field Analysis 6 VI. Cause and Effect (Fishbone) Diagram 7 VII. Pie Chart/ Bar Chart/ Run Chart 8 VIII. Pareto Chart 9 IX. Scatter Diagram 9 X. Histogram 10 XI. Control Chart 11 XII. Gantt Chart 12 XIII. Contingency Diagram 13 XIV. Team Charter 14 XV. Why Technique 15 XVI. Impact Analyzer 16 XVII. Visual Management Sheet 17 XVIII. Quad Sheet / Continuous Improvement 18

2

What it is A technique for generating a list of ideas What to use it for Generating lists of processes, topics for data collection, potential solutions How to use it 1. Decide on a topic

2. Have each member in turn offer an idea about the topic. Other members should refrain from any comment, listen and build on each other’s ideas

3. Have one person record all the ideas on a flipchart 4. Continue the process until the team feels it has exhausted its ideas on the topic 5. Discuss and clarify the ideas on the list

Example A “wish list” for new office lunchroom Running water and sink Soft drink machine Tables and chairs Fruit-juice fountain Microwave oven Free bagels and cream cheese Food delivery service Toaster Massage lounge chairs Refrigerator

What it is A technique to narrowing down a list of ideas or options. It is used in conjunction with brainstorming What to use it for Selecting a process, topic for data collection, solution, or item to monitor How to use it 1. After a list of topics is generated, have one person record the ideas on a flipchart 2. Review and clarify each idea. Combine any similar ideas

3. Have each member assign ten points to the ideas (no more than 7 points in one category), and record their points for each idea on the flipchart

4. Tally the votes for each idea. Narrow down the list to the four to six ideas that received the most votes Example A “wish list” for new office lunchroom Running water and sink (4) Soft drink machine (8) Tables and chairs (11) Fruit-juice fountain Microwave oven (7) Free bagels and cream cheese Food delivery service Toaster (4) Massage lounge chairs Refrigerator (15)

3

4

What it is A systematic process for creative thinking that combines idea-generating (brainstorming) and analysis of ideas. What to use it for 1. Identify creative alternatives for problem solving and decisions

2. To go beyond brainstorming and identify a recommended alternative solution How to use it

1. Define the topics on a 5 x 8 card and tack to the wall. 2. Define and agree on the “leaders” on major areas that need consideration on this topic and place them on a

4 x 6 card. 3. Present the guidelines:

• Evaluation and judgement are forbidden • The quantity of ideas is important • Wild, far fetched and “illogical” ideas are encouraged • Ideas may be combined, modified, or “piggybacked”

4. Give each participant some 3 x 5 note cards. When they have an idea for one topic, they write it on a card, say it out loud, and hand it to the facilitator

5. When there is silences, move on. 6. Participants begin objection-counter where any individual can raise questions, or ask for removal of an idea-

anyone can counter the objection. Cards are removed and rewritten. 7. Decision about final board are made by consensus 8. Ideas are ordered into proper sequence to be written into hard copy.

Example BEFORE A WOMAN HAS AN MRI SHE NEED TO:

Know she will need to lie still for 1-½ hours. Know the procedure will be done at the hospital. Know there is load noise during the procedure. Let her doctor know if she is claustrophobic. Know she may have tapes of music with her. Know what the size limit is for the equipment. Know to remove her valuables. Know to use the bathroom before the procedure. Know to check with her insurance to see if she needs pre-authorization. Know to tell someone if she has any history of metals in her body. Know to ask her doctor for a sedative before the procedure.

What it is An illustration of the sequence of activities that make up a process What to use it for 1. Understanding the activities that constitute a process and the relationship among those activities

2. Providing a framework for further process analysis by ensuring that the list of activities is complete 3. Identifying opportunities to eliminate problems, add missing steps, and streamline work

How to use it

1. Set boundaries for the process • Decide where the process begins and ends

2. List all the activities in the process 3. Arrange the activities in sequence, make sure to include all decision points 4. Draw arrows to clearly show the sequence of activities 5. Review the flowchart and answer these questions:

• Where are the bottlenecks in your work flow? • Where can rework or redundant steps be eliminated? • Where can time be saved?

Example Serving customers in a restaurant process flow

5

Begin, end Activity, task Decision

point Delay

Customer Enters

Take Order

Take money and give change

Food Ready

?

Wait until food is ready

Give food to

customer

Say “Thank

You!” Customer

leaves restaurant

Yes

No

What it is A method to identify forces that make possible or obstruct a change. These forces are driving forces (help you achieve a change) and restraining forces (work against a change).

What to use it for 1. Determining if a solution can get needed support 2. Identifying obstacles to execution

3. Suggesting actions for reducing the strength of the obstacles How to use it 1. Draw a force-field chart (a large “T”)

2. Write the current situation at the top center of the chart 3. Write the desired situation at the top right of the chart 4. Brainstorm for driving forces (pushing toward what you want) and enter them on the left side of the chart 5. Brainstorm for restraining forces (preventing you from getting what you want) and enter them on the right

side of the chart 6. Discuss the chart and determine which factors could be altered to increase the chances of success 7. Decide whether your solution is doable. If it is, make a list of action items to alter the forces. If it isn’t,

develop another solution. Example

6

Present Delivery System

Proposed Delivery System

Current Situation What you Want

Driving Forces Dissatisfaction of “regular order” customers Shipping department backup

Dispatcher errors

Low morale

Lost business

Restraining Forces

Grocer hollers at “Emergency” driver Unhappiness from “emergency“ grocers who get orders late

Phone calls to shipping from irate customers

Resistance from scheduling office

Resistance from management over drivers making their own schedules

What it is A diagram showing the possible causes for a problem, with detailed causes attached to the main causes What to use it for 1. Getting the big picture of a problem 2. Facilitating team members’ use of their personal knowledge to identify causes of the problem

3. Providing ideas for data collection and/or solutions

How to use it 1. Write the problem on the right side of a flipchart and draw a large arrow that points toward the problem 2. Draw arrows indication the main types of causes (or contributing factors) and points toward the central error 3. Brainstorm for specific causes and attach each specific cause to an appropriate main cause 4. Break down the causes further by brainstorming for sub-causes

Example

7

Hand and Wrist Injuries

Machines People

Methods Materials

Assembly line

Drill Press

Carelessness

Physical Problems Fatigue

Ignorance of correct procedure

Lighting

Monitoring

Poor machine maintenance

Assembly lineSharp objects

Heavy Objects

Ceramics

Metals

Bases Tools

Height

Lack of guard

Poor eyesight

Poor hearing

Poor coordination

Speed

Maintenance

Work movements

This is the “effect”, or major error

This is major cause

This is a sub-cause

This is a category of causes

8

Trend Chart of New Recruits

02468

10121416

1 3 5 7 9 11 13 15 17 19

Week

Num

ber o

f New

Rec

ruits

Sharpshooters

Cooks

Infantry

Calvary

Medical

Officers

2428

13620

24283153 3090

6841

0

2000

4000

6000

8000

10000

12000

14000

16000

Number of Troops

Num

ber o

f Tro

ops Sharpshooters

CooksInfantryCalvaryMedicalOfficers

What they are A way to describe what is happening by summarizing quantities of data in simple visual displays What to use them for 1. Seeing results yourself

2. Presenting results to others Examples Pie Chart The pie chart divides the whole into parts, showing each part as a slice of the pie.

Bar Chart

The bar chart displays comparisons, with each bar indicating the number or volume of the items measured.

Run Chart The trend chart, or run chart is widely used for monitoring and tracking changes is processes over time.

What it is A technique for determining the most significant causes of problems. What to use it for Identifying the one or two situation categories in which most of your problems occur. How to use it 1. Define the categories to be used in

your diagram

9

Causes of Heat Loss

$0$200$400$600$800

RoofWalls Other

Category of Heat Loss

Cos

t per

C

ateg

ory

0%20%40%60%80%100%

Perc

enta

ge

2. Sort the data into categories and arrange the categories in descending orders as defined by the data

3. Make a bar graph based on the data, with the highest category on the left

4. You can also include a cumulative run chart on the bar graph that shows the percentage of the entire data set each category contains

Example

0

2

4

6

8

10

12

0 2 4 6 8 10

X

What it is A graphical representation of data points What to use it for To illustrate the relationship between two variables How to use it 1. Gather data and determine high and low value for each factor

2. Decide which factor will be plotted on the horizontal axis 3. Draw and provide clear labels on axes 4. Plot the paired data 5. Identify and classify the pattern of correlation

Strong correlation – suggests that control of one results in control of other Weak correlation – suggests control of one does not necessarily result in control of other No correlation – suggests no relationship Complex correlation – suggests non-linear relationship

What it is A graphic summary of variation in a set of data What to use it for To identify patterns in a set of data How to use it 1. Collect at least 40 data values

2. Determine the range of the data by subtracting the lowest data value form the highest Highest Value – Lowest Value = Range

3. Determine how many bars you will use to display your data on the histogram (6 to 12 bars is good – use more for large collections of data)

4. Divide the range by the number of bars to determine the range of values that will be represented by each bar 5. Create a chart with the horizontal axis labeled with the bar ranges and the vertical axis labeled with the

corresponding number scale 6. Draw the bars on the chart 7. Use the chart to identify and classify patterns of variation and to develop a plausible and relevant

explanation for the pattern Example

10

Height of 10-year old boys

0

5

10

15

20

25

30

35

0 to2

3 to4

5 to6

7 to8

9 to10

11 to12

13 to14

15 to16

17 to18

19 to20

21 to22

23 to24

Ranges (range = 24 inches)

# of

boy

s in

rang

e

What it is A tool used to analyze and understand the variation in a process over time What to use it for 1. To observe and predict the performance of a process

2. To determine if a process is “in control” How to use it 1. Plot data in time order

2. Calculate the average 3. Determine the median of the ranges 4. Multiply the median of the ranges by 3.14 5. Add the result to the average to get the Upper Control Limit (UCL). Subtract the result from the average to

get the Lower Control Limit (LCL). 6. Draw the centerline (average) and control limits on the chart with the data points

Points in control?

• Only common causes of variation • Points fall within control limits • Greater uniformity cannot be attained with the process as it currently exists • Improvement can only be achieved by changing the process

Points out of control?

• Points outside the control limit (investigate cause, eliminate special cause if identifiable negative, incorporate special cause if positive)

• Runs: a group of points collected one after another ( six points in a row above or below centerline, 14 points in a row alternating up or down)

Example

0 : 0 0

0 : 1 4

0 : 2 8

0 : 4 3

0 : 5 7

1 : 1 2

1 : 2 6

D a y s o f t h e W e e k

Valu

es (m

inut

es)

U C L

L C L

11

What it is A graph of a project schedule What to use it for 1. To help make scheduling easier

2. To help monitor time How to use it 1. List elements of your project plan where work is done down the left edge

2. Draw a timeline across the bottom 3. Draw a bar between the start and finish dates for each element

Example

Gantt Chart for planting a garden

12

ID Task Name Duration1 Plant garden 1.81 days

2 Draw garden layout 2 hrs

3 Buy seeds and supplies 3 hrs

4 Plow dirt 2 hrs

5 Make holes 1 hr

6 Plant seeds 2 hrs

7 Cover seeds 0.5 hrs

8 Spread hay or mulch betw 1 hr

9 Water garden 3 hrs

8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2Thu Aug 17

What it is A way to find good solutions to persistent problems using reverse logic. What to use it for To plan actions that will prevent a problem from recurring How to use it 1. Select a situation where change is needed and possible

2. Draw a diagram like the one below and write the situation in the oval. 3. Work with others to brainstorm actions that would make the problem continue or worsen and write those

actions on the lines to the left of the oval. Follow these guidelines: • Assign one person to record all ideas on a flipchart • Have group offer ideas in turn (If a person does not have an idea, they can pass) • Never criticize, praise, or question ideas • Continue until the group has no more ideas • Discuss and clarify the list

4. Think of actions that would prevent the problem from continuing or worsening and create a prevention checklist that describes these actions as specifically as possible

Example

Problem: losing information between day and night shifts

13

Losing Information

Don’t provide a place to record information

Prevent shifts from seeing each other

Blame the other shift

Assume everyone knows that information is important

Prevention Checklist

Keep a detailed logbook Have change-of-shift meetings Designate someone on each shift to be responsible Explain why information is important

14

What it is A written document describing the

purpose of a team’s process improvement effort and how it is to be accomplished

What to use it for 1. Focusing the activities of the team

2. Showing others what the team is doing

3. Providing a record of past improvement activities

4. Providing a framework for ongoing discussion between the team sponsor, leader, and members about the process improvement effort

How to use it 1. Draft a team charter, including the

following :

Name of the process to be managed or improved

Organizational goals and strategies to be addressed

Boundaries of the process Improvement targets and measures Resources available Constraints Time frame for completion Team strategies: expectations about

how the work will be done 2. Review the team charter with

members of the improvement team and modify it as needed

Example

Name of process to be managed or improved

License Renewal Team Charter

License renewal (for applicants who come to a Registry office; mail applications are not included). Delighting the public through excellent customer service Beginning and end points Beginning: Applicant enters registry office.

End: Applicant leaves with new license or other disposition of application. What is not included?

Not included: Applicants who come in for multiple purposes; mail applications A. Significantly decrease turn-around time- Measure = cycle time B. Significantly increase applicants’ satisfaction- Measure = customer satisfaction ratings A. Team members can meet for three hours per week, counted as regular work time. B. Team can spend up to $1 million for new equipment, training, facilities, etc. None other than above Begin March. Expect new system to be implemented by October. A. The project will focus primarily on customer satisfaction, although reductions in cycle time

should also result in eventual cost savings B. Large-scale redesign of processes can be considered. Benchmarking against other state agencies

is expected. C. The team will include representatives of all major functions involved in the process

Name of process to be managed or improved

Organizational goal and strategies to be addressed

Boundaries of the process

Improvement targets and measures

Resources available

Constraints

Time frame for completion

Team Strategies

15

What it is A way to move through layers of causes to get at the preventable root cause of a recurring problem What to use it for To find the root cause of a problem that may be masked by other symptoms How to use it 1. Select a recurring problem

2. Ask “Why did the problem occur?” to uncover the first-layer causes 3. Take the causes that you uncovered in step 2 and ask “Why did they happen?” to uncover the second-layer

causes 4. Continue asking why the previous causes happened until you believe you have uncovered the most

important, root cause Example Problem Recently, a number of projects have been delivered late. Why did that problem occur? (first-layer cause)

Despite our best efforts, we were not able to complete those projects on time. We’re spread too thin. It seems as though we’ve got way too many projects for the number of people in the department. Why did that occur? (second-layer cause) Productivity is down, and employees are calling in sick every day. Why did that occur? (third-layer cause) Our employees have been doing way too much overtime in the last six months – they’re getting burned out. Why did that occur? (fourth-layer cause) One big reason is that the computer network is always going down. This causes repeated work stoppages and even lost files, which must then be recreated from scratch. Also, file transfers are very slow over the network, which causes work delays. Basically, it’s taking our employees longer to do less work. Why did that occur? (fifth-layer cause) The company has outgrown its network. MIS tells us that we are now running 132 terminals over a network designed to handle 100 workstations, maximum.

What it is A way to identify the effects that a change will have throughout an organization What to use it for 1. Visualizing the impact of process changes before they change happens

2. Planning to manage changes in an organization How to use it 1. Identify the proposed change and write it in the center of a flipchart

2. Brainstorm the primary effects of that change and write them on the flipcharts, connecting them to the proposed change with a single line

3. Review the primary effects and determine whether there are any expected secondary effects. Link those to the primary effects with a double line

4. Repeat step 3 for the secondary effects, connecting tertiary effects to secondary with triple lines 5. Determine action steps for successful implementation

Example 16

Plan to use more people

in other areas

Gear up HR for

counseling

Develop new

procedures

Change reporting relations

Consolidate

functions

Redeploy staff in

data entry

Install new

hardware

Create new

software

Align MIS function with new process

Redesign billing process

Train meter readers on

new technology

Supervisors more

involved in training

Enlarge training budget

The team realized that the changes it was visualizing would require additional training for supervisors and revisions in the reporting relationships and structures. Members decided on the following action steps:

Schedule an executive meeting off-site to review the organizational structure

Inform HR of its expanded role in redeployment activities

Provide training skills to the supervisors

What it is A method of communicating project goals, roles and responsibilities, resource requirements, progress, and

outcomes What to use it for To have a clear, concise document of a project to show to others in the organization

Reason for the project Why we are doing this project, or what is wrong with the status quo

Process Owner/ Executive Sponsor

Which Senior Staff-person is ultimately accountable for the project’s success

Physician Sponsor Which Physician is responsible for gathering physician input and buy-in for the project

Project Team Leader Who is responsible for providing day-to-day project management

Advisors Who is responsible for providing project management and other types of technical support

State the Project A concise statement of what the project will achieve, by when and at what cost

Objectives A list of specific outcomes the project will achieve

Measures of Success How we will track progress and know we have achieved the desired outcomes

Work Breakdown Structure (WBS)

A summary of the main steps of the project and the timeline for completing those steps

Resource Requirements What resources are needed to make the project succeed

Requirements for Success

A list of internal factors that might endanger the success of the project (things the organization can control)

Protect the Plan A list of external factors that might endanger the success of the project (beyond the organization’s control)

17

18

What it is A document that helps to identify problem areas and develop action plans to solve the problems What to use it for 1. To identify problem areas in a process

2. To document these problems as well as the improvement plan

How to use it 1. Fill out the top portion of the Quad

Sheet with the Management Model Section the problem corresponds to, the process name or approach, the process owner, and the date the sheet is initially filled out 2. In the concern box, write your reason

for filling out the sheet (the problem that caused your concern about the process)

3. Determine the gap you are trying to close (the measures dealing with the problem) and put that in the Performance box

4. Brainstorm causes leading to the gap and place them on the fishbone in the Contributing Factors box

5. Be positive by identifying the strengths in the process and place these in the strengths box

6. Determine areas in the process that need improvement and place them the Improvement Areas box

7. Develop an improvement plan to

close the gap. The improvement plan involves determining actions, the person responsible for the actions, the date the action should be complete, and the measure that will determine whether the action was effective or not

Example: Continuous Improvement Plan Worksheet

Management Model Section: 2.2 Selecting, Attracting, Matching Process name (Approach): Applicant Tracking Process Owner: Jon Joffe Date: 2/23/2000

Concern: The current Applicant Tracking database does not meet internal or external customer needs.

PERFORMANCE Current system is a stand-alone

database- does not connect to other databases

The same data must be entered into multiple databases

CONTRIBUTING FACTORS Causes:

Limitations & design of Access database Staff who try to make system work Processes not documented or communicated Lack of funding for more robust system

STRENGTHS HR senior management support Passionate process owner HR project manager Strong end user desire for new system

IMPROVEMENT AREAS Enable staff to track job fulfillment

process throughout Enable staff to create a useful set of

reports Interface with current Lotus Notes

IMPROVEMENT PLAN & SUPPORT REQUIREMENTS Action Responsibility End Date Measure Joffe, White 7/15/2000 Review Date: 8/14

Begin project to install PS Applicant Tracking Module

Project meets all structure, process and outcome measures id’d in project plan

19

Courtesy of Duke Rohe (drohe@att.net) HIMSS Management Engineering & Process Improvement (ME-PI) Community

http://www.himss.org/ASP/MEPI_Home.aspCourtesy