Six Sigma Yellow Belt Short Course
Six Sigma Yellow BeltShort CoursePresenters:Victoria Jordan, PhD, MS, MBADiane Schaub, PhD, CQE, CMQ/OE UT MD Anderson Cancer Center, 2013
Victoria Jordan, PhD, MS, MBA Director, Quality Measurement andEngineeringPhD Industrial and SystemsEngineering, Auburn UniversityJoined M. D. Anderson in April 2008Previous work:– AU IE and Stats Faculty 2004-2007– Vanderbilt University Medical Center– Luftig and Warren Consulting (Alcoa,Anheuser Busch, Inland Steel, Molex)– General Electric– Ampex Corporation Founder of Cynthia Spooner HankesCancer Resource Center in ALSlide 2 UT MD Anderson Cancer Center, 2013
Diane Schaub, PhD, CQE, CMQ/OE Sr. Statistical Applications Analyst PhD Industrial Engineering, ArizonaState University Joined M. D. Anderson in May 2011 UF IE Faculty 1994-2011 Worked at AlliedSignal Aerospaceand Bethlehem Steel as a QualityEngineerSlide 3 UT MD Anderson Cancer Center, 2013
Administrivia RestroomsQuestionsBreak-out sessionsConduct request (silence cell phones) UT MD Anderson Cancer Center, 2013
Section 1 - Introduction to Six Sigma1. Introduction to Six Sigma1.1 General History of Quality and Six Sigma1.2 Meanings of Six Sigma1.3 The Problem Solving Strategy Y f(x)1.4 Comparison of CS&E, Lean, and Six Sigma2. Fundamentals of Six Sigma Implementation3. The Lean Enterprise4. Managing a Successful Six Sigma Effort Course Evaluation and Wrap-Up UT MD Anderson Cancer Center, 2013
History of Quality and Six Sigma in US Pre-W.W.IIDuring W.W.IIAfter W.W.II1980’s awareness(Ford Batavia) From industry to government andservice organizations Motorola – Six Sigma – 1981 General Electric - 1995 UT MD Anderson Cancer Center, 2013
Ford – Batavia, Ohio Meeting specification is not good enough, wemust work to reduce variation around acustomer-defined target. UT MD Anderson Cancer Center, 2013
But We Don’t Make Cars . Dr. Gary Kaplan, CEO of Virginia MasonMedical Center, on the need to increase valuein healthcareQuality UT MD Anderson Cancer Center, 2013Cost
Six Sigma DefinedManagement System Six Sigma drives strategy executionLeadership sponsorship and reviewMetrics driven governance processEngagement across the organizationMethodology Consistent use of DMAIC modelTeam-based problem solvingMeasurement-based process analysis,improvement, and controlGuided by Black Belts, Green BeltsManagement SystemMethodologyMetric The Six Sigma Black Belt Handbook, McCarty, Daniels, et.al, McGraw-Hill 2005.Metric Measure process variationAim to minimize defects permillion opportunities (DPMO),not percentages9
Why Six Sigma?To INCREASE process performance, you have to DECREASE variationToo earlyToo earlyToo lateDefectsToo lateDefectsDelivery TimeSpread of variationtoo wide comparedto specificationsLess variation provides: Greater predictability in theprocess Less waste and rework, whichlowers costsReducevariationDelivery TimeSpread of variationnarrow compared tospecifications Products and services thatperform better and last longer Happier customersEvery Human Activity has VariabilitySlide 10 UT MD Anderson Cancer Center, 2013
Defects per Million Opportunities Since 99.9997% is a bit awkward to use, a newmeasurement scale was developed usingdefects per million opportunities. A process running with Six Sigma qualityproduces 3.4 defects per millionopportunities. UT MD Anderson Cancer Center, 2013
Examples of Six Sigma Quality A process that operates at 4.6 Sigma is operating at a99.9% quality level. This means annually we have*:– 1281 errors in outpatient treatments– 11,620 mistakes in pathology or lab procedures– Nearly 4000 surgical errors If we were to maintain 6 Sigma performance, thiswould be a 99.9997% quality level. Annually this is:– 4 errors in outpatient treatments– 35 mistakes in pathology or lab procedures– 12 surgical errors*based on FY12 clinical activity at MDACC UT MD Anderson Cancer Center, 201312
Six Sigma Methodology for ProcessImprovement (DMAIC)DefineMeasureAnalyzeImproveControl UT MD Anderson Cancer Center, 2013
General Model of a Process y f(x)Controllable factorsx2xpx1 InputsOutputProcessy z1 UT MD Anderson Cancer Center, 2013z2zqUncontrollable factors
Specific Example of a InputProcessOutputDifficult to orbiditiesFinishtime UT MD Anderson Cancer Center, 2013RecoveringPatientComplications
Six Sigma is a New Way of Seeing It is helpful to look at important aspects ofyour practice, job, business as processes There will be some variables that you canreadily affect, others that are difficult tocontrol Your task will be to optimize the ones that youcan, and to mitigate the ones that you can’t UT MD Anderson Cancer Center, 2013
Quality ImprovementPatient SatisfactionBaselinePatient Wait TimeIntervention1UCL 92.78692X 90.21288LCL 87.637841713192531374349Wait Time (Minutes)Strategic ImprovementObjective– Increase/decreasein key metric seenfollowing teaminterventionPatient Satisfaction Score 240UCL 32.95X 19.2820LCL 5.6105517131925MonthVariance From BudgetX -0.090713192531375543490.96P 0.92520.90LCL ng CompliancePercent CompliantPatient Complaints025Month30Month UT MD Anderson Cancer Center, 201349UCL 1LCL -5.801Number of ComplaintsKaizen IncrementalContinuousImprovement– Many smallimprovementsmade by manypeople over time43UCL 5.615-5 37Performance Evaluations CompletedProportionMaintenanceObjectives– Maintainperformance onkey metricsPercent 31Month456090807001530Month4560
The Process Improvement Triad: CS&E,Lean, and DMAICOVERALL PROGRAMSCS&ELeanDMAICIMPROVE CLINICALSAFETY andEFFECTIVENESSELIMINATEWASTE,IMPROVECYCLE imeCapableClinical Flow Requirements allocation Capability assessment Predictable Process QualityLEAN Flow Mapping Waste Elimination Cycle Time WIP Reduction Operations and DesignVariation Reduction Predictability Feasibility Efficiency Capability AccuracyAdapted from: Introduction to Statistical Quality Control, 5th Editionby Douglas C. Montgomery.18Copyright 2005 John Wiley & Sons, Inc.
Section 2 – Fundamentals of SixSigma Implementation1. Introduction to Six Sigma2. Fundamentals of Six SigmaImplementation2.1 Understanding the Voice of the Customer (VOC)2.2 Critical to Quality Characteristics (CTQ’s)2.3 DMAIC Methodology2.4 Case Studies3. The Lean Enterprise4. Managing a Successful Six Sigma Effort Course Evaluation and Wrap-Up UT MD Anderson Cancer Center, 2013
What is a Process? Business Processes are designed to add valuefor the customer and should not includeunnecessary activities The outcome of a well designed businessprocess is increased effectiveness (value forthe customer) and increased efficiency (lesscosts for the company) (Wikipedia) A business process should listen to the Voiceof the Customer (VOC) UT MD Anderson Cancer Center, 2013
The Customer We have many customers both external andinternal. One external customer is obviously thepatient, however, insurance companies, CMSJCAO are also external customers Our internal customers are the ones who aredownstream from us. Physicians, RNs arecustomers of diagnostic imaging, labs,pharmacies, etc. UT MD Anderson Cancer Center, 2013
The internal customer Along with viewing our work as a process, weshould understand that our output leads to theinput of our internal customer. This is viewed byour external customers as the output of ourhospital. By adopting this view, we can find ways toimprove our outcomes. For example, efficiently admitting a patientresults in fewer insurance payment issues andyields a happier patient. UT MD Anderson Cancer Center, 2013
The external customer More information is readily available to ourexternal customer. USNWR rankings Hospitalcompare.hhs.gov Metrics reported to agencies HCAHPS Surveys UT MD Anderson Cancer Center, 2013
Translate Customer Needs (VOC) toCTQsVerify Customer Needs Most often, we will need to translate a customer need into aquantified requirement for the product or service This quantified requirement is termed a CTQ– Critical To Quality Project goals needs to be based on:– A Target Value– Specifications or Tolerance Limits– Defect levels UT MD Anderson Cancer Center, 2013Slide 24
Translate VOC to CTQs UT MD Anderson Cancer Center, 2013DelightDelightersResignedCustomer SatisfactionKano Model Describes which needs, if fulfilled, contributeto customer dissatisfaction, neutrality, ordelight “Must Be” needs– Those the customer expects– Generally taken for granted—unlessthey are absent! “More is Better” needs– Have a linear effect on customersatisfaction– Customers generally discuss or bring upissues related to More Is Bettercharacteristics “Delighter” needs– Do not cause dissatisfaction when notpresent, but satisfy the customer whenthey are– Can be differentiators between you andthe competitorPleasedto RealityNeutralMust BeNotTaken ree ofAchievementSlide 25
Translate VOC to CTQsVerify Customer Needs:QualityFeatures, Attributes, Dimensions, Accuracy, Accessibility, Effectiveness Defect freeCostPrices to Customer, Price to Insurer, HMO, or Hospital, Payment TermsDeliveryService &SafetyComplianceLead Times, Delivery Times, Turnaround Times, Setup Times, Cycle Times,DelaysService Requirements, Service Responsiveness, Database Maintainability,Records Maintenance & Retention, Customer-Required Maintenance, ProductLiability, Product/Service SafetyEthical Business Conduct, Environmental Impact, Regulatory and LegalCompliance (this area tends to be a Business non-negotiable)The key is to understand how your customers define and prioritize thevarious needs and expectations they have of your products and services UT MD Anderson Cancer Center, 2013Slide 26
Translate VOC to CTQsCritical to Quality RequirementsSignify importance to the customer The customer “cares about it”Value propositionSpecify a requirement “Must have” attributesUltimately satisfiesPotentially delightsIf CTQs are not defined to the pointthat a clear target withspecifications is established,the team will not be able todetermine the baseline level ofperformance.Establishes a basis for targets Customer specificationsAcceptable range of performanceCan be measuredEffective process improvement requires that we understand and quantify thecause and effect relationship of every element of our business operation UT MD Anderson Cancer Center, 2013Slide 27
Translate VOC to Measurable CTQsKey Customer IssueVoice of the CustomerActual customer statementsand comments which reflecttheir perception of: An attribute of a productor serviceAn experience with aproduct or service or itsdeliveryAn encounter orexperience with a businessprocess or representative UT MD Anderson Cancer Center, 2013The real customer concerns,values, or expectationsregarding a product or service,stated in an unbiased,unemotional manner.Describes: The primary issue thecustomer may have with theproduct or serviceCritical To QualityRequirementThe specific, precise andmeasurable expectation that acustomer has regarding aproduct or service.The experience surroundingthe attributes of the productor service expected or desiredby the customer Slide 28
Translate VOC to Measurable CTQsVoice of the CustomerA. “The Point-of-Use InventoryScanning System is too hard touse.”Key Customer IssueCritical To QualityRequirementA. Take less than 15 seconds to login and find patient.A. Wants the scanning system to beuser friendlyScanning should take less than 3seconds.B. Add additional menu items tothe voice system (bad)B. “I’m always on hold or end uptalking to the wrong personB. Wants to talk to the right personquicklyC. “I always wait a long time for thedoctor when I have anappointment.”C. Wants to keep to promisedschedule UT MD Anderson Cancer Center, 2013Customer reaches the correctperson the first time within 30seconds (good)C. Patient sees the doctor within 5minutes of scheduled timeSlide 29
CTQ Tree: ExampleNeedDriversCTQsTake less than 15 seconds to log in andfind patient.OperationScanning should take less than 3seconds.Ease of Operationand MaintenanceMaintenanceModificationScanner should be fully charged.Computer operational 99% of the time itis needed.Scanning system can be customized forindividual unit needsRequested modifications take 1business day to completeGeneralHard to measure UT MD Anderson Cancer Center, 2013SpecificEasy to measureSlide 30
Why CTQ’s? You can’t directly change customersatisfaction ratings, but by improving the CTQvariables, the output quality will improve They are measureable, and impactableExamples: *How would you describe a good cupof coffee?*How do you choose your doctor?*Which car would you buy? UT MD Anderson Cancer Center, 2013
Develop Measures and IndicatorsResolution ofBilling IssueCustomerNeedCTQBusinessGoalSix SigmaPerformance UT MD Anderson Cancer Center, 2013Product /ServiceCharacteristicTime toResolve IssueMeasureTime mit(s)AllowableDefect Rate36 HoursBefore 48Hours 3.4 DefectsPer MillionOpportunitiesSlide 32
ActivityDevelop Measures and IndicatorsObjectiveInstructionsApply the VOC concept to a project Time UT MD Anderson Cancer Center, 2013Define a preliminary measure based on yourCTQs CTQ Specification Unit of MeasureWhich is a good chart to start with?20 MinutesSlide 33
Six Sigma Methodology for ProcessImprovement (DMAIC)DefineMeasureAnalyzeImproveControl UT MD Anderson Cancer Center, 2013
Overview of DMAICDefine the goals of the improvementactivity (objectives and primary andconsequential metrics.) Obtain goalsfrom direct communication withstakeholders. Select and train teammembers. Identify deliverables andtimeline. UT MD Anderson Cancer Center, 2013
Define Step:Process Metrics Business Metrics – High level existingmanagement performance indicator Primary Metrics – business or process metricthat is focus of team improvement methods Consequential Metrics – process metrics thatcould get worse as a result of improving theprimary metric Financial Metrics – Convert improvement toimpact on bottom line ( )Breakthrough Management Group, Inc.
Tools Used in DMAICDefine Phase Project charter VOC tools (surveys, focus groups,letters, comment cards) Process map QFD SIPOC Benchmarking UT MD Anderson Cancer Center, 2013
Business processes have 3 maincharacteristics: They’re a series of events that produceoutputs They’re defined through numerous steps Their beginning and end points are marked byboundaries A SIPOC chart is a good tool to understandsteps and boundariesFrom Skillsoft training materials
High Level Process Map: SIPOCSuppliersCustomersInputsProcessOutputs A SIPOC diagram is a foundation technique used to develop a high levelprocess map Outlines your process with just enough detail to get you started withmeasurement and analysis UT MD Anderson Cancer Center, 2013
Components of a SIPOC Suppliers– Providers of information, materials or other resources Inputs– Information or materials consumed or transformed by the process Process– Series of steps that transform and add value to the inputs Outputs– Product or service used by the customer Customer– People, company or process that receives output from the process UT MD Anderson Cancer Center, 2013
SIPOC: InputsIdeas UT MD Anderson Cancer Center, 2013Process
SIPOC: High Level Process ViewProcessCapture the Process in 4 – 7 Key Sub-ProcessesStep 1:MixingStep 2:InspectingStep 3:TransportingStep 4:AdministeringSlide 42 UT MD Anderson Cancer Center, 2013
SIPOC: OutputsProcessInformationSlide 43 UT MD Anderson Cancer Center, 2013
UT MD Anderson Cancer Center, 2013
Overview of DMAICMeasure the existing system.Evaluate and document the keybusiness metrics of the currentprocess. UT MD Anderson Cancer Center, 2013
Tools Used in DMAICMeasure Phase Measurement systemsanalysis Exploratory data analysis Descriptive statistics Data mining Run charts Pareto analysis UT MD Anderson Cancer Center, 2013
Reason for Sampling a Process We have a set of metrics we would like to measure to increaseour process knowledge. It may not be practical or even possible to investigate everydata point in the population. So we decide to take a sample.QuestionsPopulationSampleAnswer QuestionsMake Decisions UT MD Anderson Cancer Center, 2013Analyze
Introduction to SamplingIssues to consider Is the data discrete or continuous? Is this a one time event or will you be samplingrepeatedly over time? What is the data source?– Is it data extraction or data collection? What are the important stratification variables? UT MD Anderson Cancer Center, 2013
Introduction to SamplingIssues to consider Risk Management– Samples are great in that they are efficient. The downside to samples is that they vary.– If I take a sample of 12 out of a population of 1,000,and you also take a different sample of 12 from thesame population, we are not likely to get the sameanswer.– The larger the sample size, the better the sample willrepresent the population. However, amount of timeavailable needs to be considered. UT MD Anderson Cancer Center, 2013
Sampling StrategyIf 12 samples can be taken across 3 work shifts, which option is best?Option 1Option 2Option 3 UT MD Anderson Cancer Center, 2013
Selecting the right Sampling Choices What are the sources of variation we areconcerned about?– Measurement Variation– Within hour variation– Hour to hour– Morning to afternoon to evening– Day to day– Week to week– Month to Month UT MD Anderson Cancer Center, 2013
Measurement Systems Analysis Allows us to view equipment, operations,procedures, software and personnel thataffects the assignment of a number to ameasurement characteristic.Measurement error Process variability Observed variability UT MD Anderson Cancer Center, 2013These are like the “ribs” ofthe Fishbone diagram
Overview of DMAICAnalyze the system to identifyways to eliminate the gap betweenthe current performance and thegoal. Collect data, identify criticalvariables. UT MD Anderson Cancer Center, 2013
Tools Used in DMAICAnalyze Phase Cause-and-effect diagramsTree diagramsBrainstormingSPCProcess MapsDOEHypothesis testsInferential statisticsFMEASimulation UT MD Anderson Cancer Center, 2013
Overview of DMAICImprove the system. Find “y” as afunction of “x”. DOE, FMEA. Pilotimprovement ideas, then implementthose that lead to quantifiableimprovements. UT MD Anderson Cancer Center, 2013
Tools Used in DMAICImprove Phase Force field diagrams7M toolsPrototype and pilot studiesProject planning andmanagement tools UT MD Anderson Cancer Center, 2013
Overview of DMAICControl the new system.Standardize, maintain improvements. UT MD Anderson Cancer Center, 2013
Tools Used in DMAICControl Phase SPCFMEAISO 900xChange budgets, bid models, costestimating models Reporting system UT MD Anderson Cancer Center, 2013
Representing the Data Trends In CS&E, you learned about many tools toshow data trends. The best tool choice depends on whether youare:– Working with ideas,– Working with numbers, or– Trying to reach team consensus UT MD Anderson Cancer Center, 2013
Working with Ideas BrainstormingAffinity DiagramsFishbone ChartsFlowchartsTree Diagrams UT MD Anderson Cancer Center, 2013
Working with Numbers Check SheetsControl ChartsHistogramsPareto ChartsScatter Diagrams UT MD Anderson Cancer Center, 2013
Trying to Reach Consensus Nominal Group Technique Multi-voting Forced RankingThe “right”tool is the usually the onethat helps the teamunderstand theissue at hand UT MD Anderson Cancer Center, 2013
Case Studies
ExampleMedco Health Solutions Mail-service delivery of prescriptionmedications Pharmacy network composed of: Eight prescription-processing (‘frontend’) pharmacies Three dispensing (‘back end’)pharmacies Six call-center pharmacies
ExampleObjective:To reduce medication errors in itshome-delivery service, by usingSix Sigma methodology.
Six Sigma PhasesI.Define PhaseProcess flow map
Six Sigma Phases(Continued)II.Measure Phase Standardized ENC (ExternalNonConformance) formdesigned.304 error elements identifiedwithin 13 process indicatorsCentralized error-reporting unitwith web based applicationdeveloped
Six Sigma Phases(Continued)III.Analyze Phase 3,623 ENCs gathered (Sep.15,2002 – Feb.15, 2003)Prescription processingpharmacies (96%); dispensingpharmacies (4%)New prescriptions (89%); refills(10%); renewal requests (1%)
Six Sigma Phases(Continued)Comparison of ENC's before and after SixSigma implementationError %8%4%Medication error categories11%Before six sigmaimplementationAfter six sigmaimplementation
Six Sigma Phases(Continued)IV.Improve Phase Enhanced regular and ongoingeducation, awareness and trainingfor pharmacists about commonlyoccurring medication errors.Procedure for developing,reviewing and enhancing SALAalerts
Six Sigma Phases(Continued)V.Control Phase Ongoing quality managementSustained process improvements
Univ of Pittsburgh Med Center–Inc Cath Lab Capacity Define – Identify baseline, goal, objectives Measure – Measure all aspects of cath labperformance including pre-case, examtime, and post-case processes; impact onpatient scheduling, overtime, and capacity;cycle time data; current procedures
Univ of Pittsburgh Med Center–Inc Cath Lab Capacity (cont) Analyze – Found that patients were on avg 14min early; although 2 hours were blocked,procedures only took 55 minutes. Improve – Changed procedures so beginningbaseline was reduced, staff redeployed;holding area for patients
Univ of Pittsburgh Med Center–Inc Cath Lab Capacity (cont) Control – dashboard used to monitortimes:PostPostImprovement tBaselineAverageBaselineStd.Dev.Cases Start onTime10 Mins.22.1 Mins.17.6 Mins.10.2 Mins.10.91 Mins. / In-Room Wait5 Mins.33.4 Mins.17.6 Mins.4.8 Mins.10.2 Mins. / RoomTurnaroundTime15 Mins.51.28 Mins.41.62 Mins.19.96 Mins.13.32 Mins. / MD Response toPage10 Mins.10.0 Mins.8.8 Mins.?Metric
Univ of Pittsburgh Med Center–Inc Cath Lab Capacity (cont)Results: Inc capacity by 2.08 patients per lab/per day (250days per year) Financial Impact 5.2 million annually @ 2500/ case Job satisfaction (less strain) Reduced in-room wait time from 33 min to 4.8min Reduced lab turnaround time from 51 min to 20min
Section 3 – The Lean Enterprise1. Introduction to Six Sigma2. Fundamentals of Six Sigma Implementation3. The Lean Enterprise3.1 Understanding Lean3.2 The Seven Elements of Waste3.3 Value Stream Mapping3.4 5S3.5 One-Piece Flow3.6 Spaghetti Maps4. Managing a Successful Six Sigma Effort Course Evaluation and Wrap-Up UT MD Anderson Cancer Center, 2013
What is Lean? Series of tools focused on eliminating all waste inprocesses– Identifying 'waste' from the customer perspective andthen determining how to eliminate it Focuses on delivering products and services in theright amounts, to the right location, at the righttime, in the right conditionLean was not created yesterday; it is the culmination of acentury’s worth of discovery and innovation. UT MD Anderson Cancer Center, 2013
History of Lean Methods 1900: Frederick Taylor studied work methods and used time studies to developstandard work 1910: Frank and Lillian Gilbreth used process flow charts to analyze work elementsincluding non-value added steps, and how work area design influenced workerpsychological motivation (“cheaper by the dozen”) 1920: Henry Ford developed the concept of continuous flow production and theapplication of JIT(the right number of parts at the right time) 1945: Deming & Juran: Statistical Process Control, Pareto, PDSA 1950: Beginnings of Lean: Taiichi Ohno and Shigeo Shingo incorporated Fordproduction techniques, standard work, methods improvement, SPC, and others into asystem called the Toyota Production System (TPS) 1990: Lean Manufacturing, based on the TPS, began to take root in the UnitedStates, first in manufacturing, then into the office environment, service industries, andhealthcare UT MD Anderson Cancer Center, 2013
Lean was not created yesterday; it is the culmination of acentury’s worth of discovery and innovation. UT MD Anderson Cancer Center, 2013
Lean Process Thinking Includes:– Designing processes– Improving processes– Managing processes UT MD Anderson Cancer Center, 2013
Lean is NOT: Fewer peopleLess spaceLimited resourcesEfficiency no matter whatNot enough suppliesGiving the customer the bare minimum UT MD Anderson Cancer Center, 2013
Understanding Value Waste is defined as any activity or resourceexpended that add no value to the product orservice from the customer's perspective– It may be required in the current process but it’s stillwaste Value is defined by what a customer would wantto pay for and by their expectations UT MD Anderson Cancer Center, 2013
Is your work value-added? Employees often know precisely what theirtasks are, but may only have a vague idea ofwhere they stand within the process There may also be confusion when differentpeople doing the same task have differentapproaches to it, some things may not addvalue for customers Mapping a process and all inputs can behelpful in identifying wasted effort UT MD Anderson Cancer Center, 2013
Continuous Improvement7 WastesOverproductionWaitingTransportExtra ProcessingInventoryMotionDefectsError ProofingWork CellsWork BalanceQuick ChangeoverLoad LevelingAndonVisual ControlKanbanPEOPLEEQUIP/MATERIALSSpaghetti MappingValue-Added /Non-Value AddedPROCESSStandard WorkSortStraightenShineStandardizeSustainPull System / One-Piece FlowValue Stream MapLean UT MD Anderson Cancer Center, 20135S
Continuous Improvement7 WastesOverproductionWaitingTransportExtra ProcessingInventoryMotionDefectsValue Stream MapLean UT MD Anderson Cancer Center, 2013
Hierarchy of Value Keep: Value-Added Activities Minimize: Non-Value Added, but necessaryactivities Eliminate: Non-Value Added activities thatare not necessary (pure waste) UT MD Anderson Cancer Center, 2013
Waste Any activity that takes up time, resources orspace but does not add value to the productor service UT MD Anderson Cancer Center, 2013
Seven Types of Waste OverproductionWaitingTransportExtra processingInventoryMotionDefects UT MD Anderson Cancer Center, 2013
Examples of WasteInventory, Motion – Lack of inventorycontrol leads to expirations, excessinventory, searching and extra handling UT MD Anderson Cancer Center, 2013Waiting, Transport, – Results inbatching which increasesturnaround time
Steps to Reduce Waste(Each Step is Harder than the Last!)1.2.3.4.Recognize and identify wasteHave the courage to call it wasteHave the desire to eliminate itFollow through and eliminate the wasteFinally, understand that waste simply:––––Raises costProvides no corresponding benefitNegatively affects customer satisfaction/safetyThreatens all our jobs UT MD Anderson Cancer Center, 2013
Continuous Improvement7 WastesOverproductionWaitingTransportExtra ineStandardizeSustainValue-Added /Non-Value AddedPROCESSPEOPLEValue Stream MapLean UT MD Anderson Cancer Center, 2013EQUIP/MATERIALS
What is the Value Stream? All actions and activities required by the currentstate of the process to meet the customerdemandVitalPatientRegistration Signs/Tests UT MD Anderson Cancer Center, 2013ExamSchedule nextappointmentCustomerValue
Purpose of a Value Stream Map Focus attention on the flow of a system,rather than discrete processes Increase understanding of the flow, findways to eliminate waste and to add value toa system UT MD Anderson Cancer Center, 2013
Elements of a VSMInformationPeople/ProductsValue StreamMaterial UT MD Anderson Cancer Center, 2013
Why bother with a VSM? Represents several process levels in the flow– For example, the link between information andmaterial flow Identifies sources of waste Informs decisions about changing flow Forms the basis of an implementation plan UT MD Anderson Cancer Center, 2013
Value Stream MapNew PatientsFollow-upsConsults, NV, CV1. Outside Referring Physicians2. Patient Self Referrals3. MDA Referring naryPre-OpRad OncLabDICARE1BusinessCenterIC/T 4 DaysNew Patient orAccountReviewsArrival2Clinic RegistrationI2C/T 7.2 min1I53I23C/T 6 min59 pts/day9 hr day(540 minutes)9. 15 minutes/pt.C/T 10 minC/T 5.5 minTestsExam RoomI3C/T 4-11 min23 MD5-6 APN/PA6-8 RN1 LVN1 PCAPSC Schedule2IC/T 53.4 min7C/T 10 minC/O 5 min12min7.2 min10min18min6 min5.5 min10 minNew Patient or Account Reviews UT MD Anderson Cancer Center, 20135 min8min53.4 min10 minProductionLead Time135.1 minProcessing Time87.1 min
Continuous Improvement7 WastesOverproductionWaitingTransportExtra ineStandardizeSustainValue-Added /Non-Value AddedPROCESSPEOPLEValue Stream MapLean UT MD Anderson Cancer Center, 2013EQUIP/MATERIALS
5S Program Technique of workplace organization that fosterseffectiveness Tools used to eliminate waste caused by a lack of order inthe workplace In other words,– Think Housekeeping!5S paves the groundwork for improvement! UT MD Anderson Cancer Center, 2013
Do you ever . . .ScroungeStealStashScrambleSearch UT MD Anderson Cancer Center, 2013
5S ProgramSortKeep only what is requiredStraightenArrange and identi
Section 1 - Introduction to Six Sigma 1. Introduction to Six Sigma 1.1 General History of Quality and Six Sigma 1.2 Meanings of Six Sigma 1.3 The Problem Solving Strategy Y f(x) 1.4 Comparison of CS&E, Lean, and Six Sigma 2. Fundamentals of Six Sigma Implementation 3. The Lean Enterprise 4
Today, Six Sigma is considered one of the prominent methods for Quality Management and being used by over 90% of Fortune 500 companies. Almost all National and Multi-National companies use Six Sigma in some or the other way. Six Sigma has 4 key levels of expertise identified as- Six Sigma Yellow Belt Six Sigma Green Belt Six Sigma Black Belt
Today, Six Sigma is considered one of the prominent methods for Quality Management and being used by over 90% of Fortune 500 companies. Almost all National and Multi-National companies use Six Sigma in some or the other way. Six Sigma has 4 key levels of expertise identified as- Six Sigma Yellow Belt Six Sigma Green Belt Six Sigma Black Belt
Today, Six Sigma is considered one of the prominent methods for Quality Management and being used by over 90% of Fortune 500 companies. Almost all National and Multi-National companies use Six Sigma in some or the other way. Six Sigma has 4 key levels of expertise identified as- Six Sigma Yellow Belt Six Sigma Green Belt Six Sigma Black Belt
Today, Six Sigma is considered one of the prominent methods for Quality Management and being used by over 90% of Fortune 500 companies. Almost all National and Multi-National companies use Six Sigma in some or the other way. Six Sigma has 4 key levels of expertise identified as- Six Sigma Yellow Belt Six Sigma Green Belt Six Sigma Black Belt
ICYB - IASSC Certified Lean Six Sigma Yellow Belt pg. 2 Keys to success in ICYB Exam on IASSC Certified Lean Six Sigma Yellow Belt To achieve the professional designation of IASSC Certified Lean Six Sigma Yellow Belt from the IASSC, candidates must
along Six Sigma project phases. A Green Belt is a Six Sigma team member with basic knowledge of Six Sigma tools and methodology. The next step for Green Belt is often to become Black Belt. As an Ateneo Certified Green Belt Professional, you can proceed to the Ateneo Black Belt Certification by taking only 11 days of the 16-day Black Belt program.
The Lean Six Sigma combined Green Belt - Black Belt Training Schedule is provided on the following pages In this 16-day Lean Six Sigma Black Belt program you will learn State-of-the-art tools for applying the Lean Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) improvement strategy. Hands-on exercises and tutorials
to AGMA 9 standard, improved the quality and performance of the QE range. Today, the QE Vibrator not only meets industry expectations, but will out-perform competitive models when correctly selected and operated in line with the information given in this brochure. When a QE Vibrator is directly attached to a trough it is referred to as a “Brute Force” design. It is very simple to calculate .
