Clip Game

1. Clip Game An Advanced Lean Exercise

2. Objectives To demonstrate: • The differences between “push” and “pull” systems • How a “Kanban” system works • How different scheduling systems can impact work and service capacity • The problems associated with excessive delays • How staff can provide insight into improving basic work/patient flow

4. Instruments Ready

5. The Product • We will be producing a simulated instrument tray assembly which consists of : • 1 A4 piece of paper • 4 Post It notes • 2 paper clips • 2 stickers Note: When properly assembled these supplies represent one unit

6. Total Game Pack Supplies • 100 A4 sheets of paper Includes 6 RED sheets (defective tray) and 6 BLUE sheets (timing tray) • 400 post it notes • 200 paper clips • 200 stickers • 1 roll of tape • 1 stopwatch • 1 calculator • 1 set of instructor’s notes which includes game instructions, job descriptions, and signs

7. Additional Materials Required • 4 tables (approximately 2 m in length) • 1 flip chart or overhead projector and screen (used to display game results)

8. Folder Sticker Placer Sealer Porter Timer Game Participants • It is recommended that 6 players be used to play the game:

9. WIP WIP WIP Process Flow CSSD Finished Goods Post It note attaching Paper Folding Paper Clip Placing Paper Sealing Raw Material Finished Goods

10. Production Step 1 Folder Fold the paper into 4 quarters.

11. Production Step 2 Sticker Place 4 post it notes in each 4 quarters of the A4 sheet of paper.

12. Production Step 3 Placer Put 1 clip on each of the top 2 Post It notes.

13. Date Operator Production Step 4 Sealer Fold the paper in halves, then quarters and seal with a sticker. Place a 2nd sticker on the paper and write the Date and Operator

14. Porter Distribute raw materials from the raw material area to the work area as needed and take finished instrument packs to the steriliser.

15. Timer Monitor and document the appropriate information such as milestone times and WIP levels for each run on worksheet.

16. Prior To Starting of the Game • Layout tables according to the pictures on the following slides • Assign people to the Process Positions • Organize the Raw Material Table to allow for easy accessibility for Porter

17. Assembly Work Area 1 2 3 4 Folder Sticker Placer Sealer

18. Raw Materials Inventory Use the next 6 slides as labels for the appropriate game stations

19. FOLDER

20. STICKER

21. PLACER

22. SEALER

23. RAW MATERIAL INVENTORY

24. FINISHED GOODS INVENTORY

25. Demonstration • Demonstration is used to show how one unit is produced at a steady, but unhurried pace • The Facilitator should go through the entire assembly process for one unit (1 A4 sheet of paper) • “Timer” should time and document the duration of each of the 4 steps • After completion the Facilitator should ask the group what type of measures would be valuable for the process

26. Standard Cycle Time Chart 25 20 Time (sec) Takt Time 15 10 5 Paper Sealing Paper Folding Post It note Placing Paper Clip Attaching

27. Measure Units Formula Start of 1st Piece minus End of 1st Piece Seconds Lead-time Average Cycle Timeper Unit Total Production Time divided by Number of Finished Goods Seconds Single Unit Cycle Time Start of Specified Unit – End of Specified Unit Seconds Units/Seconds/Person Number of units produced divided by the time it takes to produce them divided by the number of people to produce them Output Rate Number of Tables Number of Tables Used for production Investment Number of People Number of People Used for production WIP/Defects/Rework Number of Units Number of Pieces in System at the End of Production Calculation Descriptions

28. Run The Game (Round #1 – Push 4) • Make sure the Timer has the correct worksheet and is ready to begin • Tell the operators to start producing sets because theatre is running low Note: Parts must be produced in a lot/batch size of 4 units. 3. Insert the BLUE “timing” paper as the fourth batch into the production line 4. Insert the RED “defective” paper as the sixth batch into the production line

29. Round #1 Timeline Worksheet Time (min:sec) Measure • Start of 1st piece • Start of Blue Paper • Start of Red Paper • End of 1st Piece • End of Blue Paper • End of Red Paper • Number of People • Number of Tables • Number of Finished Units • Number of WIP Units

30. Measure Units Result Seconds Lead-time Average Cycle Timeper Unit Seconds Single Unit Cycle Time Blue Red Seconds Units/Seconds/Person Output Rate Number of Tables Investment Number of People WIP/Defects/Rework Number of Units Round 1: Calculation

31. Run The Game(Round #2 – Push 1) Make sure the Timer has the correct worksheet and is ready to begin 2. Tell the operators to start producing parts because a customer has entered an order Note: Parts must be produced in a single piece flow manner. 3. Insert the BLUE “timing” paper as the fourth unit into the production line 4. Insert the YELLOW “defective” paper as the sixth unit into the production line

32. Round #2 Timeline Worksheet Time (min:sec) Measure • Start of 1st Piece • End of 1st Piece • Start of Blue Paper • End of Blue Paper • Start of Red Paper • End of Red Paper • Number of People • Number of Tables • Number of Finished Units • Number of WIP Units

33. Round 2: Calculation Measure Units Result Seconds Lead-time Average Cycle Timeper Unit Seconds Single Unit Cycle Time Blue Red Seconds Units/Seconds/Person Output Rate Number of Tables Investment Number of People WIP/Defects/Rework Number of Units

34. Run The GameRound #3 – Pull 1 • Set up the simulation by reducing the number of tables by 50%. • Create a U-shaped work area. Minimum inventory at each station. • Create kanban squares with work-in-process units ready for the next process. • Nothing is produced in the process unless the downstream process signals for it (i.e., an empty kanban square). • Insert the BLUE “timing” paper as the fourth unit into the production line. • Insert the RED “defective” paper as the sixth unit into the production line.

35. Round #3 Timeline Worksheet Time (min:sec) Measure • Start of 1st Piece • End of 1st Piece • Start of Blue Paper • End of Blue Paper • Start of Red Paper • End of Red Paper • Number of People • Number of Tables • Number of Finished Units • Number of WIP Units

36. Round 3: Calculation Measure Units Result Seconds Lead-time Average Cycle Timeper Unit Seconds Single Unit Cycle Time Blue Red Seconds Units/Seconds/Person Output Rate Number of Tables Investment Number of People WIP/Defects/Rework Number of Units

37. Measure Units Round 1 Round 2 Round 3 Seconds Lead-time Average Cycle Timeper Unit Seconds Blue Red Single Unit Cycle Time Seconds Units/Seconds/Person Output Rate Number of Tables Investment Number of People WIP/Defects/Rework Number of Units Summary: Calculation

38. Data Trend Discussion • Trends to focus on: • Decrease in lead time from batch to pull • Decrease in BLUE and RED tray cycle times from batch to pull • Increase in tray cycle times from the BLUE tray to the RED tray in the batch demonstration • Decrease in average cycle time per unit from batch to pull • Increase in output rate from batch to pull • Decrease in WIP/Defects/Rework from batch to pull

39. Why did the numbers improve? • Why did the cycle time decrease? • Why did WIP decrease? • Why did lead time decrease? • Why was scrap reduced?

40. Lessons Learned • How do the data trends and lessons learned in this exercise apply to the processes in your facility? “From the game to your processes”