Lean 6S Training Mercy Medical Center 5046 LDLEAN6S - Version 8/20/2009

1. Lean 6S Training Mercy Medical Center 5046 LDLEAN6S - Version 8/20/2009

2. What are the 8 Forms of Waste? • What is 6S? • How do I conduct a 6S? • Examples of Mercy 6S results

3. 8 Forms of Waste • WASTED HUMAN TALENT • DEFECTS • INVENTORY • OVERPRODUCTION • WAITING TIME • MOTION • TRANSPORTATION • PROCESSING WASTE

4. Staff Staff Staff Staff Staff 1. Wasted Human Talent I’ve made a few changes to the process. I wish someone would ask OUR opinion…! Manager Not asking the staff that works the process how to improve it

5. 2. Defects @*&#!! Another defect!! A negative outcome from process failure

6. 3. Inventory Did I really order this much?? Items in greater quantities than can be immediately processed or used.

7. Staff Pharmacist 4. Over Production I didn’t get my order yet… I’ll send another fax. Hey…are these multiple orders for the same thing? @#$&*!! Generating more work than is really required

8. 5. Waiting People waiting for items (patients, supplies, specimens, etc.) to process

9. 6. Motion Why can’t I get anything done? Unnecessary human movement

10. 7. Transportation Waiting Area I have orders to run some tests. I’ll bring the patient right over. Sigh…..!! Unnecessary movement or relocation of items

11. 8. Over Processing Please approve. Please approve. Please approve. Please approve. Please approve. Please approve.

12. 8. Over Processing ??? + I’m the final approval. Please approve. The final approval?!! Applying effort to activities that are not required in the process

13. Safety What is 6S? • Sort • Straighten • Scrub • Standardize • Sustain

14. Step 1: Sort Before After Separate the needed from the not needed

15. Step 2: Straighten AFTER BEFORE A place for everything & everything in its place!

16. Step 3: Scrub (inspect) “Scrub” and inspect equipment to ensure it is in perfect working condition... Add inspecting equipment into your work routine. Regularly “scrub” to ensure everything is in perfect working condition

17. Step 4: Standardize Note: Blue taped outlines and labels ensure equipment is quickly found and returned to the same spot every time. Standard Work requires determining the best method then following that method every time.

18. Step 4: Standardize Note labels and instructions Visual Controls ensure that anyone can find what they need in a matter of moments.

19. Step 5: Sustain Develop a method for sustaining your gains

20. Step 6: Safety • Safety first when determining where items are to be located: • Keep fire hydrants clear • Electrical a safe distance from plumbing • All items accessible - Not too high, not too low • Uncluttered traffic areas - no tripping hazards • Emergency phone numbers and procedures prominently posted Safety is a top priority in all that you do!

21. How do I Conduct a 6S?

22. Preparation • Observe the process first hand (Gemba walk) • Create a spaghetti diagram - a hand drawn map of your process including: • Tasks in the sequence they are done • Location of supplies and equipment • Measure distance traveled and time spent searching or waiting Good preparation is the key to successful results!

23. Spaghetti Diagram Dedicated Staff 100 feet 16 min 200 feet 16 min 150 feet 11 min 250 feet 11 min 200 feet 1 min 150 feet 31 min 200 feet 1 min 300 feet 21 min 1,550 Feet 108min Time & Distance Traveled - Before 15 min – searching For supplies Supply Room Chart Rack 20 min – searching For printer paper Printer Ancillary Testing Patient’s Room 15 min – searching for meds 10 min – searching for PT chart Med Room Tube Station Nurse’s Station Report Room 10 min – waiting for meds tube system What forms of “Waste” can you identify?

24. How Can We Improve? What would you do to improve? • Sort out the need from the not needed • Have a place for everything so there is no searching • Move supplies or equipment closer to where they are needed • Co-locate tasks or people • Change the sequence in which tasks are done • Be creative with your solutions – you, after all, are the expert! Applying 6S eliminates waste!

25. I’ve found my “dream” job! 1.5 min 50 feet 2 min 50 feet Dedicated Staff 1.5 min 50 feet 1.5 min 50 feet 1 min 50 feet 30 min 50 feet 1 min 50 feet 1.5 min 50 feet 40min 400ft Spaghetti Diagram No Searching or Waiting - After 30 sec – 6S on supply room Supply Room 60 sec – 6S on Med room Report Room Med Room Chart Rack Tube Station Ancillary Testing Patient’s Room Nurse’s Station Printer 30 sec – 6S on chart rack 30 sec – Paper checked @ end of each shift 30 sec – Indicator light installed on tube system Reduced travel by 1150 ft & search time by 68 min.

26. Suggest you insert some before and after pictures/examples of 6S results in the next few slides.

27. Simulation – Round 1

28. Instructions to the Class Worker • Gather White, Yellow and Blue sheets of paper • Paper clip the sheets together • Place in a folder • Place post-it on the outside of the folder • Place folder and contents on the chair (to be picked up by a delivery person) Manager • Create a spaghetti diagram: • Draw the room layout, identifying the location of the supplies used in the simulation • As Participant #1 walks the process, trace his/her footsteps on the spaghetti diagram

29. Instructions to the Class • Efficiency Expert #1 • Count the number of steps Person #1 travels from beginning to end in the process. • Efficiency Expert #2 • Track how much time Participant #1 takes to do the entire process • Track how much time is wasted waiting and/or searching • Customer • Do a quality inspection on the finished product against the sample provided to you by the Instructor • Co-workers (Rest of Class) • Identify the 8 Forms of Waste in our process • Identify possible ideas for improvement

30. Quantifying the Results Capture the Results from Round 1

31. What Are the Results? • Manager • What does the spaghetti diagram show us? • Efficiency Expert #1 • How many steps did it take for the worker to do the process? • Efficiency Expert #2 • How much time did the entire process take? • How much time was wasted waiting and/or searching? • Customer • Was the customer happy with the service provided (quality inspection)? • Rest of Class • Identify forms of waste in the process • Include possible ideas for improvement

32. What Waste Did You Observe? • Wasted Human Talent • Defects • Inventory • Over Producing • Waiting • Motion • Transportation • Over Processing

33. How Can We Use 6S to Improve? • Sort – Separate the needed from the not needed • Straighten – A place for everything and everything in its place • Scrub – Ensure everything is in perfect working condition • Standardize – Determine the best method – visual queues, labeling, etc. • Sustain – Develop Standard Work • Safety – Safety first at all times

34. Simulation – Round 2

35. Instructions to the Class • Now that you have identified the waste and the opportunities for improvement in the process • Put your recommended improvements in place • We’ll run the simulation a second time • Then we’ll measure the results… ….and celebrate our success!!

36. Quantifying the Results Capture the Results from Round 2