Workshop

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Lean Concepts, Tools and Techniques
Workshop
Wait Time
Presented By Bruce Berger [phone]
BergerConsulting_at_aol.com
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What is a Process?
A Process is a series of linked activities
transforming inputs into outputs with the purpose
of producing a product or service for customer(s)
within or outside of the organization.
Note All work is a process. Workers and
supervisors manage processes on a daily basis.
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Why do we need to Improve and Manage Processes?
Managing Processes (or work activities) will
help consistently ensure that

• Products and services meet (or exceed) customer
  valid (i.e. agreed upon) requirements.

• Processes are efficient and cost-effective.

• Organization staff are well-trained and motivated.

• State and federal statutory requirements are met.

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Two Different Process Improvement Approaches
Six Sigma primarily focuses on eliminating
Defects (DMAIC) And reducing unwanted Variation
(Process Management)
Lean
Six Sigma
Increased Quality with lowered Defects, Variation
and Cost
Increase Speed with No Waste
Lean primarily focuses on increasing process
Speed while eliminating unnecessary Inventory and
Waste.
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Lean Objectives
1. Involve front-line workers in improving and
controlling process activities
2. Organize around Value Added process activities
while reducing or eliminating Non-Value Added
activities.
3. Balance process steps to allow for continuous
flow of work and thereby reducing backlogs or
inventories
4. Sequence process activities to minimize
unnecessary motion or activities
5. Anticipate and prevent process failures
6. Minimize unnecessary process Inventories
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The Lean Definition of Value and Waste
VALUE Any process activity that actually
transforms process inputs into the outputs that
satisfy customer needs
(i.e. Any activity that the customer is willing
to pay for)

• WASTE
• Any process activity that does not directly
  transform process inputs into the outputs that
  satisfy customers needs

(i.e. Any activity that the customer is NOT
willing to pay for)
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Seven Plus 1 Process Wastes
1. Handling Too Much (eg. multiple reviews, too
complex products, providing quicker service than
customer needs, etc.)
2. Over Production (created by doing more than
requested, sending Emails Reply to All,
producing more document copies as needed, etc.)
3. Wait (or Idle) Time ( for information,
equipment to be repaired or serviced, permission
to take action, etc.)
4. Rework, Scrap or Defects (includes revisions,
errors in outputs, changes due to missing
customer requirements, etc.)
5. Unnecessary Processing (doing more than
needed, inspections, routing documents for
approvals, etc.)
6. Inventory (Work In Process) (e.g. batched
orders, orders in queue, additional outputs to
cover defects, purchases for future use, etc.)
7. Motion (created by poor work station set-ups,
poor signage, not standardizing work tasks, etc.)
Plus 1 Not Engaging Staff (Purchasing tools/
equipment without employee input, changing
operations without input, etc.)
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Traditional Versus Lean Process Operations
Lean operations utilize a different approach than
traditional operations.
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Lean Benefits

• Increases Process Speed and Efficiencies
  Eliminates backlogs and idle time.
• Reduces Costs Reduces unnecessary inventories
  and resources.
• Improves On-Time Delivery Products take less
  time from request to delivery.
• Simplifies Process Reduces or eliminates
  non-value added process steps

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Lean Concepts, Tools and Techniques
We will learn the Lean Concepts, Tools and
Techniques in the sequence they are often
utilized (i.e. the DMAIC Problem Solving Process)
Measure
Analyze
Improve
Control
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Define
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Select Process (Exercise)

• Evaluate identified processes using these three
  (3) factors to find the best overall score

Measure
Analyze
Improve
Control
Define
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Identify Process Outcome Indicator(s) to Improve?
An Outcome Indicator

• displays process performance as it relates to
• customer valid requirements.

• is often displayed as a line graph with a
• Good Arrow and a Target

Example
of Patients Seen by Doctors Timely
Measure
Analyze
Improve
Control
Define
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Value Stream Map (As Is)
A Value Stream Map is a visual display of the
Process Flow from start to finish and includes
specific Lean process flow information.
Measure
Analyze
Improve
Control
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Define
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Value Stream Map Symbols
Value Stream Map Symbols
Process Step with data Box Info
Inventory or Work in Process
Suppliers, Inputs or Outputs
Data Flow
?Cycle Time
I
?Change Over Time
?Non-Value Added Time
?Value Added Time
Transportation Method / Frequency
Electronic Info Flow
Push System
Final Output
Courier 3XDaily
Pull System
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Measure
Analyze
Improve
Control
Define
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LEAN Technique As Is Value Stream Map
Steps to Create Value Stream Map
1. Select a process and a product, order or
patient group
2. Go to the location(s) where process is
performed
3. Follow one (1) order, product or patient
through each process step
4. Draw the process flow using the Value Stream
Symbols
5. Measure and record the cycle time (i.e.Touch
Time ) to perform each process step (quantify
Idle time or Non-value added separately from
Touch Time.
6. Construct a timeline from the order(s)
followed through the process
7. Review developed Value Stream Map with staff
performing the process and revised as needed to
reflect the process flow
Measure
Analyze
Improve
Control
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Define
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Lean Concepts, Tools and Techniques
Analyze
Improve
Control
Define
Measure
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Indicators Overall Equipment Effectiveness (OEE)
Analyze
Improve
Control
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Define
Measure
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Indicators Overall Equipment Effectiveness (OEE)
Example
Given
1. The Clinic was scheduled to be open from 9
am through 6 pm for Monday through Saturday last
week
(Scheduled Minutes (9hrs per
day) X (6 days) X (60min per hr) 3240 minutes).
2. Clinic opened 30 minutes late on Wednesday due
to staff illness
3. The clinic expects to serve 5 patients every
hour
Ideal Patient Served Rate (5 patients per hr) X
(9 hrs per day) X (6 days per week) 270
Patients per week
4. The clinic last week served 221 patients.
5. 44 patients had to be re-scheduled last week
due to doctor unavailability
Availability (3240 min - 30 min)/ (3240 min)
99.1
Performance (221 Patients served)/ (270
Patients expected) 81.9
Quality (221 Patients Served - 44 Patients
Re-scheduled)/ (221 Patients Served) 80.1
Overall Equipment Effectiveness ( 99.1 X 81.9
X 80.1 )65.0
Analyze
Improve
Control
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Define
Measure
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Indicators Dock-to-Dock (DTD) Time
Dock-to-Dock (DTD) Time (a.k.a. End-To-End Time)
is the total calendar time from the date/time raw
materials are unloaded at the receiving Dock to
the date/time finished goods are loaded for
shipment from the Shipping Dock
Example
Enter Hospital Lobby
Patient picked up from wheel chair outside lobby
Provide Hospital Care
Hospital Processing Cycle Time
Dock-to-Dock (DTD) Time
Analyze
Improve
Control
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Define
Measure
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Indicators Rolled Throughput Yield (RTY)
Rolled Throughput Yield (RTY) is the percentage
of Patients who go through the process from start
to finish without requiring rework or failing to
complete any process step.
Rechecked Blood Pressure on 2 Patients
2 Patients Resubmitted Payment Info
2 Patient routed to another Doctor
10 Patients Entered Lobby
8 Patients Completed Doctor Exam
Doctor Exam
History Vitals
Intake Triage
9 Patients Completed Intake
9 Patients Completed Vitals
Doctor called away for emergency
1 Patient rescheduled
1 Patient Left Early
Is the RTY 80?
First Time Yield (FTY) Intake Triage
100(7/10)70
First Time Yield (FTY) History Vitals
100(7/9)77.8
First Time Yield (FTY) Doctor Exam
100(6/9)66.7
Rolled Throughput Yield (RTY) (70 X 77.8 X
66.7) 36.3
Analyze
Improve
Control
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Define
Measure
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Indicators Build to Schedule (BTS)
The Build to Schedule (BTS) indicator calculates
how well the process is actually managed versus a
plan or schedule. The BTS calculation
incorporates the process output volumes, the
different types of products (or services)
delivered and the sequence that these process
outputs are delivered.
BTS Volume x Mix x Sequence
Analyze
Improve
Control
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Define
Measure
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Indicators Build to Schedule (BTS) Exercise
BTS Volume x Mix x Sequence
Volume 100(Actual Volume /Scheduled
Volume)100(9/12)75
Mix 100(Actual of the Scheduled Mix/Scheduled
Mix)100((CVS12) (NS1) (GS3))/(12)58.3
Sequence 100(Actual Sequenced as Scheduled /
of Sequences)100(4/5)80
BTS Volume x Mix x Sequence 75 X 58.3 X 80
35.0
Analyze
Improve
Control
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Define
Measure
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Indicators Work in Process (WIP)

• Work in Process (WIP) is the number of inventory
• (e.g. products, orders, patients, etc.) that
  have started the process 1st step yet have not
  yet completed the last process step.

Example
Start
Complete
2 Patients waiting to see Doctor
3 Patients waiting for Vitals
Intake Triage
Doctor Exam
History Vitals
Work in Process (WIP) 5 Patients
Analyze
Improve
Control
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Define
Measure
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Indicators LEAN Performance Summary (Example)

• Process Results can be summarized in various
  Performance Summaries.

Analyze
Improve
Control
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Define
Measure
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Indicators Summary
Analyze
Improve
Control
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Define
Measure
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Summary
Lean primarily focuses on increasing process
Speed while eliminating unnecessary Inventory and
Waste.
Six Sigma
Lean
Increased Quality with lowered Defects, Variation
and Cost
Increase Speed with No Waste
Lean Involves front-line workers to improve and
control their process activities by balancing
process steps to allow for continuous flow of
work and thereby reducing backlogs or
inventories. Also, improvements are aimed at
reducing or eliminating waste (ie. Non-Value
Added activities).
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6. Minimize unnecessary process Inventories