state the key elements of 5s describe the value of...
TRANSCRIPT
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Lean Tools and Methods: 5S
Jamie Harkins, RN, BSN, MBA, CPHQManagerClinical Operations
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Objectives
State the key elements of 5S
Describe the value of implementing 5S
Obtain the knowledge needed to implement 5S in your organization
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Vascular Access Cart
Wasted Time Spent Searching for
Needed items –Anything Missing?
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How’s This?
Would you know if a supply needed
re-stocked?
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5S
5S is a foundational element of Lean Hospitals
A strategy that helps to keep our workplace safe and organized
Sort
Set/ Simplify
Sweep
Standardize
Sustain/ Self-Discipline
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5S
Removes waste, including: Excess inventory Out-of-stock supplies Searching for supplies Walking for supplies Wrong and outdated parts Non-value added setup and cycle time Moving parts around workspaces
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Benefits of 5S
Assists in the elimination of waste
Improves work flow
Reduces employee stress
Provides a systematic process for continuous improvement
Focuses on the process and not the person
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5S at Work
Crash Cart Medications
Blood Sugar Supplies
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1013
23
2730
47
51
58
62
79
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Mark 1-49
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1013
23
2730
4740
Sorted / Mark 1-49
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10
13
23 27 30
47
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Numbers from 1 to 49
Standardize/ Mark 1-49
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1013
23
2730
47
51
58
62
79
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Find missing #s
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10
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23 27 30
47
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Numbers from 1 to 49
Find missing #s
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5S
1. Determine the space and scope for the 5S activity
2. Identify teams and team leaders
3. Involve as many team members as possible
4. Document the current state with photos
5. Measure current inventory levels
6. Use visuals/photos to describe current state to team
Implementation:
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5S: Sort
Sorting separates necessary from unnecessary
Most critical of the 5S steps
Objective evaluation of all materials in the 5S area
Identifies additional required supplies
Identifies proper par levels
Document key information
Consider:
Supplies are neat, but are par levels connected with use?
What do you do when there is excess inventory?
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5S : Sort
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5S: Set/Simplify
Correlate location of supplies with their use
Place higher use items closer to the point of use
Makes unnecessary items visible
Enables the team to see what is out of place
Makes Places for Necessary Items
Place most frequently used items within reach
Ensure less frequently used items are still accessible
Label items that are mobile Label items that are not
familiar to all team members Remove excess stock
Implement Set/Simplify
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5S: Shine/Sweep
Remove and replace broken equipment
Replace missing equipment/ expired supplies
Clean area Makes it obvious when things
are out of place Avoids the need for ‘cleanup’
events
Form of Inspection that Ensures Everything is Returned to its Proper
Place
Include scheduled sweeps with your eyes
Determine the appropriate sweep frequency
Determine the elements of a complete sweep
Implement Shine/Sweep
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5S: Standardize
Define teams and roles for each team member
Specify training/ orientation expectations
Define standards for personal items
Specify standards for visual controls
Specify standards for disposing unneeded items
Creates a Standard Agreement and
Communicates it to the Team
Complete team agreement Update kanbans to signal for
replenishment Document and post a visual
map of the work area Document and post pictures
of new current state Develop task sheet for each
5S area
Implement Standardize
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5S: Sustain/Self Discipline
Often the most difficult of the 5S steps
Seeks to ingrain desirable behaviors
Consistency and repetition need to become habitual
Maintains Standards Through Training,
Empowerment, Commitment and Discipline
Managers should do visual 5S sweeps at least daily
Audit the area against the 5S achievement template regularly to maintain the gains & improve
All team members must participate - Set time aside to ensure workspace is functional, orderly
Acknowledge gains
Implement Sustain/Self Discipline
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5S Example
COLLEEN’S HARD WORK
Before After
http://runningahospital.blogspot.com/2009/10/5s-projects-are-spreading.html?m=1
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5S
S Cusanza, AONE 2010
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5s
Level VContinuously Improve
Cleanliness problem areas are identified and mess prevention actions are in place
Map created for each item in storage room showing general location and layout of materials and can be retrieved quickly with minimal effort
Potential problems are identified an countermeasures are documented
Reliable methods and standards are shared throughout similar work areas
Root causes are eliminated and improvement actions focus on developing preventive methods
Level IVFocus on Reliability
Work area has documented housekeeping responsibilities and schedules, and the assignments are consistently followed
Items rotating from storage and use, create visual control to identify point of use
Inspection of area occurs daily and work areas and equipment are restocked and organized
Reliable methods and standards are adhered to by all members of the work group
Sources and frequency of problems are documented as part of routine work, root cause of non-compliance are identified and corrective action plans are developed
Level IIIMake it Visual
Initial cleaning has been completed; items disposed of accordingto auction disposition
Needed items are outlined, dedicatedlocations are properly labeled and required quantities are determined
Visual controls and indicators are established and marked for the work area equipment, files and supplies
Documentation for all visual controls exist
Work group routinely checks are to maintain 5S agreements
Level IIFocus on Basics
Needed and not-needed items are identified and those not needed are removed from work area
Needed items are stored and organized according to frequency of use
Work group has agreed on items to be checked and acceptable performance levels documented
Work group has documentedagreements for needed items, organization, and work area controls
Documentation of completed 5S is posted in work area; 5S is incorporated into new staff orientation
Level IJust Beginning
Necessary and unnecessary items are mixed together throughout the work area
Items needed are located in various places throughout the work area
Key work items are missing and current location is not known
Standards for workarea organization are not followed or documented
Work area checks are not done regularly and there is no visual measurement of 5S performance
Sorting Simplifying Sweeping Standardizing Self-Discipline
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Summary of Key Points Disorganization is a barrier to work
flow!
To “set” means to place higher use items closer to the point of use.
5S assists in the elimination of waste, improves work flow, reduces employee stress, and provides a systematic process for continuous improvement.
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Resources and References
Executive Lean Training at Virginia Mason. 2013.
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Lean Tools and Methods: Gemba WalkJudy Krempin, MS, CPHQManagerQuality, Safety, Performance Improvement
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Objectives
Be able to define Gemba
Describe the value of being at the Gemba – for RIE, for Kaizen
Know your role at the Gemba
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The place where work
is done
The place the truth is
found
What is the
Gemba?
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Go See
Show Respect
Ask Why
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Focus on:
The purpose of work
The process we undertake
Engaging people who touch the process
Walk from start to end of the value stream
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RIE Team: To gemba before
mapping the value stream & before
identifying solutions
When do I go to Gemba?
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Who goes to Gemba for a Rapid Improvement Event (RIE)?
All Members of Improvement Team –before solution is determined
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Gemba Walk for
RIE
RIE Purpose:
Understand the current state -- identify barriers to flow
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Gemba Walk for
RIE
Actions:
Observe
Draw the current process
Talk to the people doing the work
Agree on the source of the problem
Measure time for process steps
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KaizenA Leader goes
to Gemba regularly
When do I go to Gemba?
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Who goes to Gemba?
CEO – monthly or more
Chief Quality Officer - weekly
Managers and Directors - daily
Supervisors – every shift
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Gemba walk for Kaizen
Kaizen Purpose:
Be a keen observer – what questions can be asked to help people see barriers and improve the process
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Gemba walk for Kaizen
Actions:
Review the PI Board
Observe
Understand the workflow
Target the improvement plan
Coach
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Leader Standard Work: Regular Gemba Walks
Create a “no meeting” zone
The first six visits, observation only
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Learning from Toyota Gurus
Toyota managers should be sufficiently engaged on the factory floor that they have to wash their hands at least three times a day.
--Taiichi Ohno
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Gemba Walk as Part of Kaizen
1 2 3 4 5
See the facts at
the source.
Become familiar.
Agree on the nature and cause
of the problem (before
debating solutions).
Teach problem solving.
Why do you think that happened?
Why do you think those conditions exist?
Assess gap
between current
and target state.
Look for leadership
and cultivate.
Adapted from: Michael Balle’s “Go and See” presentation. Lean Enterprise Institute.
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What happens first?
Senior Leader Gemba Walk
Greet people in the area
Meet with the department leader
Review the Performance Improvement Board priorities and metrics
Gemba Walk together
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1. Focus on the current improvement topic. See the facts at the source.
What do we need to learn?
What results are required of this process?
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2. What is the current problem?
What does the person responsible for the process think?
Does everyone agree on the source of the problem?
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3. Teach problem solving.
What do we need to do to change the current conditions?
Why do you think this is happening?
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4. Assess gap between current and target state.
• If we are on target, what has helped us succeed?
• If we are not reaching our target, why?
How do we compare
against the goal for
this process?
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5. Look for leadership and cultivate.
Does this leader collaborate well within and across settings of care?
Does this department leader understand the purpose and
goal?
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Coaching at the Gemba
Traditional Coaching for Correction
Lean Coaching for Development
Specify the process deficiency
Get agreement that problem exists
Give feedback
Provide suggestions about how the process should go
Agree on next steps
Let the staff person own the problem
Let them think
Help them see
Force reflection
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Practice Coaching
Find a partner Partner should be someone you do NOT work with
currently
First person: Describe a process challenge at work Describe for 30 seconds
Second person: Ask open ended questions to help the other person think through that problem Do not use questions that can be answered “yes/ no” Practice for 3 minutes
Switch roles
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Gemba Observer Goals
Develop keen
observation skills
Develop better
engagement and
discussion skills
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Effects of Showing Respect at the Gemba
Discretionary Effort
“You hire my time and are due a full day and good effort. You can define my responsibilities, program my activities, and evaluate my performance. You can control what you see.
But I can decide how far I go beyond that, and for what.”
From David Verble’s LEI presentation May 2013
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Summary of Key Points When the Gemba walks are
introduced, observe the work for several weeks to become familiar with the process – no tampering with the process or asking questions except to understand the steps.
When coaching at the Gemba, let the staff person own the problem, let them think, help them see, force reflection.
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Resources and References
Michael Balle’s “Go and See” presentation. Lean Enterprise Institute.
David Verble’s Coaching presentation at Lean Enterprise Institute. May 2013.
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Getting Started –First Six Gemba Walks in Each Value Stream
Schedule Observe Say “Thanks!” Reflect PI Board &
Process
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Routine Gemba Walks to Support and Coach
Schedule Observe Thank Staff Coach & PI Board/ Reflect Process & Reflect
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Starter Manager coaching questions:Coaching the staff closest to the process
How is this (process) going?
If it went well, great, “how do we know we were successful?”
If it did not go as designed, “what is happening in the environment?”
Identify objective data, proof of success If we don’t know
why a process failed, “how might we learn more?”
“What do you think you would do next time?”
If remedial approach is not going to be effective, say “Good idea, but you may want to think about this…”
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Starter Senior Leader coaching questions:Coaching the manager/ director
How is this (process or staff development work) going?
If it went well, great, “how do we know we were successful?”
If it did not go as designed, “what is happening in the environment?”
Identify objective data, proof of success
If we don’t know why a process failed, “how might we learn more?”
“How might you coach staff differently next time?”
If remedial approach is not going to be effective, say “Good idea, but you may want to think about this…..”