Lean Six Sigma in the Lab Kansas City CLMA Friday, March 1, 2013 Scott Bolen Master Black Belt Quest Diagnostics – Midwest Region
Feb 09, 2016
Lean Six Sigma in the LabKansas City CLMA
Friday, March 1, 2013
Scott Bolen
Master Black Belt
Quest Diagnostics – Midwest Region
2
Agenda• Leadership
• LEAN versus Six Sigma
• Waste
• Flow
• Continuous Improvement
4
Lean Six Sigma• Leadership
• LEAN versus Six Sigma• Waste
• Flow
• Continuous Improvement
5
LEAN versus Six Sigma• Six Sigma is about meeting the customer
demand for accuracy (Quality)
• LEAN is about meeting the customer demand for timeliness (Speed)
• LEAN and Six Sigma complement each other.
• Each drives continuous improvement through the DMAIC methodology
6
LEAN Six Sigma Method:Improvement (DMAI2C) – Reduce variation and defects
in an existing process
Define the project, process, and customer requirements.
Measure the process to set baseline and quantify factors.
Analyze the data to determine root cause.
Innovate Improvements that address root cause.
Control improved process and determine effect.
7
• Six Sigma is about decreasing variation.
• Lean is about decreasing waste.
Customer Spec
Virtually No Defects
12
34
56
TargetCustomer Spec
Many Defects
6
12
34
5
Target
2.8 Low Quality10% Error Rate100,000 DPMO
High Quality0.00037% Error Rate3.4 DPMO
Good Bad Good Bad
Improving Operational Efficiencies
8
Most good companies are here
Six Sigma is “S..t..r..e..t..c..h Thinking”
6 Sigma
5 Sigma
4 Sigma
3 Sigma
2 Sigma
1 Sigma
99.9997%
99.977%
99.38%
93.3%
69.1%
30.9%
SigmaSigma YieldYield
3.4
233
6,210
66,807
308,538
691,462
Errors per million opportunitiesErrors per million opportunities
3 Sigma 93.3%66,807
6 Sigma 99.9997%3.4
9
Six Sigma: The Highest Quality
• 50 newborns harmed at delivery, every day
• 5,000 incorrect surgical operations a week
• 200,000 wrong drug prescriptions a year
• No electricity for almost 7 hours a month
• 20,000 lost articles of mail per hour
• Unsafe drinking water almost 15 min. a day
• 528,000 checks deducted from the wrong bank accounts every day
At Quest Diagnostics, we perform nearly 350 million tests a year.
If we did 99% of them right:3.5 Million Tests
would have an error!
We want Six Sigma Quality:
99.9997% of tests done correctly!
Less than 1200 would have an error
99% Good Means: Quest Diagnostics Quality:
10
How do we control Processes?
UCL=0.101493
LCL=0.088782
CEN=0.095137
UCL=0.085759
LCL=0.07426
CEN=0.080009
UCL=0.054193
LCL=0.045126
CEN=0.04966
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
Target = .05(50,000 DPMO)
Proportion of Patients Waiting >15 Min.
Off Target & Inconsistent
Consistent butOff Target
Consistent &On Target
Control Chart
11
What the Customer Wants
14.513.512.511.5
50
40
30
20
10
0
Minutes Waiting
# Pa
tient
sAverage = 13 MinutesAverage = 13 Minutes
12
Which is Better?
Average = 11 Minutes Average = 13 Minutes
The average wait timeis decreased by 2 min.
The # of patients waiting >15 min.has increased from zero to ~20 But….
Most customers don’t experience the average!
13
LEAN Six Sigma• Leadership
• LEAN versus Six Sigma
• Waste
• Flow
• Continuous Improvement
14
Reduce or eliminate waste
DOTWIMP1. Defects2. Overproduction3. Transport4. Waiting5. Inventory6. Motion7. Extra Processing
DOWNTIME1. Defects2. Overproduction3. Waiting4. Non-Utilized Employees5. Transport6. Inventory7. Motion8. Extra Processing
15
Perspective
• From the Function/Provider: Everyone is very busy
• From the patient: Hurry up and wait• From the specimen: Sit, Sit, Sit, Test, Sit
16
What is Value?
17
Value Added: Definition
• Must Physically Change the product / information
• Must be Done Right the First Time (no rework)
• Customer is Willing to Pay For It NonValue Add
Value Add
Business ValueAdd
18
Lean Toolkit – 5S
What is it ??What is it ?? • A systematic way to improve your workplace and processes• Focuses on creating and maintaining a clean, well organized workplace• Easily distinguish between normal and abnormal conditions • Highly dependent on employee involvement• Promotes defect reduction, cost reduction and a safe work environment
Goal:Goal: • A self-explaining, self-ordering, self-regulating, and self-improving
workplace where what is supposed to happen does happen on time, every time, day or night.
5S Parody
19
Current State
Before Warehouse Before Supply Cart
5S Exercise
20
5S - Circle the numbers in order from 1-50You have 60 Seconds
Current State
60 55 50 45 40 35 30 25 20 15 10 5
Time’s Up
5S Exercise
22
Work area less crowded
Less time needed to find things
Fewer part selection errors
Improved process flow
Reduced maintenance costs
Improved communication among employees
Implementation and Benefits of 5S
Sort Set in Order
Shine SustainStandardize
Sort - BenefitsSort - Benefits
Sort: “When in doubt throw it out”
Sort necessary from unnecessary itemsSort necessary from unnecessary items Remove all unneeded items such as racks, tools, equipment, and excess inventory
Red tag method
• Attach red tags to unneeded items and remove them to a red tag area
• Evaluate and properly dispose of items in the red tag area
5S Exercise
23
5S - Circle the numbers in order from 1-50You have 60 Seconds
1.SortGet rid of what you do not need. Keep only
what is needed. (Remove higher numbers)
60 55 50 45 40 35 30 25 20 15 10 5
Time’s Up
5S Exercise
25
Implementation and Benefits of 5S
Set in Order - BenefitsSet in Order - Benefits
Set in Order : “A place for everything and everything in its place”
The proper amount of space is designated to store items
Reduces time needed to find things, less searching
Everything is in its place and not on the floor – improved safety
Elimination of excess motion
Increased space / capacity
Sort Set in Order
Shine SustainStandardize
Arrange items so that they can be found quickly by Arrange items so that they can be found quickly by anyoneanyone Everything that is movable should have a designated place when not in use
Arrange things so they are easy to find, easy to use and easy to put away
Most frequently used items should be close-at-hand
Items should always be in the same place
5S Exercise
26
Shine - Benefits Shine - Benefits
Shine: “A clean systematic organization results in increased safety and efficiency”
Less equipment breakdown.
Defects are easy to see
Improved efficiency
Safer work environment
Improved morale
Sort Shine SustainStandardize
Create a spotless workplaceCreate a spotless workplace Keep what is left CLEAN and in good working condition
Perform a major cleanup
Assign daily housekeeping tasks at least 5 min./day
Set in Order
Implementation and Benefits of 5S5S Exercise
27
2. Set in OrderPut needed items in the proper place
(No sequential numbers in the same quadrant)3. Shine
Keep workplace neat and clean (Clean up fonts)
5S - Circle the numbers in order from 1-50You have 60 Seconds
60 55 50 45 40 35 30 25 20 15 10 5
Time’s Up
5S Exercise
29
Implementation and Benefits of 5S
Standardize - BenefitsStandardize - Benefits
Standardize:“Do the right things the right way, every time”
Increased equipment life
Clean environment
Increased visibility of normal and abnormal conditions
Consistent delivery
Improved quality
Training of new employees is easier
Sort Shine SustainStandardize
Maintain the previous changes and continuously improveMaintain the previous changes and continuously improve Standardize your processes
Incorporate sorting, storage, and shining activities into daily routines
Use aids to control what happens and when it happens
Set in Order
5S Exercise
30
Standardized Taping Scheme5S Exercise
31
5S - Circle the numbers in order from 1-50You have 60 Seconds
4. StandardizeImplement, train and maintain
best practices(Define a standard order)
60 55 50 45 40 35 30 25 20 15 10 5
Time’s Up
5S Exercise
33
Implementation and Benefits of 5S
Sustain - Benefits Sustain - Benefits
Sustain: “5S Ingrained in everyday work life”
Higher employee pride and ownership
Work place is maintained in an organized fashion without clutter
Detailed tasks are documented to make the process more efficient
Customer appeal / boosts professional image
Saves time, money on over orders & reduces out of stocks
Sort Shine SustainStandardize
Ensure the systematic organization, visual placement and cleanliness are maintainedEnsure the systematic organization, visual placement and cleanliness are maintained Follow the rules you set
Involve workers in every aspect of the 5S process including checklists and job charts
Practice and repeat until it becomes a way of life
Continuously improve through regular assessments (audits)
Fully train existing and new employees on 5S and your expectation
Set in Order
5S Exercise
34
Warehouse Before / After 5S Photos
Before:Before: After:After:
5S Exercise
35
Supply Cart Before / After 5S Photos
Before:Before: After:After:
5S Exercise
36
LEAN Six Sigma• Leadership
• LEAN versus Six Sigma
• Waste
• Flow • Continuous Improvement
37
Flow• Video
• What are the attributes of good process flow?
38
Lean in the Lab – Optimizing Flow
“Before” Spaghetti Map of Molecular
DeadAir
Bio
Hoo
d
mixer inside
mixer & centri inside
Bio
Hoo
d
coat hooks
Aci
d
Cle
an S
ink
w/ d
renc
h
36"
2 dr
fridge-70fz
coat hooks
Flame cabinet
Ampliprep Taq 96
elevator
frz frz
Ampliprep Taq 96
elevator
ABIMagNa
future ABI
pc
pc
pc
DML 2000
RapidCapture
waterbathvortex
ViperViper( future)
crt crt
c
vortex
c
labelprint
36"
36"
36"
30 "
36"
36" 36"
36"
36"Phone
Phone
coat hooks
D.I.
D.I.
Free standing unit by Quest
36"
Draincontainer under
30" AmpliprepTaq 96
elev
ator
Draincontainer under
pc 175
176
170
169191
174 174 179
179
179
191.6
191.6
191.6
189190190
amplicor
crt
Bio-robot
pc
pc
Netw
k print
36"
36"
Draincontainer under
165 171166173172
178
pc
36"
30
Phone191.5
Waste
Specimen Arrival
Waste
39
“After” Spaghetti
Map of Molecular
Lean in the Lab – Optimizing Flow
Optimizing Cells helped
reduced “Transportation Waste” by 46% (1709’ vs 930’)
DeadAir
Bio
Hoo
d
mixer inside
mixer & centri inside
Bio
Hoo
d
coat hooks
Aci
d
Cle
an S
ink
w/ d
renc
h
36"
2 dr
fridge-70fz
coat hooks
Flame cabinet
Ampliprep Taq 96
elevator
frz frz
Ampliprep Taq 96
elevator
ABIMagNa
future ABI
pc
pc
pc
DML 2000
RapidCapture
waterbathvortex
ViperViper( future)
crt crt
c
vortex
c
labelprint
36"
36"
36"
30 "
36"
36" 36"
36"
36"Phone
Phone
coat hooks
D.I.
D.I.
Free standing unit by Quest
36"
Draincontainer under
30" AmpliprepTaq 96
elev
ator
Draincontainer under
pc 175
176
170
169191
174 174 179
179
179
191.6
191.6
191.6
189190190
amplicor
crt
Bio-robot
pc
pc
Netw
k print
36"
36"
Draincontainer under
165 171166173172
178
pc
36"
30
Phone191.5
Waste
Specimen Arrival
Waste
Waste
DeadAir
Bio
Hoo
dBi
oH
ood
coat hooks
Cle
an S
ink
w/ d
renc
h
36"
2 dr
fridge-70fz
coat hooks
Flame cabinet
Ampliprep Taq 96
elevator
frz
frz
Ampliprep Taq 96
elevator pc
ViperViper
crt
c
labelprint
"
36"
"
36"
36"
coat hooks
D.I.
D.I.
Free standing unit by Quest
36"
Draincontainer under
30" Taq 96
elev
ator
Draincontainer under
amplicor
pc
36"
36"
Draincontainer under
36"
30
Waste
Was
te
Biorobot
95 Deg Bath
Acid
Refrigator
pcSmartcycler
pc
Ampliprep
Waste 36
DML 2000pc
WasteRapidCapture
waterbathvortex
Refrigator
c
pc
pc
crt
40
Value Stream Map
Oven
A010
.25Xylene Stainer
.25 .25
Xylene
.25
Cover Slip
1
Labeling / Folders Distribution
1 2
Pathologist
Total Volume: 1000 Reqs/DayIndividual Volume: 125 Samples to Drs: by 12PM (Goal 9AM)Specials to Drs: by 2:30PM
A020 A030 A040 A050 A060 A070
Cuttting
Start Cut: 12AM on StaggeredStop Cut: Staggered to 4PMBatch Size 20 MaxDaily Output 200 Blocks/DaySlides: 1-3 / Block Average
cutter
Aid
Operators Staff.25
Rework (%) %10
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins20
Batch Size Slide40
Operators Staff.25
Rework (%) %0
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins6
Batch Size Slide40
Operators Staff.25
Rework (%) %1
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins29
Batch Size Slide20
.25 .25
Operators Staff.25
Rework (%) %0
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins6
Batch Size Slide20
.25
Operators Staff1
Rework (%) %5
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins.1167
Batch Size Slide60
1
5Instruments Instruments
Operators Staff1
Rework (%) %0
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins.1667
Batch Size Slide12
Operators Staff2
Rework (%) %2
Production days/shift Shifts2
Production days/week Days5
Cycle Time Mins.1667
Batch Size Slide12
1 2
Cycle Time
Mins80
Total Slides
Slide160
Cycle Time
Mins15
Total Slides
Slide100
Cycle Time
Mins3
Batch Size
Slide60
Cycle Time
Mins6
Batch Size
Slide20
Cycle Time
Mins3.2
Batch Size
Slide140
Cycle Time
Mins16.7
Batch Size
Slide100
Cycle Time
Mins83.3
Batch Size
Slide500
41
Takt time = (time available)/(customer demand)
Example: 480 specimens arrive to the lab at 9 pm, are processed and delivered to toxicology at 10 pm. All results are due for release by 8 am. If an AU2700 can do 1 rack of 10.
How long should 1 rack take to meet the 8 am TAT?
Available time = 9 hours – 30 minutes for lunch – 2 x 15 minutes for breaks = (9*60) – 30 – 30 = 480 minutesCustomer demand = 480 specimens (assume no splits)Takt time = 480/480 = 1 minute = 60 seconds
1 rack = 10 specimens1 rack = 10 * 1 = 10 minutes
Takt time
What is the practicality of this?
42
Work Elements for the Histology ProjectOperator Balance Chart
Operator StainerDistributionCover SlipperBarcode/Labeler
12
10
8
6
4
2
0
Sum
of T
otal
CT
32
121110987654
Operation
Operator Balance Chart - Current State
Takt time = 11.36 sec.
What do you notice about this picture?
43
Operator Pizza Oven/Stainer/Cover SlipperDistributionBarcode/Labeler
12
10
8
6
4
2
0
Sum
of T
otal
CT
1211109842
Operation
Operator Balance Chart - Future State
Operator Balance Chart with Improvement
Note: We need to plan 85% - 95% of takt time to allow for variability in the process
11.36 X 85% = 9.66
Takt time = 11.36 sec.
Planned Cycle Time = 9.66 sec.
44
Lean Six Sigma• Leadership
• LEAN versus Six Sigma
• Waste
• Flow
• Continuous Improvement
45
What is Kaizen?
Kaizen: the philosophy that continuous improvement takes place through small, incremental process improvements, repeated over and over again
Workshop:•A means of implementing process improvements•Short, 3-5 day events with intensive focus on one area and problem (for example cycle time or rework)•A cross-functional, participative implementation approach •Focus on substantial improvement (30-40%)Workshop Objectives:•Achieve results•Bring new problem solving skills to the workforce
47
Questions?
Thank You!