Quality Assurance in

Healthcare
 Contents
• Why Quality?
• History of Quality?
• What is Quality?
• What is Six Sigma?
• How to implement Six Sigma?
What is Quality?
BASIC PREMISE OF QUALITY OF SERVICES

Improved Service Quality

Increased Client Satisfaction

Increased Utilization of Services

Increased Cure Rate

Improved Health (Reduced Morbidity and Mortality)

! Further use of services

! Sustainability of services
 Why Quality?
• Patients/Community Satisfaction
• Uniformity in Process -Standards and Norms –
Reduce Error
• Reduce waste
• Cost
• Accreditation
• Legal issues –consumer protection
• Technical Innovations
• Increased motivation (Providers perspective)
 Myths of Quality

Q means goodness, luxury,

shineness etc.
Q is costly - not affordable
Q is intangible - not measurable
Q problems - due to workers
Q originate from Q. dept.
 History of Quality
• Quality during Industrial revolution
• Impact of World Wars on Quality
• Establishment of ISO
• Quality Movement in Japan
• Juran’s Quality Concepts
 What is Quality?
• When we say the word “quality,” what comes
to our mind?

• reflect upon various times you’ve stayed at a hotel

and identify what about their stay made it a “quality
hotel” or a “quality restaurant”?
 Definitions

Quality is different for

different people
 Definitions

Quality is a set of
attributes of a service
 Definitions

Quality is “conformance
to the norms of Input,
Process and Output”
 Definitions
Quality is “conformance to
the norms of Input,
Process and Output” and
customer satisfaction
Quality is a state in which value
entitlement is realized by
customer and provider in
every aspect of business
relationship
 Old Quality Programme
OLD QUALITY
PROGRAMME
based on Inspection

of Product

called Managing Quality

this caused Cost For company

hence Price For customer

and Quality was related as High cost /Price

 Break of Cost
• Cost of production + cost of inspection +cost of
repair and rework
• Since during production and rework cost of staff
remain same but number of products at rework
cell is lesser than production line, per unit cost of
rework is very high.
• Plus during the time staff does rework, it looses
opportunity to do fresh production therefore as
per an estimates the cost of production is 10
times less than cost of rework
What are the Implications of Variation
and Waste
The key deficiencies of any Process include:
• VARIATION
• WASTE
Both these deficiencies have the following
implications:
• CUSTOMER DISSATISFACTION
• INCREASE IN COSTS OF DELIVERING SERVICES
How to Prevent Variation and Waste?
• Identify Chronic Problems (diseases) in the
Process
• Ensure that adequate Measurement Systems
have been defined to accurately measure the
damage i.e. Rework, Rejections, Variation,
etc caused by these Chronic Problems
• Use structured Problem Solving Methodologies
such as Six Sigma to permanently eliminate or
minimize the Waste and Variation
• Improve the Capability of the Process to meet
customer requirements Consistently at
Optimized Costs
How to Achieve Process Improvement
• Process Deficiencies are solved by a Project
by Project approach.
• Each Project needs to address a specific PAIN
(deficiency) in the process
• Each Project is a structured approach to
How to Achieve Process Improvement

• Each Project needs to have a specific GOAL

for improvement in terms of either
eliminating or minimizing the deficiency.
• Each Project needs to be conducted by a
CROSSFUNCTIONAL TEAM consisting of
members from the functions most affected
by the pain.
• Each Project needs to be TIMEBOUND
AS A PATIENT WHAT QUALITY LEVELS WOULD
YOU ACCEPT FROM YOUR HEALTH SERVICES?

90%

95%
96%

98%
99%

99.9%
 IF 99.9% IS ACCEPTABLE TO YOU, THEN…

•YOUR HEART FAILS

* 20,000 WRONG
TO BEAT 32,000 DRUG
TIMES EACH YEAR PRESCRIPTIONS
MADE EVERY YEAR
* 500 SURGICAL
OPERATIONS ARE * 19,000
BABIES ARE
PERFORMED DROPPED BY
WRONGLY DOCTORS
EVERY WEEK AT BIRTH
WELL …..
“ THERE IS ONLY A 1 %

DIFFERENCE IN THE DNA

GENETIC CODE BETWEEN A

CHIMPANZEE AND A

HUMAN BEING”
•IN OUR PROFESSION THERE IS NO SCOPE
FOR ERROR. FOR ANY ERROR COMMITTED
IS ALL THE DIFFERENCE BETWEEN
LIFE AND DEATH, BETWEEN RELIEF AND
DISABILITY

•THERE IS NO SECOND CHANCE

Then …..
HOW TO ACHIEVE EXCELLENCE IN
HEALTH

Please wait…..
 Six Sigma
1. What is Six Sigma?
2. Where it can be used?
3. Implementing Six Sigma Project

26
 What is a Process??
• Any sequence of activities that use a set of
INPUTS to produce an OUTPUT is
called a PROCESS
• A Process is a means for doing work
• Every Process has a CUSTOMER. A
Customer is the immediate recipient of the
Output from the Process
 What Can Go Wrong in a Process??
• A Process may not produce the desired output
leading to CUSTOMER DISSATISFACTION.
• The output from a process may have defects or
errors in it and this leads to REWORK or
REJECTION. This leads to the generation of
WASTE
• The produced output may be unpredictable in
its ability to meet customer requirements and
this is caused due to high VARIATION in a
Process.
• The process may be unstable and this leads to
generation of WASTE in the process itself
 What is Six Sigma?
Understanding Variation:
Variation or “spread” of
landing positions

X X X
X X
X X
X X

Average or “mean” location

of all touchdowns
29
 What is Six Sigma?
Understanding Variation – Part 2:
But…Smaller “spread” or
variation of touchdowns

XXX
X
XX XX
X
Notice it has the
same average!
So…which pilot would
you choose for your
30
next flight? Why?

What is Six Sigma?
The symbol “sigma”.

Sigma is used in statistics to denote

 Metric standard deviation
Metric
Something we can calculate and measure for
 Benchmark
Benchmark any process. A sigma value is used to relate the
ability of a process to perform defect free work.
 Vision
Vision The lower the value of Standard Deviation the
 Philosophy better the process is performing and the lower
Philosophy the probability that a defect will occur.
 Method
Method Can be integrated to the Vision of The
 Tool organization .It can become the culture and
Tool way of life “the way we work”
 Symbol
Symbol
 Goal “Six Sigma can help us reach our goals”
Goal
 Value Six Sigma Helps Reduce Defects in a Process
Value
 Six Sigma
• Pioneered at Motorola corporation in 1980s, it is
now ahs the reputation of mother of all quality
initiatives.
• In India the concept is brought by GE Healthcare.
• It focus on the deviations/variations found in any
process such as, registration and discharge, infection control
process, billing, patient complaint, staff complaint in ward for supply
of material, maintenance etc.
• It thus represent an ambitious goal to nearly
eliminate variations
32
 What is Six Sigma?
• The higher the Sigma Level i.e. 3s, 4s, etc
the better the process is performing and
the lower the probability that a defect will
occur.
• At Six Sigma (6s) level of performance the
probability of a defect occurring is reduced
to 3.4 out of 1 million and that is
considered to be virtual perfection.
 What is Sigma?
• Standard Deviation:
Metric that displays variation from it’s “target”.
Normal Curve and Probability Areas
0.4
68%

0.3
95%
0.2

99.73%
0.1

0.0
-4 -3 -2 -1 0 1 2 3 4
1 Std. Dev.
(“Sigma”)

One standard deviation around the mean is about 68% of the

total “opportunities” for meeting customer requirements!
 What is Sigma?
If we can squeeze six standard deviations in between our target
and the customer’s requirements...
Normal Curve and Probability Areas

-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6

then:
99.99966% of “opportunities” to meet customer
requirements are included!
 Defect Rates and Sigma Levels

Sigma Level PPM/DPMO

3 - Historical Standard
1 691,462
10 Times
2 308,538 Improvement

3 66,807 4 – Current Standard

4 6,210
1800 Times
5 233 Improvement

6 3.4 6 - New Standard

 Six Sigma in Practical Terms
99% GOOD (4) 9.99966% GOOD (6)
20,000 LOST ARTICLES OF MAIL PER SEVEN LOST ARTICLES OF MAIL PER
HR.
UNSAFE DRINKING WATER 15 MIN. Per UNSAFE DRINKING WATER FOR ONE
Day MINUTE EVERY SEVEN MONTHS
5,000 INCORRECT SURGICAL 1 .7 INCORRECT SURGICAL
OPERATIONS PER WEEK OPERATIONS PER WEEK
2 SHORT OR LONG LANDINGS AT ONE SHORT OR LONG LANDING
MOST MAJOR AIRPORTS EACH DAY EVERY FIVE YEARS
200,000 WRONG DRUG 68 WRONG DRUG PRESCRIPTIONS
PRESCRIPTIONS EACH YEAR EACH YEAR
NO ELECTRICITY FOR ALMOST 7 NO ELECTRICITY FOR ONE HOUR
HOURS PER MONTH EVERY 34 YEARS
 Focus of Six Sigma
• Reduce Variation
• Reduce Waste
• Reduce Defects
• Delighting Patients
• Reduce Cost
• Reduce Delivery Time
 GE Six Sigma Quality The 12 Step DMAIC Strategy

Formulating the Practical Problem

DMAIC Step 0 : Build the House of Quality “How do my customers look at me?”

DMAIC Step 1 : Select the CTQ characteristic “What do I want to Improve?”

DMAIC Step 2 : Define Performance Standards “What’s the best way to measure?”
DMAIC Step 3 : Validate the Measurement System “Can I trust the output data?”

Changing to a Statistical Problem

DMAIC Step 4 : Establish Process Capability “How good am I today?”
DMAIC Step 5 : Define Performance Objectives “How good do I need to be?”
DMAIC Step 6 : Identify Variation Sources “What factors make a difference?”

Developing a Statistical Solution

DMAIC Step 7 : Screen Potential Causes “What’s at the Root of the Problem?”
DMAIC Step 8 : Discover Variable Relationships “How can I predict the Output?”
DMAIC Step 9 : Establishing Operating “How tight does the control have to be?”
Tolerances
Implementing the Practical Solution
DMAIC Step 10 : Validate X Measurement Systems“Can I trust the in-process data?”
DMAIC Step 11 : Determine Process Capability “Have I reached my goal?”
DMAIC Step 12 : Implement Process Control “How can I sustain the improvement?”
 What is Six Sigma?
Define Measure Analyze Improve Control
1.Identify the 1. Prepare the 1. Identify 1. Determine 1.Put controls in
factors that are “AS IS” causes of solutions place to maintain
critical to process map variation and (ways to improvement
Customer and determine defects. counteract over time.
2.Define Project outputs 2. Provide causes)
Boundaries 2. Determine statistical including 2. Provide
3.Define the what to evidence that operating levels statistical
project measure and causes are DPMO evidence that the
objective and validate the real. and tolerances. improvement is
Impact measurement 3. Commit to 2.Install sustained (3
system. improvement solutions and months of data).
3. Quantify target. provide
current statistical
performance evidence that the
and estimate solutions work..
improvement
target.
40
 What is Six Sigma?
Define Measure Analyze Improve Control
1. Establish Team Charter 4. Confirm Team 9. Determine Sources of 10. Generate Ideas 16. Develop Control Plan
2. Identify Sponsor and 5. Define Current State Variation and Time 11. Conduct Experiments 17. Monitor Performance
Team Resources 6. Collect and Display Data Bottlenecks 12. Straw Models 18. Mistake-Proof Process
3. Administer Pre-Work 7. Determine Process 13. Conducts B’s and C’s
Capability and Speed 14. Action Plans
8. Identify Quick Wins 15. Implement

• Project ID Tools • SSPI Toolkit • Cp & Cpk • Brainstorming • Check Sheets

• Project Definition Form • Process / Value Stream • Supply Chain Accelerator • Pull Systems • Run Charts
• The Value of Lean Six Mapping Analysis • Setup Reduction • Histograms
Sigma - NPV/IRR/DCF • Value Analysis – Process • Multi-Vari • TPM • Scatter Diagrams
Analysis Observation • Box Plots • Process Flow • Control Charts
• PIP Management Process • Time Studies • Marginal Plots • Kaizen • Pareto Charts
• Quality Function • Baseline Analysis • Interaction Plots • Strategic Sourcing • Interactive Reviews
Deployment • Brainstorming • Regression • Benchmarking • Poka-Yoke
• Voting Techniques • ANOVA • Affinity/ID
• Pareto Charts Affinity/ID • C&E Matrices • DOE
• C&E/Fishbones • FMEA • Hypothesis Testing
• Check Sheets • Problem Definition Forms • Process Mapping
• Run Charts • Opportunity Maps • B’s and C’s/Force Field
• Control Charts • Balance Models • Tree Diagrams
• Gage R&R • Part Stratification • Pert/CPM
• Process Capability • Constraint I.D. • PDPC/FMEA
• Gantt Charts
41
Case Study 1
 g GE Medical Systems
Six Sigma Project # 3
Project Name – Mahavir Hosp,
Surat
Six Sigma for Healthcare- Differentiation

Project Title: Reducing TATAT in patient scanning CT Equipment

Team
TeamMembers:
Members: Project
ProjectSupport:
Support:
Project
ProjectLeader:
Leader:HOD
HODRadiology
Radiology CEO.
CEO.
CT
CTtechnician,
technician, Manager
ManagerAdministration
Administration
Receptionist
Receptionist EDP
EDP
Cash
CashCollection
Collection Finance
Finance Department
Department
 Any activity is a Process , where
defects can occur
CT Scan is a process – Patient expects faster scan

Measure of Quality, is total procedure time

Arrives Changing CT Room Scan Report Departs

Registration Pat. Prep Pre Scan Exam Post Scan

Goal:
Pat. Prep 10.0
Pre Scan 3.0
Exam 15.0
Post Scan 7.0
Total Pat.Time 35.0

Any
Any scan
scan which
which takes
takes more
more than
than 35
35minutes
minutesisisaadefect
defect
 Six Sigma - The Basic Concept
Every Human Activity Has Variability…Ultrasound Procedure Turn Around
Time

35 Upper Limit
min 45 min

Goal is to reduce
X
Variation ,apart from
Moving average
closer to 35 min … X
XXX
X XX1 XX
XXXXXXX X
XXXXXXXXXX defects
X X XXXXXTarget
XXXXX XXX
Time

Reducing
Reducing Variability
Variability Is
Is The
The Essence
Essence of
of Six
Six Sigma
Sigma
 What
WhatDoes
DoesThe
TheActivity
ActivityFlow
FlowDiagram
DiagramTell…??
Tell…??
MEASURE Process
ProcessMap
Mapfor
forthe
theYY

1) Patient arrives CT TECH asks

A
YES TECH prints the films dark room tech to collect
CT TECH checks the PT .Made to change the printed films
referral form The Dress
2) Asks directions
/PROCESS. Dark room technician
CT Technician comes PT.Waits in PT. Wait DR Agreed for the NO keeps the films on DR.
out & calls for the PT’s room images selected Table for reporting
as per their time
PT. Directed to
cellar A DR.Informed about
PT .Is screened by TECH adds images as
the images selected per DR.Instructions DR.Makes the hand
technician
CT TECH Informed for filming written report
about registration
PT.Looks for CT &
Comes to CT PT.Taken in to CT TECH review the scan
W Report sent for typing
Room by technician & prepares to print films

AT CT Front Desk bill

PT.Referral checked is checked & REGD in PT.Positioned & TECH shift the PT DR.Sighs the final Draft corrected by DR. & Sent
At CT front desk & the log book & given Educated on SCAN From CT scan report for final typing
Sent to billing time slot & made him to wait

Billing checks the test DR.Asks Tech to Report sent to report Report handed over
PT.Bill prepared & TECH at console
tariff with CT dept remove DESK to PATIENT
sent to CT scan receives the
&informs the PT about tariff PT From scan
DOCS

PT.Agreed for the

SCANNING
DR.review all the
images for complete W COMPLEX PROCESS !!!
DONE info of the test.
amount YES
PT.Informed about
report collection time
PT. Waits & meets the
PT.Refereed back to Doctor & if satisfied on TECH informs the
NO CT tariff he comes back DR. about completion PT made to change dress
For discounts on tariff to billing of scanning
• Part Per Million
(measure the defective items not only defects)

=Total no. of defects/to number inspected

=6/12= 0.5
• DPMU
=0.5*10,00000= 5,00,000
=1.5 sigma level
DPMU (measure defects)
• Defects Per Unit

=Proportion Defects= no. of defective found/ no. inspected

=3/12 =0.25
PPM= 250,000
Sigma level=2.2 sigma level
No. of defective will always give higher sigma level
Summarizing The Key Concepts of
Six Sigma
Critical to Quality:Attributes most important to the customer
Defect:Failing to deliver what the customer wants
Process Capability:What your process can deliver
Variation:What the customer sees and feels
Stable Operations:Ensuring consistent, predictable processes to improve
what the customer sees and feels
Design for Six Sigma:Designing to meet customer needs and process
capability
 Conclusion

Sigma quality is a tool which also gives a

competitive advantages by making organization
efficient and customer friendly

So, if all hospital achieve same level of

efficiency and customer friendliness what
will be the next step

Innovations in Services and

Service Delivery
 Conclusion

Sigma quality is a tool which also gives a

competitive advantages by making organization
efficient and customer friendly

So, if all hospital achieve same level of

efficiency and customer friendliness what
will be the next step

Innovations in Services and

Service Delivery
 SIX SIGMA DEFINE PHASE

• Develop Problem Statement

• Map High Level Process (SIPOC)
• Determine Critical to Quality Characteristics
(CTQ’s)
• Develop Project Charter
 Problem Statement
• Description of the “pain”
• What is wrong or not meeting our customer’s
needs?
• When and where does the problem occur?
• How big is the problem?
• How big is the problem?
• What’s the impact of the problem?
 Problem Statement
• Key Consideration/Potential Pitfalls
• Is the problem based on observation (fact)
• Does the problem statement prejudge a root
cause?
• Can data be collected by the team to verify and
analyze the problem?
• Is the problem statement too narrowly or broadly
defined?
 Problem Statement
• Key Consideration/Potential Pitfalls (conti...)
• Is a solution included in the statement?
• Is the statement blaming any person or
function?
• Would customers be happy if they knew we
were working on this?
 Problem Statement – Examples
• Example 1
• Poor Statement
• Because our customers are dissatisfied with
our service, they are late paying their bills.
 Problem Statement – Examples
• Example 1 (conti...)
• Improved Statement
In the last 6 months (when) 20% of our repeat
customers – not first timers (where) – were over 60 days
late (what) paying our invoices. When surveyed all of
these customers reported extreme surveyed, all of these
customers reported extreme dissatisfaction with our
service (what). The current rate of late payments is up
from 10% in 1990 and represents 30% of our outstanding
receivables (how big). This negatively affects our
operating cash flow (impact)
 Problem Statement – Examples
• Example 2
• Poor Statement
• Customers are unable to access the call centre
 Problem Statement – Examples
• Example 2 (conti...)
Improved Statement
During the year 2003, (when) 40% of our
customers (extent) were unable to access the
call centre at the first attempt (what). This
causes dissatisfaction to our customers and a
loss of dissatisfaction to our customers and a
loss of revenue opportunities to the
organization (impact).
High Level Process Mapping
Process Boundaries - Example
SIPOC Worksheet
Gather VOC Data
 Gather VOC Data
• Key Considerations In Collecting Customer Data:
• Collector’s bias may affect what is heard
• What contact/relationship do you have with the
customer?
• What are your time constraints?
• What budget is available?
• How much certainty to do you need to move forward with
the project?
• Ensure customer expectations are aligned with our
intentions/actions
 Managing Customer Expectations
• Manage customer expectations throughout VOC data
collection
• Select customers carefully
• Explain your intent for gathering the information
• Clarify your ability to act on information
• Clarify your ability to act on information gathered
• Communicate next steps to the customer

Asking For Information Does Not Translate To A Promise

To Act
 Six Sigma Project Charter
• Project Importance
– Every business operates by processes
– So what’s the process you are improving?
– Why is it so important to spend time on it?
– Ex: If you want to improve account opening
process, how does it affect..
• Competitive Advantage?
• Customer Experience & Retention?
• Administrative Costs?
• Whatever else is keeping the CEO up at night
67
 Steps To Deter mining CTQs

• A Process To Identify Customers And

Understand and their CTQs
Identify Voice Of The
Customers Determine CTQs
Customer (VOC)

•List customers •Review existing VOC •Organize all customer

•Define data data
•Decide what to • Translate VOC to
customer specific needs
collect/ select VOC
segments • Define CTQs for needs
tools
•Narrow list •Collect data
• Prioritize CTQs
• Contain problem if necessary
 Effective Brainstorming
• Brainstorming is used to establish common
method for a team to creatively and efficiently
generate high volume of ideas on any topic
• Brainstorming encourages open thinking
• Gets the involvement of all the team members
without the dominance of anyone team member
• Allows team members to build on each others
creativity while staying focus on the joint mission
 Affinity Diagram
• Record each VOC on a post it note in bold
letters
• Without talking sort the ideas simultaneously
a team into 5 –10 related groupings
• For each grouping create summary or header
cards using consensuses
• Draw the final affinity diagram connecting all
finalized header cards with their grouping
 Kano Model
• To identify & prioritize the full range of the
customers needs
• Kano model helps to describe which needs, if
fulfilled contribute to customer dissatisfaction
neutrality or delight
• Kano Model Identifies
– Must be needs - Critical to customer expectation
– More is better – Critical to customer Satisfaction
– Delighter – Converting wants to needs
 CTQ Prioritization Matrix
• Process: Invoicing
• Primary output (product or service): Invoices
sent to customers’ accounts payable
departments
 What is a Pareto Diagram?
• A diagram that shows 20% of the inputs (Xs)
cause 80% of the problems with dependent
process outputs (Ys)
• A Pareto diagram allows a team to:
– Discover what type of categories relate to
problem
– Focus on the most important items
 Pareto Diagram
• A Pareto diagram is a bar chart organized with
the largest bar to the left and the smaller bars
to the right in order of frequency.
• Pareto Diagrams – Key Points!
• Pareto diagrams are typically used to prioritize
competing or conflicting problems and to
distinguish the “vital few” from the “trivial
many.”
• Pareto diagrams determine which of several
classifications have the most count or cost
classifications have the most count or cost
associated with them.
• The base data gathered must be in terms of either counts or
costs.
 Pareto Diagrams – Key Points!
• Do not use terms that can't be added, such as
percent yields or error rates.
• Remember to use Pareto Diagrams creatively.
• If the first one doesn’t show an 80-20 pattern,
then reconsider the problem and try again.
 CTQ Tree
• Why use it
• Identifies critical to quality (CTQ)
characteristics, features by which customers
evaluate our product or service that is to be
used as the measure for our project.
• A useful CTQ characteristic has the following
features:
– It is critical to the customers perception of
quality
– It can be measured
– A specification can be set to tell whether the
– CTQ characteristic has been achieved.
 CTQ Tree
• What does the CTQ tree do…
• Links customer needs gathered from the voice
of customer data with process drivers and
with specific, measurable characteristics.
• Enables the project team to transform general
data into specific data.
• Makes the measuring process easier for the
team.
 Setting up a CTQ Tree
• Gather the sorted customer needs from the VOC data
• List the major customer needs on the left hand side of the
tree structure
• View each need from the customers point of view
• For each need ask “what would that mean” from the
customers stand point
• Each answer becomes the driver for the CTQs
• Keep asking “what would that mean” until you reach a
level where it would be absurd to continue
• Your answer at this level is the CTQ
Alignment of Project Y
 Select The Project Y
• Think Outside-In
• For your key CTQ, how does the customer define
process performance?
• Supplier Input Process Output Customer
• CTQs
• What is the exact definition the customer
recognizes for this metric?
• How does this compare with existing performance
metrics?
 Select The Project Y
• Key Questions To Address
• If the Project Y changes, will my customer feel
the impact?
• Does the Project Y match with how the
customer describes the process?
• Does the Project Y link to one at the Big Ys for
your business?
 What is a Charter?
• O ne of the most important things necessary to get a team
started on a footing is a charter
• A Charter:
• Clarifies what is expected of the project
• Keep the team focused
• Keeps the team aligned with organizational
priorities
• Transfers the project from the Champion to the Improvement
Team
• Used as a tool by the Apex Council to review project progress
SIX SIGMA MEASURE PHASE
 Measure Phase - Steps
1. Develop Detailed “AS IS” Process Map
2. Determine What to Measure (Process Y)
3. Validate Measurement System
4. Quantify Current Performance
 What is a Process Map?
• Process flow diagram that visualizes how work
is done.
 Process Map Symbols
Symbols Meaning

Start or End of Process

Activity or Process Step

Decision or Inspection Point

Connector

Direction of Flow
 Why Create a Process Map?
• A Cross Functional Process Map shows “AS IS” process.
• Process start and end points are identified and made
measurable.
• Makes process steps visible and keeps the team from drifting
outside the project boundaries from drifting outside the
project boundaries.
• Non-valued-added steps become clear and can be discarded
or minimized.
• Rework and repair is obvious. They are the hidden factories.
Hidden Factories have to be shut down.
• Is a consensus on how work is done.
Analyzing a Flow Diagram
 Learn to Recognize Waste
• Waste of correction (rework)
• Waste of waiting
• Waste of inventory
• Waste of over production
• Waste of transportation
• Waste of motion
• Waste of over processing
 Types Of Data

Data Type Is An Important Consideration

Discrete Data Continuous Data
-Binary (Yes/No, Defect/No Defect) -Can be broken down into increments
-Ordered categories (1-5) -Infinite number of possible values
-Counts
Examples Examples
-Number of incomplete applications -Cycle time (measured in days, hours,
-Percent of responding with a “5” on minutes, etc.)
survey -Weight (measured in tons,
-Number of Green Belts trained pounds, etc.)
 Data Collection Plan
• Data Collection Plan

Develop Ensure
Establish Data DataConsistency
Operational
Collection & Stability
Definitions
Goals
& Procedures

Collect Data
& Monitor
Consistency
Breaking Down the Overall
Variation
Thank You