Understanding DMAIIC and Effective Root Cause Analysis How to Apply Them to Laboratory Work Flow and Work Processes Jacquie Vealey, Director Technical Marketing Kelly Owen, Master Black Belt Session Agenda • Introduction to the Session & Objectives • Solving the Problem • Defining the Problem – Implementing short-term actions – Understanding impact & comparing to goals – Overview of the DMAIIC methodology – Activity – Illustration of how you know you have a problem • Summary & Reflection – Using data to understand a process – Key takeaways – Activity – Resources • Defining the Root Cause – What is root cause analysis – Tools & techniques – Understanding cause and effect – Activity Quest Diagnostics | 2 1 Session Introduction & Objectives • Build capabilities of laboratory professionals in structured root cause analysis • Understand the basics of defining and analyzing a problem. Understand how to apply root cause analysis tools to identify solutions • Attendees will learn to: – identify and scope a problem, – apply Six Sigma and Lean techniques to analyze key input variables, – perform a root cause analysis, – implement sustainable solutions in laboratory work flow and work processes Quest Diagnostics | 3 Defining the Problem: Overview of DMAIIC Methodology • Boundaries and Scope Plan • Definition of the Problem Define • Definition of the Defect • Baseline performance • Definition of the Goal Measure • Map the Process Do • List of probable Xs • Mapping, Graphical or Statistical Analysis validating Key Xs Analyze • Understanding of Root Cause • Problem solving • Prioritize solutions Innovate Check Improvement • Graphical or statistical illustration of improved performance • Control plan • Continuous improvement monitoring system Act Control • Leadership handoff Quest Diagnostics | 4 2 Defining the Problem: Boundaries & Scope • Problem And Goal Statements – Description Of The Problem/Opportunity And Objectives In Clear, Concise And Measurable Terms • Business Case – Why Do This Project? Linkage to Business Goals & Customer Needs, Expected Benefits The term Voice of the Customer (VOC) is used to describe customers’ needs and their perceptions of your product or service. Quest Diagnostics | 5 Defining the Problem: What is a Defect? • Failure to meet customer specification (internal or external) is called a Defect – Defects can be caught and “fixed” within any step in the process. • We generally only count defects at “the final step”. • However rework (additional cost and labor) can occur at all steps – Some defects reach the customer. • Often not reported • We learn of them when the customer leaves – To identify opportunities for improvement, it is important to measure all defects Quest Diagnostics | 6 3 Defining the Problem: Using Data 65 60 55 50 Understanding what 45 Process has a sudden shift causes that variation 40 helps us decide 1 3 5 7 9 11131517192123252729313335373941 what kinds of actions 65 are most likely to lead to lasting 60 improvement 55 50 45 40 1 3 5 7 9 11131517192123252729313335373941 4 points look very different from the others Quest Diagnostics | 7 Defining the Problem: Focusing Analytic Work Basic Question: The basic question focuses the analytic work, ensuring that the findings are actionable. The more specific the question the better, provided it is not so narrow that the “wrong” problem is addressed 1 Why is it important? 2 Who is responsible? Give specific values (e.g. $100 per day, 10 Med Identifies primary decision maker who can Tech hours per week) affect implementation of a solution (e.g. Lab Director, Processing Manager) 3 Criteria for success? 4 What is included in the study? What would indicate long-term success of a Indicates what will and will not be included in solution (e.g. no repeat samples for two weeks) the study of the problem (e.g. no overtime allowed, cannot purchase any new equipment) 5 Barriers to Impact? Details implementation challenges (e.g., communication practices, risk aversion) Quest Diagnostics | 8 4 Defining the Problem: Example Basic question to be resolved: How can we decrease backlog by 25% over the next two weeks without sacrificing productivity, cost, or safety? 1 Perspective/context? 2 Stakeholders and processes? Decreasing backlog by 25% would make Following the problem solving session, we will customers happy present to the Lab Director for her approval before implementing the change. 3 Criteria for success? 4 What is included in the study? Backlog is reduced by 25%; productivity, cost, We will focus on only changing the process, and safety remain at current levels or improve. schedules can be changed, the SOP can be changed (with approval), additional headcount is not allowed 5 Barriers to Impact? We will have 3 FTE’s on vacation during the trial and will need to communicate changes to them Quest Diagnostics | 9 Defining the Problem: Activity – “What Is Your Problem?” Basic question to be resolved: 1 Perspective/context? 2 Stakeholders and processes? 3 Criteria for success? 4 What is included in the study? . 5 Barriers to Impact? Quest Diagnostics | 10 5 Defining the Root Cause: What is RCA? Root Cause Analysis (RCA) is the systematic analysis to determine the true root cause, and separate it from the secondary causes or symptoms. Superficial “An inch deep and a mile wide” Conventional Finding out very little about many things Depth Problem of Analysis Solving Very Deep Few Number of problems investigated Many AB-619 Superficial Quality “An inch wide and a mile deep” Depth Finding out very much about a few things Problem of Analysis Solving Very Deep Few Number of problems investigated Many Quest Diagnostics | 11 Defining the Root Cause: Tools & Techniques Many common problems solved by utilizing basic techniques 100 5-whys root cause analysis 75 Structured problem solving 50 Percent of problems Cause & Effect 25 Diagram Hypothesis tree Common issues in daily Relatively complex process, Complex design, process, Complex problems operations quality, operational problems engineering, or quality issues Who: ▪ All Employees ▪ All Employees ▪ Greenbelt ▪ Blackbelt ▪ Supervisor/Manager Quest Diagnostics | 12 6 Defining the Root Cause: 5 Whys Problem Problem Problem Problem Problem Problem Problem Problem Problem Problem Problem Problem Problem A B C D E F G H I J K L M Local focus “Ask the question on causes ‘Why’ five times” 1. Why did X happen? Why? Wider focus Because of W. on causes 2. Why did W happen? Why? Because of V. Wider focus on causes 3. Why did V happen? Because of U. Why? Wider focus on causes 4. Why did U happen? Because of T. Why? Wider focus 5. Why did T happen? on causes Because of S. Why? Wider focus on causes Quest Diagnostics Mile Deep Thinking | 13 Defining the Root Cause: 5 Whys 1. Why was the 2. Why was the lab aide cut by knife left by the 3. Why was the a dissection sink? area not 4. Why is knife? cleaned on the clearing the previous day? area not a daily 5. Why are there routine? no SOPs for clearing the lab? The knife was left by the sink The area was not Clearing the area cleared on the is not a daily Standard previous day routine operating SOPs and procedures for education have clearing do not not been exist documented and/or ▪ Fixing the root cause may take more time in the short term, communicated but the investment will pay off quickly as the problem never recurs ▪ Instituting a root-cause problem solving culture leads to higher productivity and a highly motivated workforce Quest Diagnostics | 14 7 Defining the Root Cause: Structured Problem Solving 1 • Select problems to 2 • Identify source improve – Identify sources of – Define problems problems Second line Basic question to be resolved: of support The basic question focuses the analytic work, ensuring that the findings are actionable. The more First line specific the question the better, provided it is not so narrow that the “wrong” problem is addressed of support 1 Perspective/context? 2 Stakeholders and processes? Comments on the “situation” and “complication” Identifies primary decision makers who can facing the team affect implementation of a solution Consistent (e.g., scheduling changeovers, staffing during and suggests the processes through which breaks) these parties exert influence 3 Criteria for success? 4 What is included in the study? Basic question to Relevant be resolved Refers to the basis on which the stakeholders Indicates what will and will not be included in will decide whether the study of the problem. to act on the recommendations 5 Barriers to Impact? Details implementation challenges (e.g., communication practices, risk aversion) Consistent 4 • Follow-up 3 • Implement – Understand the solutions impact of solutions – Take short-term actions – Compare with Speed of Problem Primary cause Secondary cause Solutions implementation Impact Review criteria is not Lack of approved Provide approved Too many first Man consistent among samples for samples reviews technicians comparison 4.0 overturned in targets second review High variation of Call for preventative samples due to poor 3.5 maintenance analyzers Machine 3.0 Gel used by analyzers Call procurement are inferior and are about new gels 2.5 hard to read Material Samples can spill when being moved Plates used in the 2.0 analyzers are prone to contamination Plates can be entered Place a guide to backwards switching prevent backward 1.5 the results plates First reviews are not Technicians not given Increase technician 1.0 conducted as rigorous enough time for first time to get it right the as second review review